As Covid transitions from pandemic to endemic, the world must strengthen preparedness. It's inevitable that another disease – potentially even worse than Covid – will spread across the globe. Just how bad it will get depends largely on what we do today to better prevent, detect and respond to infectious disease threats. We must make progress in three areas: public health infrastructure, primary health care, and resilient individuals and communities.
First, we must strengthen our public health infrastructure. There must be sufficient and consistent funding, including at local levels, which are so often neglected despite their position on the front line. At least $5-10 billion a year of new funding will be required for at least a decade to substantially increase preparedness in low and middle-income countries.
In addition to increased financial support, the world’s public health infrastructure needs continuous improvement. The World Health Organisation is the anchor of our global health architecture and essential for data, guidance, global collaboration and country support – but it needs stronger authority and capacity as well as a larger, more flexible budget.
Regional and national public health agencies, such as the Africa Centres for Disease Control and Prevention and the Middle Eastern regional CDC currently being developed after approval by the Gulf Co-operation Council in January 2021, can contribute to more effective public health action but have important limitations. However, as we learned during the pandemic, no public health agency can succeed if the government doesn’t follow its guidance. Getting the balance right in public health organisations means making technically sound recommendations based on the best available data with clear and open communication, and effectively engaging societal leaders who can make policy decisions.
Two deadly cycles have plagued preparedness. The first is the panic-and-neglect cycle. Even now, the millions of global deaths from Covid seem to be quickly receding in the rear-view mirror, with lessons not being learned and opportunities for improvement lost. The second is a cycle of planning and more planning without action to improve systems and processes for preparedness. The first cycle can only be broken by political leadership.
To help break the second cycle, we have proposed, and many countries and organisations are adopting, a new global target of 7-1-7: every suspected outbreak identified within seven days of emergence, reported to the public health authorities within one day, and an effective response established – as defined by objective benchmarks – within seven days. Every potential or actual outbreak becomes a means of quickly improving performance. This “find-a-problem, fix-a-problem” approach enables rapid improvement and is a way to prioritise more complex issues for longer-term progress.
It will be especially important to reduce the risks posed by the interconnections among people, animals and the environment. Middle East respiratory syndrome, or Mers, remains a threat, antimicrobial resistance could make our life-saving medications ineffectual, and the risk of spillover events – which account for three fourths of emerging infectious diseases in recent decades – is increasing as humans encroach on forest areas and come into contact with wild animals, whether in wet markets or otherwise.
Second, we must improve primary healthcare systems – often defined as the first point of within the health system, providing comprehensive, accessible, community-based care that meets most health needs throughout a person's life. One of the most important lessons from the Covid pandemic is that primary health care should be central to healthcare systems. And yet, nearly half a century after 134 national government members of the WHO called for strong primary health care by signing the Alma Ata Declaration in what is now Kazakhstan, progress has been too little, too late and in too few places.
Most disease outbreaks that are stopped early are diagnosed by alert clinicians with strong connections to their local public health system. These are doctors who knew to suspect an unusual disease, arrange for testing and promptly report to the public health authorities. Epidemic-ready primary health care bridges the gap between clinical care and public health. In countries from the US to the UK to Uganda, primary healthcare workers need to be paid better.
Resilient health facilities can maintain core services, including preventive care, during pandemics, extreme weather, social unrest and other societal disruptions while also ensuring health worker and patient safety with effective infection prevention and control. Healthcare safety also means protecting healthcare workers from violence and the threat of violence. Tragically, the trend has been for healthcare facilities to increasingly become a target of rather than sanctuary from violence.
It is not a coincidence that primary health care is weak in most countries. Hospital and specialty care create aligned economic, political and social interests – even though this care isn’t the most effective or efficient way to protect and improve health. Learning from countries such as Norway, Thailand and Costa Rica, that invest in strong primary healthcare, we can transform systems and increase the health return on health spending.
