1. IN C TR 2004 The Global Perspective of ICEDOC on cancer control for underserved regions in the world Ahmed Elzawawy, Egypt Web : ICEDOC.ORG. E-mail: ICEDOC @ nilesat.net (INCTR meeting, Monday October 4,2004,Cairo,Egypt )

2. IN C TR 2004 Here, I introduce some examples of my positions and titles, not at all to show myself. In fact a president of an organization formed of distinguished international volunteer, is the most available servant for his colleagues. But, it shows that it is not contradictory-at all- to be active and loyal in more than one imitative and organization against cancer. We should cooperate more and more together. We can serve as human bridges between different noble initiatives and activities of cancer control.

3. IN C TR 2004 I am Ahmed Elzawawy, President of ICEDOC & ICEDOC's Experts in Cancer Without Borders.,USA ( ICEDOC is The International Campaign for Establishment and Development of Oncology Centres. A non-Profit Organization incorporated in Texas,USA ) web: WWW.ICEDOC.ORG &A Member in the Advisory Board,INCTR, Belgium (INCTR :International network for cancer treatment and research ) & Vice President of AORTIC for North Africa ( African Organization for research and training in cancer ). & Professor and Head of Clinical Oncology ( Radiation And Medical Oncology) And Nuclear Medicine,Port Said & Ismailia,Egypt.

4. IN C TR 2004 Moreover, ICEDOC as an organization is an associated member in INCTR. - ICEDOC is linked with AORTIC. - A World member in UK Forum for hospice and palliative care worldwide. - And others ……….

5. IN C TR 2004 According to Estimates of WHO and others : In The World : The year 2000 : population 6 bn 10 m new cases (incidence) & 6 m deaths, 50 % in developing countries with 5% resources. 2020 : population 8 bn 20 m new cases -12m deaths,70% in developing countries.

6. IN C TR 2004 The Perspective of ICEDOC : In spite of all the existing governmental and non governmental efforts,societies and organizations, reasonable cancer therapy is available for only 10-15% of the cancer patients in the world. At present, according to the current prevalence of cancer problems in the world, this number could be estimated as not less than 20 million cancer patients in the world. If the present conditions continue,then it would be not less than 60 millions by the year 2020.

7. IN C TR 2004 Cancer problems do not only touch patients, but also their families and friends who suffer for them. So, the current burden of unreachable reasonable cancer management lies heavily on not less than 80 million persons in the world.( it would be at least 240 millions persons by the year 2020 if the present conditions continue ).

8. IN C TR 2004 Cancer patients who have access to treatment. Among those patients there is a marginal improvement of results achieved this year and the last 3 years. The majority of cancer patients in the world who have no access to any reasonable cancer management facilities

9. IN C TR 2004 1960 1970 1980 1990 2000- Average cost of treatment per patient to obtain these results Improvement in results of cancer treatment in developed rich countries.

10. IN C TR 2004 This lack of services is evident in all fields of Cancer Control including prevention, early detection,diagnosis,surgery,radiation oncology, chemo and hormonal therapy and palliative and supportive care. This tragic situation should not be allowed to continue !.

11. IN C TR 2004 A Balanced National cancer Program Components Education prevention detection treatment palliation Factors geography epidemiology culture education standard existing facilities economy

12. IN C TR 2004 To achieve our target in the year 2020 and to reduce cancer incidence from 20 millions and the death toll from 10 millions a year to 6 millions, it is vital to have the following: An effective Strategy, Political will, skilled persuasion, good media relations as well as professional and industrial collaboration Also Involvement of local private sector should be encouraged Quoted from (KAROL SIKORA, Developing a global Strategy for Cancer, A WHO Cancer control meeting, Oct. 1998, London)

13. IN C TR 2004 The goals of an organization like ICEDOC are to cooperate and to participate in the followings: To decrease the morbidity and mortality of cancer. To promote the activities of early detection of cancer that should be tailored for each region and to associate them with more availability of treatment facilities. To increase cancer management facilities in under-served regions in the world. To improve the quality of the existing services.

14. IN C TR 2004 To assist in tailoring cancer treatment protocols, modalities,departments and palliative care according to the specific conditions and the socio-economic factors in each region taking into consideration the views of the local health care providers and community. The final results should be within the range of acceptable international results. ( In ICEDOC,we believe that searching and tailoring treatment modalities and protocols with the maximum possible consideration of the real local socio-economic conditions is not against the science, but it is a real scientific work and it is the needed medicine ). To conduct relevant researches.

