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
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.
Syria says Israeli strikes aiming to undermine ‘stability’
- A foreign ministry statement denounced “in the strongest terms the recent Israeli air strikes on Daraa,” in southern Syria
- It added that “these deliberate attacks, launched without reason, reveal Israel’s total disregard for international law and norms”
DAMASCUS: The Syrian Arab Replic's foreign ministry on Tuesday condemned a series of deadly Israeli strikes a day earlier, accusing Israel of seeking to sow instability in the country.
A foreign ministry statement denounced “in the strongest terms the recent Israeli air strikes on Daraa,” in southern Syria, on Monday which authorities said killed three civilians.
“This aggression is part of an Israeli campaign against the Syrian people and the stability of the country,” the statement said.
It added that “these deliberate attacks, launched without reason, reveal Israel’s total disregard for international law and norms” and “represent a direct threat to regional and international security.”
The Israeli military said it had struck “military targets” in southern Syrian including “command centers and military sites.”
On Tuesday afternoon, the Israeli military said it launched new air strikes targeting “two cannons” in the region of Khan Arnabah, in the south of Syria, close to the 1974 ceasefire line separating Israeli and Syrian forces on the Golan Heights.
Since the overthrow of president Bashar Assad on December 8, Israel has launched hundreds of strikes on military sites in Syria, saying it was acting to prevent the former Syrian army’s weapons falling into the hands of the new authorities whom it considers jihadists.
The toppling of Assad was led by Islamist-rebels, including those who once formed Al-Qaeda’s branch in Syria, though the new government has sought to distance itself from that past.
The Israeli military has also deployed to the UN-patrolled buffer zone on the Golan Heights, separating the Israeli-occupied part of the Golan from that still controlled by Syria.
Israeli Prime Minister Benjamin Netanyahu has demanded the demilitarization of southern Syria and said his country would not tolerate the presence of forces from the new authorities south of the capital Damascus.
UN humanitarian chief appeals for aid access as Gaza faces ‘total’ blockade
- ‘Worst fears materialized’ after Israel resumes airstrikes, issues new evacuation orders
- Renewal of hostilities has undermined gains during ceasefire, Security Council told
NEW YORK: The UN under-secretary-general for humanitarian affairs warned the UN Security Council on Tuesday that the aid crisis in Gaza is worsening, as Israel resumed airstrikes across the territory and continued to block vital supplies.
“Overnight our worst fears materialized,” Tom Fletcher told council members.
“Airstrikes resumed across the entire Gaza Strip. (Reports) of hundreds of people killed. New evacuation orders issued by Israeli forces. Once again, the people of Gaza are living in abject fear.”
Fletcher added the situation had returned to chaos, undermining the modest gains made during a recent ceasefire.
Humanitarian efforts in Gaza were severely hampered following the resumption of hostilities, he said.
“Today, I am distressed to report that in addition to the intense airstrikes that have resumed, since March 2 Israeli authorities have cut off the entry of all lifesaving supplies — food, medicines, fuel, cooking gas — for 2.1 million people,” Fletcher said.
“Our repeated requests to collect aid sitting at Karem Shalom crossing have also been systematically rejected. No further hostages have been released. Only medical evacuations and humanitarian staff rotations continued. Even that came to a halt today.”
The blockade has worsened living conditions, with essential services such as clean water becoming increasingly scarce.
Fletcher highlighted that the shutdown of Gaza’s desalination plant has left 600,000 people without access to safe drinking water.
“The current suspension of aid and commercial materials is reversing the progress achieved during the brief ceasefire. Survival resources are now being rationed,” he said, adding that vegetable prices in northern Gaza have tripled, while bakeries have closed due to shortages of cooking gas and supplies.
The World Health Organization has warned that public health risks remain very high, including for communicable diseases resulting from overcrowding and poor sanitation.
Fletcher again raised concerns about the growing challenges facing humanitarian workers, with the new restrictions imposed on international NGOs since the Knesset legislation banning the aid agency UNRWA took effect on Jan. 30.
“UNRWA international staff are no longer able to rotate into and out of Gaza,” he said.
Fletcher said that on March 9, Israeli authorities introduced new registration rules for international NGOs delivering humanitarian aid to Palestinians in the territory. If enforced, these will impose strict conditions and significantly disrupt aid operations.
“The Israeli Knesset is also considering a bill to impose considerable taxation on donations from third states to Israeli NGOs, including humanitarian and human rights groups.
“If implemented, this would further erode the number of partners with the capacity to implement protection interventions.
“Many Israeli NGOs are engaged on legal cases involving home demolitions and forced evictions. They also provide protective presence activities related to settler violence.”
Fletcher underscored the success of the 42-day ceasefire, which allowed deliveries from more than 4,000 aid trucks per week, the release of 30 hostages, and the distribution of essential resources to over 2 million people.
“This proves what’s possible when we’re allowed to do our job,” Fletcher said. “We cannot accept a return to pre-ceasefire conditions or the complete denial of humanitarian relief.”
The UN official also expressed grave concern about escalating violence in the West Bank, where 95 Palestinians, including 17 children, have been killed since the beginning of the year, and over 40,000 Palestinians forced from their homes by Israeli military operations.
Fletcher called for immediate action, urging that humanitarian aid and commercial goods be allowed to enter Gaza, and that hostilities cease with the renewal of a ceasefire agreement.
He warned that without funding for the humanitarian response, which has received only 4 percent of the required financial support, the situation will worsen.
“Blocking food, water, and medicine for people who need them is unconscionable,” Fletcher said. “It goes against international humanitarian law and must be stopped immediately.”
Syria’s Aleppo International Airport reopens for domestic, international flights
- The first passenger flight from Damascus landed after the country’s second major hub reopened for air traffic on Tuesday
LONDON: The Syrian Arab Republic reopened the country’s second major airport for flights after nearly three months of closure.
The first passenger flight from Damascus landed at Aleppo International Airport after it reopened for air traffic on Tuesday, amid an official ceremony attended by representatives of Syria’s new interim government, the SANA news agency reported.
The airport was closed in November during the offensive by rebel groups against the regime of Bashar Assad in early December.
Syrian authorities have conducted maintenance and restoration work over the past three months to resume air traffic to and from Aleppo, the country’s second largest city after the capital and an important industrial and trade center.
Authorities announced that Aleppo will begin receiving international flights, facilitating the return of nearly 10 million Syrian refugees currently living in Turkey and Europe. It will also enable the visits of local and foreign investors to the city, SANA added.
Alaa Sallal, the director of relations at the Syrian Civil Aviation Authority, said efforts are underway to expand Aleppo International Airport’s services “to turn it into a key air gateway in Syria capable of handling more flights and connecting the country to the world.”
In January, international flights to and from Damascus resumed for the first time since the fall of Assad with a direct flight from Doha — the first in 13 years.
