RAPPORT DE SENSIBILISATION SUR LA PREVENTION DU CANCER DU COL UTERIN: AU CENTRE DE SANTE VIRUNGA

Rapport de formation et workshop sur la prévention du cancer du col utérin: diagnostique et traitement des lésions précancéreuses. Contexte Au mois de Janvier 2011, AGIR ENSEMBLE a organisé une formation et un workshop a l’intention des médecins et infirmiers de la ville de Goma avec l’appui financier de l’UICC. Ces activités ont porté sur la prévention du cancer du col utérin: Diagnostic et traitement des lésions précancéreuses. Mais jusque la, nous n’avons pas la machine de cryothérapie, ce qui constitue un obstacle pour la mise en œuvre effective du programme de screening dans nos hôpitaux. Justification Le cancer est devenu la grande priorité de santé publique et tue plus que le HIV, Tuberculose et malaria mis ensemble. Il a été établi qu’il y a 28 millions des personnes atteintes du cancer dans le monde avec une prévalence de 12 millions chaque année et une mortalité de 8 millions chaque année. Le cancer du col de l’utérus vient en 2e position dans le monde en ce qui concerne la mortalité et en 1ere position dans le pays en voie de développement. Il a été démontré que le cancer du col utérin peut être prévenu à 100% avec des moyens très simples: screening, traitement et vaccin anti-HPV. Objectifs 1. Former 8 professionnels de santé (4 médecins et 4 infirmiers) en dépistage et traitement des lésions précancéreuses. 2. Tenir un «workshop» de 2 jours pour former 28 professionnels de santé en matière de screening et traitement des lésions précancéreuses pour la sensibilisation continue des mamans lors des séances de CPN et de vaccination. Résultats atteints A. Formation de 2 jours: 8 professionnels de santé ont été formés avec succès sur la matière susmentionnée dont 3 médecins et 5 infirmiers: Tous les participants ont réussi le post-test avec plus de 76% et tous ont signé le feuillet d’engagement pour la lutte continue contre le cancer comme une grande priorité de santé publique. Indicateur1: 3 médecins formés/4 attendus= 75% Indicateur2: 5 infirmiers formés/4 attendus=125% En bref, l’objectif a été atteint à 100% : 75+125 divisée par 2= 100% A l’issue de cette formation 8 professionnels de santé de la ville de Goma sont maintenant compétents à réaliser le dépistage pour le cancer du col utérin et livrer le service aux mamans pour prévenir à 100% le cancer du col de l’utérus. Un module de formation est disponible comme livre de référence pour les professionnels de santé. Il est vrai qu’il s’agit d’une nouvelle matière pour les professionnels de santé congolais et ce document va être une bonne source d’information pour le développement des capacités. B. Un workshop de 2 jours s’est tenu comme prévu et 25 professionnels de santé ont participé activement à ce workshop dont 5 médecins et 20 infirmiers. Tous les participants ont été actifs dans les travaux en groupes et tous ont signé le feuillet d’engagement pour la lutte continue contre le cancer comme une grande priorité de santé publique. Indicateur 1: 25 participants/28 attendus= 89.3% Indicateur 2: 25 personnes ont participé activement à l’adoption du guide/ 25 attendus = 100%. A l’issue du workshop, un guide du sensibilisateur vient d’être adopté et mis à la disposition des institutions de santé pour usage dans la sensibilisation continue des mamans pour qu’elles demandent le service de screening aux professionnels de santé. Cela permettra la disponibilité du service de screening et le plaidoyer pour la disponibilité du service de traitement (achat de machine de cryothérapie). Tous les participants ont reçu chacun une copie du guide. Pour ce workshop, un rappel de quelques sujets de formation a été donné notamment sur les démarches diagnostiques des lésions précancéreuses, le traitement par cryothérapie, l’épidémiologie et l’histoire naturelle du cancer du col utérin. Ce rappel consiste à la mise en niveau des participants du workshop qui n’ont pas suivi la formation. Ainsi donc tous les participants à ce workshop sont aussi capables de pratiquer le screening et le traitement des lésions précancéreuses. Les facilitateurs ont donné les orientations nécessaires pour le déroulement des travaux mais en gros les travaux se sont faits en groupes. Quatre groupes ont été formés dirigés chacun par 2 cadres qui ont suivi la première formation. Ce programme va se poursuivre avec la sensibilisation dans 3 centres de santé de la ville de Goma pour informer les mamans de l’importance du screening pour prévenir à 100% le cancer du col utérin, leur permettre de demander le service de screening et d’adhérer au programme quand il est disponible. NB: Le grand obstacle pour la mise en œuvre effective de ce programme est le manque des moyens pour le traitement des lésions précancéreuses: la machine de cryothérapie et cela doit être une matière de plaidoyer pour chacun de nous tous pour éviter aux mamans de faire de longues distances Goma-Kampala ou Goma-Kigali pour le traitement.

