ABU DHABI: Government-issued circulars are being sent to UAE doctors to curb over-prescription of antibiotics to prevent resistance to superbugs and tackle the cost to health insurance systems of antibiotic misuse.
Dr. Amin Hussain Al-Amiri, assistant undersecretary for public policy and licensing at the Ministry of Health and Prevention (MOHAP), said the circulars were part of a raft of measures urging doctors not to issue antibiotics as a first port-of-call.
“The impact of our rules and the circulars will firstly be for the protection of patients themselves,” he said. “But also this will lower health insurance costs because if unnecessary antibiotic prescriptions are avoided then this will minimize the bill which will be forwarded from health care facilities to insurance companies. It will minimize the costs to the UAE because government hospitals provide services free of charge to UAE nationals.”
Dr. Al-Amiri said that the measures will focus on clamping down on doctors who ‘“overdose’” patients by routinely prescribing drugs and pharmacies that issue antibiotics without a prescription.
The steps are in line with World Health Organization (WHO) reports that warn of rising resistance caused by changes that occur in bacteria and render antibiotics less effective.
“First of all, we released many circulars to physicians to not use antibiotics as the first option for the treatment of patients unless — and this is very important — it is absolutely indicated,” Dr. Al-Amiri said. “Once it is indicated there is no issue in prescribing antibiotics.”
This, he said, should mean doctors prescribing the lowest strength of antibiotics unless the patient did not respond to treatment.
“Next, which is very important, we are insisting that all pharmacies avoid issuing antibiotics without prescription which is illegal — this is against the rules and regulations of pharmaceutical law in the Emirates.”
Ministry of Health policy states that antibiotics should not be offered to patients by pharmacists without a doctor’s prescription. New legislation will further prevent pharmacy misconduct relating to antibiotic dispensation without a prescription.
Dr. Yasser Sadawey, internal medicine specialist at Al-Ain’s Medeor 24x7 International Hospital, welcomed the measures — but said it could have a less-than desirable effect on antibiotic sales in the UAE and wider region.
“It will be appreciated by insurance companies and individuals as it will reduce the insurance cost,” he said. “On the other hand, global pharmaceutical companies, which are the sole developers of new antibiotic medications, will have less revenue, which might affect the research programs. We had 65 antibiotics discovered during 1978-1998 and in the past 20 years we had just 15 new antibiotics.”
Dr. Sadawey said misuse was leading to medical practitioners losing their “first-line antibiotics.”
“If we don’t take action now, we may be back in an almost 19th-century environment where infections kill us as a result of routine operations,” he warned. “This is a global issue for governments, the medical profession, the pharmaceutical industry and individuals.”
Dr. Diab Kurdi, head of pharmacy at Abu Dhabi’s Burjeel Hospital, also welcomed the move to reduce antibiotic misuse.
“Doctors in the UAE have been issued with circulars that warn against using antibiotics as the first option for treatment if there is another potential solution,” he said. “If antibiotics are absolutely necessary, it’s recommended that doctors begin with the lowest dose possible. Measures like this are important in the UAE, as they are the world over, to prevent the overuse and potential eventual inefficacy of antibiotics.”
Dr. Kurdi said there was also a responsibility for patients, health care professionals and policy makers to tackle overuse.
“The industry itself needs to invest in research and the development of new antibiotics, vaccines and other tools; individual practitioners/physicians can take greater steps to limit the transmission of infection through cleaning of hands and equipment, and report antibiotic-resistant infections to surveillance teams. Patients must always follow guidelines for use and never share or use leftover antibiotics.”
Talal Bayaa, co-founder of the Dubai medical insurance technology start-up Bayzat, said traditionally insurers have acted as “independently managed control measures” against over-diagnosis and over-prescription of drugs such as antibiotics.
“They’ve done so by ‘rejecting’ cover for specific treatments and medications that are prescribed by medical service providers,” he said. “We as brokers, as well as insurance providers, have seen cases of antibiotic over-prescription for the treatment of conditions that can otherwise be treated by other medications that are significantly more affordable than antibiotics and have less impact on patient’s existing immunity, as well as other systems that may be affected by taking harsh antibiotics when not required.”
