How neglect of health services left MENA countries ill-prepared for COVID-19 shock

A young girl reacts as a health worker collects nasal swab sample from her at a local clinic for COVID-19 coronavirus disease testing in Gaza City. (AFP/File Photo)
A young girl reacts as a health worker collects nasal swab sample from her at a local clinic for COVID-19 coronavirus disease testing in Gaza City. (AFP/File Photo)
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Updated 14 November 2021

How neglect of health services left MENA countries ill-prepared for COVID-19 shock

A young girl reacts as a health worker collects nasal swab sample from her at a local clinic for COVID-19 coronavirus disease testing in Gaza City. (AFP/File Photo)
  • World Bank report says authorities painted over-optimistic picture in self-assessments of their health systems’ preparedness
  • Thirteen out of 16 countries in MENA expected to have lower standards of living in 2021 than their pre-COVID-19 levels

DUBAI: A combination of chronic underfunding of public health services and long-term socio-economic trends resulted in a tenuous and uneven recovery for the Middle East and North Africa region as it emerged from the COVID-19 pandemic, according to a recent World Bank report.

Titled, “Overconfident: How economic and health fault lines left the Middle East and North Africa ill-prepared to face COVID-19,” the report highlights the stress MENA health systems were under even before the pandemic hit.

The study says that a bloated public sector and excessive national debt crowded out investment in MENA countries in social services such as health — a symptom it described as “fiscal myopia.” In turn, that shifted some health costs to individuals.

 

Another symptom of stressed public health systems was the low share of government spending on preventive healthcare, a drawback that contributed to high rates of communicable and non-communicable diseases.

The report found that the region’s public health systems were not only ill-prepared to absorb the shock of the pandemic but also that authorities were guilty of over-optimism in self-assessments of their health systems’ preparedness. The survey referred to this as “overconfidence.”

Experts say the World Bank report has revealed the extent of the region’s social and economic inequalities, caused in large part by poor governance and skewed policy priorities. However, they caution against a generalizing that tends to gloss over differences at local levels.

Dr. Theodore Karasik, a senior adviser at Gulf State Analytics, told Arab News: “The lesson is about turning around priority within government budgets and other outside help besides having in place a much better healthcare system.

“However, the countries of the region all had different types of experiences and the lessons learned are going to be unique to those spaces.”

MENA governments responded to the COVID-19 pandemic in their own ways, depending on the resources and infrastructure that were on hand. Many worked within the international system or cooperated with regional donors to secure vaccines and medical supplies.

Some countries, especially the Gulf Cooperation Council energy exporters, were able to organize a rapid response to the pandemic thanks to robust systems and better preparation. “The models set up in the Gulf are extremely useful to compare and contrast on how they worked,” Karasik said.




Some countries, especially the Gulf Cooperation Council energy exporters such as Saudi Arabia, were able to organize a rapid response to the pandemic thanks to robust systems and better preparation. (AFP/File Photo)

“These models are working and there is evidence of them being used in other countries. So, leaders are applying what they see as the best methods.”

Some MENA governments that were slow to respond to the global virus outbreak, later adopted many of the same practices as their GCC counterparts, recognizing that disease control needed to be a far greater priority.

However, given the sharp differences in the region’s socio-economic circumstances, with some countries even categorized as fragile or failed states, emulation of GCC practices was no magic bullet. The UAE and Lebanon, for instance, were worlds apart in their respective vaccine rollouts.

“The differences between an urban versus a rural environment and how violence can mitigate treatment is a key issue that governments and health practitioners (must take into account),” Karasik told Arab News.

The estimated cumulative cost of the pandemic in terms of gross domestic product losses in the MENA region by the end of 2021 will amount to almost $200 billion. According to the World Bank report, the region’s GDP contracted by 3.8 percent in 2020 and is forecast to grow by just 2.8 percent this year.




A picture taken on May 24, 2020 shows a man walking across a deserted street in Rabat, as the country went into lockdown to stop the spread of the COVID-19 disease. (AFP/File Photo

Ferid Belhaj, the World Bank’s vice president for the MENA region, said: “The pandemic’s crippling impact on economic activity in the region is a painful reminder that economic development and public health are inextricably linked.

“It is also a sad reality check that MENA’s health systems, which were considered relatively developed, cracked at the seams under the crisis.”

Thirteen out of 16 countries in the region have lower standards of living in 2021 than their pre-COVID-19 levels, the report said. But for individual countries, the growth rate of GDP per capita in 2021 has been uneven, ranging from -9.8 percent in Lebanon, which is in a deep recession, to 4 percent in Morocco.

Roberta Gatti, the World Bank’s chief economist for the MENA region, said: “The last two years have shown that pandemic control is essential not only to save lives but also to accelerate economic recovery, which is now tenuous and uneven across MENA.”

