Change Makers: Princess Ghida on Fighting Cancer in the Arab World

John Whyte, MD, MPH; HRH Princess Ghida Talal

Disclosures

December 14, 2022

Dr John Whyte speaks with Princess Ghida Talal about cancer treatment and research efforts in the Arab World and the importance of addressing taboos and providing cancer care to everyone who needs it.

This transcript has been edited for clarity.

John Whyte, MD: Welcome, everyone. I'm Dr John Whyte, the chief medical officer at WebMD, and you're watching Change Makers: The Future of Health.

Cancer is a leading cause of death all around the world. Now it's true that cancer death rates are decreasing, but everyone doesn't benefit equally. The research that we get so excited about primarily occurs in the West, and those in the rest of the world, particularly in low-income countries, often don't get the same benefits. Unless we address this disparity, approximately 75% of the cancer burden will occur in the developing world in just a few years.

To find out what can be done, I literally traveled thousands of miles to Amman, Jordan, where I had the opportunity to witness an award ceremony celebrating research in the Arab world. I then sat down with Her Royal Highness Princess Ghida Talal, the chairperson of the King Hussein Cancer Foundation and Center, who helped explain to me the need for clinical excellence, but also the rationale for cancer research in the Arab world. You just can't apply what occurs in the West to other areas of the world. She discussed how she's helping erase stigma around cancer, as well as the necessity for the world to focus on refugee health. There's a word you'll hear from her a few times — passion — and why it's so important when addressing health. If you care about finding a cure for cancer that benefits everyone, this is an interview you need to watch.

Princess Ghida, thanks for joining me.

HRH Princess Ghida Talal: Thank you, John. Welcome to Jordan; we are thrilled to have you with us here.

Whyte: Well, I was thrilled to be able to be at your event last night where you celebrated research in the Middle East. And I was struck by a statistic that you quoted there — I actually wrote it down, so I'm going to read it back you: By 2030, not that far away, you said that 75% of the cancer burden will be in low-income countries — 75%, Princess Ghida?

Talal: Yes, 75%. It's a terrifying prediction. And we have to know that cancer is not uniform from country to country, region to region. And most of the research that is being done is being done in the West. So all the fruits of the research is benefiting the West. This is why it is extremely important to support and encourage research coming from the Arab world, because the Arab world is facing genetic, behavioral, and environmental factors that affect cancers in a very different way than it affects it in the West. Having said that, we are extremely grateful for all the research that comes to the West; it has helped us enormously in our development of cancer treatments. However, it really is time — we have brilliant talent, brilliant minds in the Arab scientific community, but we just have to support them in a stronger way so that they can also produce cancer research that is relevant to the populations of this part of the world.

Whyte: Is that why you produced a world-class cancer center here in Jordan, to serve the Arab world? Because people could say, "You know what, we don't need cancer centers all around the world, because we're translating research that was done in Europe or the United States and we can just adopt it here." But you're suggesting that no, it's not the same — there could be differences based on genetics and other aspects. Is that why it's so important?

Talal: We established the King Hussein Cancer Center, which has become the cornerstone for cancer care for the entire Middle East region, because there was a tremendous need for it, in terms of treatment care and in terms of research. Cancer care was practically nonexistent in our part of the world. So if you developed cancer, your fate was quite doomed. And for this reason, there was a massive need for a cancer center of excellence. The King Hussein Cancer Center changed the landscape of cancer care in the entire Middle East, in terms of treatment, in terms of research, in terms also of refugee health. There is a need to continue, to consolidate, and to also expand in other areas in order to be able to cover a population so large and that is, unfortunately, still without adequate treatments in many regions. This is why the King Hussein Cancer Center is really the institution that now takes care of the entire Arab world.

Whyte: What's your hope for the future in terms of cancer research here in the Arab world and the role of the King Hussein Cancer Center?

Talal: Last year was our first round for the King Hussein Award. As I said, the award is basically built on supporting and encouraging scientists from all over the Arab world and abroad, who are conducting research on cancer in the Arab world. Last year was the first time we reunited them at the award ceremony. And I was so surprised when one of the Lifetime Achievement awardees told me, "This is the first time I ever met my fellow Arab scientists" — there had never been a forum of this kind. To conduct research, John, we all know that not one country can conduct it alone. Why? Because you need a huge population base, because you need resources that one country alone cannot sustain. And because you need an infrastructure that also one country cannot sustain. So this is why this award is truly critical and instrumental. My hope is that it will keep growing stronger and stronger, with more proposals being given an advance, and that there will be much more cooperation between each other and with, of course, their colleagues in the West.

