Category Archives: Policy

Does language limit scientific expression?

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Scientific papers

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This is a guest blogpost by Aya Nader.

More evidence is confirming that the choice of language used in scientific literature can influence access to it, and how visible its authors are – including in the Arab world.

Language can limit the transfer of knowledge for one, concludes a study that looked into the prevalence of scientific literature written in local languages. The study, published in PLOS Biology, confirmed some sentiments that many researchers across the Arab world already have.

Over one third of conservation-related scientific documents are written in non-English languages, and a large proportion of local researchers interviewed in the study identified languages as a barrier to accessing knowledge. “I was expecting to see these results, as that was the primary motivation to conduct this work,” says Tatsuya Amano, corresponding author.

Amano says that gaps in information are formed when local scientists either do not get exposed or turn away from publishing in their original language. What surprised the researcher was that over one third of non-English literature reviewed in the study provided neither the title nor the abstract in English, so it’s essentially “invisible to international communities”.

The study might explain why Arab scientists are not as visible, in terms of science research, to international peers, he opines.

“Perhaps only 25% of the global population has some understanding of English and we cannot limit science to just a fraction of the world,” says Steve Griffiths, vice president for research at Masdar Institute of Science and Technology. According to him, having scientific knowledge being somewhat confined to the English language can present a problem when collecting scientific data or disseminating information.

“While language is probably not the driving force behind the lag in scientific visibility of Arab scientists, it certainly can hinder progress,” Griffiths says. Different factors could be causing the lag, he says, which include that the region has only been recently making strides in establishing top-tier research universities and institutes. As well, regional equivalents of supportive bodies like the US National Science Foundation or the US National Institutes of Health are absent.

One of the barriers could be the language itself. A few argue that Arabic, because of the way it’s structured, cannot be adopted as a language of science. “I personally am fluent in English and have studied Arabic for some time and clearly see the translation challenges for technical information,” says Griffiths.

On one hand, English is the universal language of science. On the other, having science available in the local language can enlighten field practitioners and local policy makers.

“The availability of scientific information in relevant non-English languages is a key to the use of science in policy making in countries where English is not widely spoken,” comments Amano. It’s one factor contributing to the divide between science and public policy. “I imagine that extremely busy policy makers would prefer just using easily-accessible information in their own languages, instead of trying to understand English-written papers.”

Poor English skills are observed in many MENA countries and particularly within the government sectors, which limits the uptake of scientific information, Griffiths highlights.

In order to compile non-English scientific knowledge effectively and enhance publishing of new and existing knowledge that is otherwise available only in English, Griffiths suggests launching regional initiatives modeled after the MIT Global System for Sustainable Development. The networking hub, specialized in sustainable development, was created to give researchers that speak English, Arabic, Chinese and Spanish seamless access to its science content.

Another approach is to encourage individual researchers to translate their work, or provide lay summaries of their work in different languages.

There’s also hope in artificial intelligence (AI) for natural language processing (NLP). “Major industry players like Google, Microsoft, Amazon and IBM are deeply engaged in AI NLP for commercial reasons, and over time the outcomes will benefit the scientific community,” Griffiths suggests.

The Throes of AIDS

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Aids and drug testing equipment. Syringe. Paperwork. Graph. Blood. Coloured liquid. Sample. Medical research. Measurements. Charts. Cure. Treatment. Thermometer. Instruments.

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As scientists, press, leaders and activists meet at the 21st International AIDS conference in Durban, the Middle East and North Africa region remains embroiled in its own fight against HIV/AIDS.

The odds are stacked against this region, solidly among those groups where infections are increasing – an issue that the conference at Durban is expected to mount concerns about, among others. In addition to discussing the state of the epidemic worldwide, and in high-risk areas, the conference will address the fact that HIV/AIDS is plateauing or peaking in several countries, plus the level of jeopardy this entails.

In this region, 80% of people living with HIV/AIDS are not aware they’re carrying the virus, 85% of those in progressive stages of infection are not receiving treatments and deaths due to AIDS have increased 176%, according to reports from UNAIDS and WHO. There are not enough national strategic plans to tackle the problem and access to life-saving medications remains limited.

Stigma is partly to blame, according to Navid Madani, senior scientist in the Department of Cancer Immunology and Virology at Dana-Farber Cancer Institute and the Department of Global Health and Social Medicine at Harvard Medical School.

Globally, growing resistance to the antiretroviral drugs used against HIV is the most serious issue facing plans to end the endemic, according to the WHO’s opening statement to Durban’s conference this morning.