INNUMBERS

* 3.8% - MENA’s GDP contraction in 2020.

*2.8% - Region’s projected growth in 2021.

(Source: World Bank)

Dr. Albadr Al-Shateri, a former politics professor at the National Defense College in Abu Dhabi, says the events of the past two years have exposed serious weaknesses in the pandemic preparedness of not just the MENA region but in fact the entire world.

“Health security has not been prioritized as much as traditional security concerns. Governments invest heavily in all kinds of weapon systems, but less in health security,” he told Arab News.

To prevent a repeat of the COVID-19 calamity, Al-Shateri said, the international community, and the MENA region in particular, must work harder to coordinate their efforts.

“The region has got to establish, in cooperation with the World Health Organization and other centers of excellence, a center for disease control for the region. The world and regional powers should contribute to such an endeavor,” he said.

Such an approach to fighting infectious diseases will benefit the entire MENA region, according to Al-Shateri. Specifically, developed and affluent countries should extend aid to the less-fortunate nations, and a regional forum for countering diseases should help drive health security.




A Moroccan municipal worker disinfects outside a house in a closed street in the southern port city of Safi on June 9, 2020. (AFP/File Photo)

In conclusion, Al-Shateri said: “All epidemics are potential pandemics, and their consequences are catastrophic for the region and the world. The region must put in place collective efforts to stop any disease dead in its tracks.”

Few experts have been surprised by the World Bank’s findings, considering that many of the fundamental weaknesses highlighted by the report — low expenditure on public health, critical health infrastructure deficits, lack of human resources and equipment — are not unique to MENA countries.

“This is nothing new,” Dr. Richard Sullivan, director of the King’s College London conflict and health research group and principal investigator and chair of the R4HC-MENA program, told Arab News.

“(What is needed is) future resilience to epidemics and pandemics, intrinsic strengthening of basic public health systems, and a complex and heterogeneous picture across the region.”

Dr. Adam Coutts, a research fellow at Harvard University’s Weatherhead Center for International Affairs, says the key lesson to be drawn from the past 10 years is that public health and social welfare in countries such as Lebanon have been low political priorities.

“One can safely say that they do not care about the health and well-being of their populations,” Coutts said.




A prong extending from the CIRA-03 remote-controlled robot prototype approaches the mouth of a volunteer to extract a throat swab sample, as part of a self-funded project to assist physicians in running tests on suspected COVID-19 coronavirus patients in a bid to limit human exposure to disease-carriers, at a private hospital in Egypt's Nile delta city of Tanta. (AFP/File Photo)

“Also, donor governments and multilateral agencies have let countries like Lebanon, Iraq, and Syria get away with minimal investment in public services for decades. Meanwhile, millions cannot access healthcare due to out-of-pocket costs.”

Apparently, people in countries such as Lebanon spend as much as Germany on healthcare as a proportion of GDP, but much of the money is poured into the private health system.

“Lip service is paid to policies such as universal healthcare in the region. We have yet to see any concrete steps taken in terms of actual political will, investment, and on-the-ground change,” Coutts said.

He said the pandemic has exposed just how hollowed-out some of these MENA states’ infrastructure really was to start with. Although these countries were badly hit by conflict and humanitarian crises, the “internal rot” had set in years before.

“Above all, the crisis shows that the political economy of health is a key area that needs to be addressed when examining the region and designing recovery policies.”




Syrians suspected of being infected with COVID-19 receive treatment at Mouwasat Hospital in the capital Damascus, on March 31, 2021. (AFP/File Photo)

In Coutts’s opinion, Jordan and the GCC countries have shown that the rule of law, stability and providing social protection are crucial if a nation is to withstand a shock such as COVID-19.

Most MENA countries, however, have not yet returned to pre-pandemic conditions and Coutts does not foresee Lebanon, for instance, recovering in the next few years as they are “too far gone and politically sick.”

He says that under the circumstances, donors and multilaterals must make aid conditional upon major social and economic reforms, which provided good social protection policies.

“Politicians in laggard countries will maintain they are trying to change but they are in fact not,” Coutts said.

“Only punitive measures work in these circumstances, I am afraid, otherwise nothing happens on the ground.”

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Twitter: @CalineMalek


France’s Macron says hoping for progress on Lebanon ‘within next hours’

France’s Macron says hoping for progress on Lebanon ‘within next hours’
Updated 03 December 2021

France’s Macron says hoping for progress on Lebanon ‘within next hours’

France’s Macron says hoping for progress on Lebanon ‘within next hours’

PARIS: French President Emmanuel Macron said on Friday he hoped there would be progress on the Lebanon crisis in the next hours.
“We will do all we can to re-engage the Gulf regions for the benefit of Lebanon... I hope the coming hours will allow us to make progress.” Macron said during a visit to the United Arab Emirates.
Lebanon is facing a diplomatic crisis with Gulf states, spurred by a minister’s critical comments about the Saudi Arabia-led intervention in Yemen that prompted Riyadh, Bahrain and Kuwait to expel Lebanon’s top diplomats and recall their own envoys. The UAE withdrew its envoys.


