VZCZCXYZ0000
PP RUEHWEB

DE RUEHUNV #0367/01 2151204
ZNR UUUUU ZZH
P 031204Z AUG 09
FM USMISSION UNVIE VIENNA
TO RUEHC/SECSTATE WASHDC PRIORITY 9905
INFO RUEHII/VIENNA IAEA POSTS COLLECTIVE PRIORITY
RUEHGV/USMISSION GENEVA PRIORITY 0902
RHMCSUU/DEPT OF ENERGY WASHINGTON DC PRIORITY
RUEANFA/NRC WASHDC PRIORITY
RUEAUSA/DEPT OF HHS WASHDC PRIORITY

UNCLAS UNVIE VIENNA 000367 
 
SIPDIS 
 
STATE FOR ISN/MNSA, IO/T, ISN/NESS 
STATE PLEASE PASS USAID 
GENEVA FOR WHO 
 
E.O. 12958: N/A 
TAGS: AORC KNNP IAEA ENRG TRGY EAID EAGR
SUBJECT: IAEA/NA: UPDATE ON HUMAN HEALTH PROGRAM 
 
------- 
SUMMARY 
------- 
 
¶1. (U) The IAEA's human health program seeks to enhance the 
capabilities of Member States for prevention, diagnosis and 
treatment of health problems.   The basis for these activities is 
Article II of the IAEA Statute.  It calls on the Agency to 
"accelerate and enlarge the contribution of atomic energy to 
health."  The mandate is carried out by the Division of Human 
Health, in the Nuclear Sciences and Application Section.  The 
Division has four offices which focus on: nuclear medicine; applied 
radiation biology and radiotherapy; dosimetry and medical radiation 
physics; and nutritional and health-related environmental studies. 
The Agency's activities in nuclear medicine are designed to help 
Member States address major health issues.  The Agency also focuses 
on education and training, with emphasis on the developing world. 
Recent initiatives include the launch of a distance-learning course 
for radiation oncologists, therapy technologists, medical physicists 
and radiation biologists and a partnership between the Agency and 
the European Society for Therapeutic Radiology and Oncology to 
conduct training on best practices in radiation oncology. 
 
-------- 
PROGRAMS 
-------- 
 
¶2.  (U)  The Applied Radiation Biology and Radiotherapy (ARBR) 
program targets both palliative and curative radiotherapy as well as 
the use of advanced techniques.   The section's work includes both 
Coordinated Research Projects (CRPs) and Technical Cooperation (TC) 
projects.  The TC component of the ARBR program is focused on 
training and educational resources for radiation therapy 
technologists and radiotherapy nurses.  ARBR also provides technical 
support to the Program of Action on Cancer Therapy (PACT). 
According to the 2008 Annual Report, the Agency has made significant 
progress in building up the PACT Model Demonstration Sites (PMDSs) 
in six countries.  The program also updates a database, the 
Directory of Radiotherapy Centers (DIRAC), on worldwide centers and 
equipment availability. 
 
¶3.  (U)   The Division of Human Health also has a program in 
dosimetry and medical radiation physics.  The section is responsible 
for ensuring safety and quality in radiation medicine.  Together 
with the WHO, the Agency provides dosimetry auditing services for 
medical centers.  The Agency's standards have been used to calibrate 
20 national standards from Member States.  These national standards 
are in turn used by national dosimetry labs to calibrate 
instruments. The section also develops codes of practice and 
guidelines for radiation measurements. 
 
¶4.  (U) The Nutritional and Health-Related Environmental Studies 
(NAHRES) program is part of the UN's Millennium Development Goals 
(MDGs) strategy.  Its focus is the application of nuclear and 
isotopic techniques to nutrition and dietary contaminants.  These 
techniques are used to establish guidelines on nutrients intake and 
to measure body composition, energy expenditure and breast milk 
intake.  The techniques are also used in the diagnosis of 
osteoporosis and Helicobater pyroli infection.  One of the projects 
carried out by the section involves a tracer dilution technique that 
estimates the body's retention levels of Vitamin A.  The section 
also studies non-radioactive environmental pollutants that may 
impact human health and tries to identify solutions to these 
problems.   NAHRES also partners with the Agency's Division of 
Nuclear Safety to undertake global, regional and local radionuclide 
measurements, radioactivity monitoring campaigns and research 
projects. 
 
