Scientific Forum 2026 - Closing Session

Good morning everybody. May I ask you all to please take your seats so we can open our closing session if I can put it that way. Well, um this is closing uh the session at the our closing session here at the scientific forum and we want to use this moment to look forward. Um over the last day and a half everyone we have heard about the progress that we've made in cancer care. We've talked about the challenges that remain uh the role of innovation, sustainable capacity building um as well as partnerships uh the roles that these um elements play in expanding access to both diagnosis and treatment. And we want to now take a moment with the distinguished speakers that I have up front here with me to reflect on the achievements, the lessons learned uh particularly under the rays of hope and most importantly DDG I guess we want to look forward at what comes what comes next. So we will consider how strategic partnerships can be strengthened, how innovative financing and domestic resources can be mobilized, how governments and international organizations, development partners, academia and the private sector industry is also a very important stakeholder here. Working together can make uh sustainable cancer care accessible to more people. So I'm going to invite each of my uh panelists to deliver a statement which they'll do from their seat and then we will continue with the discussion. If you would like to at some point I will open up uh for questions from the floor. I will begin uh with introducing with my very great pleasure uh Miss Nadmar who is the IAEA's deputy director general uh particularly the department of nuclear science and applications. She will deliver her first statement. So over to you DDG. Thank you. >> Thank you. I think we can say it's still good morning, right? >> Yes. Still morning. >> So, um I think um I'm just looking at back LA yesterday and and this morning and and I still have in my mind this woman from Malawi. >> Yes. >> Who went back to work after radiotherapy treatment? >> And she's happy and she could serve she could do her job and she could serve her family. And we have hundreds thousands women like this that now women and men actually that we have succeeded to to give them better life through all of us through raise of hope right so we should be proud of that um since 20 since the start of the raise of hope but just yesterday again I met a delegation from another country when they were telling me we still don't have any uh radiotherapy treatment in our country. So then again that it's unacceptable and we should the work we are not done yet. >> So we should be proud what we about what we have accomplished but we should keep in mind that we still have a long road ahead that we need to succeed to give access to cancer care to each and everyone >> because it's human right. it's we cannot accept that a country does not have uh diagnosis equipment and radi radi radiation treatment to the to their people. So that's the first thing and I think I is committed to do so and I think each one of us here we are committed to do so that's very important that still we still have a long long way to go not we are not done the second is we saw that we are not only providing this equipment >> to the to the member states but and to the hospital and institutions but we are also trying to make them to efficiently used. So efficiency in the use through innovation through through also uh efficiency in education you heard about uh virtual reality uh training. So many countries they cannot travel many health professionals they cannot travel to abroad. So it's very important to be able to provide them access to this to this training and and through our anchor center through the team here uh through scientists around the world we are helping member state to have access to this training also when the country has one or two linear accelerator we need to look at how we can give access to as many as we can in term of patients and while keeping the quality of treatment and and safe and secure your treatment and so this is also efficiency and we need to do much much more in that technology does not stop we continue having new technologies developing we have AI now so uh I think innovation we need to continue doing that the second we should not forget people because you buy machine you cannot use this properly there is no use so you're just wasting your time and your money so investing in people we must continue doing that we must continue doing training capacity building all of us uh I mentioned virtual reality training uh uh online education and again we I we are committed through our anchor center uh may we mentioned this morning that hundreds of professionals are being trained through our anchor centers thousands of prof 800 recently I've heard we should continue doing that we need thousands we are not done in that too and and my last point and and the most important is financing we cannot do this for free obviously and and and we need financing. We cannot just uh you know cancer care is expensive. >> Yeah. >> And and we need uh innovative financing. We need uh blended financing by being in in kind being countries committed to share uh as agency we do our part and other financial institutions. I just had the pleasure to meet a private sector this morning. They told me we are giving uh softwares that cost 600,000s to countries to be to make sure that the treatment quality control of treatment very important. So uh I I thank everyone and everyone here in this room and and those that they are not here but they are either listening us but also working with us for the the support they are giving us to give our people better life. So uh I think this is something that uh myself I'm I'm very proud that I'm part of this big project and and I think each one here in this room we are we are very proud and to think about is not we are talking not about one person that we are living a better life but to community and to next generations. So let's keep going. >> Yeah. Thank you very much DDG Mockto. That video was really touching yesterday, the story of Edith in in Malawi. But could you just take a moment also and share with us um what the IAEA's vision for the future of cancer care is? >> I think I um we will we're not stopping here. This is not the end of it. >> We our aim and DG has said this yesterday. Our aim is no no one left behind. as far as cancer care is concerned. So this is very important but of course obviously we cannot do it alone. We need we need everybody. So we need partnership and most important more importantly is the country engagement. Countries should come to us with their plans with their what they want to achieve and we will be this is partnership. This is not agencies project. This is a global project and we need to be working together with the with countries with the partners with the education institutions with the private sector. So the agency vision we are continuing this is not the end of of it. This is a major project of the of global project not only an agency project but member state all of us we are in that boat. So let's continue working together for uh for the better health for the people. >> Thank you DDG. Um I now have the pleasure of inviting Mr. Sha Jenkinson to make give his uh short remarks. He's the uh chief executive officer of the Australian Nuclear Science and Technology Organization and Stowe I believe it is. Over to you Mr. Jenson. >> Thanks Christine and good morning everybody and um DG M thank you for those opening remarks. Um you obviously touch on a number of points that are important to all of us. Um um as introduced I'm the CEO of ANSTA, the Australian Nuclear Science and Technology Organization and at the conference this year we have had a side event celebrating the 20th anniversary of the operation of the Opal Reactor. While we're talking about looking forward, I think you know what we've done recently is reflect on the impact that having such wonderful infrastructure as the Opal reactor has delivered to Australia and also to many other countries through the benefit of producing malibdum as many of you will know the most widely used diagnostic um in nuclear medicine. And so the ability to manufacture and distribute a product like Malibum that aids and supports in the diagnosing and staging of cancers and that allows the clinicians globally to help to treat those cancers whether it be targeted therapy treatment or through radiation treatment is critically important and I you know the comments made about making this more accessible to