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
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.
Netanyahu coalition jeopardized over ultra-Orthodox exemption from army
- The government must pass the budget by the end of the month or call snap elections
- United Torah Judaism holds seven seats in the Knesset, Israel’s parliament
BNEI BRAK, Israel: One of Israel’s most divisive domestic issues has reared itself again to challenge Prime Minister Benjamin Netanyahu, after a group in the ruling coalition said it would bring the government down unless it exempts ultra-Orthodox Jews from army service.
Some members of United Torah Judaism, one of two ultra-Orthodox Jewish parties in the coalition, said in a letter that they would vote against the budget if the government did not pass a new law formalising exemptions for religious students.
“If this matter is once again sidelined or delayed for any reason, we will not be able to continue as partners in the coalition,” said the March 6 letter signed by Housing Minister and party chairman Yitzhak Goldknopf and two others.
The government must pass the budget by the end of the month or call snap elections. United Torah Judaism holds seven seats in the Knesset, Israel’s parliament.
It is too early to predict the consequences. Netanyahu, Israel’s longest-serving prime minister, is a proven master at smoothing over disagreements in his coalitions. An ultra-nationalist group that quit the government over the ceasefire in Gaza in January announced on Tuesday it was returning.
But pollster Mitchell Barak, who worked for Netanyahu in the 1990s, said this time ultra-Orthodox politicians appeared unwilling to compromise, and the prime minister might have to look outside the coalition for support to pass the budget, an extraordinary step.
“He’s going to look for someone who can compromise, save him, and be that ‘freyer’,” he said, speaking before the ultra-nationalists announced their return to the coalition and using a Yiddish word for someone who lets others take advantage of him. “That’s how he operates.”
The prime minister’s office declined to comment on the ultra-Orthodox ultimatum and whether he believed the budget could pass without their support.
MILITARY STRAINED
In Israel, military service is mandatory at age 18, after which Israelis become reservists liable to be called up for training or deployment.
But dating back to Israel’s founding in 1948 it made an exemption for ultra-Orthodox communities, known as Haredim, whose young men mainly dedicate their lives to studying religious texts in academies known as yeshivot.
Those communities were initially small but have grown rapidly in the following decades. According to government data, there are now 1.4 million Haredim, accounting for about 14 percent of the population, deepening resentment among other Israelis who are conscripted.
In 2017, the Supreme Court ruled that the exemption was unconstitutional, and last year it ordered the military to conscript yeshiva students. Legal experts say the only way to restore the exemption would be to pass a new law enshrining it.
Members of the Haredi community say they would resist any attempt to conscript their children.
“They can put us in prison,” said Yehoshua Menuchin at his home in Bnei Brak, a densely populated city close to Tel Aviv where many Haredim live.
Menuchin, who has a 19-year-old son who is not serving, said the debate was driven by politics, rather than by genuine military need.
“If it’s a matter of survival, like an Arab invasion, then the Haredim will be the first to volunteer in order to save lives. But as long as it is political, it won’t ever happen.”
But 18 months into war in Gaza and major military operations in the West Bank and Lebanon, resentment is growing, and many lawmakers say the exemption is unjustifiable.
“They don’t know what 30 days of reserve duty a year is, and they don’t know what it is to dread that knock on the door,” centrist opposition lawmaker Elazar Stern, a former general, told Reuters, referring to the moment a parent learns of a child’s death in service.
DIVINE INTERVENTION
The Haredim live in insular neighborhoods centered around strict religious observance, with their own schools that largely eschew math and science. They have twice as many children as the national average, rely heavily on state welfare and charity, and those who work are often in low-paying jobs.
They believe that sending their children to the military is an existential threat, fearing that exposure to secular Israelis and outside influences could undermine their way of life.
“I know one thing: we must go the way the Torah instructs us,” said Meir Zvi Bergman, one of Israel’s most widely followed Haredi rabbis. “God does not want us to go, so we won’t go.”
The army says it is working to create conditions to make it easier for more Haredim to serve, such as dedicated battalions with strict religious practices, including regular prayer and gender segregation.
“The responsibility to defend the country must be shared fairly,” Eyal Zamir, Israel’s new chief of the military staff, said in a speech this month taking up his post. (Reporting by Alexander Cornwell, additional reporting by Maayan Lubell and Steven Scheer)
South Sudan party partially withdraws from peace process
- “The ongoing political witch-hunts continue to threaten the very essence and the existence of the (peace deal),” Pierino said
- The fighting around Nasir in Upper Nile state has displaced 50,000 people since late February, according to the UN Humanitarian Coordinator
NAIROBI: A major party in South Sudan’s coalition government said on Tuesday it had suspended its role in a key element of a 2018 peace deal as relations between its leader Riek Machar and President Salva Kiir deteriorate amid clashes and arrests.
