Governments and FDI agencies of all countries in the GCC are aligning and preparing themselves via new regulations and laws to attract more investment, as dependence on oil and its products is progressively being reduced. Good examples are energy industry plans underway in the Gulf, namely, Dubai Energy Strategy 2030, Oman’s Energy Master Plan, the National Transformation Programme in Saudi Arabia and Vision 2030, which are testament to this shift in dependency.

Of this ‘shift’, healthcare sector upgrade is recurring for most GCC countries. A lot of them are already in the process of overhauling the system, preparing it for attracting investments and allowing healthy competition from the private sector. In Saudi Arabia overall, the private sector contribution to total healthcare spend currently stands at 25 per cent, which the National Transformation Programme (NTP) targets to raise to 35 per cent by 2020 for this KPI. This will have to be done at a relentless yet thought through pace, considering private providers only account for 54 per cent of clinics in the Kingdom (vs. 46 per cent for Ministry of Health {MoH}), and 24 per cent of hospital beds (vs. 60 per cent for MoH and 16 per cent for other Government organisations). While the overall governance of MoH is shifting gradually by clearly separating regulatory and delivery function and creating independent provider networks with operational autonomy and greater accountability, little is known on how to ‘clearly’ flag the sector ‘attractive’ for private investors.

Exploration of existing conducive factors quickly highlights features, which can directly drive the required change. An example is how Saudis are power users when it comes to technology. Look at gaming, social media, and e-commerce and the numbers will tell you that Saudi Arabia is always on the top 10 either in terms of number of users, spending and early adoption.

When applied to a sector such as healthcare delivery, the clear winners include digital health: offering tools for patient self-service, prevention, unified patient records and workforce efficiency. Another one rightfully being public private partnerships (a variety of models to execute), which can facilitate private sector involvement through ownership and/or management of MoH hospitals and services; and lastly innovative medicine, which focuses on out of hospital care, which can easily be integrated into the new model of care being implemented currently.

Healthcare sector upgrade is recurring for most GCC countries. A lot of them are already in the process of overhauling the system, preparing it for attracting investments and allowing healthy competition from the private sector. In Saudi Arabia overall, the private sector contribution to total healthcare spend currently stands at 25 per cent, which the National Transformation Programme (NTP) targets to raise to 35 per cent by 2020 for this KPI.

While there is now clear recognition of how change needs to happen at the regulatory level to allow for a healthcare system to develop, which encourages vigorous competition, while aiming at delivering high quality healthcare – it remains a challenge due to several factors. These include little or no guidance from the regulator identifying demand-supply imbalances, redundant investor approach to investment, and foremost no ‘push’ from the top (only until recently) to enhance service quality in this sector.

Some recent examples to counter the above-mentioned include the ‘one doctor for every patient’ initiative in Dubai. Similarly, a different example is being laid by The National Unified Procurement Company (NUPCO) in Saudi Arabia, which is expected to expand its services to private healthcare providers by providing strategic value-added services; development of a communications platform run by the Saudi Arabian General Investment Authority (SAGIA), to promote Venture Capitalists (VCs) to gain license in three hours only, and initial conversations on the development of a new model of care for Oman, among others.

Hence, to succeed in attempt of privatisation and diversification of the economy in general, most GCC countries need to get creative. Efforts such as:

• Scaling and phasing planned mega projects in line with anticipated market demand;

• Differentiating the offer from current and planned competing schemes in the region;

• Building a legal and regulatory environment that enables the foreign investment required to deliver these projects, are critical foundations for success. Together these can further privatisation, encouragement of small/medium enterprises and international influx, which can considerably reduce the cost burden GCC countries’ finance while boosting private sector contribution and job creation.

To bear the fruits in full, reforms must be viewed as a perpetual, fast-paced effort across policy making, planning, and executive branches. Dubai is converting this methodology into constructive steps to develop ‘sector’ specific policies targeted at attracting private investors into the market. Long term goals have been aligned to tick bigger boxes – such as diversification of economy into a reliable sector with slow but sure returns. In addition, these are intended to help ‘raise’ the standards of service direly needed in the region and offer protection to investors that they are looking for.

A specific example from Dubai Health Authority (DHA) is the recent announcement to introduce the ‘Certificate of Need’ policy for the healthcare sector, which aims to do all of these in one go. This piece of regulation, once in place, is expected to attract private investment, plug the demand-supply gaps in the sector and drive quality of care up. However, several critical factors such as development of a unified payer’s ecosystem, robust capacity planning, and incentives (such as exclusivity to operate, enhanced reimbursement, etc.) offered to ensure the least financially attractive services are still being invested in are absolute necessities for its success.

This approach is ‘truly’ in tune with today’s age of accelerating regulation and scrutiny, where the regulator understands that financial and human capital are required to build strong infrastructure, which is then turned into long-term asset, and that the private sector due to several reasons is far more suitable to take lead. It can create value and contribute to the bottom line, ‘quality’ in this instance; and that the new Certificate of Need programme effectively delivers on that aspect.

DHA's ‘Certificate of Need’ policy is expected to attract private investment, plug the demand supply gaps in the sector and drive quality of care up.

