Insights

Arab countries’ commitment to Health Security

Morocco, Egypt, Saudi Arabia and the Emirates launched a mass vaccination campaign and are aiming at own production of vaccines by focusing on Health Resilience

Many Arab countries have decided to focus on health security by starting up important partnerships. The reason is to avoid relapsing into the economic crisis due to a potential return of the pandemic, as is already happening to some of them. The return of the crisis caused by the Delta variant was decisive in prompting those Arab countries that enjoy greater stability and economic strength to follow a health security policy necessary to avoid a new pandemic. In order to do so, on the one hand they are aiming at mass vaccination campaign with the purchase of vaccine doses abroad, and on the other hand on their own production to avoid being held hostage by the global market.

The first country in the Arab world to focus on health safety was Morocco. On January 28, King Mohammed VI launched the national Covid-19 vaccination campaign from the Royal Palace in Fez. On that occasion, the king received his first dose of the Covid-19 vaccine with the goal of immunizing all of the Moroccan people with 30 million doses, by vaccinating approximately 80 percent of the population. And yet, the fear is that this enthusiasm will not be enough, especially in view of the arrival of the Delta variant.

In fact, the Ministry of Health issued a new notice on July 7 on a possible tightening of health restrictions in case of non-compliance with precautionary measures, and it reiterated the urgency of returning to strict observance of social distancing. Its bi-weekly report announced that contamination cases have increased of more than 60%, and that dozens of cases of Covid-19 variants, including 43 contagions of the Delta variant in four regions of Morocco, have been recorded. According to Arab media, the government has extended the state of health emergency declared in March 2020 until August 10. The decision was taken at a time when the country had recorded an increase in new cases of Covid-19 contagion, and it reflects the authorities’ commitment to continue to guarantee the effectiveness of the measures taken in order to deal with the spread of the pandemic. This commitment was demonstrated by the decision to postpone the annual Throne Day, which falls on July 30, in order to avoid gatherings.

This is the reason why Mohammed VI on July 5 chaired, at the Royal Palace in Fez, the ceremony to launch and sign agreements related to the project of production and mobilization of Covid-19 vaccine and other vaccines in Morocco. This structured project falls within the framework of the king’s volition to gear up the kingdom with complete and integrated industrial and biotechnological capacities to produce vaccines in Morocco, according to the local media. This project aims to produce the Covid-19 vaccine and other important vaccines in the kingdom to improve its self-sufficiency and to make Morocco a leading biotechnology platform in the packaging industry field at the continental and global level.

The project, resulting from a public-private partnership, sets out to launch an initial short-term capacity to produce 5 million doses of the Covid-19 vaccine per month, before gradually doubling that capacity over the mid-term. The total investment is estimated at USD 500 million.

The Egyptian government has also decided to obtain the capacity to produce medicines and vaccines since it has recently sustained the delay of several foreign companies in supplying the contracted quantities of vaccines on time. It leaked that the enormous global demand for vaccines convinced Egypt of the inevitability of local production to avoid being held hostage of the global market.

The Qatar-based TV broadcaster “al-Jazeera” explained that Cairo’s current challenge is to be able to double the required quantities of raw materials from which the vaccine is produced since it is planned to produce 40 million doses by the end of the year. With its population of 104 million, Egypt has witnessed a considerable rise in the number of contagions recently. The fear is the arrival of the Delta variant in such a populous country.

The Egyptian Ministry of Health has implemented strict procedures in the airports and seaports to deal with arrivals from countries where mutations of the virus are being recorded. To cope with the Delta variant, all Egyptians and foreigners are prohibited from entering the country without a negative CRP test carried out no later than 72 hours before the scheduled flight departure time. This is despite the fact that no cases of Delta variant have yet been reported in the country.