Fait à Goma, le 01 Février 2011 Dr Mateus KAMBALE SAHANI Directeur du Département de Santé AGIR ENSEMBLE/RDC.

Agir Ensemble comments for Civil Society Interactive Hearing for UN summit on NCDs

On behalf of AGIR ENSEMBLE, a NGO based in Goma/DRC, member of UICC and FCA, I would like to share with you our views on the possible outcomes of the Summit and propose the following specific recommendations to be incorporated in the final Outcomes Document that will be endorsed by UN member states at the High-level Meeting on NCDs. Our organisation has been extensively involved in cancers and tobacco controls. From our own experience, we believe that civil society has been instrumental in promoting strong cancer and tobacco control measures, overseeing their implementation, and fostering public support for governments’ cancers and tobacco control policies. Yet more needs to be done. More than 8 million people die each year by cancer and 6 million annually due to global tobacco use and WHO-GLOBOCAN data base shows that cancer is the leading cause of mortality in developing country including DRC and cervical cancer takes the first place. Cervical cancer is 100% avoidable but it continues to kills women in developing countries; so programs of screening and vaccination against HPV must be implemented in all countries to avoid these avoidable deaths. Tobacco use is the only risk factor common to the four major groups of NCDs. As a result, implementing the tobacco control measures specified in the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) – which has more than 170 Parties representing 87% of the world’s population – is one of the best ways to tackle NCDs. The UN Secretary-General Report on NCDs reaffirms the effectiveness and efficiency of the key interventions in the WHO FCTC. We would like to strongly encourage all UN member states to adopt an outcomes document that reflects positions adopted by the civil society movement - the NCD Alliance - and specifically: · Calls on countries that have not yet done so, to ratify the FCTC. Key tobacco control interventions of the WHO FCTC are not only highly cost-effective but also cheap, feasible and culturally acceptable to implement. · Commits member states to ensure that their government cooperates actively to accelerate the implementation of the strategies to control and treat NCDs. · Sets a short-term global target for prevalence of NCDs and tobacco use that is both ambitious and achievable and calls on all governments to set national/regional targets which should be revised regularly. Monitoring trends and progress is essential to ensuring that commitments are honoured. · Calls on all governments to integrate NCDs in all relevant national plans for health, development and poverty reduction, and strongly encourages global investment in some key strategies to reduce prevalence and incidence of NCDs like FCTC implementation, screening for cervical cancer, vaccination programs for HPV and HBV including technical and financial assistance and scientific research. · Calls on all governments to recognise the importance of NCDs and all risk factors to the achievement of the Millennium Development Goals (MDGs), integrate FCTC implementation, screening for cancer, vaccination programs for HPV and HBV into development assistance programmes and the planning processes of UN, bilateral and multilateral development agencies. NCDs are a growing threat even in the poorest countries in the world, with socioeconomic impacts that threaten the attainment of the MDGs. Full-scale action on NCDs and the development of global and national targets and indicators are crucial steps to prevent the NCD epidemic from becoming a severe health emergency. Best regards, Mateus Kambale Sahani, M.D.