15. IN C TR 2004 But,who Is ICEDOC ? NAME: ICEDOC International Campaign for the Establishment and Development of Oncology Centers. Its main Corpus isICEDOCs Experts In Cancer Without Borders. ICEDOC has been established to complement and to cooperate with (and not to compete with ) the work of existing organizations, societies, and authorities. First founding meeting : In 1996, Vienna. Incorporated in Texas,USA : In 1999 Non-profit/non-governmental organization Today has 120 volunteer consultants WWW.ICEDOC.ORG

16. IN C TR 2004 MISSION This mission is derived from the fact that there are 85% of cancer patients in the world without access to cancer management. Its main mission and approach is to co-ordinate views and efforts of volunteers oncologists, experts, cancer treatment manufacturers, authorities, administrators and some eminent personalities in order to enhance the quantity and the quality cancer facilities all over the world. ICEDOC offers on site and tele- consultations and exchanges of experiences.

17. IN C TR 2004 AREAS OF ACTIVITIES Geography: The under served areas around the world. Undertakings: –Medical Workshops ( We havent the attitude that we give lessons,but we exchange knowledge and experiences ) –Meetings that combine Professionals, Health Authorities, Personalities, Media, Etc.(Both in formal and in friendly ambiance, we believe that the local colleagues are the best who can tailor the outcome of meetings according to their condition) –On-site visits and Tele-Technical advise. –Follow up and continuity of the programs

18. IN C TR 2004 Examples of some the previous ICEDOC meetings and Visits : Muscat (Oman),Benghazi and Tripoli ( twice), Tbilisi and Batumi( Georgia), Bangkok (Thailand), Jodhpur (India ), Shanghai (China),Twice, Annaba, (Algeria),Twice. An Example of the successful Tele-technical advice : NCI,Panama, Latin America. ( In ICEDOC we say We Should learn how we can learn from each other !)

19. IN C TR 2004 How to Join ICEDOCs Experts in Cancer Without Borders ? In front of the big challenges and complexities in the world and cancer, In ICEDOC we are trying to keep things simple as we can : No Membership fees are required. The main requirements is to kindly agree on: 1) To offer – when you can or have some free minutes- E-mail consultations in any field of cancer management you prefer upon demands of colleagues and health authorities in the world, transmitted to you by ICEDOC. Sometimes,on site visits are needed, that if you can. 2) To participate in the progress of your ICEDOC by offering your strategic advice,and –if you can- to arrange collaboration with international and national organizations, initiatives and individuals. 3)Again if you can, to arrange or assist in the arrangement of consultations meetings and workshops.

20. IN C TR 2004 The Principles of ICEDOC : We are not competitors but allies with all. We are with all, towards increasing quantity and quality of cancer management facilities. We adopt classic and innovative approaches

21. IN C TR 2004 A CONSORTIUM FOR CANCER ORGANIZATIONS working for underserved regions. A SUGGESTION FROM ICEDOC The need is derived from the following facts : The challenges of disparity between cancer problems and its control are variable in different regions of the world. This disparity is in general too great in developing countries. The real number of non profit organizations working in the field of cancer is not known. Most of these organizations are small. However, every noble initiative should be encouraged, no matter how small. More effective outcome could be achieved in the fight against cancer if there were coordination and cooperation between the willing organizations

22. IN C TR 2004 ICEDOC and ICEDOC's experts in cancer without borders, suggest that this meeting adopt the formation of an international consortium or confederation formed of the willing cancer organizations that direct some or all their activities to the underserved regions in the world. A confederation means that all the cooperating organizations or initiatives will keep its own independence and internal system. This INCTR international event would be suitable to present and discuss this suggestion. To be realistic,it would not be easy, but the expectations make it worthwhile to ask INCTR and the present distinguished colleagues to start the initiative.

23. IN C TR 2004 What I presented today is on behalf of my dear colleagues in ICEDOC. Hence,before the end of my presentation, I would like to have your kind feedback.Hence, Ill transmit it to them.You can do so directly during this conference or by e-mail : ICEDOC @ nilesat.net (web: ICEDOC.ORG) We wish to ask you : Was I successful in convening the following messages ? 1)We are all cousins in one human family ( Wishing to hear loudly a very big : YES ) 2) Let us say together Every patient in the world is my patient 3) The enormous challenges of cancer in underserved regions (85% of the patients in the world) impose full collaboration 4) ICEDOC is a small organization with a message of scientific cooperation and love for all. 5) ICEDOC belongs to all !

24. IN C TR 2004 Finally, I feel that I hear from far the 1 st movement of the 9 th Symphony of Beethoven.In depth,it calls for love for all human beings. And I remember parts of The Vienna Statement of ICEDOC, September 1996 : ……………Millions of cancer patients and their families in the world are screaming Please dont forget us … …………. Then,let us think and work together for them. Thank you all.

25. IN C TR 2004 We are presenting our deepest thanks to INCTR and personally to Ian Magrath