Finding preventive measures and a vaccine-antiviral combination that might bring us closer to a cure are underway. In fact only this week, a new study in Science provides insights into the workings of new HIV drugs and into how the virus becomes resistant. Scientists can use these to scrutinize structures insides irregular viruses like HIV to understand the molecular underpinnings of the virus in order to come up with new drug designs.

But finding new drugs is an expensive affair, as meanwhile funding for HIV has been dropping.

Back in the Middle East and North Africa, the extent of the HIV epidemic is undeniable, and governments – some reluctantly and others readily – are beginning to understand there’s a problem in need of curbing.

Just as pivotal to halting the spread is the culture of HIV-related practices, the shame surrounding the virus, the inequality cited by many in terms of medication access and the outdated fears about the prognosis for those infected. The burden falls on scientists, policymakers, healthcare workers and even at-risk communities to try and change the status quo.

World Diabetes Day: The silent killer endures

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On World Diabetes Day, a new report by International Diabetes Federation (IDF) bears bad news to the Arab world, already boasting the highest prevalence of diabetes worldwide and reeling from its different side effects. According to the report, 35.4 million adults aged 20-79 of the Middle East and North Africa region are living with diabetes – over 40.6% of these are undiagnosed.

In 2015, over 340,000 people died due to diabetes, and projections for 2040 expects the number of people with diabetes to almost double, rising to 72.1 million.

Moreover, the silent killer is depleting resources in the region, with overall health expenditure eating up 15% of the region’s healthcare budget and it’s not enough. Although expenditure is also expected to double by 2040, the IDF says it will “likely not be enough to adequately treat all people with the disease.”

The wide infrastructure development, rapid urbanization, increased life expectancy and reduced infant morality also translated into lifestyle changes that included soaring rates of diabetes across most countries in the region, especially the Gulf states.

This time last year Nature Middle East ran a detailed infograph tracing the effects of the soaring epidemic. And nothing has changed much since then, except for the certainty that diabetes is still killing more than 10% of all adults in the region, and nearly half of these under 60, the cost to society and development due to the disease and other metabolic syndromes is high and rapidly growing.

The disease is worse in some countries than others. For instance, a report by our writer Louise Sarant earlier this year cited a study by King Fahad Medical City in Riyadh, predicting that over the next ten years, one in four Saudis will be at risk of having a fatal heart attack.

Of the 4,900 urban-dwelling Saudis monitored by the study, 26% were at high risk of having a heart attack in the next decade. Those in the cohort did not have a history of cardiovascular diseases (CVD), and were between the ages of 20 and 40.

Of those studied, the research found out that 25% had diabetes, 34% hypertension, 25% were smokers, 27% were obese, 86% were not involved in any physical activity and 19% had dyslipidemia, an abnormal level of lipids in the blood.

Another report published a year earlier, also by Sarant, warns of a sharp hike in type 1 diabetes cases. More alarmingly, the incidence among infants of this type was reported to be growing with children developing the disease as early as six months, rather than the established peak ages of around seven and at puberty, when hormones antagonize the action of insulin.

Regional experts have told Nature Middle East that changes in policy, and better research into diabetes, is needed. But it seems that few are listening.

In short, the region has a ‘fat’ diabetes problem, and it’s not waning. And the Middle East and North Africa, like the rest of the world, are no closer to a cure.

 

The Middle East experiences a sharp rise in antibiotic use

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PhotoDisc/Getty Images

The region, especially countries like Saudi Arabia and Egypt, has increased its reliance on antibiotics, and the rise in numbers is dramatic, according to a new report that is hailed as the most comprehensive yet, worldwide.

The Center for Disease Dynamics, Economics and Policy (CDDEP), a non-profit think tank based in Washington DC, used national data and regional surveillance systems to calculate how antibiotic drugs are used globally. The center mapped out their use for 12 types of bacteria, over the period of ten years – and regionally, Saudi Arabia and Egypt are revealed to be the highest in terms of use, with numbers steadily growing every year.

The center measured antibiotic consumption in standard units, defined as the equivalent of one pill, capsule or ampoule. They divided reported numbers of standard units use by estimates of countries’ population, obtained from the World Bank, to get their data. To allow for easier comparison across countries, their graphics count standard units per 1,000 population (1000/pop).

CDDEP

CDDEP

In Saudi Arabia, for instance, all antibiotics use amounted to 25,171 standard units per 1000/pop in 2000. By 2010, this number rose to 32,272. The interactive maps, classified by country, can simultaneously track the use for several types of antibiotics, including broad and narrow spectrum penicillins, among others.

