Expanding and improving access to cancer care in Tajikistan
Cancer accounted for an estimated 3,843 deaths in Tajikistan in 2020 and the WHO predicts a dramatic increase to annual 8,012 deaths by 2040. Until recently, only one hospital located in the capital Dushanbe, offered radiotherapy treatment to about 4,200 patients each year. The 10-year-old radiotherapy equipment was temporarily out of service resulting in long waiting times for patients who often had to travel long distances and pay for their own accommodation. As a result, those who could afford the treatment were forced to travel abroad. In 2017, the IAEA and the Government of Tajikistan expanded and improved access to essential quality cancer treatment by all people in the country.
Tajikistan and the IAEA focused on providing essential quality cancer treatment, including to those who lived too far from Dushanbe and/or did not have the means to get there, and thus responding to (SDG 3.8) towards the achievement of universal health coverage and (SDG 3.4) towards the achievement of a reduction of premature mortality from non-communicable diseases. Additionally, this expansion of quality radiotherapy is especially provided for the most vulnerable groups, including women, children and people unable to afford long distance travel. Support in quality assurance, quality control and dosimetry ensure the protection of patients, medical staff and the environment from ionizing radiation, thus contributing to (SDG 8.8) and (SDG 12.4).
The upgrading of the existing radiotherapy centre in Dushanbe and the establishment of a radiotherapy centre in Khujand, the regional centre in the country’s north, contributed to: - reduce mortality rate of cancer patients in Tajikistan (SDG 3.4) - expand coverage of essential services for non-communicable diseases (SDG 3.8) - reduce frequency rate of fatal and non-fatal occupational injuries (SDG 8.8) - reduce hazardous waste generated per capita (SDG 12.4).
The project was tailored to support Tajikistan’s strategy for non-communicable diseases, and it identified SDGs to which nuclear science can make an important and cost-effective contribution on national scale. Following several visits to the country to evaluate its situation, gaps and needs, the IAEA procured essential radiotherapy, dosimetry, quality assurance and quality control equipment intended for the new radiotherapy centre in Khujand. In turn, the Government built a facility to house the new radiotherapy equipment in Khujand based on advice from IAEA experts and in line with international safety and quality standards. The IAEA also supported the refurbishment of two radiotherapy machines and provided ancillary equipment to the radiotherapy centre in Dushanbe. The IAEA organized two training courses for medical professionals in Dushanbe and Khujand, facilitated thirteen fellowships, several of which were supported by Armenia’s National Centre of Oncology and ensured that the radiotherapy departments staff learned to use the new and refurbished machines in a safely and effective manner. In addition, four advisory missions of international experts were fielded to support the safe and effective commissioning of the new equipment. The implementation of the project was monitored through continued communication with the project counterpart, as well as through progress reports and visits by IAEA staff in the framework of the IAEA’s results-based monitoring approach which includes regular feedback from counterparts, experts, partners and project-related events. To date, the IAEA has provided €1.4 million to support these two centres and the Government of Tajikistan has provided €185,000 in contribution towards the cost for the refurbishment of equipment.
In 2019 Tajikistan inaugurated its first radiotherapy Centre in its northern province in Khujand, the capital of Sughd province. The country now has two operational radiotherapy centres with essential equipment and is staffed by trained medical personnel providing safe high-quality radiotherapy treatment to cancer patients. As a result, the waiting times for patients to access treatment has shortened considerably. Patients from the north of Tajikistan, where the cancer incident rate is high, no longer will need to travel across 300 kilometres of mountainous roads and pay for their accommodation in the capital. The reliability of radiotherapy services to patients has increased considerably.
Enabling factors included the support and close cooperation from the Government of Tajikistan in co-financing equipment and building the necessary infrastructure to house the new radiotherapy centre, as well as the close cooperation with WHO at the country and regional level. The dedication and commitment of doctors and medical staff working in the centres have also contributed to the success of the project.
The transfer of equipment paired with the relevant competencies for medical staff and technicians ensures the sustainability of the project’s impact. The newly established radiotherapy centre also serves as a training hub for medical students and doctors in Tajikistan, thus sustaining knowledge in the country. IAEA’s activities have been planned and managed in close cooperation with the Government and national counterparts and are fully aligned with Tajikistan’s strategy for non-communicable diseases in ensuring that the support addresses an area of real need with strong Government commitment. The IAEA and its counterparts in Tajikistan are currently focusing on improving cancer diagnosis in the country and which includes the establishment of a Women’s Cancer Diagnostic and Treatment Centre.
Due to the COVID-19 pandemic, it was not possible to implement several fellowships in 2020 as planned. These have been postponed to 2021 and will hopefully be implemented soon. Planned travel of IAEA staff also had to be postponed.
SDGS & Targets
Deliverables & Timeline
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