Emergency drug for allergies in short supply


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ABU DHABI // A lack of awareness about anaphylaxis means devices used to inject the drug that treats it are not widely available in the UAE, a situation that could have deadly consequences, a local expert on allergies said.

Anaphylaxis is a severe reaction created when the body releases chemicals to fight an allergen. It is most commonly caused by insect stings, foods such as peanuts and shellfish, and medications. The seriousness of the reaction can vary, but in certain cases it can cause sudden death if the anaphylaxis is not treated. Epinephrine is the drug used to treat severe allergic reactions. It is usually administered by an auto-injector device commonly referred to by the brand name EpiPen.

But EpiPens can be hard to come by. Not all hospitals in the country have them, a situation that needs to change, said Dr Bassam Mahboub, vice president of the UAE Allergy and Respiratory Society. "Because the awareness about allergies and anaphylaxis is not there, the necessary medication is not there," he said. "It should be available in all private pharmacies as food allergies are very common. People should have access to it with a prescription."

The society has conducted a number of workshops and lectures to educate general practitioners and specialists about allergic reactions, but many still do not know the signs and symptoms. "More needs to be done," Dr Mahboub said. "It needs to be wider awareness." According to doctors, what used to be an almost unknown condition is on the rise worldwide, including in the UAE, and they are calling for contingency measures in schools along with a general awareness campaign.

Dr Mahboub said the rise in allergies in the Emirates is consistent with a global trend. The hygiene hypotheses, he said, is one of the main contributing factors to the increase in allergies. Cleaner lifestyles have caused a shift in the function of the immune system, which is designed to fend off viruses and bacteria as well as identifying other foreign substances as allergens. But with vaccines and other measures that prevent children's immune systems from becoming expert at fighting off viruses and bacteria, the immune systems are developing a greater tendency to identify allergens.

"The trend shows an increase in allergies but we do not have the exact figures," Dr Mahboub said. "Cleaner lifestyles mean we are skewing our immune system from its original function of fighting bacteria and viruses." According to the American Academy of Allergy, Asthma and Immunology, more than three million people in the US say they are allergic to peanuts, tree nuts or both. Food allergies there affect about six per cent of children younger than three years old, and children with a food allergy are two to four times more likely to have allergy-related conditions such as asthma, the academy claims.

Dr Carlos Mateluna, from the American Hospital Dubai, said anaphylaxis was on the increase in the UAE and the region as more western lifestyles were adopted, making it more common in young people now than it had been in their parents' and grandparents' generations. People were now following completely different diets from those of their parents, he said, and were exposed to a range of environmental factors that had not existed before.

"I have many patients with anaphylaxis, the most common cause being, like everywhere else in the world, food allergy," he said. "Many of these patients face enormous difficulties in their daily lives, and must restrict their activities as a result of their allergies." Dr Mahboub said all forms of allergies were on the rise but that until more research was done it would be impossible to know the extent of the problem in the UAE.

munderwood@thenational.ae mswan@thenational.ae

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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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