In Egypt, antibiotic drug intake experienced a similar hike, the figures climbed from 16,654 standard units per 1000/pop in 2000 to 24,734 by 2010.

Information regarding resistance to the drugs, however, is absent for this region, perhaps because of restricted access to data. Daniel Sahm, chief scientific officer at International Health Management Associates in Schaumburg, Illinois, tells Nature magazine that the new analysis “might contain holes: an argument for more-aggressive surveillance,” noting that it is difficult to gather data in developing countries.

 

The Middle East: most water stressed region in the world by 2040?

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The Middle East could be the least water-secure worldwide

The Middle East region could possibly be the least water-secure worldwide

This region will suffer from acute water scarcity, as projected by dreary future scenarios for 2020, 2030 and 2040 – at least according to an August 2015 report by environmental think tank World Resources Institute (WRI).

The WRI report covers the globe, but the emphasis on the Middle East comes from the fact that it harbors 14 of the 33 likely most water stressed countries in 2040. The statistics include nine countries that are considered “extremely highly stressed”: Bahrain, Kuwait, Palestine, Qatar, United Arab Emirates, Israel, Saudi Arabia, Oman and Lebanon.

The region already lacks security, water-wise, above all else. The report cites examples such as heavy migration of farmers and herders in Syria, from the countryside to urban areas, as a result of dwindling water supplies. In Saudi Arabia, and in fear of water depletion, the kingdom will depend on grain imports, instead of growing them by 2016.

Only this month, Nature Middle East reported that more than 20 million Yemenis – 80 per cent of the country’s population – have limited access to clean water due to raging conflict. The water shortages have created cases of blood diarrhoea among children under five and an increase in other diseases such as malaria. As well, they have created a crisis among farmers. Experts have warned that in many areas it is too late and the groundwater is running out or has disappeared. Eventually, this will lead to a shrinking rural economy.

“Whatever the drivers, extremely high water stress creates an environment in which companies, farms and residents, are highly dependent on limited amounts of water and vulnerable to the slightest change in supplies,” says WRI. “Such situations severely threaten national water security and economic growth.”

The report drew projections under business-as-usual, optimistic, and pessimistic scenarios. The water stress scores for each scenario and year were weighted by overall water withdrawals, but the report also provides scores for individual sectors, like agricultural, domestic, and industrial ones.

Of the Arab countries that scored the highest on water stress, a 5.0 out of 5.0 risk score, are: Bahrain, Kuwait, Qatar, United Arab Emirates and Palestine, followed by Saudi Arabia with a score of 4.99. For a breakdown of these projections, read the full report here.

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{credit}Infograph courtesy of World Resources Institute{/credit}

Hepatitis C: The case of Egypt

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In the Arab world, and worldwide, one of the most affected countries when it comes to hepatitis C virus (HCV) is Egypt – in fact, it’s estimated that 14.7% of the North African country’s population is carrying the virus and up to 100,000 new infections occur each year.

Seven months before the world celebrates World Hepatitis Day today, Tuesday, a new study revealed that between 3,000 an 5,000 Egyptian children could be infected by the virus through mother-to-child transmission, probably during pregnancy, childbirth or somewhere in the postpartum period. The transmission could contribute to up to 50% of new cases in children under five.

A feature story published by Nature Middle East in October last year explored the possible causes of one of the most widely spread epidemics in Egypt, and it turns out, medical care – or the lack thereof – is responsible, with most transmissions happening due to healthcare hygiene breaches. Hospitals and clinics are by far the largest suppliers of the virus. Wahid Doss, the head of the Egyptian National Committee for the Control of Viral Hepatitis and dean of the Ministry of Health’s affiliated Liver Institute, told our writer Louise Sarant that “[around] 60% of patients who undergo kidney dialysis will have contracted HCV within the year, because the machines are not sterilized properly. Same goes for blood transfusions, which are very risky.”

In 2011, Nature Middle East’s chief editor Mohammed Yahia wrote that “not only is the Egyptian HCV problem one of size, but the genotype of the virus in circulation is one that is not commonly found in the rest of the world. If it is not controlled, there’s no guarantee that it will be confined to Egypt.”

Egypt — and the Middle East more generally — is a stronghold for genotype 4. The prolonged 72-weeks treatment available for hepatitis C – which involves a weekly injection and a daily capsule dose – only has a 60-65% success rate for this genotype. While the preferred treatment regimen – a costly 48-week course of interferon and the antiviral drug ribavirin – is usually only effective in 30-50% of cases.

By contrast, about 75% of HCV infections in Europe and the United States are of genotype 1. Naturally, most prominent research in the West targeted the latter, and not the former.

