Strategy for the Promotion of Nuclear Medicine in Developing

Strategy for the Promotion of Strategy for the Promotion of Nuclear Medicine in Nuclear Medicine in

Developing CountriesDeveloping Countries

Muhammad Numair YounisMuhammad Numair Younis

PakistanPakistan

Nuclear Medicine in Developing Nuclear Medicine in Developing CountriesCountries

Developing countries facing crisis, Developing countries facing crisis, economic, political, social etceconomic, political, social etc

Nuclear Medicine does not feature Nuclear Medicine does not feature prominently in healthcare agendasprominently in healthcare agendas

The overall growth of Nuclear Medicine is The overall growth of Nuclear Medicine is either static or negative.either static or negative.

Nuclear Medicine in Developing Nuclear Medicine in Developing CountriesCountries

Multifaceted approach is needed.Multifaceted approach is needed. Political, economical, social and cultural Political, economical, social and cultural

issues are to be considered.issues are to be considered. The best judge and tool could be the The best judge and tool could be the

National Societies of Nuclear Medicine.National Societies of Nuclear Medicine.

Main IssuesMain Issues

1.1. ResourcesResources

– Trained ManpowerTrained Manpower– Facilities; equipment & radio pharmaceuticalsFacilities; equipment & radio pharmaceuticals– Highly specialized research and clinical tools Highly specialized research and clinical tools

eg; PETeg; PET


2.2. Scientific activitiesScientific activities

• Clinical and scientific meetingsClinical and scientific meetings• Research activitiesResearch activities• Academic activitiesAcademic activities


3.3. Coordination with other organizationsCoordination with other organizations

• Local including NM, Radiology, Clinical Local including NM, Radiology, Clinical sciencessciences

• RegionalRegional• InternationalInternational

South AsiaSouth Asia

South Asia including Pakistan, Bangladesh, South Asia including Pakistan, Bangladesh, India, Nepal, Sri Lanka, Maldives, represent India, Nepal, Sri Lanka, Maldives, represent more than quarter of developing worldmore than quarter of developing world

Of the I.3 billion people living below the Of the I.3 billion people living below the poverty line, more than 40 % live in South poverty line, more than 40 % live in South AsiaAsia

Gross national product per capita is 300 Gross national product per capita is 300 USD Vs 1200 USD for rest of the USD Vs 1200 USD for rest of the developing world.developing world.

Table: Household income & per-capita health expenditure ($US)

Pakistan

India

Bangladesh

Nepal

Sri Lank

a

AverageMonthlyincome*†

90·23 49·4 75·21 60·08 116·41

Per-capitaHealthexpenditure‡

18 20 12 11 26

Public sectorper-capitaHealthexpenditure‡

4·05 3·2 5·67 2·6 11·74

*Data from the economic reviews of the respective countries. †Converted to US$ on the basis of exchange rates as of July 18, 2001. ‡Data from the World Bank Report12

R eso u rces Scientific & Academ ic Activities C oord ia tion w ith o th er o rg an iza tion s

N a tio n a l S o ciety o f N M

Role for ARCCNMRole for ARCCNM

Most important and vital role to play Most important and vital role to play becausebecause– Other organizations Other organizations

» Help in one aspect onlyHelp in one aspect only» Temporary/ short term supportTemporary/ short term support» Focused on projects onlyFocused on projects only

– Only organization of Asian Countries Only organization of Asian Countries working in close contact with national working in close contact with national societiessocieties

Proposed StrategiesProposed Strategies

Resources Management/ SharingResources Management/ Sharing– Trained & qualified manpowerTrained & qualified manpower

» Nuclear Medicine physiciansNuclear Medicine physicians

» Nuclear Medicine TechnologistsNuclear Medicine Technologists

The training and academic programs available The training and academic programs available in some countries only.in some countries only.

