Tour of the Radiotherapy Bunkers- witnessing the concrete casting

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15th 2016

KEY MESSAGES: Global Health Relevance/Context

1) Cancer is emerging as an urgent global health issue. Talking Points
• The global burden of cancer is estimated to increase by nearly 70 percent by 2030.
• More than two-thirds of all cancer deaths occur in low- and middle-income countries
(LMICs).
• More people die from cancer than HIV, tuberculosis, and malaria combined.
• Up to 25 percent of the world’s cancers are caused by infectious diseases, with higher percentages in many LMICs compared to high-income countries (approximately 23 percent and 7 percent, respectively); with approximately 33 percent of cancers in sub- Saharan Africa caused by infectious diseases.
• Cancers caused by infectious diseases include (but are not limited to) lymphoma from Epstein-Barr virus, cervical, anal and head/neck cancers from Human Papilloma virus (HPV), sarcomas associated with HHV-8, and liver cancer from hepatitis B and C.

2) Uganda has one of the highest rates of cancer worldwide, in which six out of ten of the most common cancers are caused by infectious diseases; and in response, Uganda has invested in cancer research, training and clinical care.

Talking Points
What is Uganda Cancer Institute?
• UCI is a semi-autonomous public entity under the Ministry of Health.
• UCI was founded in collaboration with the U.S. National Cancer Institute in 1967
• Uganda Cancer Institute has contributed to worldwide cancer researches and treatments:
• The first combination chemotherapy treatment was done at the Uganda Cancer Institute, which was later adopted by the whole world.
• The concept of the essential drug list was developed at the Uganda Cancer Institute
• The description of infection related cancers was done at the Uganda Cancer Institute Epstein-Barr virus was first discovered from a tumor sample removed from a child with lymphoma in Uganda. This was the first human cancer found to be caused by an infectious disease.
• The discovery that drugs can be used to treat cancers alone without surgery was done at the Uganda Cancer Institute in which drugs were administered to children and the cancers disappeared drastically.
• Uganda Cancer Institute is the East African Centre of Excellence for Oncology and Tertiary Training.
• UCI is the national cancer referral center and also serves patients from countries including, Kenya, Tanzania, Rwanda, Burundi, Somalia, South Sudan, and the DRC
• UCI aims to be internationally recognized regional center of excellence advancing comprehensive cancer care in Africa through research, high-quality evidence-based care, and cancer-related education and training.
• Uganda Cancer Institute has developed a formal partnerships, with organizations such as Fred Hutchinson Cancer Research Centre, Seattle to support-the development of strong biomedical infrastructure in Uganda to contribute to the prevention, early detection, diagnosis and treatment of cancer and related health concerns through research and training.
• Uganda Cancer Institute (UCI) has served Uganda cancer patients, in addition to patients from seven regional countries, through clinical care (radiotherapy treatment), research, and training/education since 1967.

3) Radiotherapy Treatment
Talking Points
• There are two kinds of radiotherapy treatment; outer bim and inner bim radiotherapy treatment.
• The Institute embarked on construction of the six bunkers to cater for the current and radiotherapy needs and future needs. This process started in 2014.
• These bunkers will house 4 linear accelerator machines and 2 brachytherapy machines.
• Currently the outer bim radiation is down (tele-therapy) while the inner bim (brachytherapy) is fully functional.
Breakdown of tele-therapy service
• The service broke down in March 2016. This cobalt-60 machine was working on an average of 24,465 patient days of operation annually.
• Various steps have been taken into consideration to regain this service such as;
• Identification of equipment in collaboration with IAEA
• Decommissioning process has started to end 31st November 2016
• Addressing of safety issues
• Taking of patients to Aga Khan Hospital Nairobi to receive treatment.
• Renovation of the existing bunker

What have we witnessed today?
• Casting of the concrete on the radiotherapy bunkers which are expected to be complete in May 2017. This is where licensing for the operationalization of the bunker is done.
• The groundbreaking for this construction was done in May 2016.

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