 

A recent report discovered that the potential value for a patient healthcare record on the Dark Web is over a thousand dollars. Alarmingly, the latest Mimecast Email Security Risk Assessment (ESRA) found that one in every 350 emails received by the healthcare industry were impersonations, compared to the average of one in every 4,290 emails for other industries.

Moreover, Ponemon Institute’s 2018 Cost of a Data Breach Study reported that “for the eighth year in a row, healthcare organisations had the highest costs associated with data breaches, costing them US$408 per lost or stolen record, nearly three times higher than the cross-industry average (US$148).” Furthermore, Black Book Market Research found that the overall impact of cyberattacks on hospitals and healthcare systems is estimated to be nearly six billion per year.

Everybody uses emails. However, healthcare is like many other industries that haven’t invested or taken cybersecurity seriously over the years, Jeff Ogden, General Manager – Middle East, Mimecast, highlighted in an interview with Arab Health Magazine.

He said: “An email leak or a data breach has reputational impacts, as well as risk to individuals. You can’t change records in healthcare as it includes personal information and health data that can be used to create targeted cyberattacks.”

Ogden stressed that almost 70 per cent of the attacks seen in healthcare is ransomware. “Losing records or ransomware means that perhaps a procedure or an operation that was planned for the day couldn’t take place. Or there was a process of recovery that delays the operation, which could impact revenue and reputation,” he explained.

An email leak or a data breach has reputational impacts, as well as risk to individuals.

The Middle East and the UAE have invested heavily in healthcare. It is a hot spot for medical tourism and many overseas brands and institutions are present here along with local government institutions. According to Ogden, these factors have made the healthcare industry a big focus in the region, however, it is still a bit behind in putting the appropriate technologies in place to secure the infrastructure.  

Healthcare is reportedly the only industry where the predominant threat of a data breach is internal staff. “For example, one of the things that happens is that consultants can often be sub-contracted by several institutions. Sometimes it’s easier for them to email records, either to the patient or to themselves or other consultants for additional information, making it extremely complex to control those patient records,” he explained.

The consultants have to move records around and are instructed that these have to be online, protected and encrypted, and sometimes burnt to a CD. However, that doesn’t always happen as sometimes patients insist that they can’t collect their records and ask for it to be emailed. And once it’s outside the system, it is out of the control of the facility.

Ogden said: “Mimecast’s ESRA measures the level of security the organisation has in their emails. About 11 per cent of malicious emails come through a typical organisation. In healthcare, we are seeing that it is over 16 per cent and it is a big number. The risk and cost of a breach in the industry are significantly higher.”

To combat this situation, Mimecast is doing a lot of work to educate users and have restricted what they can send in and out. “We are teaching people to understand the difference between a legitimate email and one that isn’t. We do a lot of education and have the Mimecast Awareness Training (MAT) where we can teach people to look for signs such as how the header, content and subject for suspicious emails can look like. Everyone across the board gets training. Our services are also Health Insurance Portability and Accountability Act (HIPAA) and GDPR compliant. We also do two-factor authentication that makes the system far more secure,” he concluded.

Value creation is where corporate strategy and corporate finance are aligned to support shareholder returns; not to be confused with value-based healthcare, which is a reimbursement mechanism that leverages clinical quality measures to incentivise the healthcare industry.

While a balanced approach to both shareholder returns and clinical quality is critical to the success and advancement of healthcare, the UAE has undertaken tremendous initiatives to accelerate quality infrastructure and sustainability in the region, such as attracting new players to the market, evolving regulatory reforms, and increasing health insurance penetration. Enterprises with a short-term view may regard these initiatives as a risk to shareholder returns.

As the Middle East healthcare industry evolves, there are four key ideas to ensure your healthcare business thrives and provides shareholders with returns and, more importantly, delivers on the mission of the healthcare industry; to treat, cure, or rehabilitate society..

Consider your place on the value chain

Horizontal and vertical integration of the value chain can provide competitive benefits and maximise returns. In the region, much of the integration activity seems to be horizontal to increase market share as the key driver of value creation (e.g. hospitals acquiring long-term care providers and specialty services or building more healthcare facilities). Assuming sound due diligence is completed, both vertical and horizontal integration can drive significant value creation. If we look to other markets, we see radical movements such as healthcare systems acquiring health insurers and health insurers acquiring healthcare providers and, even, healthcare providers launching their own pharmaceutical/medical consumable companies. One interesting example receiving media coverage is CivicaRx, a not-for-profit pharmaceutical venture, kick started by hospitals struggling with the high prices and supply challenges affecting availability of life-saving medications imposed by pharmaceutical companies.

Proactively address concentration risk

It’s easy to point out concentration risk scenarios such as when specific payers dominate the market driving up premiums and impacting provider cash-flows. A second common example in the region is hospitals operating in a specific city/country without tapping into volume opportunities or the maturity of developed markets. While the UAE is a thriving economy, there are still opportunities in the healthcare space to ensure the market is kept competitive, stable, and transparent for investors. If we look to a local Middle East enterprise that has successfully de-risked on a country level, it would be NMC Healthcare, which operates in 19 countries across four continents. While resolving concentration risk doesn’t need to be on a global scale or trigger a state of panic, it simply needs to be targeted toward a scenario that drives shareholder returns and/or reduces volatility. Types of concentration risk to consider for your business are country, product/service line, payer, patient mix, supplier/distributor, and credit risk.

