Cancer kills far too many
people – particularly in Africa.
Rays of Hope sets out tochange that by supporting
the establishment ofradiotherapy services,
starting with the23 countries thatcompletely lack thefacilities for radiation
treatment.

Rays of Hope
Closing gaps in cancer care

One country in four does nothave access to a single
radiotherapy machine.
This is a sobering statistic.
And it is unacceptable.
— Rafael Mariano Grossi, IAEA Director General

www.iaea.org

October 2021

With over 19 million new cases and 10 million deaths in2020 alone, the global cancer burden is expected to growto 30 million new cases and 16.3 million cancer deathsby 2040. The disease places its heaviest burden on lowand middle-income countries (LMICs) where over 70% ofcancer deaths are expected to occur, yet these countries
receive only 5% of global spending in this area.

systems and supported by effective financing strategies,
monitoring systems and quality management.

Over half of cancer patients require radiotherapy at somepoint, but this ratio is significantly higher in countries
where cancer is often recognized in late stages only.
Over 70% of the population of Africa does not haveaccess to radiotherapy. The situation is most acute in
the countries that lack facilities and trained personnel inradiotherapy altogether.

IMPROVING CANCER OUTCOMES
THROUGH RADIATION MEDICINE

Even though the assistance provided by the IAEA has
enabled many countries to establish safe, secure andeffective radiotherapy capabilities over the last decades,
the IAEA needs more resources to bridge the enormous
shortfall in equipment and highly skilled and well-trained
personnel in the poorest countries.

IAEA’S ROLE IN
FIGHTING CANCER
The IAEA has six decades of experience in helping countries
fight cancer. From procuring equipment for diagnosis andtreatment to training staff on its safe, secure and effective
use and providing quality assurance services, the IAEA helps
countries respond to the growing cancer burden.
Tackling the burden of cancer requires systematic,
equitable and evidence-based strategies for prevention,
early detection, diagnosis, treatment and palliation.
These strategies have to be formulated into a national
cancer control strategy. This requires inclusion of allelements across the cancer continuum, framed by health

Rays of Hope will integrate the breadth of the IAEA’s
expertise to support Member States in the diagnosis andtreatment of cancer.

Complementing the ongoing efforts of the IAEA to assist
Member States improve their cancer care capacities,
the Rays of Hope initiative focuses on countries most in
need: those that lack radiotherapy services altogether
or have a poor coverage of the required infrastructure.
Rays of Hope will directly contribute to the fulfilment of
the 2030 Agenda and the Sustainable Development Goal(SDG) 3 (Good Health and Well-Being), target 3.4 (Reducepremature mortality from non-communicable diseases).
The projects included in the initiative, based on innovative
research and a focus on sustainability, will build or
strengthen radiation safety legislation and infrastructure
and provide quality control, guidance, training andequipment. Rays of Hope combines several elements into
a set of interventions that build on and complement eachother in order to maximize impact. Through a sharp focus
on countries without radiotherapy or with poor access,Rays of Hope will initially focus on prioritizing a limited
number of high-impact, cost-effective and sustainableinterventions in line with i) national capacities,ii) national needs, iii) measurable processes andiv) outcome objectives.
In order to successfully launch the initiative, ensure
its sustainability and maximize impact, the IAEA ismobilizing additional resources, advocacy andpartnership opportunities.

GLOSSARY
Radiotherapy: is a therapy using ionizing radiation for cancer
treatment to control or kill malignant cells
External beam radiotherapy: a therapy that uses a machine toaim radiation at the cancer from outside of the body

Internal beam radiotherapy / Brachytherapy: a cancer treatment
administered using a dedicated machine containing radioactive
sources and delivered using applicators inserted in or near the tumor
Bunker: a dedicated special room that houses radiation therapy
equipment and complies with radiation safety specifications andrequirements

FUNDING NEEDSRadiotherapy is an essential component of cancer careand has a demonstrated benefit on extending life span
and increasing survival rates. It uses ionizing radiation
emitted by a radiation source to attack and kill cancer cells.
A safety infrastructure is paramount to protect patientsand staff from the harmful effects of ionizing radiation.
Various machines are required for the treatment of cancer,
including simulation units, cobalt machines and linear
accelerators, which provide radiation externally, as well as
equipment to administer radioactive isotopes directly tocancerous tissue in the body.
The packages below comprise optimal combinationsof such machines and are built upon decades ofexperience of the IAEA in assisting countries in thedevelopment of safe and secure radiotherapy facilities.
The funding needs listed here are for building the facility,
purchasing the equipment and training the personnel.
Also included are the operating costs for two years tobetter support sustainability.