The goal is to prevent finding itself in a situation similar to the Tunisian one, where contagions have zoomed upwards and have led to a new evening curfew in Tunis, which has ruined the summer tourist season, thus striking another hard blow to the country’s economy. Such is the upturn of the epidemic in the country - also due to the presence of the Delta variant - that Tunisia has decided to start selling lambs for the Islamic Festival of the Sacrifice (Eid al-Adha), which this year fell on July 20, for the first time via the Internet instead of selling them in livestock markets. The Tunisian Ministry of Health declared that the country’s health system has crumbled, with intensive care departments full, exhausted doctors and the pandemic spreading rapidly. “We find ourselves in a catastrophic situation. The health system is collapsing, it’s extremely difficult to find a bed in the hospitals, we are struggling to provide patients with oxygen, and the doctors are suffering from unprecedented fatigue,” Tunisian Health Ministry spokesperson Nissaf Ben Ali told a local radio station. On July 7, Tunisia recorded almost 10,000 new contagions and 134 deaths, with a record-breaking daily increase from the beginning of the pandemic that led to 317 deaths being reported a few days later, on July 24, the highest figure since March 2020.

A similar problem was recorded in the Sultanate of Oman, which announced it was enforcing a total curfew during the Eid al-Adha holidays to prevent an escalation in the number of people infected by the virus. With its economy collapsing, Lebanon is also finding it difficult to lay down a health security policy. On July 10, the interim adviser of the government for health affairs, Petra Khoury, announced that her country has passed the threshold of one million people vaccinated with the first dose of the Covid-19 vaccine, while on July 24 only 16.7 percent of the population had been vaccinated.

To avoid finding itself in the same situation, Saudi Arabia instead conducted a blanket vaccination campaign, trying to reach the entire population. The ministry of health of Riyadh announced that over 24 million doses of the coronavirus vaccine were distributed and administered before July 24 through more than 587 vaccination sites in all regions of the Kingdom. According to the pan-Arab broadcaster “Al-Arabiya”, at the end of May this year Saudi Arabia announced that up until that time 40% of the population had received at least one dose of the vaccine, as part of the distribution of vaccines to bring life back to normality and to tackle the pandemic. The Saudi Arabian Ministry of Health confirmed that the second dose of the coronavirus vaccine is available for adults aged 60 and over in all parts of the Kingdom.

This campaign allowed the country to successfully get through a critical moment from a health security perspective, which is the pilgrimage to Mecca (Hajj). On July 20, the pilgrimage rites came to a successful conclusion thanks to a series of measures taken. The first was that of a rationed presence consisting of only 60 thousand pilgrims residing in the Kingdom who had completed the vaccinations. Riyadh also developed numerous applications and technologies that allowed the pilgrims to easily carry out their rituals and helped ensure social distancing requirements.

One of these technologies is the Hajj Smart Card, designed to connect the operations and services provided to the pilgrims. The card works with the Near Field Communication (NFC) technology, which allows the cards to be read using self-service devices available at holy sites, and includes many functions and features, such as guiding the pilgrims to their lodgings, controlling access to several facilities, and restricting irregular pilgrims. The ministry of Hajj and of Umrah in the Kingdom also adopted the “electronic bracelet”, which displays the pilgrim’s identity and all official data, and also allows their state of health to be monitored and to intervene in case of emergency. Plus, it offers the possibility to use it to send public awareness messages to the pilgrims. Lastly, again to guarantee social distancing, the use of robots to serve pilgrims of the Great Mosque has been introduced. They are equipped with screen, camera and microphone to answer the pilgrims’ questions while working to measure temperatures and check the observance of wearing face masks using artificial intelligence technologies.

And so, people are beginning to talk about the importance of Health Security in the Kingdom as well. It is a concept that is spreading in the wider Mediterranean area, as Giorgio Roscigno, an expert on the subject, explains, and that also the former President of the United States Barack Obama expressed during the 2016 Ebola outbreak, which was then broadened and consolidated in the Global Health Security Agenda of the WHO. This concept crosses the borders and is aimed at mitigating public health incidents and ensuring the health of the populations on a global scale.