While the UAE is a thriving economy, there are still opportunities in the healthcare space to ensure the market is kept competitive, stable, and transparent for investors.

Ray Berry

Use the phrase “What if” during your strategic capital planning process

In the last two years, Abu Dhabi and Dubai have released investment guides, which outline where and how to deploy capital in the healthcare sector. For health systems looking to deploy capital, it can be tempting to build a new facility, purchase new radiology equipment, or invest in marketing efforts. Capital requests tend to randomly pop up in different departments so before approving capital requests be sure to understand their urgency and viability. For mid to long term plans, call the appropriate internal stakeholders to the table to pressure test financial models. When pressure testing a financial model, it’ll be important to ensure costs are well detailed, understand if costs are redundant, account for unintended costs/inefficiencies caused by new projects, identifying capital financing options, and build in other sensitivity levers. By asking “What if”, you’ll be able to come up with relatively accurate scenarios that support decision making and ultimately return invested capital.

Create a value creation management culture

Educating your enterprise and arming them with financial acumen will certainly pay dividends. The healthcare workforce is generally not well-versed on corporate finance concepts. To develop a value creation culture, make the concepts very pragmatic. First, start by drafting a list of decisions per department, walk each department through how to assess their own business needs, and create capital request procedures that force the thought process. The classic example would be purchasing advanced radiology machinery (e.g. CT or MRI). Preemptively leverage the finance team to demonstrate to the radiology team the type of research, data, assumptions, and decisions that need to be assessed such as volume forecasts, depreciation, payer mix, maintenance costs, financing costs, and manpower costs. This approach, of course, is not limited to one department, it should be used to educate any department that makes significant capital requests.

In conclusion, driving value to shareholders and patients alike is critical for the advancement of healthcare while delivering value to shareholders can and should be consistent with delivering value to patients. Growth, risk, capital planning, and management culture are only a few ways to drive value creation. As health systems in the UAE consider more robust value creation strategies, I hope these often overlooked or unrecognised approaches help your healthcare business navigate the evolving market and deliver on its mission.

Driving value to shareholders and patients alike is critical for the advancement of healthcare while delivering value to shareholders can and should be consistent with delivering value to patients.

An obesity epidemic

In 2015, a news article in CNN Abu Dhabi proclaimed an obesity epidemic in the Middle East showcasing a young boy who weighed more than 600 kgs and had to be forklifted from his apartment to get medical help. The article announced that obesity and diabetes rates in the Middle East are staggering, particularly in the Gulf region – Kuwait, Saudi Arabia, Bahrain, and the United Arab Emirates. The article went on to suggest that perhaps the luxurious lifestyle and the abundant availability of food without an equal focus on physical activity could be at the heart of the problem.

The United States has also struggled with the obesity epidemic for many years. More than one-third of American adults are now obese, which has nearly doubled since the 1960’s, and another third are overweight (National Center for Health Statistics, 2016). The issue is urgent because we know that physical health can impact mental well-being as well. Depressed and obese people are far more likely to become obese or depressed, respectively, over time (Luppino et al., 2010). Many initiatives are being supported nationwide to focus on health and well-being and encourage a healthier lifestyle. What if our environments, and the buildings we live in, are the hurdle towards this goal?

A design opportunity

Public health research for many years has held that unhealthy behaviours are really a consequence of unhealthy environments and unhealthy prompts within these environments. In 2016, the AIA supported the Center for Advanced Design Research and Evaluation, Planning4Solutions and HKS architects to study how design could influence people to make healthier decisions. The team concluded that while there were many design strategies that could create a healthy environment, we need to focus on the “points of decision” where people make choices about their physical activity or diet and influence the decision at that point.

The following are some of the design strategies this study found that can nudge people to make healthier physical activity and diet choices in college settings:

Increase visibility of healthy choices
—– A well-placed staircase in lieu of elevators.
— – A smartphone app that prompts us when there is a park or a health food store.
— – Signage.

Enhance walkability
—– Well-maintained walkways.
— – Greenery, gardens, multi-use fields, sheltered picnic areas, public plazas.
—– Quality street lighting.
—– Mixed-use development that includes appealing and accessible healthy food options and other amenities.

Improve transportation infrastructure
— – Bike lanes and bike share/parking facilities.
— – Easy access to public transportation system.

Increase availability of healthy food options
—– Easy access to fresh produce such as supermarkets, farmer’s markets, and community gardens.
—– Healthy “grab ‘n go” options in vending machines and cafeterias.

These strategies involve various scales of environmental design ranging from information design to urban realm. The research recommends a detailed analysis of the users and different personas to assess how to create better point of decision design. Given the unique culture in the Middle East, for example, perhaps a compelling point of decision prompt would be to have healthy lifestyle options in places where there are large social and family gatherings. Large Middle East families tend to visit patients in hospitals. Perhaps developing educational programmes in the main lobby that teach healthy cooking options or exercising will allow them to spend time in the hospital while learning. Given that more than half of the population is in school, a similar programme can be developed for schools in order to educate and improve the health of the population now and in future generations. The unique climate needs to be taken into account to ensure that activity and hydration options are planned together, while remaining culturally sensitive.

Given that more than half of the population is in school, a similar programme can be developed for schools in order to educate and improve the health of the population now and in future generations.