people really hit home. I think we're very fortunate in Australia to have wide access across our public health service and um having been to a number of events where people have actually come up and spoken to me directly because the benefits of the products we make have impacted their lives and their family lives at such a vulnerable time and people have actually personally thanked the team at Ansto for enabling them to have more time with their families at a very difficult time of their life. We need to make that available to everybody. It's not just about what we can do in Australia. It's what can we do for the broader community. So the opal reactor at 20 years is on the start of a journey and we need to make sure the products out of that provide access to everybody globally. In addition to that, having something like Opal enables us to think about the end-to-end responsibilities we have as an organization to then manage the waste coming out of the reactor >> and so that we can safely take that waste from nuclear medicine production and lock it away. And we have a technology called synrock we're developing so that one feeds the other. And then beyond that, we think about the talented people at Ansto and the work they're now doing on newer alternate therapies to support health care. So our scientists and clinicians are working on research that is looking at neutron enhanced proton therapy capture. So uh taking these current therapies we have and taking them forward to make them more effective. And once again, while we're making those effective in some countries, we have to make sure that existing therapies become broadly available globally and then that these newer therapies become the standard of care and again there's access from everybody. the work also that we're doing at our synretatron light source facility around detecting difficult to detect breast cancers. We're delighted to announce we've just been given regulatory approval to put humans into the beam of our um imaging and medical beam line at the synretron which is a a big regulatory process but very important as we move forward so that we can get a new technique that will help detect difficult to detect breast cancers in dense tissue. And again the idea of this now is to then say how does that technology move from a big synretatron into a more tabletopsized capability that we can take globally and improve diagnosis and early diagnosis for this disease globally. So at Ansto it's about celebrating what we've done so far and improving access but more importantly it's about how do we ensure that access gets out broadly globally and makes equitable access around the world. So hopefully that gives you an insight into what we're doing at Anstone. Thank you. >> Thank you, Mr. Jenkinson. Um just on the aspect of um waste management, um this is obviously a very important aspect to be able to maintain the social license of operating a um nuclear facility. So can synrock technology be used to treat waste from other nuclear medicine production? >> Yeah, thanks for the question. I mean the social license is critically important to everything we do in nuclear science and technology and with a technology like synrock that can be used for nuclear medicines and other nuclear medicines and also for maybe the emerging ways from new small modular reactors. This helps us to develop a social license as an industry so that we can confidently talk about how we safely confidently manage the waste from our operations in a way that gives the public confidence. We have a very good and strong regulatory environment in Australia and again that's about building public confidence. So when you bring those two things together and you also talk about the broader capability of nuclear science and technology and how it benefits the health of people around the world then that's really building social license for nuclear. >> Thank you Mr. Jenkinson. And now invite Miss Mary Gosparovich Evans uh to give her uh short remarks. She is professor of radiation oncology at Princess Margaret's Cancer Center at the University Health Network. Over to you. Thank you. First of all, congratulations to the uh program committee. It's so important to talk about the future. Um actually Mary Cury is known for her saying is that one never notices what has been done. One only sees what remains to be done. And our expectations in cancer have changed has shifted. When I started practicing it was all about survival and not dying. Our expectations are now much more ambitious. We want to cure patients. We want patients to live longer and live better. And in addition, we want the world to have fewer cancers and do it in a very equitable way. So there's very high call order. I'd like to address three topics. One is the opportunities offered by advances in science and technology. Cancer is complicated and cancer science continues to evolve. It was all about stem cells. But once we decided or discovered that when we eradicate stem cells the stemness can be acquired by non- stem cells there was a focus on micro environment in cancer that led to the attention to the metabolism and now we're talking about the dialogue metabolic dialogue between tumor and the host. So the science of cancer continues to evolve and I don't have to um tell this audience about the tremendous advances in technology that offered new opportunities with um increase in computing power AI. A lot's been said about it. The advances and potential for advances in radiotherapy were very much uh very well summarized by professor richer in the previous sessions talking about the dose rate effect that needs to be investigated in the cancer. We used to uh think that that doesn't matter anymore but with advent and investigation or flash radiotherapy the dose effect is hu huge. the special fractionation uh fractionated radiotherapy that looks at nonuniform dose distribution. It used to be said that one of the benefits of radiotherapy is very um very well uh standardized uniform dose distribution. But we now need to explore and challenge that dogma. Particle radiotherapy offers the new um opportunities for control but we need to move beyond the protons and the implementation of new technologies and investigations of better particles uh are ongoing and finally we need to integrate external beam radiotherapy which is most what radiotherapy in the world is done to with radiotherapy that people are talking about that offers new opportunities. So it is very important to build the capacity for research together with building the capacity for uh treatment and I think that the race of hope program which is very visionary program that expands radiotherapy and talks about expanding radiotherapy in the context of cancer treatment needs to also include education and research as part and parcel of the new uh facility. ities. The second um topic that I'd like to say a few words about is the future of multimodality approaches in cancer treatment. Most cancer patients right now uh require multimodality approach and the previous previously we had this dichotomy the treatment was either curative or paliotative and there was nothing in between. This is no longer true. We can cure patients with recurrent cancers. We can also uh have patients live for many many years without being cured and live a very good quality of life. So the advances in immune checkpoint inhibition, CARTT cells, mRNA, mRNA vaccines, the whole diagnostics of liquid biopsies and multicancer early detection test that needs to be investigated and um there's a huge opportunity to re reassess the role of radiotherapy uh in the context of these new therapies. um the areas of radiotherapy that was per they were previously not used at all such as treatment for metatastasis bridging radiotherapy in with cartis cell therapy are all f uh very fertile areas for investigation and the last but probably um the biggest area which I think needs attention in the future is the whole concept of systems approach to cancer control. We need to move beyond best buys. Best buys and priorities are important. But if we talking about um care for all and meeting the requirements for all the patients with all cancers, then we need a a systems approach. and the race of hope. The program that is focused on uh bringing radiotherapy in technology but in the context of comprehensive cancer approach is actually an excellent example of how to move forward. Uh and I think I can possibly add a little more about systems approach cancer control in the discussion maybe. >> Yeah, perhaps um but for the moment thank you very much miss Kospodarovich. Could