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

The World Bank report says authorities painted an overly optimistic picture in self-assessments of the readiness of their health systems.
Thirteen of 16 countries in MENA are expected to have lower living standards in 2021 than their pre-COVID-19 levels
DUBAI: A combination of chronic underfunding of public health services and long-term socioeconomic 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. report.

Titled, “Overconfidence: How Health and Economic Failures Left the Middle East and North Africa ill-prepared to deal with COVID-19,” the report highlights the stress on MENA’s healthcare systems even before the pandemic.

The study says that an inflated public sector and excessive national debt displaced investment in MENA countries in social services such as health, a symptom it described as “fiscal myopia.” In turn, that transferred some health costs to individuals.

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

The report concluded that the region’s public health systems were not only ill-prepared to absorb the impact of the pandemic, but also that the authorities were guilty of over-optimism in self-assessments of the readiness of their health systems. 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 political priorities. However, they caution against a generalization that tends to overlook differences at the local level.

Dr Theodore Karasik, Senior Advisor at Gulf State Analytics, told Arab News: “The lesson is to shift the priority within government budgets and other outside aid, as well as having a much better healthcare system.

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

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

Some countries, especially the energy exporters of the Gulf Cooperation Council, were able to organize a rapid response to the pandemic thanks to robust systems and better preparedness. “The models installed in the Gulf are extremely useful to compare and contrast their performance,” said Karasik.

“These models are working and there is evidence that they are being used in other countries. Therefore, leaders are applying what they consider to be the best methods. ”

Some MENA governments that were slow to respond to the global virus outbreak subsequently adopted many of the same practices as their CCG counterparts, recognizing that disease control should be a much higher priority.

However, given the marked differences in socioeconomic circumstances in the region, with some countries even classified as fragile or failed states, emulating GCC practices was not a magic bullet. The United Arab Emirates and Lebanon, for example, were worlds apart in their respective vaccine launches.

“The differences between an urban and a rural setting and how violence can mitigate treatment is a key issue that governments and health professionals (need to consider),” 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 nearly $ 200 billion. According to the World Bank report, the region’s GDP contracted 3.8 percent in 2020 and is forecast to grow just 2.8 percent this year.

Ferid Belhaj, World Bank Vice President for the MENA region, said: “The devastating impact of the pandemic 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 to see that MENA’s health systems, which were considered relatively developed, were cracked by the crisis.”

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

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

IN NUMBERS
* 3.8% – Contraction of MENA’s GDP in 2020.

* 2.8% – Projected growth of the region in 2021.

(Source: World Bank)

Dr. Albadr Al-Shateri, a former professor of politics at the National Defense College in Abu Dhabi, says that the events of the last two years have exposed serious weaknesses in preparing for a pandemic not only in the MENA region but also in all the world.

“Health safety has not been prioritized as much as traditional safety concerns. Governments invest heavily in all kinds of weapons 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 should establish, in cooperation with the World Health Organization and other centers of excellence, a disease control center for the region. World and regional powers should contribute to such an endeavor, ”he said.

Such an approach to combat infectious diseases will benefit the entire MENA region, according to Al-Shateri. Specifically, developed and rich countries should extend aid to less fortunate nations, and a regional forum to counter disease should help boost health security.

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

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

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

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

Dr. Adam Coutts, a researcher at Harvard University’s Weatherhead Center for International Affairs, says the key lesson drawn from the past 10 years is that public health and social welfare in countries like Lebanon have had low priorities. policies.

“You can safely say that they don’t care about the health and well-being of their populations,” Coutts said.

UN envoy in Yemen on rare visit to besieged Taiz

AL-MUKALLA / NEW YORK: The UN envoy in Yemen, Hans Grundberg, visited the besieged city of Taiz in the south of the country on Monday, where he met with the governor of Taiz, leaders of political parties, businessmen, activists and journalists, his office told Arab News.