A new paradigm: Healthcare facilities as health destinations

In conclusion, there is a need for healthier environments, but there is also a growing awareness and expectation from the patients to live healthy and be treated in health promoting environments.

As designers we can keep the following tenets in mind, while designing any healthcare facility:

• During master planning, ensure planning for pedestrian friendly environments that promote engagement with nature.
• Consider creating a “health neighbourhood” around healthcare facilities, especially those in the community so they can become a health destination rather than a “sickness” destination
• Carefully consider diet choices and health food availability in designs. Create appealing environments around healthier options and provide sensory cues at key points of decision.
• Promote stair use for ambulatory patients by creating attractive, accessible stairs that are strategically positioned at key points of decision.
• Make health and well-being a core focus of healthcare facilities by designing facilities that are warm, environment-friendly, well-lit, integrated with nature and actively promote healthier choices.

A recent report titled Healthcare in Saudi Arabia Opportunities in the Sector by Knight Frank highlighted that the prevailing picture in the country is one that offers several prospects to existing operators/investors and new entrants, hence there is a possibility to unlock a significant growth potential by fulfilling existing and future gaps. In an interview with Arab Health Magazine, Shehzad Jamal, Partner, Healthcare and Education, Knight Frank, underlined that in the context of the growing healthcare demand in the Kingdom of Saudi Arabia (KSA), government initiatives call for greater participation of the private sector in healthcare as emphasised in the National Transformation Plan (NTP). He also shed light on the technological transformations changing the industry. Excerpts:

What do you think is driving the healthcare industry forward in Saudi Arabia? Are there any current trends you would like to highlight?

The healthcare sector in KSA is undergoing continuous changes and in the right direction. In my opinion, the top three factors that will drive the sector forward are:

Demographic profile: This factor is often overlooked, because of the general perception that KSA is a country with a young demographic profile. However, in the next decade, the country will see a structural shift in its population composition resulting in a significant increase in the population above the ages of 40 and 60. This will drive demand for healthcare services, and the nature of services, spend per patient, duration of care and type of specialisations will significantly change compared to what the industry is seeing today.

Government initiatives and policies: This includes factors such as the National Transformation Programme 2020, including the mandatory health insurance for private sector employees and planned coverage of public sector employees that will improve the overall propensity to spend on healthcare. This will tilt the scale towards the private sector as patients increasingly prefer the private sector on account of the quality of care, efficiency and reduced lead times for appointments. The private sector will gain more prominence and have more opportunities for investment, as the government sector moves away from being a healthcare service provider to a regulator.

Tech: Technology, in general, has helped improve the service delivery of healthcare. However, there are some technologies that are disrupters, and will change how healthcare can be delivered. For example, the use of telemedicine and wearable health monitors; if these are allowed to be more mainstream it will change how business is conducted. The healthcare operators will need to reconsider how to reconfigure their hospitals and other outpatient facilities as the volume of patients coming to hospitals with minor conditions or follow up visits may reduce. In addition to the reconfiguration of their healthcare facilities, the healthcare operators will also need to consider the investment in IT infrastructure to support these platforms.

Could you share some key insights from Knight Frank’s Healthcare in Saudi Arabia Opportunities in the Sector report?

The healthcare sector in KSA is poised for growth on account of the demographic shift and increased insurance coverage. The population dynamic alone shows that there can be an expected increase in the burden of lifestyle diseases and associated comorbidities that would result in a demand for specialised medical and surgical care.

There is a visible gap in the infrastructure available versus what is required in the healthcare sector, which is a sufficient business case for investment in healthcare. Primary research conducted by our team revealed the following:

– Healthcare services in high demand include orthopaedics, obstetrics and gynaecology, IVF, ENT, gastroenterology, cardiology/cardio surgery and ophthalmology.

– Healthcare services with capacity constraints: rehabilitation, oncology, orthopaedics and cosmetic surgery – there is significant outbound medical tourism for these services.  

What are the major healthcare market segments that are likely to expand in the coming year, and why is this so?

I see two segments within the healthcare sector that are likely to expand multi-fold:
a) preventive care (wellness driven) and
b) medical care (long term care, rehabilitation and geriatric care).

The population of KSA is susceptible to non-communicable diseases (diabetes and obesity) due to sedentary lifestyle and unhealthy food choices, which unfortunately are more accessible in terms of cost and availability. In developed countries as well as the GCC, the wellness concepts of nutrition management, active lifestyle, healthy living etc., are catching up. We are observing the increasing interest of investors in this sphere, and believe it is a very promising segment.

In a similar vein, the anticipated demographic changes with the population between 40-59 years and above 60 years is set to increase by almost 1.5 and 3 times respectively. We expect an increase of interest from government authorities, operators and investors alike in niche segments such as long-term care, rehabilitation and geriatric care. For European and North American countries, which have stepped in the era where healthcare sector concerns skewed towards the ageing population, these concepts are widely spread and are implemented as successful business models.

 

What are some of the current issues the GCC’s healthcare industry faces and what are the possible solutions?

The issues faced by the healthcare sector is broadly similar across the GCC, such as reliance on foreign qualified healthcare resources, lack of certain specialised healthcare services (forcing people to travel abroad for treatment), lifestyle diseases, lack of a quality primary care facilities especially in rural areas, which leaves tertiary care overburdened with patients.

