Category: Nuclear Weapons

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Indonesia Launches New National Cancer Control Plan Building on Review Mission Recommendations

Source: International Atomic Energy Agency – IAEA

The full imPACT Review team with Minister of Health Budi Gunadi Sadikin and senior members of his team. (Photo: M. Nobile/IAEA)

Cervical cancer is a priority in Indonesia, accounting for 18 per cent of cancer-related deaths among women. Rates of cervical cancer can be reduced through human papillomavirus (HPV) vaccination and effective screening to diagnose and initiate treatment in earlier stages. Partha Basu from the IARC said: “Indonesia has demonstrated its commitment to eliminating cervical cancer by introducing the HPV vaccine in 2023, initially targeting more than two million girls in the fifth and sixth grades. The goal is for 90 per cent of the target population to be vaccinated. This, combined with the latest initiative to scale up HPV detection-based screening across the country, will accelerate the elimination of cervical cancer in this highly populated country.” 

Childhood cancer is also a priority for the Government, which is committed to meeting the Global Initiative for Childhood Cancer target of at least a 60 per cent survival rate for six common childhood cancers by 2030. In 2022, it was estimated that over 12 000 children up to the age of 19 were affected by cancer in Indonesia (Globocan 2022). To help the country address this challenge and increase early diagnosis and care for children with cancer, St. Jude Children’s Research Hospital was actively engaged in the July imPACT mission as the WHO Collaborating Centre for Childhood Cancer and as the technical and financial partner in implementing WHO’s global initiative.  

“Working with the Ministry and key hospitals and foundations across six provinces to date, our team at St. Jude Children’s Research Hospital is pleased and committed to continue strengthening collaborations in education, capacity building, research, and advocacy and resource mobilization in Indonesia as part of our St. Jude Global Alliance.  It has been particularly encouraging to work with the Ministry and local paediatric oncology professional and civil society community to apply health systems and policy tools over multiple months together to complement the valuable in-person imPACT review site visits and discussions,” said Catherine Lam, Director at the WHO Collaborating Centre for Childhood Cancer at St. Jude Children’s Research Hospital.   

Another partner actively involved in the mission was MD Anderson Cancer Center. Their existing partnerships in the country strengthened professional development, in particular for cervical cancer, medical oncology and pathology. “Our team at MD Anderson is honored to collaborate with the Ministry of Health and Dharmais Cancer Hospital on projects to reduce the burden of cancer in Indonesia. We have been partnering on cervical cancer prevention, breast cancer treatment as well as the strengthening of pathology and radiology services. Participating in the imPACT review helped our team further focus our efforts, particularly in the areas of pathology, medical oncology and the elimination of cervical cancer in Indonesia,” said Kathleen Schmeler, Director of the MD Anderson Cancer Center .  

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Dominican Republic Successfully Eradicate Mediterranean Fruit Fly Infestation in Record Time

Source: International Atomic Energy Agency – IAEA

In December 2023, the Dominican Republic’s Ministry of Agriculture detected the Mediterranean fruit fly near Punta Cana, triggering the activation of an emergency response protocol to contain the outbreak. Thanks to the Ministry’s surveillance network, the pest was detected early and declared transient, which confined the affected area to less than 50 km² — a significant improvement compared to the 2015 outbreak that affected over 2000 km².

In February 2024, a Technical Advisory Committee (TAC) composed of IAEA, FAO, and OIRSA experts visited the area to provide guidance on tailored eradication strategies and offer technical recommendations. The National Plant Protection Organization (NPPO) implemented a contingency plan that included:

  • Weekly releases of 3 million sterile flies for 26 weeks
  • Field surveillance and control measures, such as insecticide-bait sprays and bait stations
  • Continuous technical support from international experts

The eradication of the pest was officially declared on 27 September 2024, less than 10 months after the initial detection, with no quarantine restrictions imposed by importing countries.

“The success of this project in the Dominican Republic shows how close international cooperation can protect farmers from insect pests that can have a devastating impact on harvests and a country’s agricultural production and trade,” said Rui Cardoso Pereira, Section Head of the Joint FAO/IAEA Centre of Nuclear Techniques in Food and Agriculture in Vienna, Austria.

