Jordan launches its first national cancer control plan

After decades of sustained efforts by public health professionals, clinicians, and policymakers, Jordan has launched its national cancer control plan, which offers a coordinated and equitable response to the country’s cancer burden.

According to the Ministry of Health of Jordan, it was prompted by both national priorities, such as reducing cancer mortality and improving access to care, and international commitments to strengthen noncommunicable disease control. It is also aligned with broader efforts to strengthen the health system, including integration of cancer services into primary care, expanded insurance coverage, and stronger health information systems.

With more than 11,000 new cases and 3,445 related deaths in 2023, this strategic document provides a framework to guide prevention, early detection, and diagnosis, timely and effective treatment and comprehensive supportive care.

For Dr Omar Nimri, a leading Jordanian public health expert who has worked in cancer registration, surveillance and prevention for more than 20 years, the endorsement of the NCCP represents a turning point. It also comes at a crucial time, when the health system is facing mounting pressures.

Based in Amman, Dr Nimri has been closely involved in national cancer control efforts since 2005 and earlier when early attempts to develop a comprehensive strategy first began. Looking back, he describes a long and often frustrating process.

Despite technical support from international partners and repeated drafting efforts, Jordan’s plan was delayed for years. “Financial constraints were the main obstacle,” Dr Nimri explains. “Cancer care in Jordan is fully covered for citizens, and the high cost of treatment made it difficult for decision-makers to commit to a broader, fully costed strategy that extended beyond hospital-based care.”

According to the Ministry of Health, while the plan has been costed and is supported through government budgets, insurance schemes, and international partnerships, ensuring long-term sustainability remains a challenge, particularly given the high cost of treatment and reliance on external funding for some programmes.

At the same time, says Dr Nimri, frequent changes in political leadership made it challenging to sustain momentum. He recalls that even ministers with a background in oncology struggled to prioritise longterm cancer planning once in office, as more immediate pressures took precedence. Yet the underlying rationale for a national plan was to ultimately reduce costs and improve outcomes. "With strategic investment now in prevention, early detection, and system strengthening the country saves much more later, both in lives and in resources,” says Dr Nimri.

In recent years, conditions finally aligned to move the plan forward. A renewed commitment from the government, coupled with closer collaboration across the health sector and technical support from the WHO country office in Amman, allowed the NCCP to be updated and formally launched. The process brought together a wide range of stakeholders, including the Ministry of Health, King Hussein Cancer Centre, the Royal Medical Services, academic institutions, private providers, and civil society.

A key enabling factor was a major policy decision last year to expand access to free cancer treatment at the King Hussein Cancer Centre for approximately 4.1 million people, including those aged 60 and above and children and adolescents up to 19 years of age.

Addressing prevention and early detection gaps

Although implementation of the NCCP is still in its early stages, governance and accountability mechanisms are now in place. A national committee for monitoring and evaluation has been established, bringing together the Ministry of Health, cancer specialists, civil society, and international partners to oversee progress, strengthen cancer registry data, and track key indicators. “This shared responsibility is essential, as cancer control in Jordan is delivered across multiple sectors, and no single institution can act alone,” says Dr Nimri.

One of the plan’s central aims is to strengthen cancer prevention, early detection, and screening, including the integration of key diagnostic services, and increase investment in workforce training to improve diagnostic accuracy and timeliness of care. 

Tobacco use is a major concern. Despite existing legislation and international commitments, enforcement has been weak, and smoking rates, particularly among young people and women, remain high. Dr Nimri warns that without stronger action; Jordan is likely to see a sharp rise in tobacco-related cancers in the coming decades.

Screening programmes also require sustained investment. Jordan has had a breast cancer early detection initiative in place since 2007, which has helped increase the number of early-stage diagnosis. Coverage remains limited and largely opportunistic, however, rather than systematic.

Dr Nimri is realistic about the constraints: “Progress is hampered by limited infrastructure, shortages of trained personnel, and insufficient funding. Still, we advance step by step, and that is what matters. Even partial screening programmes have already helped identify cancers earlier than in the past, when many patients were diagnosed at advanced stages. This allows us to treat them more successfully, less invasively, and at a lower cost.”

While policy frameworks and financing mechanisms are essential, however, Dr Nimri emphasises that it is doctors, nurses, and the range of health professionals involved in care who translate plans into realworld impact for people affected by cancer and their families.

“Cancer care is most visible at the bedside: the availability of trained staff, hospital beds and essential medicines shapes people’s experience of the health system.”

In Jordan, health educators in particular play a critical role across the cancer pathway, from patient education and early detection to navigation, treatment delivery, symptom management, and psychosocial support.

A strained health system

At the same time, the national cancer plan is being implemented in a context of exceptional strain on Jordan’s health system. Beyond longstanding financing constraints, one of the most significant challenges remains ensuring access to cancer services for vulnerable populations, particularly those living in poverty, in remote areas, or without stable social support.

“The barriers that prevent people from accessing care are not only medical but practical,” Dr Nimri explains. "There is the cost of transportation, the need for accommodation during long treatment periods, and the loss of income for people living with cancer and their family."

These pressures are compounded by Jordan’s large refugee population. According to Dr Nimri, more than three and a half million nonJordanian residents live in the country (2.9 million estimated in 2024), including refugees from Syria, Iraq, Yemen and Palestine.

“Many arrived over a short period of time, placing sudden and sustained demands on health services that were not designed to absorb such rapid population growth,” says Dr Nimri. “This has had system-wide consequences. You cannot suddenly have enough medication, beds, doctors or nurses to face these numbers,” he adds, noting that refugees are often among the most vulnerable: children, women and older people who require a wide range of health services, including cancer care. “While international and humanitarian support initially helped offset some of these pressures, funding has declined over time.”

For Dr Nimri, the national cancer control plan offers an opportunity to better identify gaps, coordinate actors, and prioritise action. By bringing prevention, early detection, treatment and supportive care into a single strategic framework, it creates the conditions for more deliberate planning around who is being reached, and who is not.

"This is where implementation matters most, to ensure that policy translates into practical solutions that respond to the realities faced by vulnerable communities, while strengthening the health workforce that delivers care on the ground,” says Dr Nimri.