Dubai Health Authority

Following its creation in June last year and the completion of its initial planning review, the Dubai Health Authority (DHA), unveiled the first elements of its proposed implementation plan in November. This included the proposed structure of the DHA and a number of related agencies.

As part of the Government’s proposals for reforming the existing healthcare system, the DHA will take over responsibility for the development and implementation of healthcare strategy and policy for Dubai, from the existing Department of Health and Medical Services (DoHMS) in phases over a four year period. Completion is expected in 2012. The DHA’s remit is to set and enable the implementation of a comprehensive health strategy and policy for Dubai.

In addition to its focus on strategy and policy, the DHA will be different from DoHMS in a number of key respects:

● It will not engage in any service delivery (which will be the responsibility of the agencies)
● It will manage the agencies using agreed performance targets focused on improving service standards
● It will establish consistent regulation and licensing across the public and private sector
● It will work to strengthen the role of primary care in improving health
● It will encourage private sector participation to improve standards of care and health outcomes

The DHA says it will also ensure continual-improvement in the standard of health care in Dubai. These changes will benefit all UAE nationals, residents and visitors and create an environment that provides better opportunities for professionals and support staff within the health sector.

While various elements of the DHA are established during this four-year period, the management and provision of all public sector medical services within Dubai will continue to be performed by DoHMS whose principle focus continues to be the provision of good quality care for all patients and the wellbeing of its staff

Speaking on behalf of the DHA, Qadi Al Murooshid, director general, DHA, said: “The creation of the Dubai Health Authority is about a better and healthier Dubai through the provision of the very best healthcare that we can provide the people of the Emirate. The DHA will deliver a health strategy for the whole of Dubai in support of the Dubai Strategic Plan.”

Dubai health Insurance

In association with the Dubai Health Authority (DHA), the Health Insurance Committee (HIC) hosted ‘Big Talk’, in early November. The discussions are part of the extensive ongoing consultation process regarding the future of healthcare in Dubai.

This event brought together more than 60 representatives of varying ages, professions, ethnic backgrounds and cultures.

Speaking before the event Qadi Al Murooshid, director general, DHA, said: “The event will provide a platform of insightful and creative thinking as part of the ongoing programme of consultation and engagement which the HIC is undertaking as it reviews the future of healthcare in Dubai and how we are going to fund it.”

The HIC’s consultation programme recently established a ‘Think Tank’ of world healthcare experts and economists who will provide their expert knowledge. It has also seen an international benchmarking team travel to a number of best practice countries and regions in the world including Australia, California and the East Coast of the USA, Singapore and the United Kingdom.

On 26 December the HIC submitted its final report and recommendations to the Executive Council. An international advisory think tank will consider the report before providing an independent endorsement of the proposals. The Executive Council will then review all recommendations prior to passing the proposals into law sometime in 2008.

Speaking on receipt of the report, Ahmed Bin Byat, secretary general of the Executive Council said: “This has been a very intense process involving some of the very best experts from around the world, the region and here in Dubai. From the Dubai Strategic Plan we acknowledge the role that better healthcare has in securing and helping us to promote the economic growth and future prosperity of Dubai and to help us create a sustainable future. The funding mechanism will identify the best way to pay for it to the benefit of everyone living and working in Dubai, including all UAE nationals, residents and visitors.” Qadi Al Murooshid, director general of the Dubai Health Authority (DHA), has signed a second strategic agreement with Harvard Medical Faculty Physicians (HMFP) to help ensure the DHA provides the very best clinical and scientific practices and services to the population of Dubai.

This Memorandum of Understanding (MoU), signed in Boston, follows the earlier announcement from the director general’s office which will bring the very best diabetes facilities to Dubai with the opening of US-based, world renowned Joslin Diabetes Centre (Dubai), the first dedicated treatment centre for the disease in the city.

Al Murooshid signed the MoU with HMFP together with Dr Stuart A. Rosenberg, president and CEO of the Harvard Medical Faculty Physicians Group, with the presence of Dr Mark Zeidel, Professor Herrman L. Blumgart the medical chair at Harvard Medical School.

New air ambulance

Prestige Jet, a new, private aviation company operating out of Abu Dhabi International Airport and Al Ain Airport, has signed an agreement with Flight Ambulance International (FAI), a world leader in medical evacuation and repatriation services.