A long convoy of armored vans and military vehicles was seen crossing into sections controlled by the city government as local security authorities tightened security and closed the streets around the governor’s office, residents said.

Taiz, Yemen’s third largest and most populous city, has seen the bloodiest clashes between Yemeni government forces and the Iranian-backed Houthis since early 2015.

The Houthis, who control the city limits, have besieged the city after failing to take control due to heavy resistance from army troops.

The militia has prohibited people from leaving or entering through checkpoints, obstructed humanitarian assistance to trapped people, and repeatedly bombed loyalist neighborhoods to force surrender.

“Coming … to Taiz for the first time is important,” Grundberg said after his meeting with the governor. “It is a place that encompasses many things that are fundamental to all of Yemen. There is political plurality, an entrepreneurial spirit, cultural and historical wealth, and the strength to face the pain and difficulties that this war has inflicted on its people.

“Taiz also shares the same pains that we see in other parts of Yemen, (where) it is civilians who bear the brunt of this conflict.

“Here we have also seen children killed or maimed, and most recently in the deplorable attack on October 30 that claimed the lives of three children. And in this sense I would like to express my deepest condolences to the family of these children ”.

The local government and military officials urged Grundberg to use his influence to pressure the Houthis to lift the siege, end attacks on residential areas and the use of landmines, and stop the recruitment of children.

The local government and military officials urged Grundberg to use his influence to pressure the Houthis to lift the siege, end attacks on residential areas and the use of landmines, and stop the recruitment of children.

“Our demands are to break the siege, end the killing of children, civilians and women, and stop the attacks on hospitals and infrastructure in Taiz,” Abdul Basit Al-Baher, a Yemeni army officer in Taiz, told Arab News by phone, noting that Taiz residents feel that UN officials have “ignored their suffering.”

He said: “We want the UN to be fair and treat us like the Houthis. UN officials visit Houthi militias that plant landmines and even give them cars and humanitarian assistance that fuel their military activities.

On Sunday, Grundberg met with Yemen’s prime minister and foreign minister in Aden to discuss peace efforts.

“He explored the possibilities of de-escalation in Yemen, summarized his discussions in the region and shared his concerns about the impact of the military operations in Marib,” the envoy’s office said on Twitter.

Grundberg is now trying to convince warring factions to immediately establish a nationwide truce, which would include ending the Houthi attacks on Marib and lifting restrictions on the Sanaa airport and Hodeidah seaport.

In the same vein, the United States’ special envoy for Yemen, Tim Lenderking, landed in Aden on Monday, where he discussed with the Yemeni prime minister and the Yemeni foreign minister the efforts to end the war, the Houthi offensive. in Marib, the Riyadh Agreement and the Yemeni government measures to safeguard. the economy, the state news agency SABA reported.

Foreign Minister Ahmed Awad bin Mubarak tweeted that he discussed in a separate meeting with the US delegation the impacts of the Houthi military operations in Marib and peace activities to end the war. “I expressed our appreciation to the United States for its continued support,” he said.

Meanwhile, on the ground, a local military official told Arab News on Monday that heavy clashes broke out between Yemeni government forces and the Houthis south and west of the central city of Marib.

In the west, dozens of rebel fighters were killed in intense battles that continued from Sunday night to Monday afternoon in Al-Kasara. “The fighting was very fierce. The national army succeeded in thwarting the suicide attacks by the Houthis, ”said the official, who requested anonymity.

In the south, government forces participated in the fighting with the Houthis in Al-Amud and the surrounding areas under heavy air cover from Arab coalition fighter jets.

“Working for peace in Yemen is an uphill battle,” Grundberg said. “However, we must never forget that there is always a way to break the cycle of violence. There are always opportunities for peaceful dialogue. And the people of Taiz know it too well.

“Overall, Taiz is the reminder of the possibility of a pluralistic Yemeni state and remains a key part of achieving sustainable peace in Yemen.”

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