you maybe just uh say one or two words about how the benefits of radiotherapy will be expanded in the future. >> I think that uh radiotherapy has always been thought of being very expensive and very complicated. But we have done research before and it's been mentioned here before that it's a very cost-effective treatment. That upfront investment in the infrastructure of radiotherapy pays off for many many years. And um fortunately with our partnership with industry, the equipment is getting better, simpler, simpler to use, training will be easier. And I think that the future access to radiotherapy will be um probably maybe not as simple as the iPad that my granddaughter can operate at the age of five, but uh certainly much less complicated than it is today. >> Thank you very much for that. It's my pleasure now to invite Miss Hedveig Hiashki. She's the chair emmeritus of the department of radiology at Memorial Sloan Ketering Cancer Center. Over to you, professor. >> Thank you very much. Um, so I too want to say thank you to the organ congratulation and thank you to the organizing committee. Uh the two days have been both informative and inspiring and also thank you for inviting me. Uh talking about imaging um yesterday there were so many wonderful speakers saying that what you cannot see you cannot treat. And so imaging is really today your eyes and the GPS to cancer care. In the last 40 years, imaging has tremendously evolved and today nobody questions that imaging is essential to cancer care. But looking forward, the next 20 years are going to be with so many so many advances and advance healthc care will reform and imaging will have a number of advances that will create a totally new landscape. One of the advances that's emerging is really the entrance of quantum computing into imaging technology. We already have today the sensors and the detectors that are making a huge difference. Some of them have transitioned from laboratory to clinic. But we are also developing using quantum technology and quantum enable reconstruction. We are developing a platforms where you will have CT, MRI and PET all in one unit on one platform and it will offer advances in imaging, seeing anatomy, function, metabolism at a much much higher spatial resolution. It isn't far-fetched. They are already startup companies. They predict being enthusiastic five years from now, I think 10 years from now, we will start a human studies. what this will allow and one thing as we deployed those new quantum CT PET CT and MRI machines we really need to put equity at the beginning so we don't find ourselves like we are finding ourselves now a tremendous difference between low and higher income countries equity has to be our blueprint from the day one. Second is molecular imaging and terronostics. We heard a lot about molecular imaging, teranostics. It is becoming a staple of precision oncology and it is getting more widely available. And one thing we should say thank you to IAA for re for their efforts in disseminating nuclear technology globally. The third one the third one of course is AI. We talked so much about AI. uh it has challenges, it has problems but AI in imaging is embedded in the equipment and already today modern CTS for example AI directs the entire workflow it's from image acquisition the radiation dose reduction motion correction and Even latest is in a in image interpretation calling for urgent results which is crucial and is widely AI already embedded in the machines for screening such as breast cancer screening and other diagnosis. And then there's digital health. We already have pointof care devices, portable x-rays that not only going portable and available in the low middle inome countries but AI is embedded to give you the diagnosis such as TB. This is only the beginning. Ultrasound health device is another point of care device that is becoming so great that you can immediately transmit the images but it can give you the basic diagnosis. So the reason we emphasize that so much the workforce shortage is tremendous. Having those embedded not overlay AI are really something that comes with the machine and the manufacturers already today if something goes wrong they actually know that before we know that and it can be fixed. And then there are medical devices. There are medical devices for imaging leading with breast. Uh there is a smart bra thermal smart bra and now from MIT is coming ultrasound breast patches that you put in your bra. So those are innovations on wearable devices that are going to be especially good for the low middle inome countries because it's all AI connected. >> So with this imaging is going to have a new landscape but we do have a problem. We have to incorp make sure that imaging is incorporated in universal health care, >> right? >> And we have to make sure that imaging is a part of the national cancer plans. >> That way we're just going to make it even stronger, better, and more usable. And lastly that was said at the very beginning and that is that buying when you want to improve imaging buying technology is not sufficient. It has to go hand in hand workforce technology and infrastructure and I do think that the future is extremely bright. Thank you. Thank you so much, professor. And also ending on that very positive note, but please hang on to your mic because I do have a follow-up um question for you. Um >> you've made it very clear how the advancements uh in in artificial intelligence are changing the delivery of imagery services, but what safeguards um are needed to ensure that AI helps to reduce rather than to worsen the global disparities? Well, um that's a question that's very dear to my heart. The reason is that at the beginning we believed that AI is going to leapfrog the AI use in the low middle inome countries is going to leapfrog the high income countries just like the landlines were scratched and low income country low resource country I like it better if you don't mind um the low resource country really jumped directly to the mobile phones. It didn't happen. Actually, today AI is widening the gap between the low and high middle inome countries and it has even a term it's called AI paradox deployment paradox. Uh and we cannot sit back and say well you know we have to do something right now because the workforce shortage is tremendous. By 2050 we will have 100 million shortage of health care workforce in oncology only. out of that 65 million are nurses and I didn't hear much talk about nursing. Nurses is nursing is really the basic we need without nursing there's no oncology care and 16 million is diagnostics. So we can talk about diagnostics >> uh in the and without AI >> you don't have diagnosis you can treat. So without AI is must and we have to find a way to employ it for the low for the low resource countries. It's not optional. >> Yeah, that's right. Thank you, Professor Richard. Um I now have the pleasure of inviting Mr. Jackson Orm. He's executive director of the Uganda Cancer Institute. >> Uh thank you very much uh Christine. >> Thank you doctor. I think I should also add my voice uh to appreciate the tremendous uh organization and in the last two days I think we have got uh very good deliveries on issues uh especially the race of hope and coming from uh subsaran Africa uh and leading one of the cancer centers that has been in existence for a very long time actually precisely 59 years. Um some of the things that uh I kind of get out of this uh conference um reflects to the importance of how we can actually uh provide continuity in as far as the services are concerned. But given that uh uh cancer is more common now in the low and middle inome countries and especially in subsaran Africa uh the issue of technology which seems to be uh emphasized may actually not be the only uh issue which needs to be addressed. Uh to me uh the issue of financing uh perhaps is the biggest obstacle uh to uh getting equitable care as well as uh good outcome in the developing countries. And we do know very well that there is increasing uh incidence, increasing prevalence as well as of course poor outcome of cancers in these in these countries. And if you ask yourself of all the uh policies that are being uh implemented in the developing countries especially uh regarding uh cancers uh the biggest obstacle to proper implementation of those policies actually is financing. Technology may be an issue but without financing the technologies cannot reach to the people where actually it should go. So that actually informs my participation in this discussion on this panel uh to emphasize a different aspect