AGIR ENSEMBLE/DRC

Capacity Building Workshop Training of UICC in Cape Town

A workshop training in cancer prevention including social marketing for Tobacco control has been held by UICC in Cape Town/South Africa in March 2010. AGIR ENSEMBLE has been represented as a member of UICC by Dr Mateus Kambale Sahani. Thank you, Dr Sahani

Capacity of health professionals in cervical cancer screening in Goma/DRC M. Kambale Sahani1,2, M.M. Mutumwa3, P.K. Mukama4

Capacity of health professionals in cervical cancer screening in Goma/DRC M. Kambale Sahani1,2, M.M. Mutumwa3, P.K. Mukama4 1Health Department, AGIR ENSEMBLE, 2Virunga General Hospital-GOMA, 3Clinic Chaine de l'Espoire-GOMA, 4Centre Medical Belle vue, GOMA, The Democratic Republic of the Congo Overview Cancer is now the leading cause of death worldwide, 28 million of people live with cancer in the world and 8 million die each year by the disease. In DRC, cancer killed approximately 33,000 people in 2005 and cervical cancer was the killer no 1 among women and prostate cancer among men. If nothing is done now, this figure will reach 65,000 in 2030. Source: WHO infobase In DRC no woman has access to cervical cancer screening in all the life (service not available in all the country, a country of more than 70,000,000 people). Objectives This research project aims to know the degree of understanding and competency of health professionals (doctors and nurses) in screening methods (VIA and VILI) to make sure that the screening can be initiated without any difficulty in the city of Goma and, if there are difficulties, how they can be solved to this services being accessible to people. To measure also their capacity of using cryotherapy for treatment of precancerous lesions. Method We used the STEPS Method of the WHO, especially Step 1 using questionnaire and interview of 50 doctors (general practitioners) and 500 nurses in the city of Goma. Sample was constituted from all public and private hospitals and health centers of the city. We used comparative statistic test among people who know the method and those who don’t know it. Hypothesis Our study was focused on the following hypothesis: - Health professionals know well the usage of VIA and VILI methods, - Health professionals usually educate their patients on prevention of cervical cancer, - Health professionals know how to use cryotherapy to treat precancerous lesions. Results At the end of our study, we found that: 1. 85% of doctors (43) never understand about VIA and VILI methods and 98% of nurses (490) are too. 2. 10% of doctors (5) have understood about the methods but don’t know how to proceed and 1% of nurses (5) are too. 3. 5% of doctors (3) know the substances used for VIA and for VILI but don’t know how they are used and 1% of nurses (5) are too. 4. 10% of doctors (5) give an education message to their patients (avoid genital infections) and 2% of nurses (10) do too. 5. 10% of doctors (5) are aware of HVP vaccine to prevent cervical cancer and no nurses (0) know that. 6. No health professional (doctors or nurses) knows that precancerous lesions can be treated and no one knows how to use cryotherapy. 7. No health professional (doctors or nurses) has participated in a campaign for cervical cancer prevention. 8. No health institution in Goma has a screening service. Conclusions Health professionals in the city of Goma don’t have sufficient skills in cervical cancer screening and HPV vaccine. This constitutes a need for training in this area and it is also a big challenge to the availability of the service.

