UAE tightens use of antibiotics amid superbug fears and rising health insurance costs

Dr. Amin Hussain Al-Amiri, assistant undersecretary for public policy and licensing at the Ministry of Health and Prevention. (Courtesy of UAE Ministry of Health and Prevention website)
Updated 02 March 2018
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UAE tightens use of antibiotics amid superbug fears and rising health insurance costs

ABU DHABI: Government-issued circulars are being sent to UAE doctors to curb over-prescription of antibiotics to prevent resistance to superbugs and tackle the cost to health insurance systems of antibiotic misuse.
Dr. Amin Hussain Al-Amiri, assistant undersecretary for public policy and licensing at the Ministry of Health and Prevention (MOHAP), said the circulars were part of a raft of measures urging doctors not to issue antibiotics as a first port-of-call.
“The impact of our rules and the circulars will firstly be for the protection of patients themselves,” he said. “But also this will lower health insurance costs because if unnecessary antibiotic prescriptions are avoided then this will minimize the bill which will be forwarded from health care facilities to insurance companies. It will minimize the costs to the UAE because government hospitals provide services free of charge to UAE nationals.”
Dr. Al-Amiri said that the measures will focus on clamping down on doctors who ‘“overdose’” patients by routinely prescribing drugs and pharmacies that issue antibiotics without a prescription.
The steps are in line with World Health Organization (WHO) reports that warn of rising resistance caused by changes that occur in bacteria and render antibiotics less effective.
“First of all, we released many circulars to physicians to not use antibiotics as the first option for the treatment of patients unless — and this is very important — it is absolutely indicated,” Dr. Al-Amiri said. “Once it is indicated there is no issue in prescribing antibiotics.”
This, he said, should mean doctors prescribing the lowest strength of antibiotics unless the patient did not respond to treatment.
“Next, which is very important, we are insisting that all pharmacies avoid issuing antibiotics without prescription which is illegal — this is against the rules and regulations of pharmaceutical law in the Emirates.”
Ministry of Health policy states that antibiotics should not be offered to patients by pharmacists without a doctor’s prescription. New legislation will further prevent pharmacy misconduct relating to antibiotic dispensation without a prescription.
Dr. Yasser Sadawey, internal medicine specialist at Al-Ain’s Medeor 24x7 International Hospital, welcomed the measures — but said it could have a less-than desirable effect on antibiotic sales in the UAE and wider region.
“It will be appreciated by insurance companies and individuals as it will reduce the insurance cost,” he said. “On the other hand, global pharmaceutical companies, which are the sole developers of new antibiotic medications, will have less revenue, which might affect the research programs. We had 65 antibiotics discovered during 1978-1998 and in the past 20 years we had just 15 new antibiotics.”
Dr. Sadawey said misuse was leading to medical practitioners losing their “first-line antibiotics.”
“If we don’t take action now, we may be back in an almost 19th-century environment where infections kill us as a result of routine operations,” he warned. “This is a global issue for governments, the medical profession, the pharmaceutical industry and individuals.”
Dr. Diab Kurdi, head of pharmacy at Abu Dhabi’s Burjeel Hospital, also welcomed the move to reduce antibiotic misuse.
“Doctors in the UAE have been issued with circulars that warn against using antibiotics as the first option for treatment if there is another potential solution,” he said. “If antibiotics are absolutely necessary, it’s recommended that doctors begin with the lowest dose possible. Measures like this are important in the UAE, as they are the world over, to prevent the overuse and potential eventual inefficacy of antibiotics.”
Dr. Kurdi said there was also a responsibility for patients, health care professionals and policy makers to tackle overuse.
“The industry itself needs to invest in research and the development of new antibiotics, vaccines and other tools; individual practitioners/physicians can take greater steps to limit the transmission of infection through cleaning of hands and equipment, and report antibiotic-resistant infections to surveillance teams. Patients must always follow guidelines for use and never share or use leftover antibiotics.”
Talal Bayaa, co-founder of the Dubai medical insurance technology start-up Bayzat, said traditionally insurers have acted as “independently managed control measures” against over-diagnosis and over-prescription of drugs such as antibiotics.
“They’ve done so by ‘rejecting’ cover for specific treatments and medications that are prescribed by medical service providers,” he said. “We as brokers, as well as insurance providers, have seen cases of antibiotic over-prescription for the treatment of conditions that can otherwise be treated by other medications that are significantly more affordable than antibiotics and have less impact on patient’s existing immunity, as well as other systems that may be affected by taking harsh antibiotics when not required.”
Bayaa said: “As it stands, given the volatile nature of how medical service providers prescribe treatments and medication, medical insurance premiums tend to be erratic in nature, and the fluctuation in year-on-year premiums is quite extreme.
“Given a more controlled and regulated prescription/diagnosis environment, we can expect medical insurance premiums to reach increased stability and predictability. However, it would take insurers at least a year to be able to properly assess and predict the levels of risk of claims in the region related to antibiotics.”