an aspect of making sure that there's understanding of the importance of provision of financing uh to the developing countries uh the low middle inome countries especially those ones in subsaharan Africa um if you look at at the demographics uh of the patients that we see uh in this part of the world uh you'll be amazed that actually the face of cancer uh in this demographic is young woman and if you ask about what are the factors that contributes uh to the biggest burden of cancer in this population you'll be amazed 42% of the cancers in this part of the world are actually caused by infections. And what does this mean? That means that actually these are cancers that can be easily prevented and probably also easily treated and with good outcome. But the barrier to this good outcome is not technology is actually financing. And that is why uh as the Uganda Cancer Institute, we are so thrilled to be here to actually uh present the need for innovative financing to add to the already existing portal of uh funds that are being uh used in the fight against cancers in this part of the world and we do think that a lot more can be done. Thank you. >> Thank you Dr. Oram. Um you you've underscored the the importance and and the urgent need really for innovative financing. Um but could you maybe just say a few words about how Uganda has stepped up um as a pilot country for this new sort of model? Tell us about that model and why Uganda stepped up. >> Uh thank thank you very much. Uh I think uh I should just start uh by saying that uh cancer in the first place requires sustained uh I would say uh financing in all aspects from prevention uh diagnosis as well as treatment and then the current uh public approach uh to budgeting kind of has a short cycle and usually uh there is competition with other aspect effects uh of uh needs uh in this part of the world. And of course uh the biggest burden uh of the financing usually is coming through uh household. That means there is the element of financial toxicity that usually improvages uh the the population and for that matter uh in as far as uh we are concerned uh our country uh is moving ahead uh to make sure that uh there is harnessing of for instance diaspora remittances uh to supplement what our governments are already doing. Of course, public funding is one thing and that can be supplemented by for instance uh funding from development partners but all these may not actually be enough in order to meet uh the need of the population and that is why actually uh we have moved uh ahead to include uh innovative financing as part of what should actually be used for supporting our cancer efforts. Thank you very much Dr. Orurim. I now have the pleasure of inviting Mr. Evans Simbur. He's head of implementation at Med Access. Um thank you for that. Um I'll take this opportunity just like um the rest of the panel to thank the organizing committee. Um I do guess this has been a wonderful time. um we've learned a lot and um I think this panel will also um um inform us more. So I work for an entity um called Med Access Guarantee Limited. We are a British organization that is owned by the British government through um the British International Investment which is the British Development Finance Institution and our mandate is to use financing tools like um guarantees, loans and other tools to improve access to healthcare. And so as uh Mr. Jackson talked about financing. This is where we actually come through. So I'll go in and start talking through you know what we are seeing in cancer care. And I'll probably first go back to you know what we've seen in the last 25 years. We've seen in the last 25 years that infectious diseases um have been well tackled through a lot of donor funding and support. What then happens is in cancer we do not have such um mechanisms. Unfortunately, this then means um a lot of procurement within cancer care are heavily fragmented. Um we do see that negotiations take place country by country or hospital by hospital or again um machine by machine which then means that you'll see a lot of variability um across countries. Um when we started paying a lot of interest in this as med access what came through was that um if you look at Africa for instance um only about 32 countries out of 54 African countries had any form of radiotherapy technology in their healthare systems and um even when those technologies were available a lot of them were not working and this is because countries seem to struggle with managing um separate um maintenance and servicing contracts. Um it's quite expensive to you know buy the instrument separately and then have these contracts on the side and um because of that then you again find that um very expensive instruments just sit unused which is quite unfair to patients. Um and so we did grapple with that challenge um of radiotherapy access. Um and what then we decided uh to work on is a market shaping tool that would then go ahead and you know tackle this problem. And to us what we wanted to attempt was um work closely with government governments across um a couple of countries provide them with um visibility to costs and also um address the incentives around um manufacturers coming back and addressing their the maintenance um situations. And so in our minds the best tool for that was um a tool we call a volume guarantee. And in essence um this tool was then going to be uh remodeled and um apply an an old inclusive procurement approach which we have called a pay-per-use model. And in a sense how that works is basically instead of government buying an instrument a standalone instrument they buy a package and this package includes the instrument itself but then also uh ongoing maintenance and service contracts and how that then works in in practice is the government just pays a very small portion of the costs up front and then um the rest of the costs are paid through a series of uh payments based on patients that actually use this instrument. struments and we believe this kind of approach will of course uh reduce the burden and especially when you're talking about financing being a challenge uh to treasuries and countries in in general but also go ahead and incentivize u manufacturers to come back and make sure that these instruments are actually working um in two countries that we are launching this um that's Kenya and Tanzania we did have to work a lot with other partners um and you mentioning here the national cancer control programs in those two countries who are quite um open to sharing information and helping us design these tools. But again closely guided by the work that IEA does with countries in developing bankable documents and um what we are seeing now is greater confidence um from the suppliers we are working with uh but also um even ourselves in underwriting some of these contracts. What I need to say for the suppliers how we are making sure that um they get comfortable is that we provide them with demand assurance that once these instruments are installed they'll be utilized otherwise these are corporate entities they need to go back to their ownership and um defend that this is actually a good decision and should there be a shortfall in demand then med access will come in and offset that um so risk that these companies are taking. Um again I want to say thank you to IEA and national cancer control programs for the you know sort of like going ahead and and you know being quite brave in trying to implement a new uh approach in u procurement. So I'll stop there. >> Yeah thank you so much for that Mr. Murat. The payer use model is a very interesting one. Could you just say a little bit more about um how scalable this is uh given your interactions with um the authorities in Kenya, Tanzania, the adoption of that, the other stakeholders and what it will take to scale that particular model. >> Thanks for that. So the thing I'll have to mention is that as much as it's quite new for uh radiotherapy, it's been used in other areas of health. So we do know for molecular uh instruments for instance when it comes to um HIV viral load for instance um this has been very successfully deployed. So what we tend to see is um you know you start with a few starter countries and over time as lessons are learned and um you know platforms like these are shared um other countries gain interest and um that is deployed. The other thing I have to mention about this is um it only succeeds if partners come together. So med access cannot work by itself. You know we have to have um entities like um IA we have to have um implementation partners for instance in in