Raising Awareness Session in Goma/DRC

1. Introduction On April 24th, 2010, AGIR ENSEMBLE has organized a Raising Awareness Session (RAS) on tobacco control for youth in the church community (CBCA KESHERO) in the city of Goma. We had planned to join together 50 young people of the community church and inform them that tobacco is dangerous for their health and explain them the strategies used by the industry to grow its clients. This session took place normally as expected and got the audience of 59 young people joining the meeting. The duration of the event was 2 hours from 2:00 pm to 4:00 pm. 2. Objective of the session AGIR ENSEMBLE, in its commitment of spreading information which can save lives and maintain the health of population in the community, settled following objectives for this session: - Bring together a group of 50 young people from KESHERO CBCA community church, who can receive the message that tobacco is a global priority of public health, - To teach to the group how to protect himself and to protect others against tobacco smoking, the reason of not begin smoking and at the end of the session at least 95 % of participants will know correctly the importance of not to begin smoking. 3. Context of organization Considering the financial difficulty, the event was held in the worship hall of KESHERO CBCA CHURCH from 2:00 pm till 4:00 pm. The event has been attended by 59 persons among whom 38 females and 21 males. We didn’t find possibility to make T-SHIRTS for participants. 4. Progress of the event The event took place around the subject: "Tobacco and youth", the role of youth in tackling tobacco usage. The moderator of the session was Mr. Alphonse KAVWIRWA, president of the Board of AGIR ENSEMBLE and the speaker was Dr Mateus KAMBALE SAHANI, the director of the Health Department of AGIR ENSEMBLE. The session began with the allocution of the president of AGIR ENSEMBLE, Mr. Alphonse KAVWIRWA who welcomed all participants to the session of the day and presented the missions of AGIR ENSEMBLE. Then Dr Mateus SAHANI began explaining the background of the event and presented the relevance of acting against tobacco. “Most importantly, our collective voice must show our commitment to fight tobacco in our community and worldwide and it must be a global priority for the public health” he said. After this, the speaker began the session “Tobacco and Youth, the role of young people in the fight against tobacco” in which he gave the place held by tobacco as a big public health threat. “Tobacco is the first Risk factor of cancer and kills each year 5.4 million people worldwide and cancer is becoming the leading cause of death worldwide. We know that cancer kills 8 million people each year and if nothing is done by now cancer will kill 12 million of people. Every one may act by now if you want to save the 28 million of people living with cancer in the world and if you want to address the cancer burden worldwide. The voice of each one is needed for the fight”, he said. Then some questions were asked and answered by the speaker. All participants were interested by the session of the day and 15 questions have been received. Almost all questions were well answered. After this a cocktail was offered to participants. 5. Participants In total 59 people attended the meeting among whom 38 females and 21 males and were interested by the theme of the day. 6. Evaluation of the session. We expected 50 people for the meeting and brought together 59. This objective was reached in 118%. The second objective was reached in 90%. In all our performance was 104%. The main barriers for us to reach our maximum of goals were the background of the organization of the event, and missing financial support and we didn’t be able to organize transport for participants. 7. Questions and recommendations Some pertinent Questions - What is the importance of tobacco for community and for smokers? - If tobacco kills 5.4 million of people each year, why is it allowed to be selled? - Are governments aware that tobacco kills people and cause diseases? What are they doing to protect people? - What can be our attitude as young people towards our parents who smoke? - What is the good strategy we can use to sensitizer our parents who smoke? - What can be the attitude of a wife towards her husband who is smoking? - Why industry targets young for its activities? Recommendations At the end of the event, participants have recommended: - To organize multiple sessions like this one to allow spreading the message that can save lives of population. - To choose a place and a moment which allow more people to attend the event for the next time. - Such events need financial support for a real success: media campaigns, advocacy with politicians, etc. Can LAF help us? 8. Conclusions Generally the activities of the planned were well realized and it was a real success even if there were some difficulties. All was done as planed and our objectives were reached. Participants were satisfied by the event and the message was new for almost 97% of them. They recommend us to them more information and strategies to allow them to sensitizer their parents who are smoking and they ask us to give them some posters to be used in their living rooms. Goma, April 24th, 2010. Dr Mateus KAMBALE SAHANI AGIR ENSEMBLE/DRC

World Cancer day, 4 February 2010 in Goma

AGIR ENSEMBLE has organized a public debate on cancer focusing on the campaign slogan: “cancer can be prevented too”. The target people were teachers of Visoke institute. The event took place in one of the classrooms of the school (Visoke Institute) on February 4th, 2010 directly after courses from 12:45 – 16:00. The official langage of the event was French. The event has begun with presentation of participants and a little presentation on mission of AGIR ENSEMBLE. The moderator was Mr Paul and was in charge of taking picture. The speaker was Dr Mateus Kambale Sahani (in yellow T-SHIRT). After presentation, the speaker begun with the topic: “Cancer, a global priority” and after he continued by giving the key messages of the campaign through the topic: “Cancer can be prevented too”. The speaker has insisted on some simple measures to prevent cancer and this was received by participants as good news because all of them didn’t know that it could be possible to prevent cancer. Then, the moderator opened the debate and 15 questions have been received and all found responses. At the end, Dr Mateus gave the press release, key messages and the Diary notes to the headmaster of the school (Visoke institute). After this, some recommendations were given by participants: 1. for next time, to invite more people and look for a common moment and sufficient time to allow people to understand better the matter of cancer, screening for cervical cancer, breast cancer, tobacco control, etc. 2. the headmaster has asked to AGIR ENSEMBLE to do more sessions of raising awareness for their pupils and said that they need more posters for their classrooms and the public room of teachers. Some key outcomes: At the end of the day activities: 1. All participants have understood and convinced that cancer can be prevented too (this was the first time for them to understand that cancer is also preventable), 2. All participants have made commitment to sign the world cancer declaration, 3. All participants have made commitment to spread this message to their pupils but they need some materials as posters and some modules.

