IAEA’s DIRAC Database Reveals Urgent Need for Global Action on Radiotherapy Access

The database has provided vital insights to inform international efforts aimed at achieving equitable cancer care, particularly in low-income regions.

The International Atomic Energy Agency’s (IAEA) Directory of Radiotherapy Centres (DIRAC) has played a pivotal role in identifying and addressing global disparities in radiotherapy access, as highlighted in the recently published Lancet Oncology Commission on Radiotherapy and Theranostics. The database has provided vital insights to inform international efforts aimed at achieving equitable cancer care, particularly in low-income regions.

Since its inception in 1959, DIRAC has served as an international inventory of radiotherapy centers and equipment. Transitioning from print to a digital registry in 1995, the directory now includes extensive data on radiotherapy technologies such as proton and light-ion centers, teletherapy machines, brachytherapy equipment, and more. With contributions from external sources and ongoing updates by the IAEA, DIRAC is the world’s most comprehensive radiotherapy database.

Critical Insights for Cancer Care

DIRAC’s data underpinned the Lancet Commission’s findings, which revealed stark disparities in radiotherapy access. On average, one teletherapy machine serves 130,000 people in high-income countries, while in low-income nations, the figure escalates to 15.6 million. To meet the international target of one radiotherapy machine for every 500 cancer patients, low-income countries require more than an eightfold increase in their current capacity.

As of 2020, only 28 of Africa's 54 countries had any radiotherapy infrastructure, underscoring the urgent need for investment and innovative solutions to expand access. DIRAC data also informed the World Intellectual Property Organization’s (WIPO) Global Innovation Index (GII) 2024, revealing a 2.7% increase in global radiotherapy equipment from 2022 to 2023.

Promoting Innovation and Accessibility

WIPO’s collaboration with DIRAC has led to the development of two novel indicators for tracking global adoption and accessibility of radiotherapy equipment. In 2022, only 20.9% of countries met the minimum resource requirements for radiotherapy, highlighting a growing gap between cancer cases requiring treatment and available technology.

Sacha Wunsch-Vincent, co-editor of the GII, emphasized DIRAC’s role in measuring technology adoption: “DIRAC’s data allows us to analyze how innovations improve productivity and enhance everyday lives, especially in critical health sectors like cancer care.”

Looking Ahead: Strengthening Global Collaboration

The IAEA has called for continued international collaboration to harness DIRAC’s potential as a catalyst for advancing global health equity. May Abdel-Wahab, Director of the IAEA’s Division of Human Health, noted that DIRAC enables targeted strategies for accelerating access to radiotherapy through resource optimization and innovative approaches.

Additionally, the database supports academic research, health infrastructure planning, and policy advocacy. With cancer cases projected to reach 32.6 million annually by 2045, DIRAC’s contributions to evidence-based decision-making will remain indispensable.

Expanding the Reach of Radiotherapy

To further address global inequities, the IAEA is advocating for partnerships to enhance DIRAC’s scope and functionality. Policymakers, researchers, and other stakeholders can support these efforts by contacting the IAEA directly at dirac@iaea.org.

DIRAC’s legacy underscores the transformative power of data in tackling complex global health challenges. By driving investments and innovation in radiotherapy infrastructure, the IAEA aims to ensure that lifesaving cancer treatments reach the underserved populations that need them the most.