Council of Arab

Ministers of Health

Introduction to the council:

A general overview of the council
The Council of Arab Ministers of Health aims to
improve health service in the Arab world by raising the
level of scientific and practical in various disciplines.The
Arab Health Ministers' belief in unifiying their efforts to
provide better health services for all Arab citizens, and
in their desire to achieve this goal, they created the socalled Council (the Council of Arab Ministers of Health).
The Arab Health Ministers Council is a technical specialist council under the
umbrella of the Arab League. It is composed of the Arab League member
states health ministers, has all the powers and competencies necessary to
achieve the objectives set out in the Statute of the Council compling with the
Charter of the League of Arab States.
The Arab Health Ministers Council is the first ministerial specialist council
created within the Arab League's scope , under the League's Council
resolution.

Background Information on the Topic:

General Background
Infectious diseases pay no heed to national borders. Mankind has always been
threatened by zoonoses, such as influenza, Ebola hemorrhagic fever, SARS,
tuberculosis and prion diseases. As seen with the emergence and pandemic of
the swine-originating H1N1 flu virus in 2009 and the enterohemorrhagic E.
coli (O104) crisis of 2011, it is not possible to predict outbreaks of emerging or
re-emerging infectious diseases. The 2010 outbreak of a foot-and-mouth
disease highlighted the tremendous effects that trans-border infectious
diseases in animals have on society and the threat they pose to the supply of
animal protein.
Human/animal health and ecosystems are threatened not only by biohazards
(such as infectious disease-causing pathogens and microbial toxins) but also
by hazards from chemicals discharged into the environment as a result of
man's production activities. These hazards include poisonous metals such as
mercury, cadmium and lead, pollutants such as DDT, PCB and dioxins, and
emerging pollutants contained in flame-retardants and surfactants known to
have caused global-scale contamination. People living today's modern
lifestyles of convenience have a duty to pass safe living environments on to
future generations. Infectious diseases and health hazards from chemicals are
often activated at the interface between humans and animals, only
manifesting themselves after they have gradually spread. To protect our

environment from hazards and realize the One World - One Health ideal, it is
imperative to detect minute changes and abnormalities at this interface so
that appropriate preventive measures can be taken. In light of this,
contributions from veterinary medicine and veterinarians, who carry a
responsibility to ensure the health of animals and people alike, are now
needed on a global scale to support the soundness of ecosystems and health.
As the trans-border movement of humans, animals, and food increases
throughout the world, so does the risk of spreading dangerous pathogens and
infectious disease. While new economic markets and technological advances
have created unprecedented economic and social opportunities for the League
as a whole, the risks especially health risks of our increasingly
interconnected world continue to proliferate.
For any member state, the health and well-being of its population has broad
social, political, and economic implications. Rapid urbanization, population
growth, and changing lifestyles in the Middle East have strained the public
health systems of many Member states. In addition, political instability, and
economic uncertainty have the potential to undermine public health systems.

A statement of the issue

Displacement is a hallmark of modern humanitarian emergencies.
Displacement itself is a traumatic event that can result in illness or death.
Survivors face challenges including lack of adequate shelter, decreased access
to health services, food insecurity, and loss of livelihoods, social
marginalization as well as economic and sexual exploitation.
Displacement takes many forms in the Middle East and the Arab World.
Historical conflicts have resulted in long-term displacement of Palestinians.
Internal conflicts have driven millions of Somalis and Sudanese from their
homes. Iraqis have been displaced throughout the region by invasion and civil
strife. In addition, large numbers of migrants transit Middle Eastern countries
or live there illegally and suffer similar conditions as forcibly displaced people.
Displacement in the Middle East is an urban phenomenon. Many displaced
people live hidden among host country populations in poor urban
neighborhoods often without legal status. This represents a challenge for
groups attempting to access displaced populations. Furthermore, health
information systems in host countries often do not collect data on displaced
people, making it difficult to gather data needed to target interventions
towards these vulnerable populations.
The following is a discussion of the health impacts of conflict and
displacement in the Middle East. A review was conducted of published
literature on migration and displacement in the region. Different cases are
discussed with an emphasis on the recent, large-scale and urban displacement
of Iraqis to illustrate aspects of displacement in this region.

