Real change is starting in the Middle East (6)
I believe the answer is:
israel
'in the middle east' is the definition.
('Israel' is part of 'middle east')
'real change is starting' is the wordplay.
'change' is an anagram indicator.
'starting' is a charade indicator (letters next to each other).
'real' with letters rearranged gives 'rael'.
'rael' put after 'is' is 'ISRAEL'.
(Other definitions for israel that I've seen before include "Jewish state" , "Serial (anag)" , "Serial set in Middle East state" , "Jewish republic" , "Eastern Med nation" .)