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IAEA Reviews Progress of the Philippines’ Nuclear Infrastructure Development

Source: International Atomic Energy Agency – IAEA

INIR mission team leader Mehmet Ceyhan presents the draft report to Raphael P.M. Lotilla, Philippine Secretary of Energy, at the closing meeting on 6 December. (Photo: Department of Energy of the Philippines)

As the Philippines embarks on the development of the country’s nuclear power programme, it is making progress in developing the necessary nuclear infrastructure, according to an International Atomic Energy Agency (IAEA) review mission that concluded today. The follow-up Integrated Nuclear Infrastructure Review (INIR) mission, conducted at the request of the Government of the Philippines, took place from 2 to 6 December 2024.

The mission team assessed the progress in addressing the recommendations and suggestions made during the initial INIR mission in 2018 to assist the Philippines in its infrastructure development. It reviewed the status of nuclear infrastructure development using the Phase 1 criteria of the IAEA Milestones Approach. Phase 1 evaluates the readiness of a country to make a knowledgeable commitment to a nuclear power programme.

The follow-up INIR mission team, comprising two international experts from Türkiye and Pakistan and two IAEA staff, noted that the Philippines has made significant progress to address most of the recommendations and suggestions and has adopted a national position for a nuclear energy programme.

In 1984, the Philippines completed the construction of a 621-MWe pressurized water reactor at the Bataan Nuclear Power Plant (BNPP). However, the plant was never commissioned. A presidential executive order in 2022 outlined the government’s position for the inclusion of nuclear energy in the country’s energy mix, and earlier this year, the Philippines announced its Nuclear Energy Roadmap aiming to have commercially operational nuclear power plants by 2032, with at least 1200 MW initially and increasing gradually to 4800 MW by 2050.

The mission noted that the Philippines has drafted and advanced a comprehensive nuclear law towards enactment; completed assessments in human resource development, regulatory framework, radiation protection, radioactive waste management, and emergency preparedness and response; and drafted policies and strategies in the relevant areas.

“The Philippines expanded the composition of its Nuclear Energy Programme Implementing Organization (NEPIO) to 24 organizations, and all sub-committees of NEPIO are actively engaged to implement relevant activities. This indicates the level of commitment of the Philippines to proceed with their nuclear power programme,” said mission team leader Mehmet Ceyhan, Technical Lead in the IAEA Nuclear Infrastructure Development Section.

The team indicated that further work is needed to finalize the Philippines’ nuclear power strategy and to complete necessary studies for future activities related to the electrical grid, industrial involvement and national legislation.

“We welcome this follow-up INIR mission that will help guide the Philippines to safely and gradually progress in its aspiration to adopt nuclear energy alongside renewables in its power mix, while strictly adhering to global standards. This exemplifies our commitment to receive objective and professional international evaluation from the IAEA that will refine and strengthen our push to secure cleaner and diversified energy sources toward attaining inclusive and sustainable growth for our people,” said Raphael P.M. Lotilla, Philippine Secretary of Energy. “We express our thanks to the IAEA for its partnership and support. We recommit ourselves to work closely with the IAEA and all stakeholders of the country.”

About Integrated Nuclear Infrastructure Review (INIR) Missions

INIR missions are based on the IAEA Milestones Approach, with its 19 infrastructure issues, three phases (consider, prepare and construct) and three milestones (decide, contract and commission/operate). INIR missions enable IAEA Member State representatives to have in-depth discussions with international experts about experiences and best practices in different countries.

In developing its recommendations, the INIR team considers the comments made by the relevant national organizations. Implementation of any of the team’s recommendations and suggestions is at the discretion of the Member State requesting the mission. The results of the INIR mission are expected to help the Member State develop an action plan to fill any gaps, which in turn will help the development of the national nuclear infrastructure.

INIR follow-up missions assess the implementation of the recommendations and suggestions provided during the main mission.