To ensure steady improvement in the health sector, it is imperative to encourage private sector investment. This will create competition, which in turn improves quality of services, efficiency in the system etc. However, there needs to be a strong mechanism in place that should ensure an oversupply situation will not arise as that would be detrimental. The government must analyse the sector and identify gaps within the different healthcare specialties. This will allow the private sector to channel their investment to serve these segments. This will not only reduce the investment risk within the healthcare sector but also build the overall healthcare capacity of these countries holistically.

To draw private sector interest, further concentration is required on the following:

Investor friendly legislation and schemes: Increased private sector participation by the introduction of PPP schemes (with clear structures), tax holidays, low-cost credit etc.

Foreign Investment: Expedite company formation process for foreign firms, permit repatriation of profits, assist visas for specialist staff to overcome human capital issues etc. We understand that the Saudi Arabian General Investment Authority (SAGIA) is playing a promising role in this.

Capacity to spend: Expedite the implementation of mandatory insurance for Saudi nationals employed in the public sector. This will shift the quantum of care towards the private sector and help reduce the burden of healthcare from the shoulders of the government. These matters need to be addressed now because as the population starts ageing, the cost of care will increase and then implementation and shifting of care to the private sector may become challenging.

Healthy lifestyle awareness campaigns: Although GCC governments have been professing this for some time, a concentrated initiative is required, targeting all age groups and society at large to promote a healthy lifestyle as the way of life.

Increased use of technology:
—Telehealth: The potential in this area is immense and can pave the way for collaboration of domestic healthcare operators with other internationally renowned healthcare providers. The practical advantage of this method of care is that it provides immediate access to healthcare professionals, restricts travel to a healthcare service provider on a need basis and reduces the burden in the outpatient department of healthcare facilities. In critical cases, the use of telehealth may also result in the saving of lives as real-time specialist guidance can be provided to stabilise a patient in healthcare facilities, which do not have adequate specialists
—
Technology wearables: These instruments can constantly track a person’s vitals and provide complete data allowing physicians to provide holistically proactive care rather than reactive treatment. This is more cost-effective and better for the entire system.

Is Saudi Arabia emphasising prevention?

Several government-driven initiatives are already changing the dynamics of the sector and contributing to reshaping the healthcare landscape in the Kingdom. What is important is to understand how the general public is responding to such ideas and how that is resulting in opportunities for investment.

Our research highlights that growing general public awareness of healthcare shows an increasing inclination of the population seeking preventive care and for reactive measures, they are preferring centres of excellence over general hospitals.

This trend presents an opportunity for existing and new market participants to introduce:
– Windows for preventive care services such as screening programmes, genetic studies to understand the disease predisposition among others, which has proven long term health and economic benefit for patients and the overall health system of a country.
– Development of centres of excellence in areas of their core strength especially in medical conditions relating to oncology, orthopaedic and lifestyle-related diseases.  

Several government-driven initiatives are already changing the dynamics of the sector and contributing to reshaping the healthcare landscape in the Kingdom.

At Informa Markets – Healthcare Group, our vision is to become the ‘Global Information Hub’ for the B2B healthcare industry and with more and more people logging in online to consume industry news and developments, we felt it’s time to make a change and embrace the digital future.

From 2020, Arab Health Magazine, the GCC’s leading healthcare publication, will be rebranded as Omnia Health Magazine. This move has been made to establish the magazine as the official publication for all the events under the Informa Markets – Healthcare Group. The print and digital mediums of the publication will continue reporting the latest advancements transforming the healthcare industry and feature exclusive content around all our international shows such as Arab Health, Medlab Middle East, Africa Health and FIME, among others.

Omnia Health will bring out two print issues with digital extensions and four exclusively digital magazines, along with topical supplements and 12 dedicated e-Newsletters that will be circulated to a global audience. Additionally, the most recent news and developments from across the globe will be reported weekly on insights.omnia-health.com and promoted on our social media channels.

Omnia Health Magazine strives to provide commentary and analysis to key decision-makers in the healthcare industry. The B2B publication will cover topics related to the Investment, Management, Economics and Technological aspects of healthcare. Both our print and digital platforms have been designed to deliver the latest news in the industry and will offer a crucial insight into the trade.

The brand-new website (pictured below) has been designed to focus on the user experience and will offer engaging content and optimised design and text that is user-friendly, to make it more accessible and interactive. The website will also feature embedded videos, webinars and whitepapers to give a more visual and engaging experience. It will host up-to-date analyses and reports on market developments and provide constant updates on new projects, products and technologies that will make it a must-read for healthcare professionals.

Omnia Health’s online content platform will complement the digital Omnia Health Global Medical Directory that features products from leading medical and healthcare companies from around the world. Omnia Health is on the path to becoming a powerful business intelligence tool that will support all stakeholders in the healthcare industry grow.

Currently, Omnia Health is coming together, evolving, changing and growing, and we hope you’ll be part of our exciting journey!

Omnia Health is on the path to becoming a powerful business intelligence tool that will support all stakeholders in the healthcare industry grow.

Arab Health, the annual industry-defining platform where the healthcare industry meets to do business with new customers and develop relationships with their existing clients, will be split into 8 sectors according to main product categories for 2020. The exhibition, combined with accredited medical conferences, has continued to grow and bring investment and new technologies into the Middle Eastern healthcare community for 45 years.

