Cancer treatment has advanced rapidly, yet access to those advances remains profoundly unequal. A patient’s chances of receiving an early diagnosis, accurate imaging or effective radiotherapy often depend less on the nature of the disease than on where that patient lives.
In major urban centres, cancer care may involve advanced imaging, specialist oncology teams and precisely planned radiation treatment. In many low- and middle-income countries, patients must travel hundreds of kilometres to reach an overcrowded hospital—or discover that the required treatment is not available at all.
The International Atomic Energy Agency’s Rays of Hope initiative is attempting to narrow this divide by helping underserved countries establish and expand radiotherapy, nuclear medicine and diagnostic imaging services. Rather than delivering equipment alone, the programme combines technology, professional training, quality assurance, safety systems and international partnerships to build services that can remain operational over the long term.
Cancer Is Universal, but Survival Remains Unequal
Cancer affected approximately 20.6 million people worldwide in 2024, and the annual number of diagnoses is projected to reach 35 million by 2050. However, the burden is not distributed equally.
The World Health Organization’s Global Status Report on Cancer 2026 found that five-year survival for certain cancers exceeds 85 percent in high-income countries but falls below 45 percent in low-income countries. The report concludes that survival increasingly depends on economic circumstances and place of residence, not only on a tumour’s biological characteristics or stage.
These disparities begin before treatment. People living in rural or low-resource communities may have limited access to screening, pathology, diagnostic scans and specialists. Delays allow potentially treatable cancers to become more advanced, while travel and accommodation expenses can prevent patients from completing treatment.
Cancer therefore creates both a health crisis and a financial one. The WHO estimates that approximately half of patients and their families experience catastrophic health expenditure, including direct treatment costs, lost income, transport and caregiving expenses.
Why Radiotherapy Access Matters
Radiotherapy uses carefully controlled radiation to destroy cancer cells or prevent them from growing. It can be used independently or combined with surgery, chemotherapy, immunotherapy and other forms of treatment.
More than half of all cancer patients require radiotherapy at some point, yet access remains severely uneven. Some countries have only a few machines serving millions of people, while others still lack a public radiotherapy service entirely.
The absence of radiotherapy has particularly serious consequences for patients with breast, cervical, prostate, head and neck, lung and childhood cancers. It also affects palliative care, where radiation can reduce pain, bleeding and other symptoms in people with advanced disease.
The IAEA Rays of Hope programme gives priority to countries with no radiotherapy capacity or highly unequal access. Its projects are designed around national needs, available infrastructure and the government’s ability to maintain the service safely and sustainably.
Rays of Hope Goes Beyond Donating Machines
A radiotherapy machine cannot transform cancer outcomes if a hospital lacks trained professionals, reliable electricity, quality-control equipment, maintenance contracts or appropriate radiation-safety regulations.
For that reason, Rays of Hope combines equipment procurement with infrastructure planning, professional education, regulatory guidance and technical support. The programme helps governments assess what they need before introducing technology that may be expensive or difficult to maintain.
Medical physicists must verify that radiation doses are accurate. Radiation oncologists must design suitable treatment plans. Technologists must operate equipment safely, while engineers and maintenance teams must keep machines functioning. National regulators must also establish systems for licensing, inspection, security and radiation protection.
The IAEA has more than six decades of experience helping countries develop radiation medicine capabilities in cooperation with the WHO. Its approach treats equipment as one part of a complete clinical system rather than as a stand-alone donation.
More Than 100 Countries Have Requested Support
Since its launch in 2022, Rays of Hope has received requests from more than 100 IAEA member states. By early 2026, the initiative had mobilised more than €90 million in additional funding and procured over 90 pieces of diagnostic and treatment equipment.
The equipment included 10 linear accelerators used for radiotherapy and 55 mammography units intended to strengthen breast-cancer detection. The programme has also supported PET-CT scanners, SPECT equipment and other technologies used to diagnose disease, plan treatment and monitor how patients respond.
The initiative’s progress is visible in countries that previously lacked essential services. Malawi opened its first public radiotherapy centre at Kamuzu Central Hospital in July 2025. The facility represented a major change for patients who previously had no access to radiotherapy within the country’s public health system.
In Jordan, a PET-CT scanner installed at Al-Bashir Hospital became the first advanced nuclear-medicine diagnostic system in a public hospital. The equipment is expected to serve hundreds of patients who might otherwise have faced long delays or private treatment costs.