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Press Arrangements for IAEA Board of Governors Meeting, 12 December 2024

Source: International Atomic Energy Agency – IAEA

The IAEA Board of Governors will convene a meeting at the Agency’s headquarters starting at 10:00 CET on Thursday, 12 December, in Board Room C, Building C, 4th floor, in the Vienna International Centre (VIC).

The meeting is convened by the Chair of the Board following a letter addressed to him by the Governor from Ukraine, requesting a meeting of the Board.

The Board of Governors meeting is closed to the press.

Photo Opportunity

There will be a photo opportunity before the start of the Board meeting on Thursday, at 10:00 in Board Room C, Building C, 4th floor, in the VIC.

Press Working Area and Accreditation

The Press Room on the M-Building’s ground floor will be available as a press working area starting from 09:00 on 12 December.

All journalists interested in covering the meeting in person – including those with permanent accreditation – are requested to inform the IAEA Press Office of their plans. Journalists without permanent accreditation must send copies of their passport and press ID to the IAEA Press Office by 14:00 on Wednesday, 11 December. 

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Update 263 – IAEA Director General Statement on Situation in Ukraine

Source: International Atomic Energy Agency – IAEA

Ukraine’s three operating nuclear power plants (NPPs) have largely restored their electricity production after sharply reducing output last week as a precautionary step due to renewed attacks on the country’s increasingly fragile energy grid, Director General Rafael Mariano Grossi of the International Atomic Energy Agency (IAEA) said today.

The NPPs – Khmelnytskyy, Rivne and South Ukraine – have nine reactors, of which eight are currently operating while one is in shutdown. Over the past week, most of them have gradually increased output again, even though some units operated below full capacity for several days after the military strikes on 28 November, which affected electrical infrastructure that is essential for nuclear safety. Still, some of the off-site power lines that the plants use both for receiving and transmitting electricity remain disconnected.

“A stable electricity grid that provides secure off-site power is essential to ensure nuclear safety at Ukraine’s operating nuclear power plants, which are vital for producing the electricity the country needs, especially during the cold winter months. The operators have demonstrated significant resilience during and after this latest period of grid instability so that these plants can maintain nuclear safety and generate electricity following last week’s output cuts,“ Director General Grossi said.

“However, the fragile grid situation remains a source of deep concern and we will continue to closely monitor relevant developments, including with follow-up expert visits to the electrical substations on which the nuclear power plants depend. Once again, I call for maximum restraint, so that no action affecting the external power supply and nuclear safety is taken,” he said.

Despite the effects of the military conflict, including frequent air raid alarms, the IAEA teams at the Khmelnytskyy, Rivne and South Ukraine NPPs and the Chornobyl site reported that nuclear safety and security at these facilities is being maintained.

At the Khmelnytskyy NPP, the IAEA team members were required to shelter at the site for a short period of time on Tuesday, but without any impact on the site itself. At the South Ukraine NPP, the IAEA team was informed that a total of 17 drones were detected earlier this week, some three kilometres from the site.

Ukraine’s largest NPP – the Zaporizhzhya site – has not produced electricity for more than two years. Its six units are all in cold shutdown but still require off-site power for reactor cooling and other essential nuclear safety and security functions. However, the situation in this regard remains precarious, with both remaining power lines prone to frequent outages.

In the latest instances highlighting the precarious external power situation, the ZNPP’s last remaining 750 kilovolt (kV) power line was disconnected between 21-23 November, followed last weekend by a two-day disconnection of the 330 kV back-up power line.

Also related to the external power situation, the IAEA team was informed that the voltage stabilizer for the ZNPP’s 750 kV power line, located in an open switchyard outside the plant, was being repaired after it was automatically disconnected by the activation of a protection mechanism. The ZNPP expects to return the voltage stabilizer to operation within the next month. The 750 kV connection was not affected.  

