Middle East Cancer Consortium (MECC)
The agreement forming the Middle East Cancer Consortium (MECC) was signed in Geneva in 1996 by the Ministers of Health of Cyprus, Egypt, Israel, Jordan, and the Palestinian Authority, at a time when the peace talks between Israelis and Palestinians were in progress. The U.S. through the National Cancer Institute (NCI) was instrumental in the establishment of MECC, and then DHHS Secretary Donna Shalala formally witnessed the signing ceremony. DHHS Secretary Tommy Thompson followed with strong U.S. support, and current DHHS Secretary Michael O. Leavitt continues this support by chairing the Ministerial Steering Committee. The Director of NCI serves as a member of the MECC Board of Governors, and the liaison with MECC is through the NCI's Office of International Affairs (OIA).In June 2004, the MECC Joint Registry Steering Committee met in Ankara, Turkey, where His Excellency Professor Dr. Recep Akdag, Turkey's Minister of Health, signed the MECC agreement, making Turkey the sixth member to join the consortium. The U.S. was represented at the signing by Dr. Joe Harford, Director of NCI's OIA. With the addition of Turkey, the population represented by MECC membership has increased by approximately 70 million bringing the total to over 160 million.
As a result of Turkey's becoming its sixth member, MECC will begin providing support to the existing population-based cancer in Izmir, Turkey. It is envisioned that the registry at Izmir will serve as a hub for cancer registry throughout Turkey. The first tangible support by MECC of its newest member will take the form of an NCI-sponsored training course in Izmir for Turkish cancer registrars. Course material and the MECC Manual of Standards have been translated into Turkish. This manual also exists in English and Greek with Arabic and Hebrew versions anticipated.
A major activity of MECC has been the establishment and support for population-based cancer registries in the region. MECC has been providing support for registries in Nicosia covering the Republic of Cyprus, in Tanta covering the Gharbia governorate of Egypt, in Jerusalem covering Israel, in Amman covering Jordan, and separate registries in Gaza and the West Bank for the Palestinian Authority. Thus the registry in Izmir, Turkey becomes the seventh MECC-affiliated population-based cancer registry.
Experts from the United States, including those from the NCI's Surveillance, Epidemiology, and End-Results (SEER) program have assisted the MECC registries with training, technical support, and quality control. The first peer-reviewed publication arising from the MECC activity appeared in 2003 and represented the first ever comparison of cancer incidence rates from Israel and one of its Arab neighbors (L.S. Freedman et al., A Comparison of Population-Based Cancer Incidence Rates in Israel and Jordan, Eur. J. Cancer Prev. 12:350-365, 2003). Authors of this paper include Israelis, Jordanians, and Americans with three authors from NCI. An NCI monograph providing a detailed analysis and commentary on cancer incidence in the Middle East has also been made available: Cancer Incidence in Four Member Countries (Cyprus, Egypt, Israel and Jordan) of the MECC compared with US SEER (NIH Publication No. 06-5873, March 2006, available at http://seer.cancer.gov/publications/mecc/).
MECC activities encompass issues that range from prevention to end-of-life care. Recently, a MECC workshop was held on the topic of "Palliative Care". Experts on this topic from the U.S., Europe, and the Middle East served as faculty for this workshop, and participants represented all of the MECC members. Palliative care has been identified by the World Health Organization as the highest of priorities in cancer for those countries with the most severely limited resources. Throughout the developing world including the Middle East, cancer patients often present with more advanced, less curable cancer. This fact makes building of capacity in palliative care and symptom management all the more pressing in the developing world. Because palliative care is relevant to a number of diseases in addition to cancer, the MECC workshop on palliative care for the first time included experts beyond cancer.
Expansion of MECC's influence in the region beyond cancer was also a theme at a second workshop held on the topic of "Disease Prevention and Health Promotion." This workshop was organized by MECC and NCI in conjunction with the DHHS Secretary's office. Faculty included international experts in not only cancer but also in heart disease and diabetes covering topics related to smoking and tobacco control activities as well as diet and physical activity.
The last five years have been a difficult period in the Middle East as a whole, yet the activities that require Arab-Israeli cooperation have been maintained. Despite the troubles in the region, MECC has persevered. Since its inception eleven years ago, MECC has provided a shining example of how geopolitical differences can be put aside to strive together toward the common goal of reducing and ultimately eliminating suffering and death due to cancer.
More about MECC can be found at http://www.mecc.cancer.gov.
