How falling cases of tuberculosis in Iraq reflect a wider health system recovery

Special How falling cases of tuberculosis in Iraq reflect a wider health system recovery
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Equipped with new, cutting-edge tools and technologies, health care providers in Iraq can reach more people across the country to test for, treat and prevent the disease. (Photo: Global Fund/Ashley Gilbertson)
Special How falling cases of tuberculosis in Iraq reflect a wider health system recovery
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Chest X-ray of human chest or lung to detect tuberculosis. (Getty Images)
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Updated 17 April 2025
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How falling cases of tuberculosis in Iraq reflect a wider health system recovery

How falling cases of tuberculosis in Iraq reflect a wider health system recovery
  • Iraq has halved its tuberculosis rate over the past decade through tech-driven diagnosis and expanded mobile health services
  • AI-supported X-rays and GeneXpert machines now detect TB faster, even in remote areas and among high-risk populations

DUBAI: Sameer Abbas Mohamed, a Syrian refugee from Qamishli who fled to Iraq in 2013, was terrified when his one-year-old son, Yusuf, was diagnosed with tuberculosis. He knew the disease was life-threatening — and highly contagious.

“I have two older boys, and I was scared they would catch the disease,” said Mohamed, who lives in Qushtapa refugee camp for Syrians in Irbil, home to most of the 300,000 Syrian refugees in the Kurdistan Region of Iraq.

“Yusuf was also very young and I worried about losing him.”




IOM mobile medical teams conduct TB awareness sessions and screening of presumptive cases in settlements hosting displaced and Syrian refugees as well as other hard to reach areas. (Photo: IOM/Raber Y. Aziz)

Mohamed consulted several doctors when Yusuf began coughing. Scans revealed a mass on the right anterior wall of his chest. A diagnosis was finally made when a general surgeon reported the case to Iraq’s National TB Program.

Following surgery to remove the mass, Yusuf returned home, where nurses delivered an all-oral regimen, monitored his treatment, tracked his progress, offered support, and educated the family on isolation measures to prevent the disease’s spread.

Within six months, Yusuf was cured.




An IOM medic checks a little girl at the family's rented house in Kirkuk. (Photo: Anjam Rasool/IOM Iraq, 2019)

His journey reflects the progress made in combating TB in Iraq, especially the drug-resistant variant that has emerged in the conflict-affected country — which until recently had the region’s highest prevalence of TB cases.

Iraq’s NTP, supported by the International Organization for Migration, the Global Fund, and the World Health Organization, is tracking TB among displaced communities using advanced diagnostic technologies and artificial intelligence.

Giorgi Gigauri, IOM Iraq’s chief of mission, told Arab News that TB detection and timely treatment have helped to drive a significant decline in cases in Iraq.




Lab technicians at the Chest and Respiratory Diseases in Erbil use blood samples to test TB patients' tolerance for medication. (Photo: Global Fund/Ashley Gilbertson)

This was achieved, he said, through a tech-driven strategy, including the installation of the advanced 10-color GeneXpert detection machine across Baghdad, Basrah, Najaf and Nineveh, enabling faster diagnoses.

IOM’s mobile medical teams were also equipped with 10 AI-supported chest X-ray devices, known as CAD4-TB, which can detect the disease in seconds — even in high-burden areas such as refugee camps and prisons.




Chest X-ray of human chest or lung to detect tuberculosis. (Getty Images)

Routine screenings by these mobile units helped to increase the detection rate of drug-resistant TB from 2 percent to 19 percent, and drug-sensitive TB from 4 percent to 14 percent between 2019 and 2024, according to IOM data.

FAST FACTS

• TB is caused by the Mycobacterium tuberculosis bacterium that primarily affects the lungs.

• It spreads through airborne droplets when an infected person coughs or sneezes.

• Symptoms include a persistent cough, chest pain, fever, night sweats and weight loss.

• With proper treatment using antibiotics, TB is curable, though drug-resistant strains exist.

After screening, sputum samples are taken to central labs, making testing accessible for those unable to travel or living in areas with limited health care access.