US critics of Israel face challenges in redrawn Congress districts

US critics of Israel face challenges in redrawn Congress districts
Updated 03 December 2021

US critics of Israel face challenges in redrawn Congress districts

US critics of Israel face challenges in redrawn Congress districts
  • Planned changes to district boundaries could affect nine members of Congress who have a record of voicing support on Palestinian issues

CHICAGO: Nine members of Congress who have been vocal critics of Israel’s policies towards the Palestinians could face tougher re-election campaigns as a result of their districts being redrawn, an analysis by Arab News shows.

Every 10 years, the dominant political parties in many states re-draw district boundaries based on demographic data provided by the US Census, which does not count Arab and Muslim Americans as a separate category.

Where population shifts have led to proposed boundary changes, incumbents may be forced to stand in new districts. That’s the challenge facing Illinois representative Marie Newman, who won election in 2020 in the 3rd Congressional District, which has the largest concentration of Palestinian American voters.

Newman has chosen to face-off with Sean Casten, who is very strong on climate change, in the new 6th District rather than stand against Jesus “Chuy” Garcia, who is one of only two Hispanic congress members in Illinois, in the 4th District. Casten is a strong supporter of Israel and silent on Israeli violence against Palestinians, while Garcia has often joined Newman to support pro-Palestinian legislation, including voting against a bill giving Israel $1 billion for its Iron Dome defense system last September.

“Rep. Newman was supportive of the push to create a second congressional district of Latino influence and understood that doing so would mean the need to shift boundary lines of existing CDs in the Chicagoland area,” Newman campaign spokesperson Ben Hardin said.

Describing the challenges as “inevitable,” Hardin said: “Representative Newman is grateful … to have the support of so many people here in Chicago’s southwest side and in the south and west suburbs, including a strong coalition of supporters from the Arab and Muslim American community.”

The new Illinois district map was approved by Illinois Gov. J.B. Pritzker, one of Israel’s strongest advocates, in November. Pritzker aroused anger among Arab Americans after refusing to apologize for disparaging remarks he made in a 1998 congressional race in which he accused a rival of accepting money from a Muslim group that Pritzker asserted supported terrorists.

“There is no doubt that the Illinois Democrats are seeking to undermine Newman, who has been a vocal supporter of Palestinian, Arab and Muslim rights,” said Hassan Nijem, the president of the American Arab Chamber of Commerce.

“She and Chuy Garcia are the only Illinois Democrats to defend Palestinian rights and recognize our growing community.”

The Illinois primary has been delayed from March until June 28, 2022, because of the COVID-19 pandemic.

In addition to Newman and Garcia, seven other members of Congress who voted against the Iron Dome money could be affected by district changes.

They include Cori Bush of Missouri; André Carson of Indiana; Raúl Grijalva of Arizona; Ilhan Omar of Minnesota; Ayanna Pressley of Massachusetts; Rashida Tlaib of Michigan; and Thomas Massie of Kentucky, a Republican Congressman who consistently votes against all foreign aid regardless of the recipient.

Tlaib, Pressley and Omar are members of the “Squad,” a group of progressive Democrats that includes New York Congresswoman Alexandria Ocasio-Cortez. Instead of voting against the Iron Dome funding, however, AOC voted “present” not taking a position.

In Michigan, which is holding its primary on Aug. 2 next year, mapmakers are proposing to re-draw Tlaib’s 13th district, increasing the number of African American voters. That could be important even though Tlaib defeated several African American candidates when she first ran and won office in the predominantly African American district in 2018.

Tlaib may be forced into a new district against pro-Arab Democrat Debbie Dingell. However, she could survive as the Michigan process puts remapping in the hands of an independent commission rather than partisan politicians. The final Michigan remap might not be completed until late January.

Also in Michigan, proposed changes would pit Jewish Democratic Congressman Andy Levin, who has been an outspoken supporter of the two-state solution for Palestine and Israel, against Brenda Lawrence.

Minnesota congressional remapping plans have targeted Omar and another pro-Palestinian Congresswoman, Betty McCollum, although maps in those districts have not been finalized.


Israeli agents convinced Iranian scientists to blow up their own nuclear facilities

Israeli agents convinced Iranian scientists to blow up their own nuclear facilities
Updated 03 December 2021

Israeli agents convinced Iranian scientists to blow up their own nuclear facilities

Israeli agents convinced Iranian scientists to blow up their own nuclear facilities
  • They posed as Iranian dissidents and smuggled bombs into the Natanz facility disguised as food
  • Israel had pledged to never allow Iran to obtain nuclear weapons

LONDON: Agents from the Mossad convinced Iranian scientists to blow up their own nuclear facilities by “posing as dissidents” and smuggling explosives disguised as food into facilities, according to reports.