The IAEA team has continued to closely follow the maintenance activities at the ZNPP, including  related to elements of the safety systems of reactor units 2, 3 and 6. The team also visited unit 1 to observe the repairs conducted last month on one leaking impulse line. The team was informed that gamma radiography had been performed on approximately 30 other locations in unit 1, which identified one more weld that had degraded, but without any leak. Both welds were repaired and tested again. The IAEA team will continue to monitor this issue.

The IAEA team continues to be denied access to the external spare parts warehouse and diesel fuel storage facility. However, it has been informed that the diesel fuel storage tank that was damaged more than two years ago has been repaired.

The IAEA team at the ZNPP has continued to hear explosions on most days, mostly at distances far away from the site, and no damage to the plant was reported.

As part of the IAEA’s comprehensive programme of assistance in support of nuclear safety and security, it arranged new deliveries of equipment to Ukraine, bringing the total to 86. The State Enterprise VostGok, an uranium ore mining and processing plant in Ukraine, received a dosimetry system to enhance the capacity to monitor individual doses for their staff exposed to ionizing radiation. The equipment was procured with funds from Japan. With funds provided by Denmark, the country’s Hydrometeorological Center and the Hydrometeorological organizations of the State Emergency Service of Ukraine received three portable liquid nitrogen generators. In addition, one Cisco integrated services router with 10 connecting switches was delivered to the Rivne NPP, made possible with funds provided by Ireland.

Separately, in partnership with France and Ukraine’s Energoatom, the IAEA assisted in the delivery of spare parts and rubber products needed for the timely maintenance of emergency diesel generators at the South Ukraine NPP.

With these deliveries, equipment related to nuclear safety and security worth more than 14 million euros has been delivered to Ukraine since the start of the conflict.

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IAEA Building “Strong Cooperation” with Uzbekistan in Nuclear Energy and Health

Source: International Atomic Energy Agency – IAEA

President Shavkat Mirziyoyev also released a statement after the meeting saying that the IAEA and Uzbekistan are expanding cooperation. “Collaboration will focus on strengthening national agencies, training specialists, and advancing projects in nuclear energy, agriculture, water management, healthcare, and ecology,” the statement said.

Uzbekistan is currently planning to embark on its own nuclear power programme, with an initial build focusing on SMRs with six 55 MW reactors planned.

Director General Rafael Mariano Grossi started his inaugural visit to the Central Asian country with meetings with Director Azim Akhmedkhadjaev of the Uzatom Agency which will oversee the project, Energy Minister J. Mirzamakhmudov and nuclear regulator R. Abduvakkos.

Mr Grossi said: “The IAEA stands ready to support Uzbekistan’s ambitious plans to introduce nuclear power, including SMRs. Together, we’ll work on the adoption of a robust legal framework to ensure the highest safety standards.”

On the second day of his visit the Director General spoke at a major conference on the benefits of nuclear energy for the region, organized by Uzbekistan, which highlighted how the IAEA can help countries advance their nuclear power plans in a safe way.

In an address prepared for the conference, President Shavkat Mirziyoyev said: “Our country was one of the first in the world to begin the construction of small nuclear power plants in accordance with international requirements and standards. We consider the IAEA as our major partner in the successful implementation of these projects, as well as a number of healthcare and scientific programs.”

Other speakers included Minister of Energy Mirzamakhmudov, Justin Friedman from the Bureau of International Security and Nonproliferation, U.S. Department of State and Andrey Rozhdestvin CEO of Rosatom Western Europe, as well as Sama Bilbao from the World Nuclear Association. During the conference the Director General also signed an addendum to the country programme framework with Uzatom on support for the introduction of SMRs in the country.

Another key area of IAEA support to Uzbekistan is in the field of healthcare, under the Agency’s Rays of Hope initiative, to improve access to cancer diagnosis and treatment.

The Ministry of Health of Uzbekistan requested IAEA help to train personnel for a new oncology centre, in a project financed by the IsDB with a budget of $ 2.3 million.

During his trip, the Director General visited key sites advancing nuclear science in the country, such as the Institute of Nuclear Physics and the National Research Nuclear University (MEPhI).