Whyte: When you and I last spoke, you talked about the need to change how the Arab world thinks about cancer. You talked about the issue that there's still stigma of a cancer diagnosis; there's still a taboo about talking about cancer. And that can impact screening, which is a passion of yours and the work that you do here. What progress has been made over changing that perception? People don't even want to say the word sometimes.

Talal: Well, John, I believe that every country has its taboos and has its ways of dealing with their taboos. In Jordan, we certainly have had very challenging taboos and stigmas to deal with when it came to cancer. Cancer was viewed as an automatic death sentence. It was associated with feelings of fear, shame, and guilt even. As you said, people would do anything to avoid saying the word "cancer" and would simply say "that other disease" until our beloved King Hussein was himself afflicted with cancer, and he led his private battle publicly in order to break these taboos. He spoke openly about his cancer; he removed his headscarf in public to show everyone his bald head and that there was no shame associated with it.

To follow in his footsteps at the King Hussein Cancer Foundation and Center, we work very hard to break those taboos, to normalize early detection, and to make it part of our daily vocabulary. So we took many steps in regard to early detection. We launched nationwide campaigns and regional campaigns to encourage women to get their mammograms. And I'm so proud to say, John, that in a very short amount of time, we were able to flip the statistics and to halve the number of women who go to their oncologist at the late stages of their disease. But it's not enough; it's never enough. We will only rest when not one woman will have to die simply because she didn't go toward early detection.

We also focused on mental health. When you have cancer, you're depressed, you're scared, you're anxious, you don't know what to do. So we have established a network of psychiatrists and therapists. And we have an open dialogue with the community — not just with the patient with cancer, but with their families and also with the staff of the hospital. I'm so happy to say that people come in droves to these clinics. This is part of the job we have done in regard to reversing taboos.

Whyte: You started your career as a journalist and have worked at ABC News, The Sunday Times, Reuters. What's the story that the world needs to hear about cancer in the Arab world?

Talal: The world needs to hear that, just like in the West, cancer is in every household in the Arab world, and that the same anxieties and distress that is felt in the West is also felt in the East. And there is no way about it but to unite our resources, our expertise, anything that we can offer one another, in order to pave the way toward living with this disease and, ultimately, hopefully overcoming it for good. This is what I feel we are doing at the King Hussein Cancer Center. We are immensely grateful for our international partners — for MD Anderson, for St. Jude's, for the National Cancer Institute (NCI), for all these centers that are being very generous with their experience, expertise, and resources, and are leading the way and are teaching us how to go about it. I don't think there is really a very large divide. But we have to also let the world know that we are here and that we exist and that we need this.

Whyte: And you're doing all of that by letting the world know. You studied at Georgetown; you and I met in Washington, DC, many years ago, and you have a degree in international politics. What role does the political world play in addressing cancer care here in the Arab world?

Talal: As you know, John, it's all about personal relations. It's all about communication. And I believe if you are credible and if you tell your story…this is what I do. I meet leaders, I meet decision-makers, and I tell them the story of the King Hussein Cancer Center, and why it should be supported and how it is giving back a chance for life to thousands and thousands of patients and families who would not live otherwise. And I believe that they listen and they are interested; then they come and visit, and then they see. We always engage the people we work with: our donors, our supporters, our suppliers. With the center, we always ask them to come, to visit, to see the people whom they have helped.

I think it is a question also of, you start developing your reputation. Let me say this: My first goal, first priority has always been humanitarian — always — before the medical, before everything else. This is why I firmly believe that no one should be allowed to die just because they did not have access to the right treatment or just because they didn't have the funds necessary for that. All of these statistics, John, that we are just now talking about, behind these statistics are people, are families, you know; when one person dies in a family, when the mom dies, the whole house crumbles. And as a result, the community around it crumbles. So it has devastating effects. We just absolutely need not to waste a second and keep on combating it.