– May be possible to send the people in between May be possible to send the people in between the Asian countries for training/ professional the Asian countries for training/ professional educationeducation


Resources Management/ SharingResources Management/ Sharing– Equipment & RadiopharmaceuticalsEquipment & Radiopharmaceuticals

» eg; Gamma Cameras, Dose Calibrators, Survey eg; Gamma Cameras, Dose Calibrators, Survey meters etcmeters etc

» Tc-99m Generators, Re-188 Generator, Tl-201, Ga-67 Tc-99m Generators, Re-188 Generator, Tl-201, Ga-67 etcetc

» Cold KitsCold Kits

Some countries within the Asia can make their ownSome countries within the Asia can make their own


Resources Management/ SharingResources Management/ Sharing

– Highly specialized research and clinical tools Highly specialized research and clinical tools eg; PET & Cyclotroneg; PET & Cyclotron

The technology now available in developingThe technology now available in developing

countries. ? Can be transferred / provided to othercountries. ? Can be transferred / provided to other

developing / Asian countriesdeveloping / Asian countries


Scientific ActivitiesScientific Activities– Must for creatingMust for creating

» Academic trainingAcademic training

» Updating & sharing knowledgeUpdating & sharing knowledge

» awareness among other medical professionalsawareness among other medical professionals

» awareness among political leadersawareness among political leaders

» Involving economic leaders / finance providersInvolving economic leaders / finance providers

Responsibility of National society of NMResponsibility of National society of NM


Coordination with other organizationCoordination with other organization– Responsibility of National Society of NM to Responsibility of National Society of NM to

create a working relationship with create a working relationship with » other NM societies of the regionother NM societies of the region

» Other medical organizations; local / regionalOther medical organizations; local / regional

» International organizationsInternational organizations

» Government and non-governmental institutes Government and non-governmental institutes

Proposed Strategies: Tasks for Proposed Strategies: Tasks for ARCCNMARCCNM

Only representative organization of NM for Only representative organization of NM for Asian countriesAsian countries

Have close collaboration with NM societiesHave close collaboration with NM societies Can bridge the gaps between developing/ Can bridge the gaps between developing/

Asian countriesAsian countries Can provide means for communication, Can provide means for communication,

assist for materializing many unattended assist for materializing many unattended issuesissues

The only forum availableThe only forum available


Resource SharingResource Sharing– ARCCNM have the data base; many survey ARCCNM have the data base; many survey

forms/ questionnairesforms/ questionnaires– Central system of information where the Central system of information where the

academic & training programs are available and academic & training programs are available and which countries can offerwhich countries can offer

– Established ASNM, yet need to coordinate the Established ASNM, yet need to coordinate the activitiesactivities


Resource SharingResource Sharing– Provide knowledge and assistance to NM Provide knowledge and assistance to NM

societies for the availability of equipment & societies for the availability of equipment & radio pharmaceuticals from within the radio pharmaceuticals from within the Asian/developing countries. Asian/developing countries.

» Expected to reduce the cost as the travel/shipment Expected to reduce the cost as the travel/shipment distance may be shortened and also because of low distance may be shortened and also because of low cost of the products itselfcost of the products itself

– Can guide the local companies through NM Can guide the local companies through NM societiessocieties


Scientific Activities and Coordination Scientific Activities and Coordination between organizationsbetween organizations– ARCCNM already helping through holding its ARCCNM already helping through holding its

OCM at the annual scientific sessions of NM OCM at the annual scientific sessions of NM societiessocieties

– ARCCNM providing financial support to attend ARCCNM providing financial support to attend international meetingsinternational meetings

NM societies need to be pursued by the NM societies need to be pursued by the ARCCNM ARCCNM

Resources Sharing C oord ina te & Pursue Sc ien tific ac tiv ities C oord iantion w ith o ther o rgan iza tions

NM Societies

A R C C N M

Thank YouThank You

Technology

Strategy for the Promotion of Nuclear Medicine in Developing