Thanks to these efforts, TB cases in Iraq have fallen dramatically — from 45 to 23 cases per 100,000 people between 2013 and 2023. The current prevalence is 15 per 100,000, with an estimated mortality rate of three per 100,000.




Hussain Khader Ismael is screened for TB inside a mobile lab parked outside a home for elderly people in Mosul. (Photo: Global Fund/Ashley Gilbertson)

In many ways, these numbers reflect Iraq’s wider public health recovery after decades of instability, including the crippling sanctions of the 1990s, the successive bouts of violence that followed the 2003 US-led invasion, and the 2014 rise of Daesh.

“Despite years of instability, progress made in the detection, treatment and prevention of the spread of TB restored trust in health care services by strengthening infrastructure and extending care to vulnerable groups like prisoners and displaced populations,” Gigauri told Arab News.

“It also supports upskilling of health professions and creates sustainable systems that can support responses to other communicable diseases.




Abdi was transported to a TB center for urgent examination as soon as he showed symptoms of TB. (Photo: IOM/Raber Y. Aziz)

“Efforts made by all partners under NTP have contributed to national recovery by addressing urgent health needs and laying a foundation for timely detection of preventable and treatable diseases.”

Despite a period of relative stability, Iraq still faces considerable humanitarian pressures amid a fragile economy and an unpredictable security landscape. According to UNHCR, more than 1 million Iraqis remain internally displaced, with 115,000 living in 21 camps across the Kurdistan Region.

Roughly five million displaced people have returned to their towns and villages since Daesh’s territorial defeat in 2017. But these areas often lack basic infrastructure, increasing the risk of TB outbreaks.




Qayara Airstrip Camp, south of Mosul, was built by IOM as an emergency site to host displaced persons from Mosul. (Photo: Raber Y. Aziz/IOM Iraq, 2016) 

In Mosul — Iraq’s second-largest city, which endured three years under Daesh — those unable to afford housing live in overcrowded settlements, where malnutrition and exposure to the elements weaken immunity.

The mobile medical teams have been a game-changer for these vulnerable communities.

Digital X-rays equipped with CAD4-TB, powered by AI, now enable quick and accurate TB detection — a stark improvement from the three-month wait many patients once faced for CT scans.




The CAD4TB system uses AI to instantly analyze digital X-rays for signs of TB. (Photo: Global Fund/Ashley Gilbertson)

This technology also reduces radiation exposure. A single CT scan can expose patients to the equivalent of 300 X-rays, according to Dr. Bashar Hashim Abbas, manager of the Chest and Respiratory Diseases clinic in Mosul.

Abbas said that mobile medical teams and digital X-ray devices have been vital for reaching remote communities and detainees who lack clinic access.

“The mobility of these machines helped us examine prisoners who were difficult to bring into the clinic due to complex security protocols. We discovered many cases, especially multidrug-resistant TB patients, in this way,” Abbas told Arab News.

“We conduct X-rays and take sputum samples for further lab investigations. Therefore, we take the diagnostic tools to them as much as we can, scaling up TB prevention and providing treatment.”




IOM maintains seven Mobile Medical Teams in five crisis-affected governorates with high numbers of IDPs, returnees and vulnerable host community members. (Photo: Global Fund/Ashley Gilbertson)

A centralized disease surveillance system, District Health Information Software 2, allows lab results to be registered and coordinated across labs, facilities, and the Iraqi Ministry of Health, improving routine TB reporting.

IOM’s TB services reached 6,398 people in 2024, with 120 drug-resistant TB cases treated. These efforts have been bolstered by $11 million in Global Fund support since 2022.

A key breakthrough has been shifting the treatment of multidrug-resistant TB from a burdensome series of injections to a simpler, all-oral regimen, which shortened recovery time from two years to six months and significantly improved outcomes.




An all-oral regimen has shortened recovery time from two years to six months and significantly improved outcomes.. (Photo: IOM/Raber Y. Aziz)

“Previously, treatments involved daily injections for at least six to eight months, which were difficult to sustain for patients and treatment outcomes were relatively poor at 50 percent,” Grania Brigden, senior TB adviser at the Global Fund, told Arab News.

“However, the innovation in treatment through the all-oral regimen has reduced treatment to six months with a 75 percent to 80 percent success rate.”