Earlier Diagnosis Can Change the Outcome
The fight against cancer cannot begin only after a patient reaches a radiotherapy department. Early detection remains one of the most effective ways to improve survival and reduce the intensity and cost of treatment.
Rays of Hope has therefore expanded access to mammography and other forms of medical imaging. Fifty-five mammography units are being deployed across Africa, Latin America and the Caribbean.
At Hospital Nacional Nuestra Señora de Fátima in El Salvador, a newly provided mammography unit allowed the facility to begin screening women from surrounding communities. Patients with highly suspicious findings were referred immediately for specialised evaluation, improving the connection between detection and treatment.
The broader WHO cancer programme emphasises that effective control requires prevention, screening, diagnosis, treatment and palliative care to function as a connected system. A screening programme has limited value when patients with abnormal results cannot obtain confirmation or treatment.
Anchor Centres Spread Knowledge Across Regions
Training every cancer professional through international travel would be expensive and slow. Rays of Hope addresses this challenge through a network of Anchor Centres.
These are established cancer institutions selected for their clinical capabilities, quality-management systems and experience in research and professional education. They act as regional hubs, training specialists from neighbouring countries and helping hospitals improve radiotherapy, nuclear medicine, imaging and medical physics.
The network had expanded to 20 Anchor Centres by June 2026. The newest addition, China’s CNNC Medical, joined institutions across Africa, Asia, Europe, the Middle East and Latin America.
Anchor Centres provide fellowships, technical mentorship and regional workshops. They also participate in research and help develop standardised training materials. This model allows expertise to circulate within regions instead of remaining concentrated in a small number of wealthy countries.
The IAEA Anchor Centre network is particularly important for long-term sustainability because hospitals need continued education after equipment has been installed. Cancer technology and clinical standards evolve, while trained professionals may move between institutions or countries.
Sustainable Cancer Care Requires Reliable Financing
Purchasing equipment is only the beginning of the financial commitment. Hospitals must budget for maintenance, software, replacement components, staff salaries, consumables and eventual equipment renewal.
A machine that remains unavailable for months because a hospital cannot obtain a replacement part offers little benefit to patients. Sustainable cancer investment must therefore consider the full operating life of the technology.
Rays of Hope works with governments, development banks, private companies and other funding partners to mobilise resources. In 2025, Djibouti and Uzbekistan secured financing from the Islamic Development Bank to establish or expand radiation-medicine services, while manufacturers supported training, research and equipment programmes.
The IAEA also partnered with MedAccess to explore financing approaches that could improve access to affordable, high-quality radiation services. The IAEA–MedAccess partnership reflects the recognition that many countries need structured financing rather than isolated charitable donations.
Technology Alone Cannot Eliminate the Cancer Divide
Advanced machines attract attention, but genuine progress depends on whether patients can reach and complete care.
A radiotherapy centre located only in a capital city may still be inaccessible to families living in distant provinces. Patients may abandon treatment because they cannot afford transportation, temporary accommodation, childcare or weeks away from employment.
Closing the gap therefore requires decentralised diagnostic services, patient-navigation systems, stronger referral pathways and financial protection. Governments must also invest in cancer registries so they can identify where disease is occurring, which treatments are needed and whether programmes are improving survival.
Prevention remains equally important. Tobacco control, vaccination against human papillomavirus and hepatitis B, healthier environments and effective screening can reduce future cancer cases. The WHO cancer fact sheet notes that many cancers can be treated successfully when detected early and managed effectively.
Bringing Cancer Care Closer Is the Real Measure of Progress
Rays of Hope demonstrates that nuclear science can serve a practical humanitarian purpose. Its impact is not measured only by the number of machines delivered, but by whether hospitals can operate them safely, professionals can use them effectively and patients can obtain treatment without impossible journeys or financial ruin.
The initiative has already helped establish new services, trained hundreds of oncology professionals and created a growing regional support network. Yet the projected rise to 35 million annual cancer diagnoses by 2050 means the need will continue to expand.
Modern oncology possesses the knowledge and technology to prevent many cancers, identify others earlier and treat a substantial proportion effectively. The remaining challenge is ensuring those capabilities reach communities that have historically been excluded from them.
Cancer care becomes truly successful when geography and income no longer decide who receives a timely diagnosis or life-saving treatment. Bringing that care closer to underserved patients is how scientific progress becomes a genuine ray of hope.