Taking place between 27 to 30 January 2020, at the Dubai World Trade Centre and Conrad Dubai Hotel, the free to attend show has established itself as an important platform to conduct healthcare business in the MENA region. This is illustrated in the fact that the upcoming edition of the event is expected to welcome over 4,250 exhibiting companies, 55,000 attendees from 159 countries, over 5,350 delegates, and will host 37 country pavilions and 15 conferences.

Since it was established, Arab Health has showcased the latest innovations in healthcare, from state-of-the-art imaging equipment to some of the most cost-effective disposables, to developments in surgery as well as advances in prosthetics. The exhibition has defined itself as the one-stop-shop for all healthcare sourcing and procurement needs by bringing a variety of healthcare product manufacturers and service providers under one roof with thousands of products to explore.

The show is the largest gathering of healthcare and trade professionals in the MENA region and is the perfect place to meet new customers and develop relationships with existing clients from across the globe. It allows companies to increase their international presence, generate new business, network with industry leaders and potential buyers and showcase products to an engaged audience.

Furthermore, many exhibitors benefit from market testing that they carry out while exhibiting to gain general and healthcare industry opinion about their offerings. Companies also use this opportunity to stay abreast of the industry’s latest trends and advancements and keep ahead of the competition in one of the fastest-growing medical destinations.

Arab Health provides a beneficial experience for all dealer and distributor job functions – from senior management of larger organisations that are looking to connect with key industry players, sales and business development professionals tasked with expanding their product portfolios and entrepreneurs hoping to source the next ‘big product’ to supply in their country.

Sectorisation

For 2020, the Arab Health exhibition show floor will be split into sectors according to main product categories to improve the show floor navigation thus enhancing visitor experience. This move has been made to increase traffic within the halls by attracting a relevant audience interested in a particular product category, thereby increasing quality leads.

The show floor will be divided into the following sectors: Medical equipment and devices, disposables and consumer goods, imaging and diagnostics, preventive and post-diagnostic treatments, healthcare and general services, healthcare infrastructure and assets, IT systems and solutions, and orthopaedics and physiotherapy/rehabilitation.

Arab Health Congress

Healthcare professionals can improve their knowledge and skills through educational opportunities available at the event through conferences, workshops and training sessions. A wide variety of dedicated Continuing Medical Education (CME) accredited conferences provide professionals with the opportunity for growth in multiple fields and disciplinaries.

The upcoming edition will feature 14 CME conferences, 1 non-accredited educational forum, 400 plus international and regional speakers, and over 5,300 delegates.

With the aim of bridging the gap in medical knowledge, these carefully designed conferences will upgrade attendee knowledge through immersive educational tracks and provide the very latest updates and insights into cutting-edge procedures, techniques and skills. The sessions will take place at the Dubai World Trade Centre and the Conrad Dubai Hotel.

For instance, the newly introduced Midwifery Conference will focus on the contemporary role of the Midwife and will present an excellent opportunity to explore the challenges presented within this profession. Some of the other newly introduced accredited conferences include GI Endoscopy, Patient Experience, Primary Care, Anaesthesia and Pain Management, and Physical, Rehabilitation and Sports Medicine.

Returning for its 20th edition is Arab Health’s Total Radiology Conference, which is a four-day scientific meeting, will shed light on the latest advances in medical imaging, accurate imaging diagnosis and improvement of care quality for radiology patients. While the 12th edition of the Obs & Gyne Conference is a four-day multi-focus event highlighting the fields of general Obs & Gyne as well as reproductive health, maternal health, minimally invasive surgery, foetal medicine, gyne-oncology and imaging. The agenda features local and international speakers providing the latest updates in the treatment, management and diagnoses of a range of disorders.

Construction is a trending topic in the healthcare sector with numerous projects being planned or under construction throughout the GCC. The ageing population, market competition, and the need to continually raise the bar in the delivery of care have kept healthcare organisations vigilant. While balancing these dynamics with financial resources has proven to be challenging, companies are confidently forging ahead with initiatives that are benefiting the entire sector. Arab Health will be hosting the Healthcare Infrastructure Conference this year to draw attention to the future of the healthcare infrastructure industry. The complimentary four-day non-CME conference will cover essential topics such as public, private partnerships, specialised healthcare facilities, healthcare facility accreditation and will provide crucial updates about healthcare projects in the GCC.

The upcoming edition will feature 14 CME conferences, 1 non-accredited educational forum, 400 plus international and regional speakers, and over 5,300 delegates.

Innovation Zone and Innov8 Talks

Innovation is taking centre stage in healthcare and everyone right from start-ups to small companies and larger tech and pharmaceuticals, are getting involved in bringing new technologies to the market. These innovations are being designed to improve the quality of care while lowering costs and speeding up the time to diagnose and treat a patient.

After a successful run at Arab Health 2019, the Innovation Zone will be back again in 2020. It is a dedicated area for visitors to immerse themselves in the latest healthcare innovations. The zone comprises of two key sections – Innovation Showcase and Innov8 Talks.

The Innov8 Talks will be returning with new content, products and pitches and will be a great place to share new ideas and discuss how innovations can be brought to life. Over 32 companies will be participating at the upcoming edition.