He noted: “The Institute of Nuclear Physics and its research reactor have been safely operating for 60 plus years and contributing to medical and industrial radioisotope production. This legacy sets a strong foundation for Uzbekistan’s nuclear power plans.”

Mr Grossi also met with MEPhI students, telling them: “The highest standards of education are the foundation of any successful nuclear power programme. This is one of the world’s most prestigious institutions in the field and shows its constant dedication to excellence. The IAEA will be supporting you all the way.”

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IAEA Mission Finds Ghana Committed to Nuclear and Radiation Safety, Encourages Continued Improvements

Source: International Atomic Energy Agency – IAEA

An International Atomic Energy Agency (IAEA) team of experts has commended Ghana for its commitment to the continuous improvement of nuclear and radiation safety as the country advances its plans to develop a nuclear power programme. The team emphasized that maintaining the effective independence of the Nuclear Regulatory Authority (NRA) in making safety-related decisions is crucial and urged the Government to ensure this independence is upheld and protected.

The ten-day full scope Integrated Regulatory Review Service (IRRS) mission – that took place from 25 November to 4 December – was conducted at the request of the Government of Ghana and hosted by the NRA in Accra. It was the first IRRS mission conducted in the country. Its purpose was to perform a peer review of Ghana’s legal and regulatory framework for nuclear, radiation, radioactive waste and transport safety, as well as the interface between safety and nuclear security.

IRRS missions are designed to strengthen the effectiveness of the national nuclear and radiation safety regulatory infrastructure, based on IAEA Safety Standards and international good practices, while recognizing the responsibility of each country to ensure nuclear and radiation safety.

Ghana is embarking on a nuclear power programme and is currently conducting preparatory work to develop the required safety infrastructure for a nuclear power plant, including drafting national policies for nuclear and radiation safety, as well radioactive waste management. Ghana also uses nuclear and radiation technologies in healthcare, agriculture, research and industry.

The IRRS team – comprised of 14 regulatory experts from 13 countries, as well as three IAEA staff members – engaged primarily with the management and staff of the NRA, as well as with representatives from the Ministry of Environment, Science, Technology and Innovation (MESTI) and the Ministry of Energy. Members of the IRRS team also undertook site visits to and observed regulatory inspection activities at the GHARR-1 Research Reactor facility, the Radioactive Waste Management Centre, an industrial facility using radiation sources and a hospital. During the site visits, the IRRS team members held discussions with management and staff of the facilities.

The IRRS team recognized that the NRA is committed to ensuring continuous improvement of safety and the protection of people and the environment. The IRRS team found that Ghana has affirmed its commitment to nuclear and radiation safety by initiating the development of its management system and regulatory guidance to ensure the consistent implementation of regulatory functions and activities, as well as by inviting an initial IRRS peer review mission.

“The efforts and constructive engagement of NRA staff during the peer review process enabled the IRRS team to gain a comprehensive understanding of Ghana’s regulatory framework,” said Thiagan Pather, IRRS mission Team Leader from the National Nuclear Regulator in South Africa. “As a country with ambitions for a nuclear power programme, it is important that the Government of Ghana and the Nuclear Regulatory Authority work together to deliver the improvements identified during the mission.”

The IRRS team highlighted Ghana’s commitment to safety, in line with international best practices through:

  • Establishing the NRA as an independent nuclear regulatory authority;
  • Delivering on Ghana’s national obligations under the various international instruments for nuclear and radiation safety;
  • Initiating the strengthening of the regulatory framework for nuclear and radiation safety through the development of regulations and guides; and
  • Providing support and advocacy for the NRA, through the provision of financial and human resources commensurate with the current national nuclear and radiation programme. This commitment aims to further enhance the regulatory capacity in line with the expanding nuclear power programme, enabling the NRA to grow its capability and capacity to maintain effective regulatory control of all nuclear and radiation facilities and activities in Ghana.

The IRRS team considers that Ghana’s primary challenge is the completion and issuance of regulations and guides to support the consistent and stable implementation of the National Regulatory Act, considering both the existing nuclear and radiation programme in the country and the envisaged nuclear power programme.