Whyte: You've been passionate about how we treat refugees and the importance of making sure they get care. There are lots of priorities when it comes to refugees in terms of jobs, in terms of economics, in terms of housing…

Talal: We are a country that is surrounded by several countries in conflict: Syria, Palestine, Iraq, Yemen, Libya, Sudan. And with conflict, with crisis, come refugees. It is bad enough to be a refugee, John — to literally be totally dislocated, from your home, from your family, from everything you know, everything that's familiar, and come to a foreign country and have to be in a refugee camp. And then what happens? You get cancer. And you have no coverage. This is just too unacceptable a fate for me. When we started receiving thousands and thousands of refugees — Jordan has about 1.7 million refugees — we immediately at the King Hussein Cancer Foundation established goodwill funds. And we have so far spent over $150 million.

Whyte: You talked about change. And this series is about change makers and Princess Ghida is a change maker. So I want to ask you, 5 years from now, what will you have changed?

Talal: I will have hopefully been able to offer treatment to anyone who needs it, advanced treatment, and give them a real chance for life. I would have eradicated the taboos and the stigmas. I would have, hopefully, eased the anxieties and mental health problems that come with cancer. I will have engaged the community more. And I will have always remembered that, at the core, it is a humanitarian mission.

Whyte: That's a lot to accomplish. Can we do it in 5 years? Is that too soon? Should I have said 10?

Talal: I think it's a process. As you know, with any great work, you do it all the time, every day; it is part of your life. This life is my life. It is not a job. And I hope it is the same for many people who work in this field, because you grow very attached to the people you meet. I think that you absolutely have to have passion.

Whyte: Why did Princess Ghida get involved in this? There's a lot of things you could have done. I've referenced you are a journalist and involved in political science. Why do this?

Talal: First of all, I had a personal story that my husband, Prince Talal, developed cancer in the very early stage of our marriage. So I was exposed to the fight against cancer in my 20s. And I realized how important it is to feel with the people of the Arab world who, if afflicted with a serious cancer, had nowhere to turn to. This is when I set my mind to establish the King Hussein Cancer Center because, as the wife of a cancer survivor, I really knew firsthand all the anxieties, all the trepidation, all the fears that come along with a cancer diagnosis. And I also know all the hope, and all the advances, and all the optimism that can come with a cancer diagnosis.

Whyte: Now you are a trailblazer; we have said that. You have broken down barriers, and I have to say, talking to you, listening to you, it seems easy, but I'm sure it's not. What can people learn from Princess Ghida about breaking down barriers and going through obstacles? How did you do it, which is not easy to do in the field of cancer care here in the Middle East?

Talal: I always believe that you need to have passion. And when you have that passion, you need to work hard. You need both; you cannot have passion without hard work or hard work without passion.

Whyte: Is treating cancer a human rights issue, because it sounds a little bit that's what you're suggesting?

Talal: By humanity, I mean, it's not just about human rights. It's really about feeling with others, it's about trying to help others, supporting others, encouraging others, showing kindness to others.

Moving a little bit from the materialistic world that we all live in, because really, when you have a cancer diagnosis, this is how I felt when we were diagnosed with cancer. I say "we" because this is how I feel. I felt that I removed a veil from the front of my face, I really did. I felt that all of a sudden, my priorities were totally rearranged. My relationships were totally rearranged. The only thing that mattered was saving the life of this person who is next to you and who is dependent on you. It is a human rights issue in many ways. Yes, I do believe that it is not right for the rich only, the privileged, to be able to have access to the best treatment; everybody should have access to the same standard. This is really what takes place.

Whyte: Around the world, irrespective of where?

Talal: Irrespective.

Whyte: Whether they're insured or not?

Talal: Whether they're insured or not. I really believe it is your right. That's why I feel particularly concerned with the people who fall between the cracks — not just the refugees but underprivileged people, people who really have no one and nowhere to go. Maybe as a result of what we're doing, maybe the life of one person will change. And if you can change the life of one person, then everything that you have done is worth it.

Whyte: Where can people learn more about the work that you're doing, as well as support the work that you're doing?

Talal: I would welcome anybody to visit us in Jordan, to check our website, to call us, and to check the King Hussein Cancer Foundation USA, because we are registered in the United States. We are available, we are accessible, I am accessible; I totally believe in engagement. I also believe, John, that the engagement should continue, always be there. So it's not just that we are now engaging in an interview and then we don't see each other for another year or two. I believe in the dialogue continuing, and it's very important for us, for you, for me, to make sure that the fight against cancer, the breaking of taboos, becomes normalized and becomes part of our daily vocabulary.

Whyte: Princess Ghida, I want to thank you for all that you're doing to address cancer care — not just in the Arab world, that's what we focused on today, but you're really addressing it globally as well. So, thank you.

Talal: Thank you, John.

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