Abu Dhabi

Source: Alittihad Newspaper

Mufakiru Alemarat

Dr. Ali Mohamed Al Khouri

Public health is one of the most important pillars of social stability and economic development in any society. This issue is increasingly important in the Arab world with the rise of complex health challenges, including chronic diseases, mental health, and weak health services and preventive systems. Although these issues are similar to those facing many other countries in the world, the economic and demographic context in the Arab world adds an additional dimension to the seriousness of these challenges. The rentier nature of Arab economies, rapid urbanization, and steady population growth make public health a priority in their policies.

Healthcare Market
According to Fortune Business Insights, the healthcare market in the Middle East and North Africa (MENA) region is estimated to be worth $241.13 billion in 2024 and is expected to grow to $412.25 billion by 2032 at a CAGR of 6.9 percent. This growth reflects the potential significant pressure on Arab economies’ budgets, and the assumption that profitability dominates healthcare services, which could lead to higher healthcare costs, neglect of preventive aspects, and weaken national productivity.

Non-communicable diseases
Non-communicable diseases are one of the most prominent health crises facing the Middle East and North Africa region. According to the World Health Organization, chronic diseases such as heart disease, diabetes, and cancer account for more than 70 percent of all deaths in the region. This reality extends to have a significant impact on countries’ economies, and is reflected in high treatment costs and low societal productivity. While these challenges are not limited to Arab society alone, the lifestyles and environment prevailing in Arab cities, coupled with the individualistic culture’s tendency towards unhealthy habits, exacerbate the dimensions of this problem.

Infectious diseases and epidemics
Infectious diseases and epidemics are other major health challenges that clearly indicate the weakness of Arab health systems. The Covid-19 pandemic has revealed the limited capabilities of health infrastructure and medical resources. Its repercussions were not limited to economic losses represented by a contraction in the region’s GDP by about 5 percent in 2020, according to estimates by the International Monetary Fund, but also extended to exacerbating the unemployment and poverty crises, and deep social and economic impacts, leaving economic scars that are difficult to erase.

Antimicrobial resistance
Another hidden health issue is antimicrobial resistance, which makes traditional treatments, such as antibiotics, less effective or even ineffective, makes infectious diseases more difficult to treat, and contributes to their spread. According to the World Health Organization, Arab countries are the countries in the world that consume the most antibiotics in an excessive and unregulated manner, whether in human or animal treatments.

According to a study published in The Lancet in September 2024, antimicrobial resistance could cause up to 39 million deaths worldwide by 2050, and annual economic losses of up to $3.4 trillion by 2030.

Mental health
is a health issue that is often overlooked in the Arab world, despite statistics indicating that approximately 35.5 percent of the region’s population suffers from mental disorders. Mental health services remain limited in terms of specialized personnel and qualified hospitals, leaving a large segment of society without treatment. The reasons may be due in part to a lack of funding and training opportunities, in addition to negative social views towards psychotherapy. This marginalization in dealing with this issue may have wide-ranging negative effects on economic productivity and social stability in the Arab region.

Health disparities
Health disparities between countries in the region are another issue that reflects the depth of the gap in terms of access to and quality of healthcare services. The Gulf Cooperation Council countries have relatively advanced healthcare systems, with a general trend towards investing in hospitals and medical technology. In contrast, the healthcare systems in Arab countries are still outdated, suffer from limited and insufficient medical services, in addition to the collapse of healthcare systems in some countries experiencing conflicts and wars.

Data on healthcare spending as a percentage of GDP in Arab countries indicate that most countries spend less than the global average of 10 percent of GDP on healthcare systems. At the level of the Arab Gulf countries, the average healthcare spending as a percentage of GDP ranges between 4 percent and 6 percent.

Strained Resources and Chronic Crises
It is clear from this narrative that health challenges in the Arab world are more than just a health issue, as they directly impact economic growth trajectories. Studies indicate that the cost of treating lifestyle-related diseases, such as obesity, diabetes, and heart disease, in the GCC alone could reach $68 billion by 2030 if effective preventive measures are not taken. Add to this the fact that strained health systems drain financial resources that could be directed towards other sectors, such as education, infrastructure, and innovation.

Recommendations
Addressing these challenges requires policymakers to adopt integrated strategies. The complex challenges, some of which have been reviewed here, are not isolated problems, but rather intertwined issues that require a systemic approach. The following recommendations provide general proposals for action areas aimed at helping policymakers address the structural aspects of health systems and improve their response capabilities to adapt to current and future challenges.

Digitizing health systems
Developing health care systems should be a priority on national agendas. Arab countries should leverage digital technologies to build smart, connected health care systems. National electronic health records and AI-based predictive analytics have become a global trend that must be adopted in the Arab region to improve disease management, allocate resources, and deliver optimal health care.

Global practices such as telemedicine should also be emulated to expand community access to healthcare, a practice that has already seen great success in countries such as the UAE. It is also important for governments to build partnerships and collaborations with major and emerging technology companies, and encourage them to accelerate digitization in the growing health technology sector.

Financing models
Current financing models adopted by governments and health institutions in the Arab world, such as budget allocations, individual contributions, and health insurance systems, are clearly inadequate to address the complex health challenges facing the region. Policymakers should explore innovative financing mechanisms, such as health impact bonds, where private sector investors finance specific programs to improve national health outcomes, such as reducing the number of patients with certain diseases, and then pay out financial benefits based on the results achieved.