The most appalling example of public protest evolving into bitter civil conflict
is Syria. The consequences for the region continue to be deeply disturbing.
First, the human costhundreds of thousands of families displaced and living
as refugees in Jordan, Lebanon, Turkey, and Iraq. With over 2 million
refugees and over 4 million internally displaced Syrians, the UN last month
launched the largest humanitarian appeal in its history. Second, the
geopolitical threatas tensions between nations rise as a result of the Syrian
conflict, and as conflicts between different groups within the Arab world
escalate, the potential for further confrontations elsewhere remains high. And
third, the economic burdenpolitical instability will create adverse economic
conditions for sustainable growth in the region, with important impacts on
prospects for poverty reduction and increased investments into the health
sector. In Syria, the health system is already effectively destroyed. The risk of
damage to neighboring health systems is real.
These political events make it all the more important to examine the
conditions for advancing health and wellbeing in the region. This Series
describes the state of health of Arab and non-Arab peoples living in the Arab
world by estimating the burden of diseases, injuries, and risk factors they face.
But then the Series departs from the usual format of our country studies.
When the authors met to plan their work, they did not want to use the
conventional approach of a health systems analysis, a report of the challenges
either from infectious diseases or to maternal and child health, and a call to
action. Instead, they wished to describe the region by emphasizing, in
particular, the major political determinants of health. A previous
comprehensive analysis of health in the Arab world had already been
published, so there was considerable scope to, and advantage from, this
different approach.
With that objective in mind the Series begins with governance. It is followed
by studies of non-communicable diseases, universal health coverage, the
changing geographies of war, and finally the issue of survivalecological
sustainability in the Arab world. These papers are complemented by a
Viewpoint on recent political changes across the Arab world and their
meaning for health, two essays on research networks and state formation, and
four Comments looking at issues ranging from health equity to tobacco
control.

History of the Topic in the Arab World

According to the World Health Organization, non-communicable diseases

(NCDs) are the leading global cause of death and strike hardest at the worlds
low and middle income populations. NCDs include cardiovascular diseases,
diabetes, cancers and chronic respiratory diseases, with risk factors including
tobacco use, unhealthy diet, physical inactivity, and the harmful use of
alcohol. These risk factors pose a growing threat to public health and safety
for all members of the League.
In addition, communicable diseases pose a large and dangerous threat to the
health and stability of the League, as they are spread from one person to
another or from an animal to a person. The spread often happens via
airborne viruses or bacteria, but also through blood or other bodily fluid.
Infectious diseases are estimated to account for about a quarter of deaths
worldwide, more than 13 million deaths each year. The top causes of death
from infectious disease include lower respiratory tract infections and diarrheal
diseases.
The emergence of new pathogens such as human immunodeficiency virus
(HIV), severe acute respiratory syndrome (SARS), tuberculosis, and malaria,
as well as previously unknown animal diseases, such as bovine spongiform
encephalopathy (mad-cow disease), are of particular concern to governments
around the world as they have the potential to severely disrupt public health
systems.
Furthermore, the Council of Arab Ministers of Health might consider public
health during times of crisis. For example, hospitals, ambulances and clinics
throughout Syria are currently are prominent targets for regime air strikes.
According to a first-hand account, remains of ambulance vehicles, bombed or
destroyed by gunfire, mar the streets of Aleppo and surrounding villages.
Every medical facility in town bares some damage from explosions. The
doctors here [unidentified hospital in Aleppo] say they have all been arrested
at least once for their role in treating the wounded. Most were tortured.
Health status indicator reporting throughout the region rarely reflects the
dramatic variations in public health services and infrastructure accessible to
urban and rural communities, to religious or ethnic minorities, and to the
large expatriate labor populations in the Gulf States. Most of the Gulf States
partially or completely exclude these migrants from government-supported
health services.
HIV/AIDS prevalence remains low in the Middle East, especially when
compared to the noncommunicable disease burden related to tobacco use,
chronic diseases such as cardiovascular conditions and diabetes, and