Under the agreement, Prestige Jet will be the exclusive representative for FAI in Abu Dhabi and Al Ain and will offer a worldwide air ambulance service for patients, transporting them between the two cities and any destination in the world.

Vaccination pledge

Wyeth chairman and CEO, Robert Essner, has underlined Wyeth’s commitment to make pneumococcal vaccination accessible to all children in the world.

Prevenar from Wyeth is the only vaccine conjugate currently available to help protect infants and toddlers against invasive pneumococcal disease.

Speaking during a trip to Dubai, his first visit to the Middle East, he said: “An important part of realising Wyeth’s mission to lead the way to a healthier world is by working to combat the burden of serious diseases and expand access to Wyeth’s pneumococcal conjugate vaccine around the world.”

The World Health Organisation (WHO) estimates that pneumococcal disease results in up to one million deaths in young children worldwide each year. The WHO has recommended priority inclusion of the pneumococcal conjugate vaccine in national immunisation programmes worldwide.

Addressing a gathering of key opinion leaders, health officials, industry representatives and Wyeth distributors, from the GCC and the region, Essner said: “Wyeth had expected extensive use of the vaccine in the developed world, but there is an even greater need for it in some of the poorest countries in the world.”

Ergomed HQ in Dubai Ergomed, the specialised international clinical development company, is to locate its Middle East and India headquarters to DuBiotech, Dubai’s new biotechnology and research park.

Ergomed is the first contract research organisation (CRO) to establish a base at DuBiotech. Founded in 2005, DuBiotech is one of the fastest growing biotechnology clusters in the world. Spread over 300 hectares, it serves as an ideal platform for leading global biotechnology brands to establish their footprint in the region.

Dr Miroslav Reljanovic, CEO of Ergomed, said: “We see this expansion as a strategic move, with the Middle East and India now emerging as truly attractive regions for biotechnology. As with our co-development business model, Ergomed has once again become a pioneer in the geographic broadening of a rapidly changing industry. DuBiotech offers the ideal environment to locate our regional headquarters and our presence in the park will gain us new business opportunities.”

Saudi pharma IT deal

A strategic partnership agreement has been signed between Saudi Arabia-based Waseel ASP, a leading application service provider for electronic data interchange in the Gulf region, and Bathabile-Knowledge Objects, of South Africa.

The agreement sets out a joint venture between the two companies to build a pharmaceutical claim management solution to manage and process pharmaceutical claims and approvals on behalf of healthcare insurance companies.

The system will help both the insurance companies and healthcare providers execute certain tasks in a fast seamless manner, with great reduction in medical and administrative errors.

Wassim Khashoggi, CEO, Waseel ASP says: “ Over the past four years, Waseel ASP have succeeded in developing and implementing its own system of Electronic Data Interchange and Web Portal to link healthcare providers and insurance companies enabling them to communicate and perform electronic transactions with efficiency and ease. And as part of our ongoing quest for growth and development, we tackle the issues arising in the provider-payer relationship. A major portion of these issues come from pharmaceutical services and drug dispensing which represents 40-60% of the work volume.

This is one of the many reasons that lead us to sign this joint venture agreement with Bathabile, to implement Pharmaceutical Benefit Management Solution enabling us to process pharmaceutical claims and approvals with the least human intervention. The benefits of such a solution are tremendous, from saving cost and time to reducing administrative and medical errors through the utilisation of proven medical and formulary guidelines. The drug dispensing system efficiently manages the drug dispensing process and prevents drug intervention or over utilisation through the implementation of electronic health record for every patient.

Refugee hospital on hold

A desperately needed hospital in Lebanon's largest and most violent Palestinian refugee camp has been unable to open on time because funds to buy beds and other basic medical equipment have dried up, reports IRIN (9 December 2007).

The US$5m Al-Quds hospital in Ain al-Hilweh, just outside the southern port city of Sidon, is the single largest investment in the camp's 60-year history and aims to treat a range of chronic diseases, heart problems, cancers and nervous disorders suffered by Ain al- Hilweh residents.

It also aims to have a children’s wing and an intensive care unit. But hospital director Ibrahim Marshoud told IRIN the hospital was still some $2m from completion after international donations to the Palestinian charity Badr Foundation, which has paid for the hospital, ceased in recent months. “The Badr Foundation is waiting for money.

