Doctors urge action on the UAE's No 1 killer


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DUBAI //Doctors have called for a centralised, long-term programme to tackle heart disease, the nation's biggest single killer.

Heart disease is the cause of 25 per cent of deaths in the UAE, and the average age of contracting the disease is 15 years younger than in the western world.

A national board should be set up under the federal government with a clear timetable for cutting the death rate, said Dr Wael Abdulrahman Al Mahmeed, president of the Emirates Cardiac Society.

The board would include health, food and Islamic affairs authorities, media and schools.

"Everybody is doing small things in their own spheres, but to really have an impact you need a national plan," Dr Al Mahmeed said.

Different authorities would carry out their own programmes, coordinated at federal level.

Food control authorities could initiate laws to regulate the labelling of foods, along with education campaigns to teach consumers how to interpret and understand the labels.

Islamic affairs authorities could regularly circulate Friday sermons on how to avoid heart disease.

Schools could ban junk food and sugary drinks from canteens.

Central government could increase taxation on cigarettes and tobacco, a major factor in heart disease.

"It would look at all the aspects of heart disease, and look at ways to reduce it," Dr Al Mahmeed said. "It would be a very complex thing and would require a lot of input."

Dr Al Mahmeed said the UAE could follow the example of Finland, which in the 1960s had the highest mortality rate from heart disease in the world, but managed to reduce those levels by 80 per cent through a dedicated national programme centred on healthy eating.

Obaid Al Jassim, head of cardiothoracic surgery at Dubai Hospital, agreed that a collaborative approach is needed.

"Everyone is doing something little here, or something little there," he said. "The effect is not that big.

"It's important for everyone to join forces. If you had a national programme for the whole country, it's more unified.

"In other countries they do big things, and they see big results. If you do something small here, after a while it's forgotten."

Dr Naeem Tareen, chief of cardiology at the American Heart Centre Dubai, said the fragmented nature of the health landscape meant a concerted effort was needed.

"There are so many different healthcare bodies," he said. "A lot of things are overlapping with each other. Everyone needs to work together to tackle the issue."

Dr Al Mahmeed said the reason the issue had not been previously addressed may have been the difficulty in coordinating so many different authorities.

"You also need to bring all these people together and on the same page," he said. "That is not an easy task and is quite complicated."

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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.”

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