According to The Jewish Chronicle, Israeli agents convinced up to 10 scientists to destroy the Natanz nuclear facility, wiping out 90 percent of its centrifuges – crucial for research into nuclear weapons.

They are said to have smuggled some explosives into the plant in food lorries, while others were dropped in via drones and picked up by scientists – who they convinced to use against the nuclear sites by posing as Iranian dissidents.

The attack on the facility is just one of a long line of Israeli sabotages of Iranian nuclear facilities, a strategy that they have engaged in more as Iranian nuclear research has progressed.

The Natanz facility, a critical nuclear research site, has been hit by at least three attacks linked to the Israeli secret service, the Mossad.

In another incident, agents used a quadcopter drone to fire missiles at the Iran Centrifuge Technology Company in an attempt to disrupt its research.

In recent years, following the US withdrawal from the 2015 Iran nuclear deal, Iran has increased its atomic energy research, including enriching growing quantities of uranium above the levels required for civilian nuclear activity such as energy production.

In April Iran said that it would start enriching uranium up to 60 percent after the attack on its Natanz plant which it blamed on Israel – that is closing in on the 90 to 95 percent enrichment required for nuclear weapons.

This week – much to the ire of Israel – Iran and the US returned to the negotiating table to try to find a deal to curb Iran’s nuclear activity in exchange for relief from crushing economic sanctions imposed on the country by the US and its allies.

But on Thursday, Israeli officials called on the US directly to cease those negotiations.

In a phone call with US Secretary of State Anthony Blinken, Israeli Prime Minister Naftali Bennett called for “concrete measures” to be taken against Iran.

He said that Tehran was carrying out “nuclear blackmail” as a negotiation tactic and that “this must be met with an immediate cessation of negotiations and by concrete steps taken by the major powers,” according to a statement released by his office.

The Israeli leader also expressed his concern about a new report from the UN, issued during the US-Iran talks in Vienna, which showed that Iran had “started the process of enriching uranium to the level of 20 percent purity with advanced centrifuges at its Fordo underground facility.”

Israel, the only nuclear-armed state in the Middle East, has pledged never to allow Iran to obtain nuclear weapons.


Lebanon information minister resigns

Lebanon information minister resigns
Updated 53 min 38 sec ago

Lebanon information minister resigns

Lebanon information minister resigns

BEIRUT: Lebanon’s Information Minister George Kordahi has officialy submitted his resignation on Friday to “give Lebanon a chance.”
“I will resign this afternoon,” Kordahi earlier told AFP. “I do not want to cling to this position, if it can be useful, I want to give Lebanon a chance.”
An official at the presidency confirmed to AFP that President Michel Aoun had received a call from Kordahi confirming he would submit his resignation.


UAE, France sign $18 billion deal for 80 Rafale jets as Macron starts Gulf tour

UAE, France sign $18 billion deal for 80 Rafale jets as Macron starts Gulf tour
Updated 03 December 2021

UAE, France sign $18 billion deal for 80 Rafale jets as Macron starts Gulf tour

UAE, France sign $18 billion deal for 80 Rafale jets as Macron starts Gulf tour
  • Macron arrived in the early hours of Friday for a brief Gulf tour where he will also visit Qatar

DUBAI: French President Emmanuel Macron met Abu Dhabi Crown Prince Sheikh Mohammed bin Zayed on Friday at the start of a two-day Gulf tour that saw France sell the UAE 80 French-made Rafale warplanes for $18.08 billion (€16 billion). 
France’s Defense Minister said the deal was France’s largest-ever weapons contract for export while the Minister for the Armed Forces hailed the deal as "historic."

There was no immediate confirmation of the deal from Emirati officials. Macron was greeted at the leadership pavilion at Dubai’s Expo site for talks with Sheikh Mohammed.
“I don’t want to reveal the Christmas present” before the meeting, UAE presidential adviser Anwar Gargash told journalists in the build-up to the talks in Dubai.
Macron arrived in the early hours of Friday for a brief Gulf tour where he will also visit Qatar, host of next year’s World Cup, before traveling to Saudi Arabia on Saturday.
The UAE, which celebrated its 50th anniversary on Thursday, is expected to order dozens of Rafale jets to replace its Mirage 2000 aircraft acquired in the late 1990s.
The Emirates is the fifth biggest customer for the French defense industry with $5.31 billion (€4.7 billion) from 2011-2020, according to a parliamentary report.
Macron is accompanied by a large delegation in Dubai including Foreign Minister Jean-Yves Le Drian, Finance Minister Bruno Le Maire and Defense Minister Florence Parly.