Now the hospital can only undertake minor operations; we still need 36 beds, incubators, scanners, electrical beds and five kidney dialysis machines,” said Marshoud, a former member of the British Medical Council and previously senior medical adviser to the UN agency which assists Palestinian refugees, UNRWA.

“The health problems in the camp are both disease and the environment. The streets are an environmental disease, while medically chronic diseases are extremely common, such as diabetes, hyper-tension and cancers.” UNRWA says the camp is home to nearly 46,000 refugees, while estimates by Fatah, the dominant faction in the camp, say around 80,000 people are crammed into the camp’s 1.5sqkm.

US-Saudi cancer partnership

The US-Middle East Partnership for Breast Cancer Awareness and Research has been launched in Saudi Arabia. Partners in the launch are the King Fahd Medical City, Saudi Cancer Society, Susan G. Komen for the Cure, and The University of Texas M. D. Anderson Cancer Centre.

The partnership is facilitated by the US Department of State’s Middle East Partnership Initiative, bringing together distinguished medical professionals and breast cancer awareness advocates from Saudi Arabia and the United States in an effort to work together in the areas of awareness, research, training, community outreach, and women’s empowerment.

The launch event (23 October 2007) was held under the patronage of Her Highness Princess Hessa Bint Tarrad Al Sha’lan, the wife of the Custodian of the Two Holy Mosques, and Laura Bush, first lady of the USA. Bush said: “Over the next quarter-century, an estimated 25 million women around the world will be diagnosed with breast cancer.

Breast cancer does not respect national boundaries, which is why people from every country must share their knowledge, resources, and experiences to protect women from this disease.”

Good news – no sweat

An innovative surgical procedure is now available in the UAE for sufferers of hyperhidrosis, an excessive and uncontrollable sweating of the hands, feet and underarms.

The one-hour minimally invasive surgery – an outpatient operation – provides immediate relief. It has a success rate of more than 90%, with fast recovery and minimal discomfort. The process of sweating is controlled by two sympathetic nerves.

In the Endoscopic Thoracoscopic Sympathectomy (ETS) procedure, the surgeon makes a small incision on each side of the chest to insert an endoscope to locate the nerve, which is then cut.

The latest ETS procedure was performed at the American Hospital Dubai by Dr Fouad M. Azoury, chairman of the Cardiothoracic Surgery Department. Dr Azoury commented: “Of course, sweating is perfectly normal but with this condition it can be amplified to the point where the sufferer cannot even write because of excessive perspiration wetting the paper.

ETS has been refined to the point where it is now the ‘gold standard’ and is considered as the first line of treatment for palmar (hands) hyperhidrosis. “If more suffers become aware of this treatment especially in this hot climate region, then it may encourage more to come forward.”

Eye experts focus on UAE

Two international ophthalmology experts speaking at a gathering of over 130 private practitioners hosted by Moorfields Eye Hospital Dubai (MEHD), said the most common eye problems in the United Arab Emirates – diabetic retinopathy and congenital eye disease – can be prevented with regular screening, preferably from a young age.

Professors Tony Moore and Roger Hitchings are preeminent in their fields, and base their research at MEHD’s 200-year old parent facility, Moorfields London. Prof Hitchings is the hospital’s research and development director, and specialises in glaucoma; Prof Moore’s speciality is genetic eye disease. He has been instrumental in developing breakthrough gene therapy programmes, particularly for childhood retinal diseases.

The UAE has higher-thanaverage rates of diabetic eye disease, which the Ministry of Health has addressed by offering free retinal exams for diabetics; and congenital eye disease, ranging from glaucoma to rarer pathologies.

Both experts advised that the public should be educated about options for screening. Prof Moore said: “We at Moorfields tell governments that although fewer children than adults are blind, children will have to live many more years with blindness than an older person who develops complications from glaucoma.

If children are screened early, the problems they present stand a better chance of being treated.” Prof Hitchings, who recently developed a fiveyear research strategy for the Royal College of Ophthalmologists, stated that public education on eye health is vital: “The two biggest problems in the UAE are diabetic retinopathy and congenital eye disease.