in both Kenya and Tanzania we're working with the Clinton health access initiative chai um and beyond that of course um the support from the governments themselves so ministries of health and uh treasury departments. >> Thank you Mr. Turu. Uh I now have the pleasure of inviting Miss Marie Klyber, chief executive officer of AX Healthcare. >> Thank you. Um yeah, thanks for having me uh on this very interesting panel. Um let me quickly introduce myself um who we are and what we do. So Amex is an Austrianbased uh supplier of healthcare products to to the United Nations and to other humanitarian aid and development organizations. Um we are based in Austria. We have offices in Mexico and in Kenya and um yeah we are I think we're one of the largest healthcare suppliers to the UN. Um we work uh with all the agencies that are active in healthcare and I think also since more than two decades we work with uh the IAA um and supply them with uh yeah different types of products and uh I'm very proud that uh today we also brought that one step further um because we formalized that cooperation in a practical arrangement with um rays of hope and um Yeah, why did we do that or what's the context of that? Um, we found ourselves uh in in a pretty unique situation that um as part of their support to uh developing countries, the Austrian government provides uh concessional finance uh vehicles um to a defined list of eligible countries. So that's basically a very favorable uh loan with um a long-term loan with a with a grant component and um these loans are obviously earmarked for certain project. It needs to have a a public benefit. So healthcare is a is a obviously a priority there. Um so a a public cancer center will be a textbook example um of such a of such a project and uh there is a couple of conditions which apply. Uh first of all uh the the whole project needs to be implemented by an accredited Austrian uh company. Okay, so that's how we come into this equation and um then also part of the value creation needs to be done in Austria and here we are also in a favorable situation that the world's leading uh manufacturers of uh radiotherapy and imaging we saw them also earlier on stage uh without saying any names but um they do carry out part of their value creation in Austria. So um yeah, putting all these things together, we found that this is a very unique partnership that we can work on where Rays of Hope carries out the groundwork. Um right, they um they advise countries, they help on need assessment and they support with bankable documents and all that. And then when it comes to the actual physical realization of a project meaning building something or delivering some pro some some products um then we come come in and manage that project and um yeah that hopefully in the end delivers a a workable sustainable cancer center. >> Thank you uh Miss Clber. So, as you mentioned, partnerships are central to um turning plants into functioning cancer services. And um could you maybe just describe for us um the AIX and raise of hope partnerships um partnership what the strengths of this are and what each side sort of brings that the other cannot. >> Thank you. Um so I run I I'm a second generation um family company. Um I run that together with my co-CEO who also happens to be my husband. So I I know a little bit about relationships I would say and so one one of the things I learned is that liking each other is not enough uh neither in a marriage nor in a professional relationship. So what what I appreciate is complimentary skills. So uh you can be very different. Um and I I five minutes ago in the in the break I had a chat with uh with your colleague Mark uh from the agency and I uh we we said that actually a organization and the IEA could not be more different. We are very different organizations and I think that that that's one of the things that make this this partnership very beautiful because we have completely opposite complimentary skills. Um and that's what I think what makes this very successful. So raise of hope uh prepares the ground uh works on the need assessment builds the capacity trains right we heard a lot about workforce shortage um today and these are all things that raise of hope is very very good at um and we are definitely not um and then once all this groundwork is done we can come in and we can bring a financing vehicle that works for a country and we can act as the actual project implement enter. Um, so yeah, I think these two things together, one and one, we all know, right? Ideally, it makes 11 when you put it next to each other. So, I think that's what we have there. >> Thank you, Miss Clver. H, and now I would like to invite Mr. um, Mikail Hubil. He's director general of the Uratom Supply Agency and acting deputy director general in the European Commission's Directorate General for Energy. Over to you, Mr. Hubil. >> Too many titles. Thank you very much and thanks for the opportunity to take part in this important event. Congratulations really uh for the success of these s of these of your discussions over the last two days and really for the success of the raise uh for hope partnership and I think we should call it that a partnership u of which we obviously share the values and objectives in the European Commission. Addressing cancer has been a priority for us for many decades. It started as a priority in our public health policy and a few years ago uh the European Commission made it a flagship priority across its services across the different areas of engagement through what was called the European beating cancer plan which is still our guiding uh our guiding um um objective and our guiding the guiding principles behind our work and this is how people in an energy DG get into a health discussion. Um our strength is that partnership and the contribution in all of this which we make is to really look at the supply chain and look at the side of the medical radioisotopes. So we were asked in this introduction to draw a few conclusions out of the experience and it is obviously an experience we have also with working in partnerships within our own European Union but also in partnerships globally and with international organizations and I think these key points I would raise in this first round of intervention are very similar to what was said before. I think the first is really about fragmentation. uh it is important to to integrate to work together across partners uh but also across different different agendas and one important example maybe that hasn't been raised so much because we see research often really as a success story and it is but we also have a big fragmentation on the research side and I do think that uh um the uh way we have tried to focus research in this field um through uh our new initiatives on the European radioisotope valley uh uh project which we have just launched is one important area of bringing uh really partners in industry, academia, research organizations and so on together and this is also about the public private partnerships and innovations which we have been talking about. Secondly, and I do come from the energy field. I'm sorry for that, but we need secure supply chains and we're working in the Samira action plan and this isotope valley initiative very much on an integrated approach looking at the security of supply and integrating it with ideas around innovation, quality and safety, skills and access to health care. and will take forwards this initiative really in a coordinated way because radioisotopes uh I think we're the world leading uh producer of medical isotopes uh in Europe and about 50% of what is produced in Europe goes into the global market and I think it's very very important that we have a secure supply and a modernized supply not just of the traditional isotopes we need for diagnostic but also uh what we need in terms of source materials for these innovations in nuclear medicines all the way to teranostics which have been mentioned which have been mentioned here before and that includes an important area where I think the IIA is is in a key position to help us which is the question of crossber transport of these of these issues and then of course we need sustainable resources and when I mean resources obviously I mean investment in infrastructure and so on but I also means skills and people and this has been mentioned before and this in many areas and particularly I think in the areas of health and health care is an enormous challenge for the future enormous shared challenge which we will take which we will take forward together. So the European Union through