But perhaps things are changing; already scientists in the region are starting to pay some attention to the virus and its possible new treatments.

Last year, two Egyptian scientists sent sample crystals of two proteins of the hepatitis C virus to space for analysis, in their search for possible cure. The proteins are HCV genome 4, and the researchers, working at the German Aerospace Center (DLR), said they were hoping to understand the behavior of this specific type located heavily in Egypt.

Separately, researchers in Qatar collaborated with Harvard Medical School to develop a therapeutic cocktail that combines antiviral agents and cholestrol-lowering drugs, commonly known as statin, to ease the burden of hepatitis C complications. This statin therapy, announced in April, can complement treatment by slowing the progress of liver fibrosis and reducing the risks of liver cancer in virus-infected patients.

Research aside, in a chronic case like Egypt, prevention remains the saving factor in this affair. And it’s not an easy feat; it involves an overhaul of hospital practices, measures like proper sterilization across health facilities, more investment in awareness and educational programmes aimed at curbing the virus’ spread, in addition to easing access to treatments, especially in rural areas.

Hepatitis C: Training for journalists

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Hepatitis viruses under an electron microscope

Hepatitis viruses under an electron microscope{credit}Image courtesy of U.S. Centers for Disease Control and Prevention{/credit}

Nearly 2.5% of people in the world is estimated to be infected with Hepatitis C – that’s a whopping 150 million people. And it’s more than most other infectious diseases, yet many people know little to nothing about the disease.

In addition to limited awareness of a disease that kills millions yearly, Hepatitis C receives narrow media coverage.

But for reporters to be able to cover the disease, properly, journalists need to know more about the virus and the disease. What are the different genotypes? Which new medications are there? Why is the disease burden so high around the world?

To mark World Hepatitis Day, the World Federation of Science Journalists (WFSJ) is launching a new online portal to educate and support journalists who are covering viral hepatitis all over the world. The portal should give reporters the appropriate tools, data sets and education to accurately cover the killer virus.

To produce this education plan, a steering committee of science journalists from around the world came together with experts, researchers, clinicians and patient advocacy groups representatives to identify the most important topics to cover; ranging from the global disease burden and its risks to health policy and the rapidly evolving hepatitis treatment landscape. I was part of this committee which met twice, then worked together online, to build the training programme.

The material is packaged into modules made available freely online, with each covering hepatitis C from a specific angle. Together they offer journalists different ways to tell the hepatitis C story.

Hepatitis C has been around for so long that it suffers from the same predicament that a condition like HIV/AIDS does: people feel it’s an old story that they don’t know how to keep telling.

But there is so much happening in the hepatitis C landscape to make the story both very fresh and very important. Through this portal, journalists will find tips on how to address said story, in a way that suits their community.

The portal’s steering committee worked on coming up with fresh angles and the portal is expected, still, to help journalists tie loose threads; for example, reporters on the virus should be able to explore questions related to drug policy, commercial use of hepatitis C drugs, accessibility and reach.

The portal also offers a database of experts, policymakers, researchers, clinicians and patient advocacy groups from around the world, with contact information readily available to all visitors of the portal. The experts speak different languages to suit the needs of journalists globally.

The second part of the programme will see the WFSJ use the material online to host face-to-face workshops for journalists on the ground in countries and regions where hepatitis C is most prevalent, such as Egypt and Pakistan.

The workshops will be held in several regions and in different languages to make sure that as many people as possible can benefit from them. In addition to field workshops, the portal will offer a series of online webinars by award-winning science journalists.

Tough times, tough measures for Kuwait

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Kuwait has greenligted the creation of a DNA database of all its 1.3 million citizens, and 2.9 million foreign residents – a surprising move that DNA privacy advocates deem “ill advised.”

Parliament, based on a government request, mandated the law earlier this month, allowing the country’s Interior Ministry to establish said database. Now, people who refuse to provide genetic samples for testing could be jailed or fined, according to this AFP report. Furnishing fake samples is punishable by a seven-year prison sentence.

The decision came in the wake of a suicide attack in a Shiite mosque in Kuwait’s capital that left 227 people wounded. The militant terror group known as the Islamic State (IS) has claimed responsibility.

The entire endeavor is expected to set back the Kuwaiti government some $400 million, dug out from the country’s emergency cash, something that Hellen Wallace, director of GeneWatch UK, genetic science watchdog, calls “a waste of resources.”

“It does not help to solve more crimes or prevent acts of terrorism, especially by suicide bombers who are not concerned about their identities being revealed after the event,” she tells Nature Middle East.