In addition, establishing sovereign health investment funds by investing public funds can contribute to allocating independent financial resources to finance major health projects, such as building hospitals, developing health infrastructure, regional disease surveillance systems, and supporting medical research.

Regional integration of health policies
It is important for Arab countries to consider establishing a unified public health body, similar to the European Centre for Disease Prevention and Control, to oversee regional health initiatives. Such an institution could facilitate data sharing, coordinate responses to epidemics, and provide technical expertise to countries with limited resources. Such a unified approach would support better security of medical supplies, building global health partnerships, as well as harmonization of priorities and policies and a united collective response to health issues at the international level.

Private sector participation
Policymakers should create an enabling environment for private sector investment in developing the national health system. Tax exemptions, grants, and stimulating public-private partnerships can encourage private companies to invest in the pharmaceutical and medical device industries, and adopt health technology, such as diagnostic systems, smart consultations based on artificial intelligence, surgical robots, and others. Localizing pharmaceutical manufacturing in Arab countries and employing modern production technologies can also reduce dependence on imports and reduce the risks resulting from disruption of global supply chains.

Urban planning
Health outcomes are closely intertwined with the way cities are planned, transport systems, and environmental policies. The global trend shows governments focusing on “healthy cities” initiatives that link urban planning with public health considerations. Expanding green spaces, building pedestrian-friendly infrastructure to encourage physical activity, and strict environmental regulations to reduce air pollution and emissions can improve public health and reduce the health burden on health systems. A World Health Organization report suggests that investing in developing and improving health systems in developing countries could generate 4 percent economic growth by 2030.

Leveraging Genomics and Precision Medicine
Arab countries with advanced healthcare infrastructure, such as the UAE and Qatar, have the potential to be leaders in genomics and precision medicine. Investing in research laboratories and centers specializing in genomics and biomedicine can revolutionize the prevention and discovery of treatments for genetic disorders prevalent in the region, such as thalassemia and sickle cell anemia. In the Sultanate of Oman, for example, statistics indicate that 5 percent of the population carries the sickle cell gene.

Precision medicine initiatives also have the potential to address the factors behind the high incidence of diabetes and cardiovascular disease among the Gulf population, which is among the highest in the world.

Unified health approach
It is also important for Arab countries, whether agricultural or importing, to focus on developing integrated health policies based on the ecological system that links human, animal and environmental health, to confront the problem of antimicrobial resistance. As for agricultural countries, they must impose strict regulations on the use of antibiotics in agriculture, and establish effective monitoring systems to monitor antimicrobial resistance trends.

Importing countries should strengthen screening standards for imported products, such as meat and agricultural products, to ensure they are free of antibiotic-resistant microbes. These measures should include restructuring import standards and collaborating with trading partners to reduce the use of antibiotics in production. Regional cooperation can also support these efforts by establishing committees to coordinate policies and research, and share expertise and resources.

Mental health programs
Mental health and mental health care in the Arab world require addressing the stigma surrounding them, to change cultural perceptions and negative beliefs about them in local communities. Media campaigns on digital platforms, social media, and school curricula that address mental health may be among the influential means.

Training programmes for primary health centre workers, health assistants and social workers in schools and care centres will enable them to provide health education and raise awareness in local communities, in addition to directing cases to available mental health services. Educating and raising awareness among families may also help them identify early signs of mental health problems that may appear in their members, thus representing a fundamental pillar for supporting general mental health and building individuals who are more prepared to contribute to building society.

Health Workforce
Given the chronic shortage of healthcare workers in many Arab countries, expanding the workforce of healthcare professionals and improving the quality of services provided should be a national and strategic priority. National policies should encourage investment in establishing and developing medical colleges, institutes and centers of excellence for medical training, as well as leveraging emerging technologies such as artificial intelligence and virtual reality to provide high-quality educational opportunities at reduced or partially covered costs, or by government or private sector colleges. Cooperation between Arab countries can also help address gaps resulting from the shortage of medical personnel in some countries, through the exchange of human resources and expertise.

Regional Emergency Funds
to Ensure Rapid Response to Public Health Crises Arab countries should establish a regional health emergency fund, which aims to provide immediate and flexible funding to address any health emergency crises they may face. This fund can serve as a tool to support regional efforts to prepare for and respond to epidemics and health disasters. In addition, member states and international partners can jointly finance this fund, with funds allocated to disaster preparedness, vaccine procurement, and rebuilding health infrastructure in conflict-affected areas.

Establishing a rapid deployment mechanism could significantly enhance the region’s resilience to future health emergencies. Adding an international dimension to the Fund could also enhance its role and impact, such as participating in providing health assistance to countries with weak health systems, or supporting relief efforts in areas outside the Arab region, which could allow it to leverage international grants and aid to boost its resources.

Conclusion: The necessity of strategic action
. In conclusion, public health challenges in the Arab world are no longer reduced to being purely health problems, but have become a strategic issue that deeply affects the stability of Arab societies and future development paths in the region. Policymakers face a great responsibility that requires the adoption of comprehensive and bold national strategies that go beyond traditional solutions and current patterns of thinking and development, and lay new foundations for dealing with these challenges.

Current data imposes that public health must become a priority that cannot be postponed on the agendas of strategic planning and decision-making. The health issue cannot be the responsibility of a single sector, but rather represents a national commitment and responsibility that requires the integration of efforts of all state institutions and calls for activating the role of all components of society. There is no doubt that regional and international cooperation will add a vital element towards building more flexible and sustainable health systems. Delay here will place the economic and social future of Arab countries at critical junctures whose repercussions will be difficult to overcome.