Emirati astronaut prepares to join elite Arab space club

Updated 57 min 20 sec ago
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Emirati astronaut prepares to join elite Arab space club

  • Hazza Al-Mansoori 'living a dream' as he and backup astronaut train for space mission in September
  • Soyuz-MS 15 launch could be the beginning of a bold new era of Arab exploration of space

DUBAI: More than 30 years after an Arab first journeyed into space, an  Emirati is preparing to become the latest Arab space traveler when he joins a team of astronauts at the International Space Station (ISS) in September.

For months, Hazza Al-Mansoori and backup pilot Sultan Al-Neyadi have been undergoing intensive training in Russia, Germany and the US to prepare for the mission. The first Emirati to travel into space will make the historic journey on board a Soyuz-MS 15 spacecraft due to take off from the Baikonur Cosmodrome in Kazakhstan on Sept. 25.

During the eight-day mission, he will conduct a tour of the ISS for Arabic viewers on Earth and carry out 15 experiments for the Science in Space schools competition conducted by Dubai’s Mohammed bin Rashid Space Center.

The crew, who will include an American and a Russian, are allowed to take up to 1 kg of personal items with them on the mission.

“I will take my family photo and share the experience of being in space with them,” Al-Mansoori said. There will also be an image of Sheikh Zayed, the UAE’s founding father, meeting American astronauts in 1976.

“I am also going to take an Emirati flag. I am living my dream and want to give something back to my country.”

‘I will take an Emirati flag into space. I am living my dream and want to give something back to my country.’

Emirati astronaut Hazza Al-Mansoori

Al-Mansoori will join an elite space club comprising Saudi Arabia’s Prince Sultan bin Salman and Syria’s Muhammed Faris. Prince Sultan became the first Arab to travel to space as part of space shuttle Discovery’s crew in 1985. Faris was a crew member of USSR’s Soyuz spacecraft in 1987.

The Emirati astronaut is aware that history is resting on his shoulders. Speaking to the media recently during his training program in Houston, Al-Mansoori  said it is a huge personal honor to be the first Emirati chosen for space exploration.

“I’m excited about the whole mission, but especially to experience the microgravity and be living in the ISS, and conducting daily experiments and working with the amazing group on board,” he said.

Al-Mansoori and Al-Neyadi have been undergoing rigorous training at the Johnson Space Center in Houston. The program includes familiarization with NASA equipment on board the space station, and handling emergency situations, such as ammonia gas leaks and depressurization.

The Emiratis have been trained to fend for themselves if the return goes off course and they land in the wilderness of Russia.

Speaking of the Soyuz-MS 15 mission, Yousuf Al-Shaibani, director general of the Mohammed bin Rashid Space Center, said: “We strive to see the UAE Astronaut Program achieve its objective of preparing generations of Emiratis who will contribute to enhancing the country’s position in space science and research to serve the ambitious aspirations aimed at building a national knowledge-based economy.”

The September launch could prove to be the beginning of a bold new era for Arabs and space. Al-Neyadi, the backup pilot, has been promised a seat on a future mission, and the UAE and Saudi Arabia are drawing up ambitious plans for the development of the region’s space industry.