Recommendations and suggestions for further improvement include:

  • The Government should establish and implement national policies strategies for safety and for radioactive waste management.
  • The Government should ensure that all the elements for safety are established through legislation consistent with the IAEA Safety Standards.
  • NRA should expedite the development and approval of the management system.
  • NRA should establish and implement an enforcement policy and process, including criteria for corrective actions, for responding to non-compliance with regulatory requirements.
  • NRA should develop an emergency plan and procedures for the functions assigned to it regarding preparedness and response to nuclear or radiological emergencies.

“The NRA appreciates the efforts of the IAEA to review its nuclear and radiation safety infrastructure within the context of this IRRS mission for Ghana,” said Aba Bentil Andam, NRA Board Chairperson. “The mission has provided the NRA with a clear understanding of the state of its regulatory infrastructure with reference to the IAEA Safety Standards. The results of the mission will be helpful to the NRA in its quest to improve the nuclear and radiation safety infrastructure to adequately ensure the protection of people and the environment.” The final mission report will be provided to the Government of Ghana in about three months.

“I am confident that the recommendations and suggestions by the IRRS review mission will be implemented by Ghana to strengthen their national regulatory framework for safety, and they intend to invite the IAEA for a follow-up mission within the next few years.” said Hildegarde Vandenhove, Director of the IAEA Division of Radiation, Transport and Waste Safety.

IAEA Safety Standards

The IAEA Safety Standards provide a robust framework of fundamental principles, requirements and guidance to ensure safety. They reflect an international consensus and serve as a global reference for protecting people and the environment from the harmful effects of ionizing radiation.

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What is Soil Erosion? How Can Nuclear Techniques Help to Identify and Mitigate it?

Source: International Atomic Energy Agency – IAEA

Although soil erosion is a natural process and it occurs on all continents, human activities have greatly accelerated it. In general, soil erosion is more common on steep, sloping land. It is often caused by natural factors, including strong wind or heavy rains; however, unsustainable human activity, such as deforestation or improper land management, can accelerate this process by two to three orders of magnitude.

Soil erosion makes land vulnerable to the loss of fertile topsoil and this, together with the losses of associated nutrients and chemicals, is a threat to agricultural production, food security and the environment, mainly water resources. Soil is the source of as much as 95 percent of all agricultural production, so its health and availability impact the quality and quantity of our food. Approximately a quarter of the world’s population directly depends on food produced on degraded land, and every year the rate of degradation is increasing, leading to the annual loss of millions of hectares of land worldwide.

Eroded soil also affects water quality and aquatic life, since soil can be transported by runoff to water courses, such as rivers and lakes, clogging water reservoirs and causing the nutrients washed from the fields to accumulate in water and lead to algae outbreaks. This jeopardizes water quality and harms the habitats of aquatic life. In addition, even in larger reservoirs, such as oceans and seas, sediments may accumulate in large enough quantities to increase turbidity and reduce visibility in nearby waters, further threatening the sustainability of aquatic ecosystems and often leading to die-offs among the flora.

Other consequences of soil erosion include degradation of ecosystem functions, amplified risks of landslides and floods, significant losses in biodiversity, damage to urban infrastructure and, in severe cases, displacement of human populations.

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IAEA Profile: Harnessing Technology to Build Connections and Protect Data

Source: International Atomic Energy Agency – IAEA

Zvirawa was introduced to the world of information security when she moved to a software company specializing in security solutions. Her role involved working with large companies where cyber security attacks could have significant financial implications, and she was able to hone her problem solving and communication skills. “That’s where I fell in love with cyber security,” she says.

A significant turning point in Zvirawa’s career was when she joined the United Nations Population Fund (UNFPA) in New York as an infrastructure security analyst. This position allowed her to combine her expertise in computer networking with her passion for information security, and she found it exciting to work in such an international environment. “Working with over 60 countries at UNFPA opened my eyes to how IT policies and regulations vary around the world,” she says. “You have to be creative, especially when facing challenges like dealing with embargoed countries or restricted access to software in some jurisdictions.” During this time, Zvirawa also completed a Master of Science degree in information security and assurance, which was supported and partly funded by her employer.