LIVESTRONG DAY IN GOMA/DRC, October 2, 2009

1. Introduction On October 2nd, 2009, AGIR ENSEMBLE, planned to organize a Raising Awareness Session (RAS) on cancer with a group of 15 couples in the city of Goma. At first, we had planned a scientific debate with doctors and nurses of the city of Goma, but considering the not availability of doctors for a working day (Friday), we saw have changed the target of our meeting. So we invited 15 couples of parents to attend the meeting this to mean a total of 30 persons among whom 15 men and 15 women. This session took place normally as expected supporting the activities of Lance Armstrong foundation the day of anniversary of the diagnosis of Lance Armstrong and the month of raising awareness on the breast cancer, the month of October. The duration of the event was 3 hours from 1:00 pm to 4:00 pm. 2. Objective of the session On October 2 of every year is a historic date for LAF and for Lance Armstrong and finally for the whole world generally. October is also a month of raising awareness on breast cancer. So AGIR ENSEMBLE wanted to join other partners of the world acting in the FIGHT AGAINST CANCER and supporting activities of LAF to make our contribution and commitment in spreading information which can save lives and maintain the health of population in the world. For this session, AGIR ENSEMBLE settled following goals: - Bring together a group of 30 relatives (parents) gathered in 15 couples who can receive the message that the cancer is a global priority of public health, - To teach to the group how to proceed to the Breast Self Examination (BSE) for early detection and at the end of the session at least 95 % of participants will know correctly this technic and the importance of the BSE. 3. Context of organization Considering the financial difficulty, the event was held in one of the classrooms of Mont Goma Institute just after the courses from 1:00 pm till 4:20 pm. The event has been attended by 23 persons among whom 6 females and 17males. We have made T-SHIRTS (in yellow) for the participants. 4. Progress of the event The event took place around these subjects: "The cancer, a global priority ", "The Prevention of the breast cancer ", “Integrate good food customs for the prevention of the cancer ". The moderator of the session was Mr Alphonse KAVWIRWA, president of the board of AGIR ENSEMBLE and the organizing committee was composed by Mr. Paul LUGHEMBE and Mr Jonathan VALIHANO. The main speaker of the session was Dr Mateus KAMBALE SAHANI, the director of the Health Department of AGIR ENSEMBLE. The session began with the allocution of the president of AGIR ENSEMBLE, Mr Alphonse KAVWIRWA who has welcomed all participants to the session of the day and presented the missions of AGIR ENSEMBLE. Then Dr Mateus SAHANI began explaining the background of the event and presented the relevance of the LIVESTRONG Day. “October 2 is the date that Lance Armstrong got his diagnosis of cancer and he begun the battle for life and founder the Lance Armstrong Foundation. It’s a historical date celebrated by LAF and its partners worldwide. Our event is one of thousands of events around the globe. This year there are events on every continent (even Antarctica!) and in all 50 states in the U.S. LIVESTRONG Day is a day to celebrate, it is a day to educate and it is a day to advocate. But most importantly, it is the day our collective voice will show the world that cancer must be a global priority” he said. After this, the speaker began the session “Cancer, a global priority” in which he gave the place held by cancer as a big public health threat and the cancer burden worldwide. “Cancer will be soon, in some year, the leading cause of death worldwide. We know that cancer kills 7.9 million people each year and if nothing is done by now cancer will kill 11.5 million of people. Every one may act by now if you want to save the 28 million of people living with cancer in the world and if you want to address the cancer burden worldwide. The voice of each one is needed for the fight”, he said. The speaker explained also the role of bad habits in developing countries, the habits of not consulting early when people are sick. He asked to people who were listened to him to abandon these bag habits to help the world becoming “a world without cancer”. This will allows early detection and screening for cervical cancer and breast cancer. As it’s the month of October, a session on “Prevention of Breast cancer and early detection” has been developed. The speaker gave more detailed explanation of the method of Breast Self Examination (BSE), its advantages, technic and warning signs, etc. Some factors of risk for breast cancer have been given and now the speaker concluded the session by showing some pictures of sicks treated surgically