February 4, 2009, was World Cancer Day. The International Union Against Cancer (UICC) used the day to launch a year-long, worldwide effort to combat obesity, a significant cancer risk factor. The campaign’s focus will be to work with parents, teachers, and decision makers around the world to encourage children to eat a healthy diet, be physically active, and maintain a healthy body weight.
A Conversation With
A Conversation with…Dr. Joe Harford
Dr. Joe Harford is director of NCI’s Office of International Affairs (OIA), which coordinates and oversees many of NCI’s internationally focused outreach activities, including the Middle East Cancer Consortium (MECC).
On February 13, the MECC Board of Governors will meet on the NIH campus. Coupled with the meeting will be the launch of an art exhibit in the NIH Visitor Center that will include drawings by children with cancer from the U.S. and four MECC regions.
MECC has quite a history. How was it initially formed?
The launch of MECC occurred in 1996, when NCI assisted in bringing parties in the Middle East together to form this important consortium. MECC initially consisted of Cyprus, Egypt, Israel, Jordan, and the Palestinian Authority. Later, Turkey joined the Consortium. So you had a group with long histories of antagonism among its members—the Cypriots and the Turks, and Israel and three Arab neighbors, with whom three wars have been fought over the past 60 years. As the most recent conflict in Gaza graphically demonstrates, tensions in the region still run high.
Clearly the Consortium’s work had to be prioritized. Where have MECC’s efforts been focused?
At its inception, MECC members recognized that data on cancer incidence and outcomes in the jurisdictions covered by the new alliance were sketchy at best. So the members determined that a joint project on cancer registry would be the most worthwhile place to begin. With NCI support, individuals from all of the MECC regions were trained, side-by-side, and they worked collaboratively on establishing a common set of standards for cancer registry.
A milestone in these efforts came with the publication of an NCI monograph in which cancer incidence in four populations in the region were compared with U.S. incidence data derived from NCI’s SEER database. The Consortium members are now exploring what collaborative research projects should be undertaken based on this registry data.
International Cancer Initiative Works to Combat Obesity
Is there interest among MECC members to pursue initiatives that can have a more immediate impact on patient care and outcomes?
Absolutely. One of the most significant challenges facing the cancer care systems in the Middle East is late diagnosis, which diminishes the likelihood of treatment being curative and makes palliative care more imperative. So for its second joint program, MECC is working to improve palliative care in the region.
In addition to conducting an inventory of the available palliative care services in MECC jurisdictions, several successful workshops have been held to build capacity for palliative care delivery. Individuals from MECC jurisdictions have also completed common course work and bedside training at Calvary Hospital in New York. And OIA is supporting a visiting program for Palestinian and Israeli nurses in conjunction with the U.S. Oncology Nursing Society and the Institute for Nursing Healthcare Leadership.
These efforts have borne fruit. In the West Bank, for instance, one of the alumni of NCI/MECC training activities launched the Al-Sadeel Society, the first Palestinian society focused on palliative care for cancer patients. NCI is continuing to support training for Palestinians, with additional activities planned this year for Ankara, Cairo, and Jerusalem, in addition to New York City and Boston.
Is this simply NCI facilitating partnerships, or is it something more than that?
I really believe that MECC is a momentous achievement. It’s a demonstration that peaceful cooperation in the Middle East is both possible and beneficial. For the United States, MECC provides a shining example of what has been termed “health diplomacy,” or fostering peace by helping to improve the health of the people in MECC regions.
Recently, the concept of health diplomacy was resoundingly endorsed by the Institute of Medicine, which called for the new administration to expand the United States’ commitment to improving global health.
And really, that’s what NCI is doing with MECC. For a dozen years, we have been providing support for cancer research capacity in the region and improving cancer care. In essence, MECC operates on the principle captured in an ancient Middle Eastern saying, “The enemy of my enemy is my friend.” We are helping MECC members work together as friends against the common enemy that is cancer.