Diabetic eye disease can be prevented if high-risk individuals had themselves screened periodically. Congenital eye disease can also be treated early through screening, and people can also volunteer to be tested for congenital eye diseases prior to marriage.”

Oxfam Gaza warning

In a statement issued 20 November 2007, Humanitarian agency Oxfam International says there is an increasing risk to public health in Gaza as water and sanitation services begin to buckle under the strain of Israel’s restrictions on fuel, vital maintenance goods and spare parts into Gaza.

According to Oxfam International’s partner the Coastal Municipalities Water Utilities (CMWU) 15% of Gaza’s population – 225,000 people – are not receiving an adequate amount of drinking water due to the lack of diesel. Oxfam is also worried at the latest reports of Israel’s Attorney General’s Office giving approval to its new Defence Ministry’s plan to reduce the quantity of electricity delivered to the Gaza Strip.

Oxfam International executive director Jeremy Hobbs said: “There has to be an immediate resumption of fuel supplies to Gaza if we are to avoid a public health crisis. Access to clean water is a fundamental human right and must not be used as a tool to collectively punish the population of Gaza.

“As international efforts increase to breathe new life into progress towards peace, the international community is ignoring Gaza’s plight, allowing it to slip further into a crisis. Ordinary civilians in Gaza are being punished for crimes they have not committed, in clear violation of international humanitarian law. This illegal policy of collective punishment must stop at once.”

For the first two weeks of November CMWU had on average seven water wells in Gaza City that worked either partially or not at all due to the lack of diesel. As a result 50,000 people were directly affected and received 75% less water. According to partners and staff the situation throughout the Gaza Strip is deteriorating as the availability of water is dropping further. Electricity reductions would only exacerbate Gaza’s sufferings.

Arthritis in Gulf

More than one in three Gulf residents aged over 40 suffers from chronic arthritic joint pain, with the prevalence of the condition increasing from 30% in 45 year-olds to 60% in 65 yearolds, according to medical experts in the region.

Osteoarthritis is the most common form of arthritis and begins with the breakdown of joint cartilage resulting in pain and stiffness, usually in the fingers, knees, hips, and spine. But, unlike other forms of arthritis which typically affect older people, a rare but severely punishing arthritic condition known as Ankylosing Spondylitis usually strikes between the ages of 17 and 35.

The US FDA and regulatory agencies in 17 European countries have now approved Celebrex (celecoxib) for the relief of symptoms associated with Ankylosing Spondylitis.

This approval makes Celebrex the first and only COX-2 inhibitor approved to treat this painful condition. “One of the main challenges with treating this severe, chronic, and debilitating form of arthritis is the limited treatment choices,” said Dr Walaa Al Asuity, consultant orthopaedic spine surgeon in Abu Dhabi, UAE. “Celebrex offers physicians a new therapy option for this difficult-to-treat patient population.”

Bahrain’s health island

Work will start soon on a US$1.6 billion project to create a Health Island off the northeast coast of Bahrain. Officials say the development will revolutionise the country's healthcare system and turn it into a regional hub for health tourism. The Ithmaar Development Company, a subsidiary of Bahrain-based Ithmaar Bank, is spearheading the project.

Health Island will feature the latest facilities and services within a landscaped resort built on reclaimed land off Muharraq. It will cover a total of 1.25 million sq metres and include a diagnostic centre, alternative medicine centres, a nutrition and diabetes centre, an aesthetic surgery centre, a sports medicine centre and a women and children's centre as well as deluxe spas, boutique hotels and luxury residences.

Around 50% of the development, including the island’s beaches and businesses, will be open to the public, while the rest will be within gates and private areas. Infrastructure work is expected to take around 36 months.

New diabetes surgery

A new procedure for treating Type 2 diabetes was introduced to the public in Doha recently by pioneer in the field Dr Francesco Rubino from Weill Cornell Medical College in New York.

He delivered his lecture at Weill Cornell Medical College – Qatar (WCMC-Q). The novel procedure is an adaptation of an approach used in weight-loss (bariatric) surgery specifically designed to treat Type 2 diabetes.

Instead of shrinking the stomach like most approaches to bariatric surgery, his approach reroutes the small intestine, leaving the stomach intact. In a study published in the Annals of Surgery, Dr Rubino reported that the technique dramatically reduced diabetes in animals – demonstrating for the first time that surgery has a direct effect on Type 2 diabetes unrelated to weight loss.