Although no new TB vaccines are currently available, researchers are optimistic about developing more effective ones in the next five years. The existing BCG vaccine offers only partial protection and is less effective for adults and adolescents, who are more prone to transmission.




The innovation in treatment through the all-oral regimen has reduced treatment to six months with a 75 percent to 80 percent success rate. (Photo: Global Fund/Ashley Gilbertson)

New vaccines are vital for achieving the WHO’s End TB Strategy goals — reducing TB mortality by 95 percent and incidence by 90 percent by 2035. Brigden said ongoing investment is key to meeting these targets.

Meanwhile, the Global Fund is focused on halting TB’s spread in Iraq. “We have invested significantly in commodity security to ensure that everyone who tests positive or is notified of TB is put on treatment,” said Brigden.

Thanks to these steps, many — like young Yusuf — are alive today who might otherwise have succumbed without proper care.




WHO and partners join WHO mission to the Iraqi National TB institute in Baghdad. (Photo: WHO) 

“The discussions of tuberculosis we had with the nurse who gave the medication had a positive impact on us,” said Yusuf’s father, Mohamed.

“The nurse gave us information on how to isolate him after the first two to three weeks. He reassured us that if we gave him the medication regularly and made sure there were no gaps, everything would be getting well.

“This made us less scared.”
 

 


Palestinians struggling to survive as Israel plans for Gaza's ‘conquest’

Palestinians struggling to survive as Israel plans for Gaza's ‘conquest’
Updated 10 sec ago
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Palestinians struggling to survive as Israel plans for Gaza's ‘conquest’

Palestinians struggling to survive as Israel plans for Gaza's ‘conquest’
  • For many of the Gaza Strip's residents, the most immediate threat to their lives remains the spectre of famine amid a months-long Israeli blockade
  • Israel’s new military roadmap changes little as it already controls most of Gaza, a resident says

GAZA CITY, Palestinian Territories: Israel’s plan for the “conquest” of Gaza has sparked renewed fears, but for many of the territory’s residents, the most immediate threat to their lives remains the spectre of famine amid a months-long Israeli blockade.
The plan to expand military operations, approved by Israel’s security cabinet overnight, includes holding territories in the besieged Gaza Strip and moving the population south “for their protection,” an Israeli official said.
But Gaza residents told AFP that they did not expect the new offensive would make any significant changes to the already dire humanitarian situation in the small coastal territory.
“Israel has not stopped the war, the killing, the bombing, the destruction, the siege, and the starvation — every day — so how can they talk about expanding military operations?” Awni Awad, 39, told AFP.

Awad, who lives in a tent in the southern Gaza city of Khan Yunis after being displaced by Israeli evacuation orders, said that his situation was already “catastrophic and tragic.”
“I call on the world to witness the famine that grows and spreads every day,” he said.
The UN’s World Food Programme (WFP) in late April said it had depleted all its foods stocks in Gaza due to Israel’s blockade on all supplies since March 2.

There is no food, no medicine, and no nutritional supplements. The markets are empty of food, and the government clinics and pharmacies have nothing

Umm Hashem Al-Saqqa, Gaza City resident

Aya Al-Skafy, a resident of Gaza City, told AFP her baby died because of malnutrition and medicine shortages last week.
“She was four months old and weighed 2.8 kilograms (6.2 pounds), which is very little. Medicine was not available,” she said.
“Due to severe malnutrition, she suffered from blood acidity, liver and kidney failure, and many other complications. Her hair and nails also fell out due to malnutrition.”
Umm Hashem Al-Saqqa, another Gaza City resident, fears her five-year-old son might face a similar fate, but is powerless to do anything about it.
“Hashem suffers from iron deficiency anaemia. He is constantly pale and lacks balance, and is unable to walk due to malnutrition,” she told AFP.
“There is no food, no medicine, and no nutritional supplements. The markets are empty of food, and the government clinics and pharmacies have nothing.”
New military roadmap
Gaza City resident Mohammed Al-Shawa, 65, said that Israel’s new military roadmap changes little as it already controls most of Gaza.
“The Israeli announcement about expanding military operations in Gaza is just talk for the media, because the entire Gaza Strip is occupied, and there is no safe area in Gaza,” he said.
The UN’s Office for the Coordination of Humanitarian Affairs (OCHA) estimates that 69 percent of Gaza has now been either incorporated into one of Israel’s buffer zones, or is subject to evacuation orders.