accidents. However, trading patterns and uneven disease control measures at

ports and borders render the region extremely vulnerable to imported animal
diseases, including those that cross into the human population directly or via
insect vectors. Saudi Arabia and Egypt have experienced outbreaks of H5N1
avian influenza in poultry, with dozens of human cases in Egypt. Despite
growing awareness of the problem, few states in the region have devoted
significant resources to preparing for public health crises and neither
transparent sharing of health data nor pandemic planning have occurred
beyond the subregional level. To date, regional cooperation on disease control
has depended substantially on the expectation that wealthy nations will
subsidize outbreak containment efforts to protect their own interests. For
example, Saudi Arabia dedicates significant resources to preventing disease
outbreaks during the annual Hajj. When the first epidemic of Rift Valley fever
(a livestock disease transmissible to humans directly or via mosquitoes)
outside Africa occurred on the Arabian Peninsula in 2000, the Saudi
government conducted a cross-border vector control campaign in affected
parts of neighboring Yemen. In 2007, the Saudi government pledged
significant funds to Yemens malaria eradication efforts and set about
galvanizing the other Gulf states to contribute similarly. In contrast to
Southeast and South Asia, the contiguous states of the Middle East (with the
exception of Israel) fall into one WHO administrative region, allowing viable
external regional health coordination.

International Actions:
In 2007, revised International Health Regulations entered into force,
expanding WHOs authority to detect, report, and respond to transnational
health threats. This framework dramatically expands global data sharing and
cooperation, requiring nations to strengthen core capacities for detecting
health threats such as disease outbreaks at the local level, determine whether
the incidents constitute potential public health emergencies of international
concern, and, if so, report them to WHO in a timely way. If experts judge that
these crises pose authentic threats, WHO will notify all necessary stakeholders
and coordinate any international assistance. Compliance currently depends on
shaming nations that fail to disclose health catastrophes. No funding has
been made available to assist nations with capacity building; the cost of full
implementation is unclear. These regulations reflect a renewed commitment
by developed nations to international public health cooperation as a tool for
protecting national interests, fueled by concerns that Chinas lack of
transparency during the 2003 SARS epidemic prevented interventions that
might have limited the epidemic.

Increasingly, the language employed by WHO and its partner organizations

mirrors the securitization of health issues by the United States and the G8
nations, driven by fears of bioterrorism before the more recent focus on
pandemic planning. In all three regions, this shift has affected local
perceptions of disease and disaster, allowing avian influenza and other
outbreaks to be framed as security concerns instead of humanitarian
concerns. Based on levels of supranational engagement, the concept has
gained the most traction in Southeast Asia, where the 1997 economic crisis
and environmental concerns fostered a more general spirit of cooperation on
nontraditional security issues and receptiveness to a human security
framework. Public health experts in the region have characterized the
securitization of disease as an opportunity to normalize the concept that
security and development are two sides of the same coin, and that nations
are not secure if their citizens are not healthy. The security focus allows
mobilization of resources and political will at levels necessary to effect real
change but carries the possibility of backlash from stakeholders in the security
and public health communities.
Although the new international health security framework describes the need
for all states to build public health infrastructure in the name of mutual
protection, the scope of the demands may also be perceived as an enormous
obligation for developing nations assumed primarily for the benefit of wealthy
states. While the international community shows little hesitation in mobilizing
massive amounts of humanitarian aid in the wake of health catastrophes,
assistance in preparedness remains limited primarily to transient bilateral
agreements. Integration of global health security into the broader paradigm of
reciprocal responsibility could conceivably include the following concepts:
All nations have an obligation to share health information and
specimens with the international community, and no nation can fairly
withhold either for reasons of national sovereignty or economic
security.
The international community must ensure that all available costeffective and feasible interventions are supplied to states that share
information and specimens, and provide support to build necessary
public health infrastructure for those nations that lack sufficient
internal resources.
The International Health Regulations alone are not sufficient to
provide global health security, even if implemented exactly as currently
written. Further assessments will be required to determine what
infrastructure will be realistically needed to monitor, detect, and
respond to threats effectively on a global basis, and to establish the
right balance of incentives and sanctions for reporting.