Bayaa said: “As it stands, given the volatile nature of how medical service providers prescribe treatments and medication, medical insurance premiums tend to be erratic in nature, and the fluctuation in year-on-year premiums is quite extreme.
“Given a more controlled and regulated prescription/diagnosis environment, we can expect medical insurance premiums to reach increased stability and predictability. However, it would take insurers at least a year to be able to properly assess and predict the levels of risk of claims in the region related to antibiotics.”
UAE tightens use of antibiotics amid superbug fears and rising health insurance costs
UAE tightens use of antibiotics amid superbug fears and rising health insurance costs
Presidents of Congo and Rwanda meet in Qatar to discuss insurgency in eastern Congo
- Congo and Rwanda reaffirmed their commitment to an immediate and unconditional ceasefire on Tuesday
- Peace talks between the two countries were unexpectedly canceled in December
DAKAR: The presidents of Congo and neighboring Rwanda met Tuesday in Qatar for their first direct talks since Rwanda-backed M23 rebels seized two major cities in mineral-rich eastern Congo earlier this year, the three governments said.
The meeting between Congo’s President Felix Tshisekedi and Rwanda’s President Paul Kagame to discuss the insurgency was mediated by Qatar, the three governments said in a joint statement.
The summit came as a previous attempt to bring Congo’s government and M23 leaders together for ceasefire negotiations on Tuesday failed. The rebels pulled out Monday after the European Union announced sanctions on rebel leaders.
Congo and Rwanda reaffirmed their commitment to an immediate and unconditional ceasefire during the meeting in Qatar on Tuesday.
Peace talks between Congo and Rwanda were unexpectedly canceled in December after Rwanda made the signing of a peace agreement conditional on a direct dialogue between Congo and the M23 rebels, which Congo refused at the time.
The conflict in eastern Congo escalated in January when the Rwanda-backed rebels advanced and seized the strategic city of Goma, followed by Bukavu in February.
M23 is one of about 100 armed groups that have been vying for a foothold in mineral-rich eastern Congo near the border with Rwanda, in a conflict that has created one of the world’s most significant humanitarian crises. More than 7 million people have been displaced.
The rebels are supported by about 4,000 troops from neighboring Rwanda, according to UN experts, and at times have vowed to march as far as Congo’s capital, Kinshasa, about 1,600 kilometers (1,000 miles) to the east.
The UN Human Rights Council last month launched a commission to investigate atrocities, including allegations of rape and killing akin to “summary executions” by both sides.
Families urge Tunisia to release detained pro-migrant activists
- Romdhane Ben Amor, the head of FTDES, an NGO, said the 10 detainees’ organizations “were engaged in humanitarian work, not political advocacy“
- The authorities, however, “criminalized their actions“
TUNIS: The families of detained Tunisian pro-migrant and anti-racism activists, imprisoned since May, launched an appeal on Tuesday for their release.
Romdhane Ben Amor, the head of FTDES, an NGO, said the 10 detainees’ organizations “were engaged in humanitarian work, not political advocacy.”
The authorities, however, “criminalized their actions,” he said at a press conference.
The aim, Ben Amor said, was to “further weaken migrants and refugees and to push them to accept ‘voluntary returns’ organized by the (UN’s) International Organization for Migration.”
Tunisia is a major transit country for African migrants hoping to cross the Mediterranean to Europe in search of economic opportunities and a better life.
In 2023, Tunisian president Kais Saied denounced what he called “hordes of sub-Saharan migrants” who threatened to “change the country’s demographic composition.”
That was followed by a crackdown on migrants and last year’s arrest of activists.
Among those at the press conference was Emna Riahi, the mother of Sherifa Riahi, the former head of Terre d’Asile Tunisie.
She demanded that her daughter, a parent of two young children, be released and have a trial after charges against her of money laundering and terrorism were dropped.
Also present were the daughters of Mustapha Djemali, the 80-year-old founder of the Tunisian Council for Refugees and former North Africa chief for the UN’s refugee agency.
Yusra and Emna Djemali said their father had lost 35 kilogrammes (77 pounds) while in prison and had been denied medication “for four or five months.”