It will be especially important to reduce the risks posed by the interconnections between people, animals and the environment
The global epidemic of obesity, and, as a result, type 2 diabetes, is particularly severe in the Middle East. Primary health care has an essential role to play preventing the strokes, heart attacks and kidney failure for which people with diabetes are at particularly high risk. What is often not understood is that diabetes, though diagnosed because of high blood-sugar levels, isn’t a sugar disease but rather a systemic metabolic disease. For a person with diabetes, controlling their blood pressure will protect their health the most and taking a statin will be the easiest way to prevent health problems. Management of blood glucose, though very important – and life-saving in insulin-dependent diabetes, which accounts for about 5-10 per cent of all cases – will be the most difficult to achieve and result in less health benefit than controlling blood pressure and cholesterol.
Hypertension is the leading preventable risk factor for heart attacks and strokes worldwide, killing more people than any other condition – more than all infectious diseases combined and more than Covid at its peak. Only about 1 in 7 people with hypertension have controlled blood pressure globally, and only about one in 5 in many countries in the Middle East region, despite this being the single most effective clinical means of preventing the leading cause of death: cardiovascular disease. High-performing health systems can achieve blood pressure control rates of 80-90 per cent among all patients with diabetes on their panel. Effective hypertension management programmes both require and facilitate strong primary healthcare services.
Third, we must promote resilience so that individuals and communities can get and stay healthier and be better able to withstand health threats of all types. One reason Covid has been so deadly is that so many people were vulnerable because of their health status. More resilient individuals and communities are better able to withstand health threats of all types.
Although people make choices that can result in either good health or illness, many of these choices are largely determined by societal incentives and structures. Resilience is strengthened when environments are structured to make healthy behaviours the default choice and when communities are empowered to better understand and take control of their own health.
Tobacco control is one of the most successful, least recognised, yet still unfinished successes of public health. It is a good example of how effective societal action – through tobacco taxation, smoke-free public places, hard-hitting ads, and effective warnings and limitations on advertising, promotion and sponsorship – can make a huge difference. Tens of millions of people will not die early from cancer, heart disease, lung disease and other tobacco-related causes because governments have taken effective action. But much more needs to be done.
Programmes to prevent heart disease and stroke – the world’s leading killer – have a long way to go in most countries. Of all funds for development assistance in health, less than 1 per cent goes to stop cardiovascular disease even though it is readily preventable and causes more harm than any other health problem.
Many countries in the Gulf region are in a position to make bold investments that can change the course of history. Supporting public health infrastructure, making primary health care central to their own health systems and supporting focused action to do so in lower-income countries, and supporting better hypertension treatment globally can protect the health of hundreds of millions of people. The world is waiting for a country to spearhead national, regional and global efforts to curb the world’s leading killer: cardiovascular disease.
To prevent the next pandemic, faster and more effective public health action is needed, with real-time surveillance, better communication and community engagement, co-ordination and rapid response capacity. Improved primary health care can address symptomatic conditions and also the leading drivers of disability and death. Environments can be structured to make healthy options the default choices. The need, tools and effective models exist in all three areas. The world needs catalytic investment and governmental commitment to take action that can save lives today and in the future.
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The five pillars of Islam
The five pillars of Islam
BRIEF SCORES:
Toss: Nepal, chose to field
UAE 153-6: Shaiman (59), Usman (30); Regmi 2-23
Nepal 132-7: Jora 53 not out; Zahoor 2-17
Result: UAE won by 21 runs
Series: UAE lead 1-0
The bio
Who inspires you?
I am in awe of the remarkable women in the Arab region, both big and small, pushing boundaries and becoming role models for generations. Emily Nasrallah was a writer, journalist, teacher and women’s rights activist
How do you relax?
Yoga relaxes me and helps me relieve tension, especially now when we’re practically chained to laptops and desks. I enjoy learning more about music and the history of famous music bands and genres.
What is favourite book?
The Perks of Being a Wallflower - I think I've read it more than 7 times
What is your favourite Arabic film?
Hala2 Lawen (Translation: Where Do We Go Now?) by Nadine Labaki
What is favourite English film?
Mamma Mia
Best piece of advice to someone looking for a career at Google?
If you’re interested in a career at Google, deep dive into the different career paths and pinpoint the space you want to join. When you know your space, you’re likely to identify the skills you need to develop.
