In celebration of World Health Day, 2025, EMPHNET hosted a virtual discussion titled “The State of Public Health in the Eastern Mediterranean: Challenges and Opportunities”. Held on April 7, 2025, the 90-minute event shed light on key public health challenges affecting the Eastern Mediterranean Region (EMR). It specifically zoomed in on the impact of humanitarian crises, climate change, and health system gaps seen across the EMR and how such gaps affect public health practice. From another angle, speakers provided an overview of regional public health achievements, with a specific focus on the successful efforts made in the area of immunization, disease elimination and regional cooperation. 

These areas and more, were discussed through open dialogue and reflection, where insights were shared and elaborated on by a panel of esteemed subject-matter experts. Participating panelists included Former Minister of Health in Egypt and former WHO Special Envoy for COVID-19 Preparedness and Response. Prof. Dr. Maha Rabbat; Professor of Public Health at Imperial College London and Director of the WHO Collaborating Centre for Public Health Education and Training, Prof. Dr. Salman Rawaf; Dean of the High Institute of Public Health (HIPH), University of Alexandria, Prof. Dr. Heba Elkady; Professor of Public Health and Former Director of the Institute of Community and Public Health, Birzeit University. Prof. Dr. Abdullatif Husseini; and last but not least, Professor of Community Medicine, College of Medicine, University of Baghdad, Prof. Dr. Faris Lami.

This dialogue was facilitated by EMPHNET’s Executive Director Dr Mohannad Al Nsour, and EMPHNET’s Senior Public Health Specialist Dr Nada Ahmad. Together, the panelists and facilitators set out to promote context-based solutions to challenges, while sharing real-life examples.

Opening Remarks

In his opening remarks, Dr Al Nsour stated that this virtual discussion is being held at a very critical time, as our region is currently facing numerous public health crises and challenges. He added that in light of the ongoing wars, political conflicts, and challenges of climate change affecting our region, our health systems are strained, while elaborating that the shortage of health workforce and the burden of Non-Communicable Diseases (NCDs), dictate a need to shift from reactive responses to proactive long-term solutions when dealing with health threats. Dr Al Nsour further added that the session explores the findings listed in a previously prepared report under the session’s title. This report was compiled by Prof. Dr. Maha El Rabbat, Prof. Dr. Salman Rawaf, Prof. Dr. Faris Lami, and himself to provide an analysis of the public health status in the region.

Following this introduction, Dr Al Nsour went on to introduce the session’s panelists; while stressing that the session’s dialogue will be the prelude to innovative solutions, and further collaborations. He then introduced a short video highlighting the report’s key findings. According to this video, the report’s findings deduced that the year 2024 was characterized by crises escalating due to conflict and war. It identified Gaza, Sudan Yemen, Lebanon, and Syria as the hardest hit areas, and it also showed how climate change is further threatening an already fragile situation dependent on humanitarian and relief aid. From another angle, Anti-Microbial Resistance (AMR) is also on the rise regionally, thus further affecting global health, while the current focus on curative care rather than strategic solutions is an area that needs further work.  Challenges such as the rise in substance use, road accidents and conflicts, and the urgent need for improved occupational health policies were also mentioned, but on a brighter note, the positive impact of regional solidarity, the use of AI and technology in health specifically in the Gulf countries were cited as positive outcomes that need to be built on. The video concluded with a pressing need to understand these and other issues affecting our region, while calling for regional collaboration to find solutions. 

Thoughts from the Panelists

Following the video screening, Dr Al Nsour initiated the panel discussion by asking Prof Dr. El Rabbat to talk about protection for women and children. In response to his questions, Prof Dr El Rabbat kicked off the discussion by stating that different countries have different contexts when talking about the status of women and children. She added that within times of crises there is a need to distinguish between emergency needs and long-lasting resilient needs within different governing structures. She asked whether this should be an issue responded to differently by countries and depending on their context or if this should be a collective approach encompassing all countries. 

 She pointed out that special attention should be given to the policies in place to protect women and children across different governing structures, and the question of who provides healthcare should be answered. She ended her talk by stating such issues require coordination mechanisms to cover gaps, avoid duplications, and cover inefficiencies, and that longer term resilience is built through communication and feedback mechanisms that identify areas for improvement, inclusive development, programs for building workforce capacities, and response plans, amongst other regulations.

Speaking about the impact of climate change, Prof. Dr. Rawaf stated that environmental issues affect all countries in the region. Within this context, serious consideration must be given to the One Health  approach thus highlighting the interlinkage of animals, humans, and environmental health. He further added that it is our collective responsibility to protect our environment within the era of climate change. He stated that in light of these variables our health systems are not well equipped as they are designed for emergency response. A longer-term approach is required. This approach must give more emphasis on a prevention agenda, and elderly healthcare.  He further pointed out that  health systems need to consider needs attributed with changes in environmental health, and population growth.

From her end, Prof. Dr. Elkady shed light on the impact of conflict on mental health. She stated that displacement is a key attribute to the deterioration of mental health. This is further exasperated by the lack of access to mental health services. She then alluded to the gaps caused by the lack of integration of mental health in primary health care, the lack of trained mental health professionals, a shortage in culturally sensitive interventions, a lack of robust funding for mental health initiatives, and last but not least the stigma associated with mental health care.  She ended her talks by stressing on the need to integrate mental health more in health education, and to put supporting policies in place for this area.

Speaking about the burden of NCDs in the region, Prof. Dr. Abdullatif Husseini stated that  wide prevalence of NCDs in our region makes this a pressing public health issue, if not amongst the most important. Factors such as conflict, the ageing population, changing lifestyles, and urbanization are all attributes that increase the spread of NCDs. Within these variables, responding to the burden of NCDs should be placed at the forefront of our health priorities in the region. He further added that the economic burden of NCDs should be taken into consideration and that although many policies have been put in place to combat the spread of NCDs there are many implementation gaps.  The lack in public awareness about NCDs coupled with weaknesses within the health systems, both dictate that more emphasis needs to be placed  on policy enforcement while considering the social determinants of health.

Last but not least, Prof. Dr. Lami spoke about workforce development while shedding light on the role EMPHNET played  in varying areas  of public health, including but not limited to field epidemiology and NCDs. However, he also stated that there is a gap in workforce development pertaining to other health disciplines outside the field of public health. He raised his concerns about the quality of products from the region’s health institutions where many graduates are more concerned about migrating as opposed to serving within their country’s health workforce. 

A Video and Open Q&A

Following the panel discussion, Dr Nada Ahmad screened a video showing EMPHNET’s response to the above-mentioned issues in 2024.  The video was then followed by an open Q&A session where panelists responded to questions from the participants, thus gradually bringing the session to a close.

What’s Next?

 In his closing remarks, Dr Al Nsour stated that EMPHNET is a platform while calling on regional capacities to believe in themselves and their impact.  He confirmed that this session is a prelude to the production of sub-specific discussions about the issues affecting our region. He highlighted the fact that the current report produced is a generic one, yet it may be used to generate publications, videos and other materials that that can be widely disseminated.  He ended his talks by stating that meetings like this one should be  a quarterly practice, during which issues like AI, Climate Change, and others can be discussed. 

Over 1250 registered to attend the session with over 320 in attendance, deeming it another success in EMPHNET’s series of webinars and virtual events.

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