All these activists “are imprisoned to make it seem as though the president’s racist rhetoric was based on real facts,” said Ben Amor, lamenting what he called the “complicit silence” of the European Union and international organizations.
Netanyahu says Israeli strikes across Gaza that killed hundreds are ‘only the beginning’
- Netanyahu said the attack was “only the beginning” and that Israel would press ahead until it achieves all of its war aims
- Senior Hamas official Izzat Al-Risheq accused Netanyahu of launching the strikes to save his far-right governing coalition
DEIR AL-BALAH, Gaza Strip: Israel launched airstrikes across the Gaza Strip early Tuesday, killing more than 400 Palestinians, local health officials said, and shattering a ceasefire in place since January with its deadliest bombardment in a 17-month war with Hamas.
Prime Minister Benjamin Netanyahu ordered the strikes, which killed mostly women and children, after Hamas refused Israeli demands to change the ceasefire agreement. In a statement aired on national television, he said the attack was “only the beginning” and that Israel would press ahead until it achieves all of its war aims — destroying Hamas and freeing all hostages held by the militant group.
All further ceasefire negotiations will take place “under fire,” he said. The White House said it had been consulted and voiced support for Israel’s actions.
The Israeli military ordered people to evacuate eastern Gaza and head toward the center of the territory, indicating that Israel could soon launch renewed ground operations. The new campaign comes as aid groups warn supplies are running out two weeks after Israel cut off all food, medicine, fuel and other goods to Gaza’s 2 million Palestinians.
“Israel will, from now on, act against Hamas with increasing military strength,” Netanyahu’s office said.
The attack during the Muslim holy month of Ramadan could signal the full resumption of a war that has already killed tens of thousands of Palestinians and caused widespread destruction across Gaza. It also raised concerns about the fate of the roughly two dozen hostages held by Hamas who are believed to still be alive.
The renewal of the campaign against Hamas, which receives support from Iran, came as the US and Israel stepped up attacks this week across the region. The US launched deadly strikes against Iran-allied rebels in Yemen, while Israel has targeted Iran-backed militants in Lebanon and Syria.
A senior Hamas official said Netanyahu’s decision to return to war amounts to a “death sentence” for the remaining hostages. Izzat Al-Risheq accused Netanyahu of launching the strikes to save his far-right governing coalition.
Hamas said at least six senior officials were killed in Tuesday’s strikes. Israel said they included the head of Hamas’ civilian government, a justice ministry official and two security agency chiefs. There were no reports of any attacks by Hamas several hours after the bombardment.
But Yemen’s Houthi rebels fired rockets toward Israel for the first time since the ceasefire began. The volley set off sirens in Israel’s southern Negev desert but was intercepted before it reached the country’s territory, the military said.
The strikes came as Netanyahu faces mounting domestic pressure, with mass protests planned over his handling of the hostage crisis and his decision to fire the head of Israel’s internal security agency. His latest testimony in a long-running corruption trial was canceled after the strikes.
The strikes appeared to give Netanyahu a political boost. A far-right party led by Itamar Ben-Gvir that had bolted the government over the ceasefire announced Tuesday it was rejoining.
The main group representing families of the hostages accused the government of backing out of the ceasefire. “We are shocked, angry and terrified by the deliberate dismantling of the process to return our loved ones from the terrible captivity of Hamas,” the Hostages and Missing Families Forum said.
Wounded stream into Gaza hospitals
Strikes across Gaza pounded homes, sparked fires in a tent camp outside the southern city of Khan Younis and hit at least one school-turned-shelter.
After two months of relative calm during the ceasefire, stunned Palestinians found themselves once again digging loved ones out of rubble and holding funeral prayers over the dead at hospital morgues.
“Nobody wants to fight,” Nidal Alzaanin, a resident of Gaza City, said. “Everyone is still suffering from the previous months.”
A hit on a home in Rafah killed 17 members of one family, according to the European Hospital, which received the bodies. The dead included five children, their parents, and another father and his three children. Another in Gaza City killed 27 members of a family, half of them women and children, including a 1-year-old, according to a list of the dead put out by Palestinian medics.