The concept behind Innov8 Talks is that each company will have 8 minutes to pitch their innovative concept to a panel of judges. Companies can be as creative and engaging as possible to showcase their innovative product. The stage gives participants a chance to share how they can improve the healthcare industry to an audience of potential investors, and to network with a wide selection of industry experts. The keynote speech will be given by Dr. Maulik Majmudar, Chief Medical Officer, Amazon.

Having a child diagnosed with a chronic illness is a scary and an overwhelming experience for parents. Finding the right doctors, appropriate treatment plans and becoming familiar with the new terminology can often get taxing.

However, the numerous advancements in technology have led to breakthrough treatments, with minimum risks to children, giving parents a much-needed peace of mind. Also, clinicians today are giving increasing prominence to preventative care.

In an interview with Arab Health Magazine, Dr. Amr El-Zawahry, Lead Paediatrician, King’s College Hospital London – Dubai Hills and Assistant Professor of Paediatric, Sharjah University, discussed some of the more frequent paediatric incidents seen in the UAE.

Dr. El-Zawhary’s consultation room is a big hit with the young ones who come in for a check-up! It has colourful cartoon characters plastered on the walls, and the charismatic doctor sometimes puts on a little music, videos, and gives the little ones some sweets, so that they feel comfortable.

When asked about the doubts that parents have when it comes to paediatric care, the doctor shared that they often need reassurance, instructions and education. “The hospital runs breastfeeding, obesity, nutritional, asthma, and allergy campaigns. We get mothers and their babies to come to the hospital and teach them and give instructions. For instance, we have lactation consultants to teach mothers how to feed,” he highlighted. “Another issue a parent often worries about is the nutrition and growth of the baby and if there are any defects or abnormalities. They also need to be educated about giving vitamin D, vaccination, and misuse of medication.”

Blockchain and Artificial Intelligence has started to be employed effectively in healthcare today, according to the doctor. He cited the example of cardiology, where when a murmur is heard, it be can be diagnosed immediately. Also, the hospital has a Telehealth clinic and provides services such as teleradiology. For example, if you take a CT scan or MRI, within 30 minutes the staff can connect with King’s College in London, as the two entities work together closely.

He concluded: “One of the most challenging aspects of my job is patient behaviour, are they and their families satisfied? You can be the most amazing doctor, but do you have the talent to deal with the patient? Today, a mother wants to know everything about the child. She will go to the Internet and ask questions, so a challenging part is to cultivate trust.”

Furthermore, EOS imaging, a pioneer of 2D/3D imaging and data solutions for orthopaedics, recently installed the first EOS system in the UAE, at the King’s College Hospital – Dubai Hills. The system’s Micro Dose option reportedly allows to further reduce the low dose imaging, which is beneficial for children who suffer from chronic conditions such as scoliosis and require regular X-rays for their follow-up treatment.

The introduction of a new sequencing machine to test donor and recipient compatibility prior to transplant means that patients in Dubai who require a transplant will no longer need to go abroad with their potential donors to test compatibility.

The new system not only saves cost, time and enhances patient convenience but also it can be used to check compatibility for a range of transplants from kidney to cord blood and bone marrow.

Dr. Hatim Alabbas, Director of the Dubai Cord Blood and Research Centre (DCBRC) says, “This system is very efficient in detecting organ transplant compatibility compared to its previous versions. Earlier, patients used to travel abroad with many potential donors, usually family members, to check compatibility. This system is the newest version available and is much more effective compared to the earlier versions of testing”.

Dr. Alabbas highlights, “To check compatibility an HLA or Human Leukocyte Antigen process is required. Through this process, matching HLA gene alleles are detected before any organ or bone marrow transplantation. HLA identification and matching is compulsory for organ transplantation between two individuals. Previously, HLA typing low resolution was the system used, now we have the HLA typing high resolution or Next Generation Sequencing system, which is both highly effective as well as cost efficient compared to earlier versions of testing”.

Stem cells: The future of medicine

The DCBRC was established in 2006 and is the only government entity that offers public and private banking of cord blood. The centre has helped facilitate 19 transplantations for patients with conditions such as Leukaemia and Thalassemia. They have 7,000 stem cells stored at the centre.Most of the transplantations especially stem cells’ transplants have been conducted for young children with Thalassemia or Leukaemia.

“The success rate has been promising. Most of the stem cells received have been from family members. We conducted stem cell transplantation for a three-year-old Emirati girl in 2012 from the stem cells received from her brother. Today she is 10, is doing well, and her family advocates the importance of stem cell storage.”

Dr. Alabbas adds, “There has been a rise in awareness about cord blood banking.  Presently, more than 80 diseases can be cured with the help of stem cells.”

He says that while there is an increase in awareness about private cord blood banking, public donation of stem cells is still a new concept. “When the cord blood belongs to the same ethnicity there are higher chances of the tissue matching, this means the chances of the body rejecting the transplant is significantly lower. Normally, the success rate of transplant is higher when the cord blood is from the same ethnic group”.He explains that there are many Arab families in need of cord blood and sometimes the Centre is unable to find a match with the same ethnic group because of the genetic diversity.

“If a family has a history of certain diseases such as cancer, autoimmune diseases and blood disorders, we highly recommend that the mother preserves the stem cells of all her babies. This enhances the chances of getting a donor match in case any of her children need it in future.