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Mohammed bin Zayed Majlis
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The past Palme d'Or winners
2018 Shoplifters, Hirokazu Kore-eda
2017 The Square, Ruben Ostlund
2016 I, Daniel Blake, Ken Loach
2015 Dheepan, Jacques Audiard
2014 Winter Sleep (Kış Uykusu), Nuri Bilge Ceylan
2013 Blue is the Warmest Colour (La Vie d'Adèle: Chapitres 1 et 2), Abdellatif Kechiche, Adele Exarchopoulos and Lea Seydoux
2012 Amour, Michael Haneke
2011 The Tree of Life, Terrence Malick
2010 Uncle Boonmee Who Can Recall His Past Lives (Lung Bunmi Raluek Chat), Apichatpong Weerasethakul
2009 The White Ribbon (Eine deutsche Kindergeschichte), Michael Haneke
2008 The Class (Entre les murs), Laurent Cantet
KILLING OF QASSEM SULEIMANI
The burning issue
The internal combustion engine is facing a watershed moment – major manufacturer Volvo is to stop producing petroleum-powered vehicles by 2021 and countries in Europe, including the UK, have vowed to ban their sale before 2040. The National takes a look at the story of one of the most successful technologies of the last 100 years and how it has impacted life in the UAE.
Read part four: an affection for classic cars lives on
Read part three: the age of the electric vehicle begins
Read part one: how cars came to the UAE
KILLING OF QASSEM SULEIMANI
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The years Ramadan fell in May
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More coverage from the Future Forum
How to watch Ireland v Pakistan in UAE
When: The one-off Test starts on Friday, May 11
What time: Each day’s play is scheduled to start at 2pm UAE time.
TV: The match will be broadcast on OSN Sports Cricket HD. Subscribers to the channel can also stream the action live on OSN Play.
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The Sand Castle
Director: Matty Brown
Stars: Nadine Labaki, Ziad Bakri, Zain Al Rafeea, Riman Al Rafeea
Rating: 2.5/5
The specs: 2018 Nissan 370Z Nismo
The specs: 2018 Nissan 370Z Nismo
Price, base / as tested: Dh182,178
Engine: 3.7-litre V6
Power: 350hp @ 7,400rpm
Torque: 374Nm @ 5,200rpm
Transmission: Seven-speed automatic
Fuel consumption, combined: 10.5L / 100km
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Zayed Sustainability Prize
The White Lotus: Season three
Creator: Mike White
Starring: Walton Goggins, Jason Isaacs, Natasha Rothwell
Rating: 4.5/5
Defined benefit and defined contribution schemes explained
Defined Benefit Plan (DB)
A defined benefit plan is where the benefit is defined by a formula, typically length of service to and salary at date of leaving.
Defined Contribution Plan (DC)
A defined contribution plan is where the benefit depends on the amount of money put into the plan for an employee, and how much investment return is earned on those contributions.
Total eligible population
About 57.5 million people
51.1 million received a jab
6.4 million have not
Where are the unvaccinated?
England 11%
Scotland 9%
Wales 10%
Northern Ireland 14%
Mohammed bin Zayed Majlis
Company Profile:
Name: The Protein Bakeshop
Date of start: 2013
Founders: Rashi Chowdhary and Saad Umerani
Based: Dubai
Size, number of employees: 12
Funding/investors: $400,000 (2018)
The specs
Engine: 4.0-litre flat-six
Torque: 450Nm at 6,100rpm
Transmission: 7-speed PDK auto or 6-speed manual
Fuel economy, combined: 13.8L/100km
On sale: Available to order now
ONCE UPON A TIME IN GAZA
Starring: Nader Abd Alhay, Majd Eid, Ramzi Maqdisi
Directors: Tarzan and Arab Nasser
Rating: 4.5/5
NO OTHER LAND
Director: Basel Adra, Yuval Abraham, Rachel Szor, Hamdan Ballal
Stars: Basel Adra, Yuval Abraham
Rating: 3.5/5
What is Reform?
Reform is a right-wing, populist party led by Nigel Farage, a former MEP who won a seat in the House of Commons last year at his eighth attempt and a prominent figure in the campaign for the UK to leave the European Union.
It was founded in 2018 and originally called the Brexit Party.
Many of its members previously belonged to UKIP or the mainstream Conservatives.