The IAEA will also support the development andstrengthening of radiation safety infrastructure. The
packages include Innovation and support for Regional
Anchor Centres. Innovation is essential to ensure available
resources are used to scale up quality access to radiation
medicine. It includes the participation of recipient
country experts in online training events and professional
discussions, as well as in innovation such as research
to increase the cost efficiency and effectiveness ofinterventions. Regional anchor centres will provide muchof the training and quality assurance to countries nearby.
However, these anchor centres need to first improve theireducational and quality assurance infrastructure and be
provided with tools to support continuous improvementin the region.
The packages will also contribute to advancing donor
development priorities including, gender equality, reducing
health inequities for women and children, enhancing
education and training, fostering socio-economic inclusion.

Package 1

Package 2

Package 3Value: US$ 7.5 million

Value: US$ 12.5 million

Value: US$ 16 million

Capital costs and operating costs over two years,
including participation in ongoing learning
activities and support from a regional anchor
centre of excellence

Capital costs and operating costs over two years,
including participation in ongoing learning activities
and support from a regional anchor centre of excellence

Capital costs and operating costs over two years, including
participation in ongoing learning activities and support from aregional anchor centre of excellence• Optimal as entry package for countriesof limited financial and humanresources that lack radiotherapy.

• Optimal as entry or expansion package forcountries with trained human resourcesand enough financial capacity to sustain
maintenance costs.

• Optimal as expansion package for countries withprevious experience in radiotherapy service delivery
and enough financial resources to sustain it.

• It can treat optimally up to 500 cancer
patients per year and is scalable witha second treatment unit for a total of1000 cancer patients per year.

• It can treat optimally up to 1000 cancer
patients per year. Equipment configuration
can be upgraded to tailor future needs.

Includes:1. Two bunkers
2. One conventional simulator
3. One teletherapy cobalt unit
4. One HDR brachytherapy afterloaderFeatures:• Less dependence on water andelectricity infrastructure• Maintenance needs are lower, leading
to less expected downtime• Shorter learning curve required tooperate• Requires reliable electricity and water supply.

• It can treat up to 1000 cancer patients per yearwith the more advanced techniques, but higher
maintenance costs. Needs reliable electricity andwater supply, as well as resource-intensive quality
assurance programme.
Includes:Includes:1. Two bunkers

1. Two bunkers

2. One CT-simulator

2. One CT-simulator

3. Two multi-energy LINACs

3. Two single-energy LINACs
4. One HDR brachytherapy afterloader

4. One HDR brachytherapy afterloader
Features:Features:• No need for exchange of radioactive cobalt
source, therefore logistics of long-term
operations is easier and there is no nuclear
security concern• Greater versatility in tailoring procedures toindividual patients’ needs• Requires reliable infrastructure• Requires reliable infrastructure• Longer learning curve / prior knowledge andtraining required to operate• Longer learning curve / prior knowledge andtraining desirable to operate• Higher ongoing maintenance costs the recipient
country will eventually need to bear

Conventional simulator: an X-ray machine used to plan
radiotherapy treatment(teletherapy) to treat cancer; two main types: Cobalt-60 units andLinear Accelerators (LINAC)

CT-simulator: a special computed-tomography unit used to plan
radiotherapy treatments

Brachytherapy afterloader: a medical device incorporating a
miniaturized source, with a computer-controlled mechanism
used to drive the source to deliver radiation from a short distanceinside the patient.

Teletherapy unit: a medical device used to deliver external beam
radiotherapy from outside the patient at a specified distancePARTNER CONSULTATIONSIn preparation for the launch of the Rays of Hope initiative, the IAEA is pursuing a series of partner consultations.
We seek cooperation from donor Member States, the private sector, development agencies and international
financial institutions for this ambitious activity. By organizing a coalition of donors and partners, in collaboration
with Member States who want to implement these activities, we can best support the enhancement of radiation
medicine and save lives.
More information on the Packages listed in this document, including detailed calculations, are available on request.
Email: RaysOfHope@iaea.org

The IAEA has six decades of experience in helping countries
fight cancer. From procuring equipment for diagnosis andtreatment to training staff on its safe, secure and effective
use and providing quality assurance services, the IAEA helps
countries respond to the growing cancer burden.