“The advent of new challenges in the field of security that increase the vulnerability of the countries has created a growing demand for measures to counter the spread of highly transmittable diseases such as Ebola and now Covid-19, which do not respect borders and cross them”, added Roscigno. “The Covid-19 pandemic has also recently extended the concept of Health Security tied to the strengthening of the healthcare infrastructure in the high spread and high risk countries to the concept of Health Resilience linked to the ability of national responses to pandemics with the local production of vaccines, drugs and healthcare products”.

Both the US Centers for Disease Control and Prevention, an important public health control body in the United States, and the European Centre for Disease Prevention and Control (ECDC), an independent European Union agency with the purpose of strengthening the defenses against infectious diseases of the member countries of the Union, have launched a sweeping programme to support African Health Security and the African CDC for epidemiological tracking and medical personnel and laboratory training. The African CDC has created a task force to coordinate activities of the countries and institutions of the Donor Countries with the countries receiving these aids.

“In the area of the Health Security and Health Resilience activities, the African Union and the African CDC hosted a High Level Virtual Conference on the local production of vaccines and drugs in April 2021”, the expert added. “This conference was attended by the heads of government of all the African countries, of the United States State Department and of the European Commission, and it contributed to the creation of a great deal of awareness and recognition of the fact that Health Resilience is a fundamental tool for ensuring health and social equity”.

In June 2021, the European Commission, represented by the President Ursula von der Leyen, announced in Rome together with the Italian Prime Minister Mario Draghi the start-up of an initiative and an investment of EUR 1 billion to support the local production of vaccines, drugs and healthcare technologies in Africa. The president of South Africa, Cyril Ramaphosa, launched the first African technological hub, mRNA, for the production of Covid-19 vaccines for the entire region in June 2021.

These initiatives are also of great interest to Arab countries, particularly those in the Gulf. The first challenge for Riyadh is, in fact, the organization of the Hajj, the pilgrimage to Mecca, which will end on July 20. For this reason, the Saudi Home Affairs Minister Prince Abdulaziz bin Saud bin Nayef bin Abdulaziz held a video conference seminar on July 12 entitled: “Health Security During the Hajj” at the security forces hospital of Mecca. The symposium is part of the work of the “Kingdom’s Vision 2030” programmes, which is in line with the enormous efforts put forth by the Kingdom during the pandemic to meet the health security challenges that are a top priority for Riyadh. Indeed, this year Saudi authorities prevented residents outside the Kingdom from participating in the pilgrimage to Mecca, precisely in order to prevent it from becoming a chance for contagion.

The United Arab Emirates adopted a similar policy as they need to secure the city of Dubai in particular in view of the Expo next fall. According to the news carried in the local newspaper “al-Khaleej”, the government of Abu Dhabi revealed that the percentage of those of the total population who have received the first dose of the vaccine has reached 74.5%, while the percentage of those who have received two doses of the vaccine is 64.3% of the total population. The United Arab Emirates therefore rank number one in the world in the distribution of daily doses of vaccine, at the pace of 158.24 doses every 100 people, and have provided roughly 15,500,000 doses up until now.

Arab analysts agree on the fact that this type of initiative is not enough, and they are increasingly inclined to focus on Health Resilience. Therefore, a huge opportunity for Italy presently exists, as Roscigno explained, “by intervening in the support plan for the transfer of appropriate technologies for the production of drugs and vaccines, also by virtue of the presence in Italy of centers of excellence both in the public and private sectors”. In terms of the countries of the extended Mediterranean area, “in line with the plan of the African Union to select Technological HUBs in the North African region, and the accommodation capacity existing in Egypt and Morocco, we might imagine support to these two countries on the shores of the Mediterranean with the capacity to attract and export both to East Africa (Horn of Africa) for Egypt and to French-speaking Africa for Morocco”.

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