for breast cancer and who developed metastasis and are taking palliative care. Then some questions were asked and answered by the speaker. All participants were interested by the sessions of the day and 20 questions have been received. Almost all questions were answered with satisfaction of the attendees except one which was: a woman with breast cancer can continue breasting the baby with sick breast? Now the speaker proceeded to an exercise of question-answer to the public to evaluate the degree of understanding of the lesson by participants especially concerning the technic of Breast Self Examination (BSE) and this was satisfactory. After this a cocktail was offered to participants and during the cocktail a module on “Healthy eating and energetic balance” was developed by Mr. Alphonse KAVWIRWA. A sery of 3 questions were asked and answered. During the session, 2 walking people passed in front of the meeting room and were also interested by our message and now the president asked them to join us in the room because the voice and action of every one are needed. See 2 gentle men in black T-SHIRTS on photos. 5. Participants In total 23 people attend the meeting among whom 6 females and 17 males and were interested by the activities of the day. 6. Evaluation of the session. We expected 30 people for the meeting and brought together 23. This objective was reached in 76.66%. The second objective was reached in 100%. In all our performance was 88.33%. The main barriers for us to reach our maximum of goals were the background of the organization of the event, the moment and missing financial support. Doctors didn’t find time to join us because of their job at hospitals and we didn’t be able to organize transport for participants. 7. Questions and recommendations Questions - What is cancer ? - What is the cause of cancer? - Is there a link between sexual course and the disease? Does exist a sexual transmission of cancer? - A woman with breast cancer can continue feeding her baby with the sick breast? Is there a transmission to child? - From when are statistics of 7.9 millions of deaths/year by cancer and 5.4 millions of deaths/year by tobacco? - A person with cancer can still alive how many years? - Where do you place hard work of teachers? Can this replace physical effort to address risk of cancer? - With physical activities, how can some one know that he is making balance between eating and spending energy? - How to get medicines of cancer in our community? - Test VIH, TB, etc. exist; is there a test for cancer? - What are symptoms of cancer? - What to do to avoid overweight for children? - What to say to a sick of cancer considering that medicines are not available in our community? - Can a man proceed to the BSE of his wife? - Can the breast feeding influence the volume of the breasts? If a child uses preferably one breast than another, this can create difference between the 2 breasts? - There is a woman without child who presents bleeding of the nipple; this can be a sign of breast cancer? - Is there a link between medical family planning and cancer? - Prostate cancer can be linked to sexual courses? - What type of cancer is more fatal than other? Recommendations At the end of the event, participants have recommended that: - It is important to organize more events like this one to allow spreading the message that can save lives. - To choose a place and a moment which allow more people to attend the event for the next time. - Organize such event for all NGO which are members of RACID Network to permit them understanding the problem. - Choose a moment for women and young girls to explain them the modes of prevention of cervical cancer and screening. - We would like that Lance Armstrong Foundation play the role of funds mobilizator to allow support of such events for a real success. 8. Conclusions Generally the activities of the day were well realized and it was a real success even if there were some difficulties. All was done as planed and our goals were reached. Participants were satisfied by the event and the message was new for almost 95% of them. They wished us to invite more people for the next occasion. Goma, October 7th, 2009. Dr Mateus KAMBALE SAHANI AGIR ENSEMBLE/DRC.

AGIR ENSEMBLE joined LIVESTRONG Global Cancer Summit to make cancer a global priority

AGIR ENSEMBLE JOINED THE LIVESTRONG Global Cancer Summit to make cancer a global health priority

Summit Inspires New Resolve to Fight World Cancer Problems

28 September 2009

Dublin – AGIR ENSEMBLE/GOMA-DRC joined the Lance Armstrong Foundation (LAF) and other key international health organizations from August 24-26 at the Irish capital for the first LIVESTRONG Global Cancer Summit, designed to raise awareness and mobilize support to fight the growing global cancer crisis.