The reality is that Israel is killing Palestinians in Gaza by bombing, shooting, or through starvation and denial of medical treatment

Mohammed Al-Shawa, Gaza City resident

That number rises to 100 percent in the southern governorate of Rafah, where over 230,000 people lived before the war but which has now been entirely declared a no-go zone.
“There is no food, no medicine, and the announcement of an aid distribution plan is just to distract the world and mislead global public opinion,” Shawa said, referring to reports of a new Israeli plan for humanitarian aid delivery that has yet to be implemented.
“The reality is that Israel is killing Palestinians in Gaza by bombing, shooting, or through starvation and denial of medical treatment,” he said.
Israel says that its renewed bombardments and the blockade of Gaza are aimed at forcing Hamas to release hostages held in the territory.
Israeli Finance Minister Bezalel Smotrich praised the new plan for Gaza on Monday and evoked a proposal previously floated by US President Donald Trump to displace the territory’s residents elsewhere.
The far-right firebrand said he would push for the plan’s completion, until “Hamas is defeated, Gaza is fully occupied, and Trump’s historical plan is implemented, with Gaza refugees resettled in other countries.”


Norwegian NGO decries Israel plan to take over Gaza aid

Palestinians queue for a portion of hot food distributed by a charity kitchen at the Nuseirat refugee camp in central Gaza Strip
Palestinians queue for a portion of hot food distributed by a charity kitchen at the Nuseirat refugee camp in central Gaza Strip
Updated 58 min 20 sec ago
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Norwegian NGO decries Israel plan to take over Gaza aid

Palestinians queue for a portion of hot food distributed by a charity kitchen at the Nuseirat refugee camp in central Gaza Strip
  • Egeland said the Israeli government wanted to “militarise, manipulate, politicize the aid by allowing only aid to a few concentration hubs in the south”

OSLO: An Israeli plan to take over the distribution of humanitarian aid to Gaza at hubs controlled by the military is “fundamentally against humanitarian principles,” the head of the Norwegian Refugee Council (NRC) told AFP on Monday.
Israel’s security cabinet said there was “currently enough food” in the territory which has been under full Israeli blockade since March 2, and approved overnight the “possibility of humanitarian distribution” in Gaza.
“We cannot and will not do something which is fundamentally against humanitarian principles,” Jan Egeland told AFP.
He said “the United Nations agencies, all other international humanitarian groups and NGOs have said no to be part of this idea coming from the Israeli cabinet and from the Israeli military.”
Israel has accused Hamas of diverting humanitarian aid — which Hamas denies — and said its blockade was necessary to pressure the militant group to release Israeli hostages.
Egeland said the Israeli government wanted to “militarise, manipulate, politicize the aid by allowing only aid to a few concentration hubs in the south, a scheme where people will be screened, where it’s a completely inoperable system.”
“That would force people to move to get aid, and it would continue the starvation of the civilian population,” he said, adding: “We will have no part in that.”
“If one side in a bitter armed conflict tries to control, manipulate, ration aid among the civilians on the other side, it is against everything we stand for,” he stressed.
Meanwhile, the UN’s Office for the Coordination of Humanitarian Affairs (OCHA), said the Israeli scheme “will mean large parts of Gaza, including the less mobile and most vulnerable people, will continue to go without supplies.”
International aid organizations as well as Palestinians in Gaza have for weeks warned of a dire humanitarian situation on the ground.
The UN’s World Food Programme (WFP) has said it has depleted its food stocks and that the 25 bakeries it supports in Gaza have closed due to a lack of flour and fuel.


