Involvement of WHO in the improvement of nuclear medicine in developing countries

The World Health Organization's programme on nuclear medicine deals with the organization of nuclear medicine services, the training of personnel, the efficacy and efficiency of nuclear medicine, and quality assurance in nuclear medicine, instrumentation and radiopharmaceuticals. An analysis of the present situation in diagnostic imaging shows that new techniques and especially ultrasonography (US) may successfully compete with nuclear medicine. WHO is therefore concerned to stimulate objective evaluations of the appropriate role of each diagnostic imaging technology and to make relevant recommendations. In diagnostic nuclear medicine, the following main objectives are included in the WHO strategy: to restrict diagnostic nuclear medicine to those diseases where it cannot be substituted by other less costly and complicated methods; to decrease the cost of diagnostic procedures; and to prevent radiation hazard to patients, personnel and the public from the expanded use of radiopharmaceuticals. In the developing world this strategy may be carried out in two stages: (1) implementation of US in diagnostic services and the initiation of a comparative study of the diagnostic value of US and nuclear medicine imaging techniques in common diseases; (2) working out appropriate recommendations on a rational approach in imaging diagnostics and substitution of nuclear medicine by US in appropriate areas. The Intercomparison Study on Quality Performance of Nuclear Medicine Imaging Devices, established by WHO jointly with the International Atomic Energy Agency, and the organization of training workshops are examples of a successful approach to quality improvement in nuclear medicine in developing countries. (author)