-------------------------- 
INTERNATIONAL PARTNERSHIPS 
-------------------------- 
 
¶5.  (U)  The Agency frequently partners with the World Health 
Organization (WHO) to carry put projects related to human health in 
all four areas of the Division's mandate.  Last year, the two 
organizations validated a new chapter on radiopharmaceuticals in the 
professional text "International Pharmacopoeia."  The PACT project 
also relies on the support of the WHO, with a recently established 
Joint Program on Cancer Control.  PACT also concluded arrangements 
with other organizations, including the International Agency for 
Research on Cancer (IARC) and the Program for Appropriate Technology 
in Health (PATH).  Last year, the OPEC Fund for International 
Development and the Arab Bank for Economic Development in Africa 
granted the Agency loans totaling $13.5 million for cancer-related 
projects in Ghana.  The IAEA and the WHO also created a 
 
thermo-luminescent dosimeter (TLD) postal dose audit service to help 
hospitals verify the output of their radiation sources.   There has 
also been significant collaboration in nutrition-related projects. 
Together with other international and national agencies, including 
the U.S. National Institutes of Health (NIH), the two organizations 
have sponsored meetings on nutrition issues, including HIV/AIDS. 
The Agency also conducted research on biofortification for improving 
micronutrient nutrition for infants and children.  This project was 
done in collaboration with HarvestPlus.  The Agency also supported 
the International Malnutrition Task Force (IMTF), which includes the 
International Pediatric association, the International Union of 
Nutritional scientists, UNICEF and WHO. 
 
---------------- 
USG PARTNERSHIPS 
---------------- 
 
¶6.  (U) In addition to its partnership with the NIH, the Agency has 
benefitted from other USG agencies and professional organizations in 
carrying out its human health mandate.  The U.S. National Cancer 
Institute (NCI) granted the Agency in-kind support to train 
professionals from developing countries in cancer prevention. 
Argonne National Laboratory continues to host training courses in 
quality assurance procedures in radiotherapy.  Likewise, the 
American Association of Physicists provided training to medical 
physicists in dosimetry technology.  USAID was one of the partners 
in the Vitamin A Tracer Task Force that was hosted by the NAHRES 
section. 
 
------------------------------------ 
DISAGREEMENT OVER "SMART PROTECTION" 
------------------------------------ 
 
¶7.  (U)  Elsewhere in the Agency, the Division of Nuclear Safety 
(NS) is involved in health-related issues, specifically the 
development of an electronic medical card that would measure and 
record amounts of radioactive dose patients receive as a result of 
medical procedures.  The so-called "Smart Card" was a proposal of 
UNSCEAR, a non-political group.  It responds to a concern from NS, 
based on reports from various sources, that patients might be 
getting more radiation  dose from medical procedures than is 
necessary  The Smart Card would track how much dose a patient 
receives.  Each time the patient receives a dose, the amount is 
subtracted from a recommended upper limit or is added up so that it 
tracks a patient's total dose.  The doctor could see this 
information, along with data related to previous medical procedures 
and where they were undertaken, which could be used to inform 
further medical procedures.  If a doctor can see the results of a 
recent computed tomography (CT) scan performed in another hospital, 
he may not need to perform the same scan, thereby saving the 
patients a large radiation dose. 
 
¶8.  (U)  The Smart Card would function as a database of medical 
procedures the patient's doctor, regardless of the country, would be 
able to access.  The concept is similar to the electronic medical 
record (EMR) program being discussed as part of the Administration's 
health care overhaul.  Some doctors would prefer that the Smart Card 
program followed the procedure-based approach rather than the 
dose-based approach. 
 
¶9.  (U)  Although there is no official USG position or unified 
reaction from the U.S. medical community, some doctors have 
expressed concern that the program might negatively impact the use 
of radiation techniques for medical purposes.  Even though any 
'maximum' limit on the card would be an indicative limit, some 
believe it may lead patients to believe that any procedure that 
exceeds the limit will be detrimental to their health, which may not 
be the case.  Some doctors are worried that patients may turn down 
ultimately life saving procedures for fear of exceeding their 
"maximum" lifetime dosage.  They point out that a 'healthy dose 
maximum' is a calculation of ranges, not exact numbers, and that 
many factors, e.g. weight, size and which part of the body was 
exposed, influence those ranges, so it would be very difficult to 
calculate a "healthy dose maximum".  There is also concern that no 
medical doctors were involved in UNSCEAR's discussions or the Smart 
Protection program. 
 
¶10.  (U)  The Nuclear Regulatory Commission's Advisory Committee on 
Medical Issues of Isotopes (ACMUI) has been asked to study the 
program and try to arrive to a consensus U.S. position with members 
of the medical community. 
 
PYATT