Iraq’s justice minister says prisons are at double capacity as amnesty law takes effect

Iraqi Justice Minister Khaled Shwani speaks during an interview with The Associated Press in Baghdad, Iraq, Saturday, May 3.
Iraqi Justice Minister Khaled Shwani speaks during an interview with The Associated Press in Baghdad, Iraq, Saturday, May 3.
Updated 05 May 2025
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Iraq’s justice minister says prisons are at double capacity as amnesty law takes effect

Iraqi Justice Minister Khaled Shwani speaks during an interview with The Associated Press in Baghdad, Iraq, Saturday, May 3.
  • Justice Minister Khaled Shwani acknowledged the overcrowding has put a severe strain on prison health care and human rights standards

BAGHDAD: As a general amnesty law takes effect in Iraq, the country’s prisons are facing a crisis of overcrowding, housing more than double their intended capacity, the country’s justice minister said in an interview.
Justice Minister Khaled Shwani told The Associated Press on Saturday that Iraq’s 31 prisons currently hold approximately 65,000 inmates, despite the system being built to accommodate only half that number.
He acknowledged that the overcrowding has put a severe strain on prison health care and human rights standards.
“When we took office, overcrowding stood at 300 percent,” he said. “After two years of reform, we’ve reduced it to 200 percent. Our goal is to bring that down to 100 percent by next year in line with international standards.”
Thousands more detainees remain in the custody of security agencies but have not yet been transferred to the Ministry of Justice due to lack of prison capacity. Four new prisons are under construction, Shwani said, while three have been closed in recent years. Two others have been opened and six existing prisons expanded.
The general amnesty law passed in January had strong support from Sunni lawmakers who argue that their community has been disproportionately targeted by terrorism charges, with confessions sometimes extracted under torture.
But opponents say the law would allow the release of people involved in public corruption and embezzlement as well as militants who committed war crimes.
The Iraqi Observatory for Human Rights, a watchdog group, said in a statement that “the current version of the general amnesty law raises deep concerns over its potential legal and security consequences.”’
Shwani said 2,118 prisoners have been released from the justice ministry’s prisons since the amnesty law took effect, while others had been released from the custody of security agencies before being transferred to the Ministry of Justice.
“We have a committee studying the status of inmates and identifying those who may qualify for release, but the vision is not yet final,” he said. The minister said he expects a “good number” to be released but “cannot specify an exact percentage until we receive clarity from the judiciary on who qualifies for the amnesty.”
Iraq’s prisons house hundreds of foreign nationals, most of them convicted of terrorism-related charges or affiliation with the Al-Qaeda and Daesh.
The inmates hail from countries including Kyrgyzstan, Kazakhstan, Azerbaijan, Turkiye, Egypt, North African nations, and several European states, as well as a handful of US citizens. Shwani said discussions are underway with several governments to repatriate their citizens, excluding those sentenced to death.
He said inmates have been repatriated under existing agreements with Iran, Turkiye, and the United Kingdom, including 127 Iranian inmates who were recently transferred back to Tehran.
An Iranian who was convicted in the 2022 killing of a US citizen in Baghdad remains in custody, however, Shwani said.
Stephen Edward Troell, 45, a native of Tennessee, was fatally shot in his car in November by assailants as he pulled up to the street where he lived in Baghdad’s central Karrada district with his family. Iranian citizen Mohammed Ali Ridha was convicted in the killing, along with four Iraqis, in what was described as a kidnapping gone wrong.
All executions have been halted following the issuance of the general amnesty law, Shwani said.
Iraq has faced criticism from human rights groups over its application of the death penalty and particularly over mass executions carried out without prior notice to lawyers or family members of the prisoners.
Shwani pushed back against the criticisms of prison conditions and of the executions.
“There are strict measures in place for any violations committed against inmates,” he said. “Many employees have been referred for investigation, dismissed, and prosecuted.”
He insisted that the “number of executions carried out is limited — not as high as reported in the media” and said the death penalty is only applied in “crimes that severely threaten national security and public safety,” including inmates convicted in a 2016 bombing attack in Baghdad’s Karrada district that killed hundreds of people, as well as cases of child rape and high-ranking Daesh leaders.
Executions have been paused to reassess cases under the new amnesty law, he said.