In 2018, Zvirawa joined the IAEA as an IT security engineer. In this role, she focused on detecting and analysing cyber security threats and led several cyber security initiatives to strengthen the security of the Agency’s data and systems. “The global growth in access to technology is a double-edged sword,” she explains. “While it opens up incredible opportunities, it also increases risks, which makes security a top priority.”

Zvirawa’s next position at the IAEA was as an information security officer, where her focus shifted from the operational aspects of information security to governance, risk management and compliance. One of her notable achievements in this role was coordinating the organization’s efforts to obtain ISO certification in information security, ensuring it meets international industry standards.

In her current role, Zvirawa oversees how the IAEA controls access to its digital data and systems by managing user identities. “As an Agency, robust digital identity and access management are crucial for building trust, as poorly managed identities can lead to data breaches and privacy issues,” she explains. “We need to ensure the right people have access to the right resources for the right reasons.” Reflecting on her transition to this role, Zvirawa notes, “One of the advantages of working in IT is that it’s so dynamic. It’s always changing, and this keeps the work exciting and full of opportunities to keep growing.”

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Bolivia to Strengthen Cancer Control Systems Based on Review Mission Recommendations

Source: International Atomic Energy Agency – IAEA

The team visited many different hospitals as part of the mission, here at the Hospital de Clinicas in La Paz. (Photo: G. Saporiti/IAEA) 

Bolivia has taken a critical step towards strengthening its cancer control system by hosting an imPACT Review mission led by the IAEA, the World Health Organization (WHO), and the International Agency for Research on Cancer (IARC). Over the course of ten days in August, national and international experts conducted a thorough evaluation of Bolivia’s cancer care infrastructure, from prevention to diagnosis to treatment to palliative care, focusing on current gaps and areas for development.

Bolivia’s increasing cancer burden – in particular for cervical cancer, for which Bolivia has one of the highest incidence rates in the region (22 per cent of all female cancer cases), but also for prostate and breast cancers (25 per cent of male and 17 per cent of female cases respectively) – underscored the urgency of the mission (Globocan 2022). Despite efforts to decentralize cancer services and enhance cooperation among health subsystems, infrastructure and human resources remain concentrated in the country’s main cities (La Paz, Santa Cruz and Cochabamba). This centralization restricts access to cancer services, presenting ongoing challenges to achieving equitable care nationwide.

Cervical cancer was a central focus of the review due to its high incidence in Bolivia. While the government has made significant progress in expanding human papillomavirus (HPV) vaccination and screening programmes, which protect against cervical cancer, the imPACT team urged further expansion of high-accuracy HPV testing and increased awareness and access to the vaccination in underserved areas. The integration of cervical cancer screening with other cancer control efforts was recommended to enhance coordination and improve patient outcomes.

“Addressing cervical cancer must remain a national priority given the high incidence in Bolivia,” said Vice Minister Mariana Ramírez in her remarks at the end of the mission. “Expanding access to early screening and HPV vaccination is essential for saving lives,” she added.

For all cancer types, major efforts have been made to purchase the technology needed to ensure the quality and timeliness of diagnosis and treatment services across the country, but the distribution of infrastructure, technology and human resources in the public cancer care system remains uneven.  Patients face long delays, extended waiting lists and may be forced to travel to the capital to receive adequate diagnosis and treatment. A key recommendation of the imPACT Review was therefore to establish agreements between health subsystems to optimize the use of diagnostic tools and medical equipment. Investments in radiotherapy and nuclear medicine were also deemed critical, as many cancer patients lack access to essential treatment options. Ensuring regular maintenance and the modernization of equipment was recommended to help the country maintain high-quality care standards.

“Improving the efficiency and capacity of Bolivia’s diagnostic and treatment systems is not only urgent but feasible,” said Ramírez. “By maximizing the use of available resources and investing in the necessary equipment, we can significantly reduce the burden of cancer in the country.”