The agreement ended a five-year war between forces loyal to Kiir and his rival Machar, who now serves as First Vice President leading the SPLM-IO party. But the two men have a fractious relationship, which has worsened in recent weeks following clashes in the country’s east.
Earlier this month security forces rounded up several SPLM-IO officials, including the petroleum minister and the deputy head of the army, after the White Army ethnic militia forced troops to withdraw from the town of Nasir near the Ethiopian border.
The government has accused the SPLM-IO of links with the White Army, which mostly comprises armed ethnic Nuer youths who fought alongside Machar’s forces in the 2013-2018 war against predominantly ethnic Dinka troops loyal to Kiir. The party denies the allegations.
Oyet Nathaniel Pierino, deputy chairman of the SPLM-IO, said on Tuesday the party would not participate in security arrangements tied to the peace process until the detained officials were released.
“The ongoing political witch-hunts continue to threaten the very essence and the existence of the (peace deal),” Pierino said in a statement.
The fighting around Nasir in Upper Nile state has displaced 50,000 people since late February, of which 10,000 have fled to Ethiopia, according to Anita Kiki Gbeho, the United Nations Humanitarian Coordinator in South Sudan.
RAMPANT HATE SPEECH
South Sudan’s United Nations peacekeeping chief Nicholas Haysom said he was concerned the country was “on the brink of relapse into civil war.”
“With the proliferation of mis/disinformation in the public domain, hate speech is now rampant, raising concerns that the conflict could assume an ethnic dimension,” he said in a speech to the African Union.
Analysts say the war in neighboring Sudan has also spurred the breakdown of the peace process, with South Sudan’s oil revenues suspended, escalating regional tensions and arms flooding across the border.
“Already we are seeing the initial stages of spillover fighting in Upper Nile from the Sudan war. It will be difficult to prevent those tensions from spreading to (the capital) Juba,” said Alan Boswell from the International Crisis Group.
Families urge Israel PM to ‘stop the killing’ of Gaza hostages
- The Hostages and Missing Families Forum said it had received no response to its request to meet with Netanyahu
- “Now it becomes clear — the public officials did not meet with them because they were planning the explosion of the ceasefire”
JERUSALEM: Relatives of Israeli hostages in Gaza accused Prime Minister Benjamin Netanyahu Tuesday of sacrificing their loved ones by carrying out a wave of deadly strikes that threatened a fragile truce.
The Hostages and Missing Families Forum said it had received no response to its request to meet with Netanyahu and other officials to hear how the remaining hostages would be “protected from the military pressure.”
“Now it becomes clear — the public officials did not meet with them because they were planning the explosion of the ceasefire, which could sacrifice their family members,” the campaign group said.
Of the 251 hostages seized during Hamas’s unprecedented October 2023 attack which sparked the war, 58 are still held in Gaza, including 34 the Israeli military says are dead.
The overngith air strikes were by far the deadliest since a January ceasefire that largely halted the fighting and saw the handover of 33 hostages, both alive and dead, in exchange for Palestinian prisoners.
The health ministry in the Hamas-controlled territory said at least 413 people were killed in the strikes.
The forum called on supporters of the hostages to cemonstrate outside Netanyahu’s office in Jerusalem, warning that “military pressure could further endanger their lives and complicate efforts to bring them back safe and sound.”
“The families of the hostages will demand: Stop the killing and disappearance of the hostages now! First, return them — then everything else.”
The return of the hostages is a priority for the majority of Israelis.
“This morning, the moment we realized that we were going back to war, the first thing I thought about was: what about the hostages? This is a death sentence for the hostages, and it’s simply terrible,” said Muriel Aranov, a 62-year-old pensioner living in Tel Aviv.
As protesters headed to Jerusalem, Netanyahu took part in a security assessment with defense officials in Tel Aviv, including Defense Minister Israel Katz, his office said.
An earlier statement from Netanyahu’s office said the strikes were ordered after “Hamas’s repeated refusal to release our hostages, as well as its rejection of all of the proposals it has received from US Presidential Envoy Steve Witkoff and from the mediators.”
“We are at an impasse, we have said ‘yes’ more than once to concrete proposals from the US special envoy to extend the ceasefire, and Hamas has said ‘no’,” foreign ministry spokesperson Oren Marmorstein said in a briefing.
“From now on, Israel will act against Hamas with increased military intensity,” he added.
Rafah border crossing in Gaza is closed, EU spokesperson says
- EUBAM mission of the European Union has started to put in place emergency procedures
BRUSSELS: The border crossing between Egypt and the Gaza Strip in Rafah is closed, a spokesperson for the European Commission said on Tuesday.
“The crossing point is closed and the EUBAM mission of the European Union has started to put in place emergency procedures to deal with the situation as it develops,” the spokesperson told reporters in Brussels.