“However, mothers who have had past pregnancies but do not have any family history of such diseases can consider public banking of cord blood once they have stored stem cells for their family. Sometimes, mothers who have stored the stem cells for the first two or three deliveries are not interested in storing the stem cells for subsequent deliveries, in such cases we urge them to publicly donate the stem cells instead of letting them get wasted, after all stem cells can save lives.

“Stem cells are the future of medicine. Preserving the stem cell is essential and the cells can be stored for 30 years. It is such a simple procedure, which has in many ways provided a form of health security for families”.

The centre provides a tour for pregnant women and families interested in preserving stem cells for their families or for the purpose of donation.

Recurrent respiratory papillomatosis (RRP) is the most common benign laryngeal tumour in children. It is caused by the human papillomavirus (HPV), in particular low-risk HPV6 and HPV11; aggressiveness varies among patients. RRP has two forms – juvenile onset RRP (JO-RRP) and adult onset RRP (AO-RRP). In this article we will be discussing the JO-RRP.

JO-RRP occurs via vertical transmission during pregnancy or is acquired at birth from an HPV-infected mother; it has a more aggressive clinical course than AO-RRP; however horizontal transmission can occur in JO-RRP thus sexual abuse should always be considered in pre-adolescent cases.

Derkay et al. estimated an incidence rate of 4.3 per 100,000 in JO-RRP. Key risk factors for JO-RRP include (being the first-born child, having a teenage mother who has genital condylomata and vaginal delivery).  

Surprisingly, caesarean section was not found to be protective against JO-RRP, however it’s indicated on active genital HPV infection.

Children with JO-RRP are often diagnosed around three years of age; correct diagnosis might be delayed for years. Initially, children are treated for asthma, recurrent croup and reflux. JO-RRP can cause airway obstruction, hoarseness, difficulty feeding, and a child initially might present a life-threatening stridor requiring urgent surgical tracheotomy.

Diagnosis is made with clinic based flexible laryngoscopy, and bronchoscopy to further evaluate the tracheobronchial tree.

The natural history of JO-RRP is very unpredictable and differs from patient to patient, but anecdotal evidence suggests that HPV 11 has more aggressive presentation than HPV 6 in JO-RRP.

Patients often require multiple surgeries in a short amount of time and occasionally adjuvant therapy when surgery is unable to control the disease. The goal of managing these kinds of patients is to achieve adequate airway, improve voice quality and facilitate disease remission.

Traditional management of JO-RRP has been surgical excision in the operating room under general anaesthesia, primarily with potassium-titanyl-phosphate (KTP) lasers or microdebriders, with some surgeons also using CO2 lasers or cold steel instruments.

RRP remains a difficult disease to manage; for the most severe cases of RRP, medical adjuvant therapy is available. It should only be considered if indicated in persistent airway obstruction or can cause great psychological distress despite complete surgical excision.

Treatment options

Cidofovir, is an anti-viral medication, typically injected intralesional in a four to eight-week interval for eight to 10 doses per course. Once the course is completed, often the disease is less extensive or might even go into remission. Cidofovir’s main impact is to increase the interval period in between the surgical interventions rather than cure the disease. Finally, cidofovir is known to cause kidney and liver toxicity if systematically used. And intralesional might lead to malignant transformation.

Bevacizumab is an antineoplastic monoclonal antibody that blocks angiogenesis by inhibiting vascular endothelial growth factor A (VEGF-A). It showed synergistic effects when combined with angiolytic lasers (KTP/PDL). It has high reduction rate in recurrence.

While Gardisil is a Quadrivalent HPV vaccine against HPV subtypes (6,11,16,18). Most effective if administered to individuals who have not yet become sexually active. It is recommended to administer it to all boys and girls between 11-12 years of age. It also holds promise to eliminate maternal and paternal reservoir of HPV and lead to a near eradication of RRP caused by HPVs 6 and 11. Long-term results of widespread vaccination have not been established yet.


Interferon therapy is one of the first systemic adjuvant treatments used to manage RRP. The clinical efficacy of IFN therapy in the treatment of RRP is controversial and despite positive evidence for adjuvant IFN therapy, it is rarely used due to the emergence of intralesional adjuvants, such as cidofovir and bevacizumab, which have fewer local and systemic side effects.

Lastly, RRP is a benign laryngeal neoplasm that has no cure and the mainstay of treatment is to debulk the larynx to achieve a patent airway; the nature of this disease is to recur regardless of the extent of surgery. Therefore, its preferable to leave the disease in the larynx rather than damaging the larynx to achieve a complete resection. Adjuvant medical therapy is meant to decrease the frequency of surgery.

The importance of raising knowledge among healthcare practitioners is not to be underestimated. HPV is classified as a sexually transmitted disease but RRP is not. Therefore, such patients should be dealt with in a non-threatening environment and assured that their privacy will not to be violated.

To develop documentation forms to uniformly and objectively collect data from such patients will open up the floor for further advancement in communicating with sexually abused patients and to start calculating data among our society to develop preventive plans and to educate school going children about such diseases. It is also important to understand the mode of transmission and to council teenagers regarding the importance of vaccination in decreasing the chance of JO-RRP. Clinician’s should also raise their index of suspicion and report any JO-RRP case; children who have been abuse can’t be excluded.