its instruments across the policy fields we represent here, health, research, energy, um supply of nuclear materials works together towards the objective of the European cancer plan. But these are the same objectives we are seeing really in rays of hope. And I think we need good coordination, good integration between these different initiatives and objectives to really achieve uh better care for patients to achieve uh a policy addressing cancer which really goes through the continuum. there was very little talk at least in our panel now about the start of it which is about prevention uh that we talked about preventable diseases very cost-effective activity all the way to research and I think there's a lot of potential really in taking this joint work forward thank you >> thank you Mr. Hugal um you mentioned uh this recently adopted the um European radioisotops valley initiative. Could you just say a little bit more about it um and how it will benefit patients in the European Union but also globally? >> Well the initiative as I said it is part of this overall cancer plan. It works under five big pillars. research and development as I mentioned uh bringing in innovations to the market so into deployment uh investments in production facilities as I said and in industrial infrastructure it we look at market monitoring and forecasting and we look at strategic international port partnerships to take work forward we will also look at regulatory aspects uh which is an important area when we do speakers about supply chains involving the nuclear field. So, uh it's across the board. I think it will uh hopefully create a more stable international supply situation which will foster and support the new therapies and in conjunction with the work we do in other parts of the cancer plan which is about international partnerships about investment in sustainable health care systems uh globally and investment in cancer also as part of our international partnerships. It will bring uh a lot of tangible benefit hopefully uh not just into radiological diagnostics and nuclear medicine but really in addressing into addressing cancer and sustainable health care um within Europe and hopefully also globally. Thank you. >> Thank you Mr. Hubble. And um I now have the pleasure of inviting Mr. Maren Gole. He's senior health specialist at the European Investment Bank. >> Thank you. Thank you for invitation. Um let me um refer to the conclusions of a recently published um Lancet Oncology Commission um conclusions uh which reflect closely IB experience in uh supporting the development of uh um nuclear medicine and cancer care services both within EU and worldwide. And the fundamental lesson is that um uh the effective nuclear medicine and radiotherapy services require far more than financing specialized facilities or purchasing equipment. In fact, uh purchasing cyclotrons or gamma cameras or um radiotherapy machines may be the easiest part of of the challenge and um based on EIB experience um let us highlight two uh priorities here. First investments should be done um across entire health ecosystem. That means strategic investments in basic and advanced uh medical research in um what have been mentioned here in um education of medical professionals. But when we speak about um nuclear medicine, it means also engineers and medical physicists. Then um investments in healthcare facilities, investments in digital infrastructure and cyber security and investments in um supply chains of medical radio isotopes. In other words, uh we should not finance isolated piece of equipment but we should rather think about uh financing also uh what surrounds it. So this equipment can deliver uh effective services to the population throughout it throughout its uh life cycle. And second priority which I would like to highlight is that investment has to reach certain scale to provide meaningful uh coverage to the population and to ensure that the service is funded. uh reach certain operational and financial sustainability. And here is where uh complimentarity of um the agency which is hosting us today and um international finance institutions like EIB comes into place particularly. So the the agency uh like in the program raise of hope provides specialized expertise um establish um specialized uh units like nuclear medicine units and um IFIs international finance institutions like EIB can finance the surrounding. So the hospital in which such uh unit is located whether by modern modernizing it or by uh replacement construction or by uh extension we can finance medical faculty nearby which will provide uh qualified workforce to to this unit. We can finance digital infrastructure which will connect this unit and this hospital with its referrals enabling effective uh service provision. And let me make a final remark that uh there is a saying among medical doctors that uh science is global but medical medicine is local. Well that may be but not for nuclear medicine and radiotherapy. These are branches of medicine which are intrinsically international starting from the founder of of of this of these branches of knowledge Marius Kodoska Kiri who made international career and um today when we look at it it's the same the advanced u manufacturing capacity of uh radio pharmaceutical radio pharmaceuticals which are more and more diverse and effective is international and supply chain of medical radio isotopes is basically global. So if that is so then our response should also be international and this I believe we believe this response should be done in a triangle. the agency which is providing uh specialized expertise international finance institutions uh like EIB which are provide pro providing large scale and long-term uh financing capacity and what is and I am saying this as a practitioner uh with about two decades experience in this member states member states which uh can uh initiate our collabor collaboration which host our collaboration uh which implement uh the investments and at the end of the day which uh provide services cancer care services to the population. Thank you. >> Thank you Mr. Golk. Um I just had one question uh to follow up on that in terms of how the EIB working with other financial institutions, the IAEA and its member states um in terms of addressing the infu uh investment, the infrastructure and the workforce challenges that have been identified by the Lancet oncology commission particularly in low and middle inome countries. >> Thank you. So the the the oncology lancet oncology commission claims for innovative collaborative um investments. Um and um it has been mentioned here that also another buzz word blended and what uh after this two decades of being a medical doctor working with financial experts I I can say that innovative financing is a blended and collaborative financing and here we can do um uh exactly this that the agency may provide uh uh may identify priorities provide specialized expertise while we EIB and other IFIs we may change it into or transform it into sustainable long-term financial plans but we can do it only then if the member states or stakeholders from the member states like the institutions which were presenting in in in previous session come to us and initiate such u collaboration and then host such collaboration. Thank you. >> Thank you very much. And at this point, I'm just want to open it up to the audience to see if we have any questions. Um, do we have any questions in the room? This is your opportunity. I've seen one up front here. Any other questions? Right. We'll start with this question here. >> Okay, great. Thank you so much. And thank you to all the panelists. I'm actually while I have the mic, I'm going to ask two questions so I can spread it around. Um so my first question is is to uh Mary Gaspedarowitz about what do we need to do differently or do more of for the systems approach to cancer control and then while I have my mic on I I want to turn to um some of our the innovative partnerships and so to Evans and Marie um what have you what have you learned throughout these two days that maybe you hadn't thought of and you might be able to incorporate into future support for member states under the raise of hope initiative. >> Thanks. Thanks for the >> It should be on. >> Thanks for the question. Um cancer is very complex, very complicated. It's getting more complicated. Uh you know the number that's uh being banded around is there are two diff 200 different cancers. It's no longer true when you look at the international classification of cancers. the blue books. There are now more than 2,000 distinct cancer