The procedure, now known as Rubino’s Procedure, has been performed on patients at several centers worldwide. As a world leader in the research, teaching and practice of metabolic and weightloss surgery, Dr Rubino’s approaches give hope to millions of people living with obesity and diabetes. It is estimated that over 180 million people worldwide are affected by diabetes, a figure that is likely to double by 2030.

Over 30% of sufferers are not aware that they have the metabolic disorder, yet diabetes has serious consequences for health including cardiovascular disease, kidney disease and visual impairment leading to blindness.

Dr Abdulla Al Hamaq, executive director of Qatar Diabetes Association (QDA, said: "The percentage of the population with diabetes in the Gulf countries is among the highest in the world. “As part of our mission, QDA is keen on providing the healthcare community with the latest updates regarding diabetes management and control.”

Dr Rubino was recently appointed associate professor of surgery at Weill Cornell Medical College, and director of gastrointestinal metabolic surgery at New York-Presbyterian/Weill Cornell Medical Center – an entirely new section of the Department of General Surgery and one of the first of its kind in the world.

UAE hypertension MOU

Humaid Al Qatami, UAE Minister of Health, and Antoine Moukheiber, managing director of the Near & Middle East, Africa & French Overseas Territories, Les Laboratoires Servier, signed a Memorandum of Understanding (MOU), to initiate the Hypertension Global Care Programme in the UAE to tackle hypertension. Hypertension is a key risk factor for cardiovascular disease.

“In the UAE we urgently need to identify the markers for an early diagnosis of hypertension and thus reduce the disease burden on the community as a whole,” said Al Qatami. “This Hypertension Global Care programme will provide us with the resources and funding necessary to look at the problem of hypertension on a long term scale.”

Merck opens in DuBiotech Merck Serono has opened its new Middle East regional office at DuBiotech, Dubai’s biotechnology and research park. Merck Serono is a division of Merck KGaA, the German pharmaceutical and chemical company with operations in 61 countries across the world. The regional office serve Merck Serono’s operations in 12 countries in the Middle and Near East.

Cervarix in UAE

Cervarix, a new cervical cancer vaccine that protects women against the cancercausing human papillomavirus (HPV) 16 and 18, is now available in the UAE.

HPV 16 and 18 are responsible for 70% of all cervical cancer cases.

“The availability of the vaccine is another step toward our goal of providing better prevention of cervical cancer in the UAE,” said Dr Awatef El Baher, obstetrics consultant and gynaecologist at Dubai Health Authority.

Young scientists’ symposium

Nearly 60 young scientists from the Gulf region gathered for a one-day symposium titled ‘Building a Research Career: The Path to Success’. This session aimed to further explore and contribute in the area of research activities and health sciences.

The symposium, a joint initiative by the Dubai Harvard Foundation for Medical Research (DHFMR) and Harvard Medical School Dubai Center Institute for Postgraduate Education and Research in collaboration with Dubai Healthcare City, a member of Tatweer, was held on 9 December 2007 at the Grand Hyatt Hotel, Dubai.

Ahmad Sharaf, Tatweer Senior Vice President Healthcare and Energy and Member of the Board of Trustees Dubai Harvard Foundation for Medical Research, said: “DHFMR is committed to promoting health care research and today's seminar has brought young scientists together who can learn from and share knowledge and best practice.

I am confident that this forum will create a greater dynamic for research in the region that will be of immense benefit to medical practitioners and the wider community.” Dr Muhadditha Al Hashimi, CEO of Dubai Healthcare City, said: “This conference served to highlight the Foundation’s role in encouraging and nurturing young scientists and guiding them in their research activities.

It also offered an opportunity to understand the Foundation’s objectives in enabling a new generation of researchers to identify areas of research that will benefit the medical community in the region.”

Dr Robert L. Thurer, MD, executive director, Dubai Harvard Foundation for Medical Research, and chief academic officer, Harvard Medical School Dubai Center said: “The conference helped open the door for concerted scientific research in the region. Leading medical researchers from Harvard Medical School offered insights regarding healthcare research.

Their perspectives helped the young scientists in the region determine how their careers might impact the development of new treatment for geographically specific diseases.”


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