Israeli authorities destroy Palestinian homes in West Bank cities

Israeli authorities destroy Palestinian homes in West Bank cities
Updated 05 May 2025
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Israeli authorities destroy Palestinian homes in West Bank cities

Israeli authorities destroy Palestinian homes in West Bank cities
  • Israeli authorities demolish 25 structures that belonged to the Dababseh family in Khallet Al-Dabaa village
  • In Ramallah, forces raze a 150 sq. meter home that housed five people

LONDON: Israeli authorities demolished several Palestinian structures, including homes, in occupied West Bank cities on Monday.

Israeli forces demolished two homes in Al-Mughayyir village, north of Ramallah. They also destroyed a 200 sq. meter home in Al-Funduq, east of Qalqilya, for building without a permit. Additionally, several structures were demolished in the Jordan Valley.

Wafa reported that Israeli authorities demolished 25 structures that belonged to the Dababseh family in Khallet Al-Dabaa village, including homes, water wells, naturally formed caves, agricultural rooms, barns, and solar panels, after forcibly evicting residents.

In Ramallah, forces demolished a 150 sq. meter home that housed five people, while a demolition notice was issued for another house.

In the northern Jordan Valley, Israeli forces destroyed homes and livestock pens belonging to residents in Khirbet Al-Deir, while in Nabi Elias village, it raided several vehicle repair garages, the Wafa news agency reported.

The Wall and Settlement Resistance Commission, associated with the Palestinian Authority, reported that Israeli forces or settlers carried out 1,693 attacks on Palestinian towns, their properties, and lands in April.


Woman killed as gunmen attack Damascus nightclub: monitor, witness

People walk past the closed entrance of Al-Karawan nightclub on Damascus’ Saadallah Al-Jabri street on May 5, 2025. (AFP)
People walk past the closed entrance of Al-Karawan nightclub on Damascus’ Saadallah Al-Jabri street on May 5, 2025. (AFP)
Updated 05 May 2025
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Woman killed as gunmen attack Damascus nightclub: monitor, witness

People walk past the closed entrance of Al-Karawan nightclub on Damascus’ Saadallah Al-Jabri street on May 5, 2025. (AFP)
  • A witness, requesting anonymity for security reasons, said he “heard gunfire at dawn” as he was near the nightclub
  • “I saw a woman’s body, blood stains on the ground, and chaos after the shooting,” he said

DAMASCUS: Armed men opened fire inside a club in Damascus on Monday, killing a woman, according to a witness and a war monitor, the second attack in a week targeting the Syrian capital’s nightlife.
The perpetrators or their motives were unknown. Some Syrians have expressed fears that the country’s new authorities would seek to impose restrictions on public behavior but it was unclear whether the attackers were linked to them.
The Syrian Observatory for Human Rights, a Britain-based war monitor, reported that “unidentified gunmen attacked the Al-Karawan nightclub in the Hijaz area with automatic weapons and opened fire, killing a woman and wounding others.”
A witness, requesting anonymity for security reasons, said he “heard gunfire at dawn” as he was near the nightclub.
He told AFP that he “did not dare to enter the club until some time after the firing stopped.”
Inside the club, “I saw a woman’s body, blood stains on the ground, and chaos after the shooting,” he said.
Contacted by AFP, the interior ministry did not immediately respond to a request for comment about the deadly attack.
The club is located in a commercial area in the heart of Damascus, where many licensed nightclubs and bars have been operating for decades.
A resident of the same street said security forces had been monitoring the venue from a vehicle for days.
A local vendor said “there has never been any problem with the nightclub” in the five years he has worked in the area.
Hours before the shooting, a video circulated on social media showing security camera footage from a previous attack on a nightclub in the same area.
The footage, verified by AFP, shows gunmen entering the venue before beating fleeing men and women with their weapons.
Authorities said on Sunday that the gunmen involved in the first incident had been arrested.
“After initial investigations and reviewing the recordings, the individuals involved in the assault were identified, arrested and transferred to the judiciary,” the interior ministry said in a statement carried by Alekhbariah television.
“Any transgression or assault affecting citizens or public facilities will be met with strict legal measures,” it added.
Since the fall of longtime ruler Bashar Assad in December, the intentional community has been pressing Syria’s new rulers to respect personal freedoms, protect minorities and include all components of society in the transitional period.