Wallace says that a DNA database reveals private information about biological relationships, for instance. “It also allows everyone on the database to be tracked by the government or any outsider who can infiltrate the system, because people leave their DNA wherever they go, such as on their coffee cup, not only at a crime scene.

“Finally, the risk of errors increases with large databases, as DNA evidence can be planted or contaminated, leading to false accusations and even false convictions for a crime.”

The UK and Portugal have previously mulled over building DNA databases of their populations but had an about face. The European Court of Human Rights, following a case in 2008, judged unanimously that the indefinite retention of innocent people’s DNA profiles, fingerprints and samples is unlawful, breaching Article 8 of the European convention on Human Rights, which is the “right to privacy.”

A 2014 study published in the Egyptian Journal of Forensic Sciences, and co-authored by Wallace, suggests that criminalizing all those who refuse to voluntarily provide their DNA will eventually lead to public distrust. The study says that certain questions should always be asked of databases worldwide, especially ones related to safeguards needed to prevent miscarriages of justice, and cross-border sharing of DNA information.

It also highlights the importance of involving the public in such a political debate, something that Kuwait – in its hurry to impose stricter security measures and help authorities make quicker arrests – has clearly sidestepped.

Reference:

Wallace, H.M. et al. Forensic DNA databases-Ethical and legal standards: a global review. Egyptian Journal of Forensic Science https://dx.doi.org/10.1016/j.ejfs.2014.04.002 (2014)

Health situation in Yemen more desperate than ever

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The World Health Organisation’s Margaret Chan published a statement this week decrying the health situation in Yemen, in which conflict killed almost 2,000 people, and injured 8,000, according to the latest death and casualty tolls.

Around 8.6 million are in need of urgent medical help, the statement said, adding that although WHO has delivered around 48 tonnes of medicine during a recent ceasefire, this is “vastly insufficient.” The aid can only serve some 400,000 people, and more continue to suffer, “not only from war-related injuries, but from inability to get basic treatment for the most common health conditions, or get obstetric care during childbirth.”

The statement reiterates that lives are lost not just in conflict, but in the throes of an ailing health system, a reality that Nature Middle East‘s correspondent Sophie Cousins has explored in an earlier report on May 4.

Ahmed Shadoul, WHO representative for Yemen, had told Cousins that health facilities are coping with “critical shortages of life-saving medicines, trauma care, and surgical and medical supplies, as well as medical staff to cope with the growing influx of patients.” At the time, the Yemeni ministry of public health and population had predicted that major hospitals will be unable to provide services, perform operations or provide intensive care to patients.

And indeed, WHO’s latest statement reported that hospitals around the country are already closing down their emergency operations rooms and intensive care units due to shortages in staff and fuel for generators. Medicines for diabetes, hypertension and cancer are no longer available, as per the WHO. The National Tuberculosis Programme has shut down in some areas, and infectious diseases such as malaria and dengue fever are spreading.

Outbreaks of polio and measles are also serious risks.

The statement in full can be read here.

UAE bars outspoken NYU professor

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Students and faculty moved into the new permanent campus on Saadiyat island in 2014

Students and faculty moved into the new permanent campus on Saadiyat Island in 2014

A professor from New York University has been barred from travelling to the United Arab Emirates for his outspoken remarks against the country’s labour laws for migrant workers.

According to The New York Times, Andrew Ross, a professor at New York University specialised in teaching about labour issues, was in the airport on his way to spend his spring break at New York University Abu Dhabi conducting research into labour issues of migrant workers. He was stopped there and informed he is not allowed into the Gulf state.

New York University Abu Dhabi (NYUAD) is a satellite campus of the university in New York, which also has another similar campus in Shanghai, China. NYUAD has just recently moved into its new campus on Saadiyat Island in Abu Dhabi, a luxurious project that will also house offshoot branches of the Louvre and Guggenheim museums.

Ross has in the past been openly critical of the Emirates’ treatment of migrant workers, including those that worked on building New York University Abu Dhabi’s sprawling new campus in one of the most expensive areas of the emirate.

The UAE authorities have said Ross was not allowed to enter the country for security reasons. However, he suspects it is because of the stance he has taken against the country’s labour laws – sparking debates on academic freedom in offshore campuses of Western universities.

In an email sent to The Times, NYU spokesman John Beckman said that NYU faculty and students have had “zero infringements” on academic freedom and were allowed to travel freely between the campuses. But, he adds that “regardless of where NYU or any other university operates, it is the government that controls visa and immigration policy, and not the university.”