by Zeina Siam and Akl Fahed
With more than 400 million people, the Arab world encompasses diverse ethnicities, religions, cultures—and increasingly a range of public health ills.
That was not always the case. Starting in the 9th century, the Arab World contributed immensely to public health scholarship.Arab scholars discovered how to characterize several infectious diseases, described how hygiene prevents disease transmission, and introduced pharmacies and medical records. They translated texts into Latin, allowing European scholars to study and replicate the Arab world’s medical findings during the high Middle Ages and Early Renaissance. One of the most famous Arab scholars, Ibn Sina (Avicenna), wrote The Canon of Medicine, which became the standard textbook of medieval medicine.
Fast-forward to today, and in almost all aspects of public health you find the Arab World struggling. From the polio outbreak in Iraq and Syria to Sudan’s ongoing battle with leishmaniasis, communicable disease outbreaks have taken a toll on the region. Non-communicable diseases are also becoming more common. Qatar, Kuwait, Saudi Arabia, and Bahrain rank among the top 10 countries worldwide for diabetes prevalence. Several Arab countries are unable to provide basic reproductive health, withMauritania, Yemen, Somalia, and Djibouti failing to meet the Millennium Development Goals targets for reducing under-5 mortality. Mental health issues present yet another challenge—especially in areas where conflicts are ongoing and there are few mental health services. For example, in Palestine in 2009, many adolescents were found to suffer from post-traumatic stress disorder.
Behavioral risk factors are a growing concern as well. Several Arab countries have some of the highest worldwide rates of mortality from road traffic accidents, and many youths smoke waterpipes. Environmental health also is a concern. Jordan, one of the most water scarce countries worldwide, is struggling to sustainably supply water, while meeting the needs of the hundreds of thousands of Syrian refugees it is hosting.
So will public health in the Arab world improve in the near future? Perhaps. One important step was the publication in 2012 of the first comprehensive book on the subject, Public Health in the Arab World, a collaborative work of 81 authors. The Lancet’s2014 special issue on health in the Arab world produced by regional and international experts also highlighted health priorities in the region. Other positive steps have been taken, including launching the online platform Global Health Middle East, which draws global health experts’ attention to the challenges across the region.
This momentum has not slowed down. More and more public health experts are focusing their energies on the Arab world, especially following the Arab Spring, which brought new hope to large parts of the region. However, long-term improvement in the public health sector requires sustainability. It is important to keep new collaborations going, such as those between the Gulf Cooperation Council countries and state-of-the-art Western institutions, and to digitalize data, so experts can learn how to create better public health programs. In addition, improving public health outcomes requires knowledge of the region’s cultures, societies, and politics. Without that knowledge, diagnosing and treating the basis for unhealthy behaviors will be incredibly difficult, if not impossible.
Public health in the Arab world is influenced by political instability, environmental challenges, and cultural norms, among other factors. Yet, several trends—such as societal transformation following the Arab Spring, collaboration between regional and international experts, and most importantly the determination of the Arabs themselves—have given a jump-start to many public health initiatives in the Arab world. It is our continued involvement, learning, collaboration and focus as Arab health professionals and global health advocates that will determine how successful those initiatives ultimately are.
About the Author
Zeina Ali Siam is a Palestinian woman and a technical officer at the World Health Organization Regional Office for the East Mediterranean, in Cairo Egypt. She is also a short-term consultant at the World Bank Country Office in Palestine, and a contributor to ‘Kite’ Magazine, which reaches Syrian children across the region. Zeina earned her Masters of Science in Epidemiology from Harvard School of Public Health and her Bachelors of Science in Biological Engineering from the Massachusetts Institute of Technology. Akl Fahed, M.D., M.P.H. is a senior resident in Internal Medicine at the Massachusetts General Hospital and a research fellow in cardiovascular genetics at the Harvard Medical School. He studied biology and medicine at the American University of Beirut, politics and economics at Georgetown University, and public health at the Harvard T. H. Chan School of Public Health.