In 2008, Abu Dhabi embarked on an ambitious journey to eliminate the human papillomavirus (HPV), a major cause of cervical cancer, from its population. It was the first in the Eastern Mediterranean Region (EMR) to introduce the HPV vaccine in its national immunisation programme, providing it for free to all 11-12 year-old girls. This was a bold and visionary decision.
Fifteen years later, cervical cancer remains a major health threat in the EMR. In 2020, an estimated 89,800 women were diagnosed with cervical cancer in the region and more than 47,500 women died from this preventable disease.
As a woman and as a public health professional, I have a personal connection to this issue, and I hope to see all girls from the region live without fear of cervical cancer.
While acknowledging the challenges, it is important to take a moment to celebrate the progress made towards eliminating HPV and cervical cancer in the EMR. In 2018, UAE introduced HPV vaccines in its national immunisation programme for the whole country. I am proud to say that several countries in the region, including Saudi Arabia, Libya and Morocco, have followed the path and introduced the HPV vaccine in their own national immunisation programmes and a few other countries are in the process of doing so. This demonstrates the increasing political will in the region towards the elimination of the disease.
The momentum was only spurred by the launch of the World Health Organisation (WHO) Regional Cervical Cancer Elimination Strategy for the EMR earlier this year. This regional strategy is specifically tailored to the epidemiologic and sociocultural context of our countries. It will enable progress towards the 2030 targets set by the WHO in the Global Strategy for Cervical Cancer Elimination. Its ultimate goal is to reduce the burden of cervical cancer in the EMR by decreasing its incidence and mortality by 90 per cent in 2030.
The regional strategy focuses on providing equitable access to prevention, diagnosis, treatment and palliative care services for all women in the EMR. It provides guidance to all countries in the region around five key actions: HPV vaccination, cervical cancer screening, strengthening infrastructure and access for early diagnosis, treatment and palliative care, ensuring cervical cancer prevention and control are integrated and sustained within the overall health system, and raising awareness and educating the public on cervical cancer prevention, early detection and treatment.
We must also acknowledge and tackle vaccine hesitancy and resistance, which is often maintained by misconceptions and socio-cultural barriers
It is critical to prioritise HPV vaccination, as it is the most effective tool for prevention of cervical cancer. WHO and its partners are ready to support the countries that still have not yet launched an HPV vaccination programme, leaving millions of girls and women at risk. We must work to ensure that all girls, regardless of their socioeconomic status or geographic location, have access to this life-saving vaccine.
Meanwhile, early cervical cancer screening is essential. Regular screening can detect precancerous lesions when they are still treatable, but many women in low-and middle-income countries do not have access to this critical health service. We need to invest in innovative approaches to screening, such as self-sampling and point-of-care testing, to ensure that all women can benefit from this life-saving tool.
All women diagnosed with cervical cancer need to have access to the care they need and we need to ensure this. This includes not only treatment for the cancer itself, but also palliative care to manage symptoms and improve quality of life. We must work to improve access to cancer care, including through the development of national cancer control plans.
Raising awareness and educating the public on cervical cancer prevention and the role of HPV vaccination is critical to achieving the 2030 targets. Communication, advocacy, and social mobilisation efforts are needed to build trust with communities, particularly those in underserved areas.
We must also acknowledge and tackle vaccine hesitancy and resistance, which is often maintained by misconceptions and socio-cultural barriers, particularly in underserved communities. Communication especially designed to address myths and campaigns to educate are necessary to bring down barriers and ensure equitable access to prevention and treatment services.
To achieve the success of the regional strategy for cervical cancer elimination, sustained political commitment is essential. This requires reinforcing health systems and ensuring appropriate resource mobilisation to support prevention, treatment and palliative care services. It also requires the involvement of civil society, academia, the private sector, as well as international organisations and donors. Scaling up the regional strategy for cervical cancer elimination is not only crucial for achieving HPV elimination but also for addressing other public health burdens in the region.
It is crucial to continue working together towards the implementation of the regional strategy to save countless lives and strive for a future where cervical cancer is no longer a threat to communities. Through our collective efforts, we can ensure health for all in the Eastern Mediterranean Region and beyond.
MISSION: IMPOSSIBLE – FINAL RECKONING
Director: Christopher McQuarrie
Starring: Tom Cruise, Hayley Atwell, Simon Pegg
Rating: 4/5
Election pledges on migration
CDU: "Now is the time to control the German borders and enforce strict border rejections"
SPD: "Border closures and blanket rejections at internal borders contradict the spirit of a common area of freedom"
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more from Janine di Giovanni
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