At Khan Younis’s Nasser Hospital, patients lay on the floor, some screaming. A young girl cried as her bloody arm was bandaged. Wounded children overwhelmed the pediatric ward, said Dr. Tanya Hajj-Hassan, a volunteer with Medical Aid for Palestinians aid group.
She said she helped treat a 6-year-old girl with internal bleeding. When they pulled away her curly hair, they realized shrapnel had also penetrated the left side of her brain, leaving her paralyzed on the right side. She was brought in with no ID, and “we don’t know if her family survived,” Hajj-Hassan said.
Gaza’s Health Ministry said the strikes killed at least 404 people and wounded more than 560. Zaher Al-Waheidi, head of the ministry’s records department, said at least 263 of those killed were women or children under 18. He described it as the deadliest day in Gaza since the start of the war.
In his statement Tuesday, Netanyahu blamed Hamas for civilian casualties, saying it operates among the population.
The war has killed over 48,500 Palestinians, according to local health officials, and displaced 90 percent of Gaza’s population. The Health Ministry doesn’t differentiate between civilians and militants but says over half of the dead have been women and children.
The war erupted when Hamas-led militants stormed into southern Israel on Oct 7, 2023, killing some 1,200 people, mostly civilians, and taking 251 hostages. Most have been released in ceasefires or other deals, with Israeli forces rescuing only eight and recovering dozens of bodies.
US backs Israel and blames Hamas
The White House blamed Hamas for the renewed fighting. National Security Council spokesman Brian Hughes said the militant group “could have released hostages to extend the ceasefire but instead chose refusal and war.”
The ceasefire deal that the US helped broker, however, did not require Hamas to release more hostages to extend the halt in fighting beyond its first phase.
An Israeli official, speaking on condition of anonymity to discuss the unfolding operation, said Israel was striking Hamas’ military, leaders and infrastructure and planned to expand the operation beyond air attacks.
The official accused Hamas of attempting to rebuild and plan new attacks. Hamas militants and security forces quickly returned to the streets in recent weeks after the ceasefire went into effect. Hamas on Tuesday denied planning new attacks.
Israel had sought to change the ceasefire deal
Under the ceasefire that began in mid-January, Hamas released 25 hostages and the bodies of eight more in exchange for more than 1,700 Palestinian prisoners as agreed in the first phase.
But Israel balked at entering negotiations over a second phase. Under the agreement, phase two was meant to bring the freeing of the remaining 24 living hostages, an end to the war and full Israeli withdrawal from Gaza. Israel says Hamas also holds the remains of 35 captives.
Instead, Israel demanded Hamas release half of the remaining hostages in return for a ceasefire extension and a vague promise to eventually negotiate a lasting truce. Hamas refused, demanding the two sides follow the original deal, which called for the halt in fighting to continue during negotiations over the second phase.
The deal had largely held, though Israeli forces have killed dozens of Palestinians who the military says approached its troops or entered unauthorized areas. Egypt, Qatar and the United States have been trying to mediate the next steps.
Israel says it will not end the war until it destroys Hamas’ governing and military capabilities and frees all hostages — two goals that could be incompatible.
A full resumption of the war would allow Netanyahu to avoid the tough trade-offs called for in the second phase and the thorny question of who would govern Gaza.
It would also shore up his coalition, which depends on far-right lawmakers who want to depopulate Gaza and rebuild Jewish settlements there.
Released hostages have repeatedly implored the government to press ahead with the ceasefire to return all remaining captives. Tens of thousands of Israelis have joined protests calling for a ceasefire and return of all hostages.
China, Kuwait sign agreement to expand solar power projects
- China to oversee expansion of Al-Shagaya, Al-Abdiliya plants
- Shagaya part of Kuwait’s plan to generate 15% of its energy from renewable sources by 2030
LONDON: Kuwait and China signed a framework agreement this week which included a commitment to cooperate in renewable energy and solar plants technology.
The framework agreement was reached after six months of negotiations, according to Adel Al-Zamel, the undersecretary at the Ministry of Electricity and Water and Renewable Energy, who signed the agreement in Kuwait with Ren Jingdong, the deputy director of the Chinese National Energy Administration.