LIVESTRONG is a valuable opportunity to raise international public awareness of the cancer epidemic, especially in developing countries, and we are pleased to have taken part in this first Summit.

LIVESTRONG attracted more than 500 participants from some 65 countries around the world. They included world leaders and policymakers, NGOs, business executives, cancer professionals and advocates.

IAEA has a mission to bring more attention and resources to the global cancer fight through its Programme of Action for Cancer Therapy (PACT). PACT, a LAF partner, is the IAEA's umbrella programme for cancer control efforts in developing countries. But till there nothing has been done by IAEA in DRC, a country which has 60,000,000 people and without any program of fight against cancer.

“When people leave here, we know that change will be effected and that lives will be affected. We know that lives will be saved because of the programs that are created and dreamed up here,” said summit organizer Lance Armstrong, at the opening of LIVESTRONG.

Seven times winner of the world renowned Tour de France bicycle race and founder of LAF, Armstrong is a survivor of a severe testicular cancer, diagnosed in 1996, which later metastasized to his lungs and brain.

On the first day of the event, Werner Burkart joined a panel of experts to discuss the Global Impact of Cancer. Chaired by CNN's medical correspondent Sanjay Gupta, the panel included John Seffrin, CEO of the American Cancer Society (ACS), Christopher Wild, Director of the International Agency for Research on Cancer (IARC) and Lynn Faulds-Wood, President of the European Cancer Patient Coalition (ECPC).

The IAEA provides developing countries with technical expertise and equipment related to radiation medicine – a vital component in the treatment of cancer. The IAEA is working in partnership with the global health leader, the World Health Organization (WHO) and other international partners to bring more attention and resources to the global cancer fight. Our government must do more efforts and show its commitment for our population to benefit this technical expertise and equipment.

Speaking after the event, Burkart said: “The IAEA, after decades of experience helping developing countries cope with the burden of cancer, has been advocating for cancer to be added to the global health agenda, and ultimately become part of the Millennium Development Goals. The Summit was an important opportunity to make the case, together with our partners, on an international stage.”

A highlight of the Summit's second day was the presentation of a special report on the economics of cancer prepared by the Economist Intelligence Unit for LAF with support from the ACS. Entitled Breakaway: The global burden of cancer – challenges and opportunities, the report estimates that there will be 12.9 million new cancer cases globally this year alone, representing an immense economic burden of US$305 billion.

Commenting on the report, Dr Ala Alwan, the World Health Organization's Assistant Director-General for Non communicable Diseases and Mental Health, said: “These new data delineate a stark trajectory for cancer if immediate action is not taken. The rise of cancer creates an enormous burden on health systems around the world. But this is not just a health challenge; it undermines economic growth and acts as a chronic poverty trap for the poorest countries.”

And it is in developing countries that the cancer burden shows the steepest increase. Evidence shows that nearly half of all new cancer cases this year will be in low- and middle-income countries, and that figure is likely to increase dramatically over the next decade to as much as 75%. Yet currently only five percent of global resources for cancer are spent in the world's poorest nations.

Among the most important outcomes of the Summit were the need to make cancer a global priority, the need for greater financial investment in cancer, and the need for assessment of countries' national cancer control plans.

The main goal of our government could be the building of international partnerships with IAEA and others partners to help our country establishing healthcare systems that provide early detection and timely and effective treatment for all cancer patients everywhere in the country and to concept a National Cancer Control Plan (NCCP).

AGIR ENSEMBLE would like to alert all of conscientious leaders in DRC especially doctors and all health care professionals to put cancer on their agenda of priority because if leaders as us don’t speak about cancer, other people don’t pay attention on it.

By now it is known that 30% of cancers are preventable and 30% other are curable. We may prevent the preventable and cure the curable but this demands our commitment to act and raise awareness people and to educate policy makers to make cancer a global priority.

Thank you.

Dr Mateus K. SAHANI, AGIR ENSEMBLE.