After Brexit took place, the party focused on the reformation of British democracy.
Former Tory deputy chairman Lee Anderson became its first MP after defecting in March 2024.
The party gained support from Elon Musk, and had hoped the tech billionaire would make a £100m donation. However, Mr Musk changed his mind and called for Mr Farage to step down as leader in a row involving the US tycoon's support for far-right figurehead Tommy Robinson who is in prison for contempt of court.
Killing of Qassem Suleimani
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KILLING OF QASSEM SULEIMANI
Killing of Qassem Suleimani
MOUNTAINHEAD REVIEW
Starring: Ramy Youssef, Steve Carell, Jason Schwartzman
Director: Jesse Armstrong
Rating: 3.5/5
Killing of Qassem Suleimani
Where to donate in the UAE
The Emirates Charity Portal
You can donate to several registered charities through a “donation catalogue”. The use of the donation is quite specific, such as buying a fan for a poor family in Niger for Dh130.
The General Authority of Islamic Affairs & Endowments
The site has an e-donation service accepting debit card, credit card or e-Dirham, an electronic payment tool developed by the Ministry of Finance and First Abu Dhabi Bank.
Al Noor Special Needs Centre
You can donate online or order Smiles n’ Stuff products handcrafted by Al Noor students. The centre publishes a wish list of extras needed, starting at Dh500.
Beit Al Khair Society
Beit Al Khair Society has the motto “From – and to – the UAE,” with donations going towards the neediest in the country. Its website has a list of physical donation sites, but people can also contribute money by SMS, bank transfer and through the hotline 800-22554.
Dar Al Ber Society
Dar Al Ber Society, which has charity projects in 39 countries, accept cash payments, money transfers or SMS donations. Its donation hotline is 800-79.
Dubai Cares
Dubai Cares provides several options for individuals and companies to donate, including online, through banks, at retail outlets, via phone and by purchasing Dubai Cares branded merchandise. It is currently running a campaign called Bookings 2030, which allows people to help change the future of six underprivileged children and young people.
Emirates Airline Foundation
Those who travel on Emirates have undoubtedly seen the little donation envelopes in the seat pockets. But the foundation also accepts donations online and in the form of Skywards Miles. Donated miles are used to sponsor travel for doctors, surgeons, engineers and other professionals volunteering on humanitarian missions around the world.
Emirates Red Crescent
On the Emirates Red Crescent website you can choose between 35 different purposes for your donation, such as providing food for fasters, supporting debtors and contributing to a refugee women fund. It also has a list of bank accounts for each donation type.
Gulf for Good
Gulf for Good raises funds for partner charity projects through challenges, like climbing Kilimanjaro and cycling through Thailand. This year’s projects are in partnership with Street Child Nepal, Larchfield Kids, the Foundation for African Empowerment and SOS Children's Villages. Since 2001, the organisation has raised more than $3.5 million (Dh12.8m) in support of over 50 children’s charities.
Noor Dubai Foundation
Sheikh Mohammed bin Rashid Al Maktoum launched the Noor Dubai Foundation a decade ago with the aim of eliminating all forms of preventable blindness globally. You can donate Dh50 to support mobile eye camps by texting the word “Noor” to 4565 (Etisalat) or 4849 (du).
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The National's picks
4.35pm: Tilal Al Khalediah
5.10pm: Continous
5.45pm: Raging Torrent
6.20pm: West Acre
7pm: Flood Zone
7.40pm: Straight No Chaser
8.15pm: Romantic Warrior
8.50pm: Calandogan
9.30pm: Forever Young
UK's plans to cut net migration
Under the UK government’s proposals, migrants will have to spend 10 years in the UK before being able to apply for citizenship.
Skilled worker visas will require a university degree, and there will be tighter restrictions on recruitment for jobs with skills shortages.
But what are described as "high-contributing" individuals such as doctors and nurses could be fast-tracked through the system.
Language requirements will be increased for all immigration routes to ensure a higher level of English.
Rules will also be laid out for adult dependants, meaning they will have to demonstrate a basic understanding of the language.
The plans also call for stricter tests for colleges and universities offering places to foreign students and a reduction in the time graduates can remain in the UK after their studies from two years to 18 months.