entities. Um, we know about a complexity of the disease. We know about complexity of patient populations. Um, cancer can occur in any population, any age, anywhere in the world, people living in very different ecosystems. There's complexity of the tools. I think we heard about technologies, new drugs, new diagnostics and everything that's coming down the path and then there's huge huge complexity of the health systems, right? So to address the complexity, you need a systems approach. You cannot just address one thing at the time because then you have like a guacamole. You eliminate one crisis only to create another crisis. And for that we all need to work together. And it's not only about cancer system, cancer control system, but it's about um uh health care systems. Uh and very frequently people think well you we need to prioritize health system strengthening that means that cancer is being left behind. No not exactly because the health system has subsystems. So there is a cancer systems within health system. Many health systems have totally separate trauma system responding to emergencies. There are other subsystems uh directed to cardiac disease to uh mental health and so on. And I think that even within the cancer system, it's not only about strengthening one aspect. If you put patient at the center and you say this patient with particular cancer, what do they need to have? What resources do we need to bring to bear to address the patients needs? Then we no longer have a competition between systemic therapy, radiotherapy, surgery, imaging, pathology. We make sure that the within the cancer system there are subsystems that are ready to provide the resources and capabilities to meet the needs of those patients and we have now focused a lot on cancer control planning, populationbased cancer control plans and the plans are getting better, more robust. There is there are initiatives showing how the planning has been taken up around the world. How the plans are getting better and more robust and I think we need to move from plans to programs because the program has a plan. The plan is being implemented. The results are being measured and then there is a corrective action to continues to to generate continuous improvement. And cancer programs are not things that sit in the Ministry of Health. They're based in the cancer organizations whether they're cancer centers or hospitals or prevention system or diagnostics clinic whatever the system is. It's based on organizations and those organizations need to have strengthened capabilities and capabilities need to be backed by a strong data supply systems. We talked about data about manufacturing resource supply chains that are known in manufacturing. We need data to make sure that the decisions we make in cancer system are based on the information that we need, the information that has right quality that is timely and the information that's used. And we can uh use counterfactual forecasting to test and model how different healthc care interventions will improve cancer control. So I think there's lots to be need to be done to move from best buys priority programs very important they shouldn't be abandoned but we need to move beyond to have the systems approach that can confront the complexity of all the systems that I talked about. Yeah, Miss Kber, Mr. Tumbu, want both of you, whichever wants to start, whoever you want to start. >> All right, sure. Um, I guess I think it's quite clear now there's more appreciation and alignment of what the global challenges or actually challenges within um especially what we had low low resource settings are. I think that's quite clear. We have that strong appreciation of those challenges. what I feel is going on is that there's now more um effort towards innovative finance to support um you know address all those challenges. What however is lacking you know coming from the various conversations that have taken place today and yesterday is um unfortunately there's no consolidated conversation on the financing side and we did see these work quite well again referring to experiences in um tackling infectious diseases where you know financing partners donors etc used to speak or you know in the previous um um couple of years used to speak together in in the same language and we didn't have parallel funding for instance. However, now I think those conversations uh do not need to take as long as it took to figure responses in the infectious disease side on the cancer area. So I think um what we need to do is you know come together as you know entities you know you know the likes of med access, EIB and others um to you know just see what gaps are we addressing and are we doing the same thing more than one entity and leaving an area unadressed. Um yeah, thank you Lisa. That was a great question. Uh what do I take home uh from what I from what I heard in the last two days? Uh one topic that was mentioned a couple of times was um having uh sufficient trained staff in the in the in the whole industry. So nurses and doctors. This was mentioned a couple of times and um I know that and for us as a as a company sustainability is extremely important, right? We don't want to create projects or deliver some products that are not used. I mean that's the worst that can happen. Uh uh our company is here since more than 45 years. So it's something that that's dear to our heart to make sure we have sustainability. Um and I I think it's it's exactly one of the topics where Rays of Hope can deliver that um that value to create the the systems and and the partnership to to educate uh people. So that's uh that's one topic that I will take for myself and make sure we focus even more on um from what I heard here. >> Thank you. I want to come back to the room otherwise I can bring it forward here. Okay. So no questions for the moment but please do raise your hand if at any point something comes up. Um, Professor Hichuk, I wanted to just ask you about the policy priorities um that you think governments should focus on in ensuring equitable and sustainable access to essential cancer images particularly in I have to be careful to say low resource countries uh as you put it. >> Please don't forget the microphone. So yeah, >> thank you. >> I think it's better to take microphone than my glasses. it works better. Uh so policy priorities uh and they were really related to imaging, right? Yes. >> Or the technology. Um so what I think with policy priorities um is imaging um is increasingly being recognized and uh I just want to give you a little anecdote. About uh 15 years ago, American College of Radiology had a public survey saying what are radiologists and the most common answer was that radiologist fix radios. I think we are beyond that and we now accept that radiologist and radiology is valuable. Uh second when we talk about radiology it isn't just physicians we have to emphasize that it's a team is everything we do it's a team effort but they are the radiation they are technologist we call them radiographers some people don't like that uh they are medical helpers they are receptionist they are medical physicists radiology will cannot function without medical physicist without computer engineers lately and without bioengineering. I'm sure you all know that cancer bioengineering is the latest effort to make cancer what you said complex uh understand that complexity allows and understand how to address that. So with all of this, what should be done with radiology? We already said it really needs to be a part of the universal health coverage. Absolutely. Uh second, it needs to be in the national cancer plans and then I must say radiology does cost money and financing sustainable financing for radiology is extremely important. Uh another part about when we already said that you buy a machine that's nothing you need to really invest in the entire health ecosystem in the infrastructure workforce technology and infrastructure are three pillars that we absolutely have to cultivate and uh so there is a lot to be done. I know that putting radiology in the national health cover, universal health coverage is a big part. No question. But we hear stories and I I was very proud of Mr. Jackson when he talked about this. It's a very innovative financial platform and I know you will put radiology in your and thank you for that. Uh so what what is it? You hear stories very often there are there is a donation and there's a pilot study and we call it that low resource countries have from pilot to failure because once the money runs out the innovations no longer happens. So that we cannot