In 1999, Hussein bin Talal, the king of Jordan, died after a long battle with non-Hodgkin's lymphoma. Since then, his eldest son and successor, King Abdullah II bin Al Hussein, has sought to improve cancer treatment in his country as part of an effort to boost healthcare and technological development. The country's capital, Amman, now boasts a world-class cancer treatment center, which draws patients from throughout the region. To lead that effort, the king tapped Samir Khleif, chief of the cancer vaccine section at the US National Cancer Institute in Bethesda, Maryland. Khleif, who received his medical degree in Jordan, now has an even bigger mandate from the king: to build an internationally renowned institute devoted to cancer research and biotechnology. Construction on The King Hussein Institute for Cancer and Biotechnology is scheduled to begin on the outskirts of Amman this month, with an expected completion in 2010.
What will the new institute include?
The institute will focus on cancer care and cancer biotechnology research, including clinical trials, especially early phase 1 and 2 trials. In addition to a 200–250-bed hospital, it will have research facilities for basic and translational research—à la some of the free-standing cancer centers here [in the US]. It's an approximately $200-million project, and will have between 20 and 30 principal investigators. The idea is for the institute to become one of the hubs for cancer treatment and biotechnology research in the Middle East.
How did this project get started?
It's an initiative of the king of Jordan. He has a vision for Jordan to become a hub for health care and for technological transformation. It's a nongovernmental, not-for-profit organization, and the king is the patron of it.
You have been involved with this project from the start. What's your current role?
I am the chief executive officer and director. I lead the process of developing the institute, including the development of human resources plans, recruiting of staff, development of interagency relationships, building designs, etc. There is a full-time team in Jordan; I go back and forth.
What are some of the challenges you face?
Some challenges are similar to what you would face in the US, some are more exaggerated. Similar things include dealing with internal politics within institutions and generating cooperation between the center, academic institutions and local physicians. Of course, one of the most important challenges anywhere in the world is to recruit the appropriate expertise and talents. Now of course this is much easier in the US; there is a larger pool. In a country like Jordan, those pools are much smaller.
How will you staff the new center?
The idea is to really try to create what we call 'brain gain', which is to bring experts who have left back to the country.
The idea is to really try to create what we call 'brain gain', which is to bring experts who have left back to the country, including clinical experts, translational experts and basic researchers. And of course there is a pool of experts within the country and the region you can tap, so it's multifaceted. We will also be fostering communication, relationships and cooperation with the other institutions in the region, along with those in the US and Europe. [....] Of course, we have an advisory board, which includes cancer center directors from the US and Europe.
What are some of the challenges unique to Jordan in building a new institute like this?
There are some challenges specific to emerging economies. The way people deal with illness can be very country-specific. One of the issues very relevant to cancer is even knowing whether you have the disease or not. This is something that people in the US became more comfortable with in the 1950s through the early 1970s. But people in emerging economies are dealing with this issue now. For example, before we started developing the King Hussein Cancer Center [a separate Amman-based facility devoted to therapeutic cancer treatment] in 2002, a lot of families didn't want the patients to know they had the disease or that they were being taken to a cancer center. Not only families, but some parts of the public and press did not want the word 'cancer' to be on the center. [P]eople didn't even use the word; they would say 'that disease'. But we implemented certain changes, through public education campaigns, for example. Whenever you build a center for excellence, you change the thinking of the community around it. [With respect to the new institute] it's extremely important for anyone enrolled in a clinical trial to know everything about their disease so they can understand the risks and benefits before enrolling in the trial and can provide proper consent.
How will the new center influence research in the Middle East?
The Middle East has witnessed a growth spurt of universities and research centers within the past 10–15 years [...]. But critical mass is very important. The culture of research and development is newer and less mature [there] than it is in the US and Europe. Although the number of scientists and PhD holders is high in Jordan, the problem is to have the proper infrastructure and nurturing environment, which this institute will provide. In this case you will have the critical mass of experts together. This is one of those projects that could make a major difference in the community and in society. It could introduce a new level of critical thinking.
Rights and permissions
About this article
Cite this article
Schubert, C. Q & A: Samir Khleif. Nat Med 14, 362 (2008). https://doi.org/10.1038/nm0408-362