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Call for a Middle East Center of Disease Prevention
Author: Dr Safaa Bahjat
A Middle East Centre of Disease Prevention and control which deals only
with communicable disease - is it a dream that is hard to become true?
Is it like getting into a hot water?
The proposed Centre will not replace the public health institutions in
member states of the Middle East. Instead it will act as a coordination
resource and support centre on which these countries can call. Among
the tasks for this center will be harmonization of surveillance
methodologies across the Middle East providing scientific opinions and
technical assistance supporting preparedness, planning for health
emergencies and will provide a rapid response to health threats. Since
the 1950's, Arabs have made little progress in health related areas for
several reasons; the Arab Israeli conflict, the catastrophic health and
economic sanctions in Palestine, the embargos on Iraq and the major
wars which have erupted in the past few decades, mainly in Lebanon
(1975-1991), Kuwait 1990, and Iraq 1980-1988, 1991 and 2003. Military
spending by Arabs amounts to about US 60 billion dollars of which only
0.9 billion is allocated to research and development. 1
Oman, Saudi Arabia and Kuwait spent more than 10% of their gross
domestic Product GPD on defense. Iran spent more than 5% of their GDP
on defense, than on health at 4%. Historical population and GDP data
were obtained from the US Census Bureau
(http://www..census.gov/ips/www/idbacc.html)and EconStat
(http://econstat .com) respectively.
The stand off between Iran and the security council about it's nuclear
program has an alarming extra twist. It will have a detrimental effect
on the output of scientific research and endanger more the instability
of the region. From a public health prospective, avoidance of violent
conflicts is the key objective in international relations. Are there
any ways of analyzing such stand-offs, which might suggest ways to
resolve them. Commentators have noted similarities between this
conflict and that of the USA and the USSR during the cold war, in which
game theory was first used to analyze and attempt to predict the
behavior of the participants. One such a game is "chicken" when two
participants engage into a competition, say a head-on car race, which
is bound to end in a disaster unless one swerves. To outsiders the game
seems insane but to the participants in whom many complex principles of
prestige, honour, territory security and so on are at stake, it can
feel as if they have no choice but to take part. International
diplomacy is the art of persuading one or both to swerve with out loss
of face. Sometimes this is done by introducing a new factor into the
game, which both participants can agree on and use as a way out of
direct confrontation.
Are there any diversions that might be used to draw the attention of
the participants away from the conflict? One might be reassessment of
how such games affect the country's economy. So instead of military
spending which is draining resources, governments can invest in civil
health.
One of the urgent questions is are we prepared for the next pandemic of
influenza? As we began the new century did we launch arrangements
carefully and thoughtfully in order not to be overwhelmed in the first
wave of global infection, while there is still time? There is a window
of opportunity open now that will gradually close over the coming
months. Remember, the 2 pandemics in 1917 and 1968 the causalities
numbered 6 million world wide and the virology community did very
little except to observe and record. The coming influenza pandemic will
cut huge swathes in the world's community and history will look with
jaundiced eyes, should governments hesitate?
The SARS outbreak of 2003 awakened a new aggressive spirit underpinned
with molecular science and rapid diagnosis .We would no longer wish to
be the audience at macabre theatres of infection, rather, infectious
disease experts, mathematicians, virologists ,vaccine specialist's and
chemotherapists would be thrown into the fray. The world was lucky with
SARS.
In the living memory is the capricious mother nature .The Bam
earthquake and the tsunami tragedy in Asia cruelly exposed the citizens
of this area to the mercy of nature through lack of planning and
scientific planning. The earthquake in South Asia is another example.
We should seize the opportunity of the economic boom, achieved by the
huge rise in the oil prices which afford a good chance for the
countries of the Middle East to improve the public health
infrastructure of the region.
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