The emerging infectious diseases now discovered almost annually can no

longer be relied upon to remain safely in remote forests and farmlands. Health
crises constitute a real threat to national security in an era of globalization;
effective preemption relies upon institutional strength and international
cooperation. The intertwining of information, economic, and security systems
across the world creates an interdependence of vulnerability among nations,
within and between regions.
In view of the profound inequalities in resources and capacities among
nations, a commitment by resource-rich states to strengthening public health
institutions in developing nations represents not just a humanitarian dream,
but an investment in mutual defense.
The Council of Arab Ministers of Health endorses strategy to halt
the HIV epidemic in Arab countries:
March 14, 2014 represents a historical landmark of the regional HIV response
in MENA . The Council of the Arab Ministers of Health has officially endorsed
the Arab AIDS Strategy (2014-2020). A resolution on the strategy
endorsement was presented by the League of Arab States, seconded by H.E
the Minster of Health of Bahrain , H.E the Minister of Health of Mauritania
and Sudan delegation and was unanimously endorsed by all 22 Arab
Countries.
The Arab AIDS Strategy aims at reducing to more than 50% by 2020 the rate
of new HIV infections transmitted through sexual relations and among
injecting drug users as well as new infections among children; the mortality
rate of mothers living with HIV and the mortality rate among people living
with HIV.

Recommendations:
In response to the increase in international travel and trade, and emergence
and re-emergence of international disease threats and other health risks, 194
countries across the globe have implemented the World Health Organization
International Health Regulations since 2005.
The stated purpose and scope of the IHR are to prevent, protect against,
control and provide a public health response to the international spread of
disease in ways that are commensurate with and restricted to public health
risks, and which avoid unnecessary interference with international traffic and
trade. The IHR also require member states to strengthen core surveillance
and response capacities at the primary, intermediate and national level, as
well as at designated international ports, airports and ground crossings.

Some solutions to this issue will improve the identification, surveillance, the
availability of drugs and vaccines, reporting, containment, education, research
and treatment of disease in member states. As new global treats emerge, each
of these factors will change from country to country. The Council of Arab
Ministers of Health must develop a way to promote League-wide cooperation
in regard to disease outbreaks and control efforts. In addition, the Council
must consider the role of doctors and health professionals during times of civil
war or crisis.
The Trans-border infectious diseases topic that examines common public
health issues affecting member states with special regard for population
growth and the threat of trans-border infectious diseases with the refugee
crisis is of vital importance to region as a whole, and to the states that host
refugees in specific. The Syrian refuges that are seeking shelter in neighboring
states have brought about a large number of diseases due to the low living
standards. This committee shall further assess this tragic epidemic in depth.
Building upon international, regional, and national actions of member states
will be the key challenge of the delegates. The constructive debates should
desirably find the solution to the topic at hand. Taking into consideration the
rather cloudy (unclear) destiny of the current refugee increase, the concern
shall be minimizing the effects of trans-border infectious diseases. The
solutions should be reasonable, bearing in mind economic capacities of the
host Arab states (Lebanon, Egypt, Jordan, and Iraq) and the UN funding
limitations. Awareness, vaccines, educational enlightenment, and subsidies,
are not to be undermined.

Questions to Consider:
1. What effects have increasingly integrated trade, economic
development, human movement, and cultural exchange had on
patterns of disease in your country?
2. What is your countrys policy in regards to the reporting of infectious
disease outbreaks to the international community?
3. What public health issues and infectious disease outbreaks has your
country faced in the past? The present?
4. What kind of public health initiatives and educational measures has
your country implemented in the past? The present?
5. Which member states have adopted successful education initiatives?
Which have not, and why?
6. What is your countrys greatest public health concern in the next year?
The next 10 15 years?
7. What has been the effect of refugees in your country?
8. What are the diseases encountered as a result of drastic inflow in
refugees to your country?
9. What are the solutions that your governments have taken to limit the
effects?
10. Priority of this issue to your countries foreign policy?

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