The agreement outlines a plan, overseen by the Chinese side, for the third and fourth zones of the Al-Shagaya and Al-Abdiliya solar plants projects. Each project will have a joint production capacity of 3,500 megawatts, with the potential to increase to 5,000 megawatts, the Kuwait News Agency reported.
Shagaya Renewable Energy Park, which is in a desert zone near the Kuwait-Saudi border, plays an integral part in Kuwait’s plan to generate 15 percent of its energy from renewable sources by 2030.
Kuwait and China last month signed an agreement to develop the Mubarak Al-Kabeer port, which is part of China’s Belt and Road Initiative and will have a capacity to handle more than 8 million containers.
On March 22 the two countries will celebrate the 54th anniversary of establishing diplomatic relations.
Kuwait’s Ambassador to China Jassem Al-Najem and other Kuwaiti and Chinese officials were present during the agreement’s signing ceremony.
In Lebanon, Israeli strikes point to a precarious ceasefire
- The war between Israel and Hezbollah in Lebanon marked the deadliest spillover of the Gaza war
- The Israeli military has reported striking five Hezbollah members in three separate incidents in south Lebanon since Mar. 15
BEIRUT: As Israel resumes heavy strikes in the Gaza Strip, escalating Israeli attacks in south Lebanon have killed five Hezbollah members in the last few days, according to security sources in Lebanon, underlining the fragility of a US-backed ceasefire.
The war between Israel and the Iran-backed Hezbollah in Lebanon marked the deadliest spillover of the Gaza war, rumbling across the frontier for months before escalating into a devastating Israeli offensive that wiped out the group’s command and many of its fighters, along with much of its arsenal.
While the ceasefire brought about a big reduction in the violence, each side accuses the other of failing to fully implement it. Israel says Hezbollah still has infrastructure in the south, while Lebanon and Hezbollah say Israel is occupying Lebanese soil by not withdrawing from five hilltop positions.
The Israeli military has reported striking five Hezbollah members in three separate incidents in south Lebanon since Mar. 15. In one of the incidents on Sunday, the Israeli military said it struck two Hezbollah militants “who served as observation operatives and directed terrorist activities.” Security sources in Lebanon said five Hezbollah members were killed.
The Israeli military said on Sunday that a gunshot hit a parked car in the Israeli community of Avivim, and that the shot most likely came from Lebanon. No one claimed responsibility.
STRIKES DESTROY PREFAB HOUSES
In Lebanon, Israeli strikes in two towns on Monday destroyed prefabricated houses brought to the area for people whose homes were destroyed in the war, security sources said.
Noting an increase in Israeli strikes in recent days, the UNIFIL peacekeeping force in south Lebanon “urges all actors to avoid any action that could upset the current delicate calm,” spokesperson Andrea Tenenti said.
“We continue to urge Israeli forces to fully withdraw south of the Blue Line, and we continue to support the Lebanese Armed Forces in their deployment in the south of Lebanon,” he added.
The Blue Line was drawn by the United Nations in 2000, when Israeli forces withdrew from south Lebanon, and separates the country from Israel and the Israeli-occupied Golan Heights.
The ceasefire agreed in November required Hezbollah to have no weapons in the south and Israeli troops to withdraw as the US-backed Lebanese army deployed into the region.
Israel said earlier this month it had agreed to US-backed talks with Lebanon aimed at demarcating the border. It also released five Lebanese held by the Israeli military in what it called a “gesture to the Lebanese president.”
Hezbollah officials have put the onus on the Lebanese state to liberate the remaining land still occupied by Israel. Still, leading Hezbollah official Ali Damoush said on Friday the group would not give up its arms while there was an occupation.
Analysts say Hezbollah would have to think very hard before taking any decision to escalate against Israel, noting that its overland resupply route to Iran was severed by the fall of its ally Bashar Assad in Syria and that many of its supporters are homeless because of the devastation caused by the war.
“So far, Hezbollah is keen not to respond and to leave the decision to the government and the Lebanese army,” said Qassem Kassir, a Lebanese analyst close to Hezbollah.