afford. Second, we cannot afford dependency. Um, sometimes we have a you have a collaboration and you become dependent on those collaborations. Collaboration should not be road to dependency. It should be road to improve your capacity. So there are really a number of things. I actually think that we are moving in the right direction. The finance is like a f innovative platform financing from diaspora is just one way of doing it and I I really think the future looks bright. Now do remember 7070% of new cancers by 2050 will be in low middle inome countries. So we really need to I like numbers but we need to take that to heart. The problem is the challenge is only going to grow and IA thank you very much for everything that you do. >> Thank you. Um perhaps you can hand over to Mr. Om next to you because I wanted to ask him about the progress that's been made so far uh in realizing the goals that have been set uh in Uganda. uh who your key global partners are um and and what specific contributions they are making. >> Uh thank you. Thank you very much. I I I I think I wanted to really reiterate the point that Sakarak made. Um it is about sustainability. you know if you do not have the finances uh to sustain any program or any project then it is as good as you know a failure. I just wanted to reiterate that. uh but uh regarding uh the innovative financing that uh we are trying to implement in Uganda, of course uh we do have uh stakeholders uh the people who we are working with and and I would say one of the biggest uh internationally is actually the global uh healthcare catalyst. Uh and uh the other one is the global financing platform that has raised up to about a million uh dollars uh within uh the next few years uh for backing up uh this this this this plan. Of course uh without the local stakeholders uh even if you have very good international uh stakeholders uh the equation of sustainability becomes just a dream. The biggest stakeholder locally must be the local government and that in our case is the government of Uganda. uh the government of Uganda uh is the biggest stakeholder because for a very long time the government of Uganda has directly been putting in budget uh for sustaining our national cancer control plan and that is something which is a bit unusual in most cases in the developing countries uh programs like cancer control are usually actually uh supported externally. So I think that is also one of the reason why our global partners when they were looking around for countries that can actually act uh as a pilot uh Uganda kind of stood out because of that. But uh uh that said uh the local uh stakeholders must also be having I would say sub stakeholders that are also very important. uh for instance uh something like the innovative financing you cannot do it in isolation of the national bank. So in our case, the Bank of Uganda actually provides the regulatory framework uh for this uh to work and this uh they also do it alongside uh with our ministry of finance and then of course ministry of uh foreign affairs uh which has done a tremendous job in mobilizing our diaspora so that they are actually part of this. uh Uganda gets up to about uh $2 million per year uh in remittances uh from our diaspora and if a fraction of this can actually go towards financing uh cancer control that would actually be a big deal. So our ministry of foreign affairs is a big stakeholder and of course ministry of finance, the ministry of health itself and the implementing agency in this case the Uganda Cancer Institute is also very important. We have systems in place. We are the ones who have developed uh the uh key performance indicators for this. We have are the one who selected the cancers that need to actually go first. And as I stated at the beginning uh cancers in women, cancers in children are priority for us. So they are going to actually be at the front of this financing. So these are the uh different stakeholders and the different uh I would say um uh items that they bring on the table in as far as the implementation of this innovative financing system is concerned. Thank you. Thank you very much. Uh Dr. Orem. Um DDG Maka, this was obviously very specific to Uganda, but can you maybe just tell us about how member states can make the most of the IAEA's innovative financing partners for expanding access to cancer care. >> Thank you. Yeah, I think um we have heard also some examples and when you want to sell a product you need good story and to have story for for in this case is good project >> and to have this good project the country engagement is is essential. So when country comes to us and uh to tell us that they have put cancer care as a priority in their health development plan, this is very important. This is the country's commitment that they work with us and with the partners in ensuring that cancer care for everyone. And then after that we need to have the the story to the donors and there we need the we need the data. We need uh uh to look at what what are the needs in term of capacity building in term of infrastructure and this we can help the country also having that plans and having a bankable document that can be um uh shared with the donors and then the next step would be to link the country stakeholders with the donors network of donors that we are having and this as we have said it's not only one donors we need mult multi- type diverse financing. So we put them in contacts with the private sector with donors, development banks, donors, institutions, uh non-traditional donors. So >> and and there is no one blank one one size for all. So each country has its own plan and own story. And we have seen uh Uganda's examples and Malawi's examples and other countries examples during these two days and and and I think again I repeat that country's engagement and commitment is very important for sustainability and we heard that also in many of my uh colleague panelists here that once the project finish it's not the end of the story we need to continue and the sustainability is the responsibility of the country and particular particularly building um this workforce um diverse workforce it needs the entire team as we have heard and also the the to cover the country you need the several infrastructure so you need and I think through rays of hope we can succeed reaching that we can succeed turning ambition into u sustainable investment uh with good uh and measurable output and it needs I always say for cancer care it needs a village but I think we are all committed to do that. Thank you. >> Thank you DDG MT. Well this is um I just want to thank everybody uh right now because we've really reached the end of the scientific forum. Um and over the course of the forum we've heard about the progress that we've made but also about the challenges that remain. And the message has come through clearly through the course of our discussions that delivering on the promise of cancer care requires more than one technology um one institution or even one initiative. But it requires sustained national commitment. We need skilled professionals. We need strong partnerships. We need innovation and we need investment. and we need to work together to ensure that um we can make progress in bringing care for cancer patients. Rays of hope um has shown what can be achieved when countries partner and partners come together around this shared purpose of delivering cancer care to all who need it. And the goal now is to take this progress and to ex to further it to scale that progress and make it sustainable which is more important. And I'd like to encourage all of you, ladies and gentlemen, to please share the story of Raise of Hope. You said you we need a good story. We've got one. Let's share uh that progress um through the materials also that have been provided. There's the bulletin and the brochure, but also to promote that opening video. Um that is such a strong example that we can share with people in our network showing the personal impact what this all >> comes down to in the end. The people on the ground. Edith, you know, when I saw Edith, I saw my mom. >> That is who Edith was to me. Um, and the impact that Rays of Hope has had in the lives of people. So, thank you everybody, to my panelists, all those who have spoken to all our speakers, our partners, and everyone who's contributed to our discussions here throughout the forum. This brings the 2026 uh scientific forum raise of hope, delivering on the promise of cancer care to a close. See you all next year and thank you so much everybody. Let's take the message out there. Thank you.