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In Abu Dhabi, Public Health in a Hurry

Photograph by Will Kirk

In Abu Dhabi, Public Health in a Hurry

“The goal is to reach the best level of health services. It’s very tempting just to reinvent the wheel but it doesn’t help. The more we learn from the setbacks, the problems that the U.S. has had, the more likely we’ll be able to achieve our goal with minimum casualties.”—Dr. Omniyat Al Hajeri, Manager, Health Professionals Licensing Department, Health Authority–Abu Dhabi (HAAD)

When it comes to building a public health system, few places in the world can surpass Abu Dhabi’s resources, political support and ambitious agenda.

Perched atop an estimated 10 percent of the world’s oil reserves, Abu Dhabi—one of seven emirates in the United Arab Emirates—is accustomed to moving fast. When oil was discovered in the area 50 years ago, Abu Dhabi’s population was just 46,000. Today, the population is 1.7 million (more than three-quarters of whom are expatriate workers).

However, vaulting from a developing country to a developed one has not come without costs, including high rates of chronic diseases like diabetes, cardiovascular disease and cancer.

“We hope to show how Abu Dhabi can be used as a world example of how to solve a lot of the issues that health systems today suffer from and cannot answer.”

—H.E. Zaid Al Siksek, CEO, HAAD

In 2006, Abu Dhabi instituted universal health insurance and envisioned a new role for the Health Authority–Abu Dhabi (HAAD). Instead of providing care, HAAD would be responsible for regulating health care policies and setting the public health agenda. HAAD is moving quickly to build a public health infrastructure to tackle the chronic disease problems, manage the health care system and handle other critical issues. As they launched these initiatives, HAAD officials realized that public health graduate education for an interdisciplinary cadre of health leaders driving the agenda would be essential.

Enter the Bloomberg School.

HAAD officials turned to the Bloomberg School because Abu Dhabi has had a long-standing connection with Johns Hopkins. Hopkins Medicine currently manages three of the Emirate’s major hospitals. They were also drawn by the School’s reputation, says H.E. Zaid Al Siksek, HAAD’s CEO. “Hopkins is a very strong school for public health and has a lot of resources and information,” says Al Siksek. “The total reason for us being here is to tap into the knowledge transfer that may be used in Abu Dhabi to address public health issues.”

The School has previous experience in preparing health leaders for massive reform. Since the early 1990s, the School has educated a generation of health leaders in Taiwan, which launched its own universal health insurance initiative in 1995. The School drew on its Taiwan program experience and designed a specialized MPH-DrPH program in health management and leadership for 25 professionals from the Emirate’s health care system. Launched in November 2008, the cohort of physicians, nurses, pharmacists, administrators and others will take courses in Abu Dhabi, Baltimore and online.

Their goal is typically Abu Dhabian: audacious and fast-tracked. “Within five years with our limited population and unlimited access to resources, we hope to take Abu Dhabi to a position as one of the top providers, in terms of world rankings in health care quality, reform and service delivery, and maybe even to have some of the highest-end public health indicators that show a healthy population,” says Al Siksek. “From a leadership perspective, if we can achieve that in five years, we will have done wonders.”

“The Emergency Medical Service is currently run by the police, and there are many hospitals that own ambulances. My big dream is to combine that into a state-of-the-art EMS system.”

—Dr. Saleh Fares, Fellow, Disaster Medicine Section, Harvard Medical School

The Abu Dhabians will take courses in epidemiology, biostatistics, health administration and others in the standard MPH and DrPH programs, drawing on their Abu Dhabi work experience for their theses. The Abu Dhabi program coursework is designed to be completed in four years.  Students will also complete MPH Capstone projects and DrPH dissertation projects on topics important to their public health system.

Through its national health insurance program, HAAD will be able to collect comprehensive data on its population’s health status and health care utilization that will allow them to spot trends and target programs most effectively, says Laura Morlock, PhD, director of the Abu Dhabi MPH-DrPH program.“For example, once they know that diabetes is one of their serious health issues, they will be able to track blood sugar test results for diabetes and examine, over time, the impact of health promotion programs and improved health services on blood sugar levels. This capability may help them prevent the complications of diabetes over time,” Morlock says. They will eventually be able to gauge the impact of health promotion programs and improved health services on cardiovascular disease, diabetes, road traffic injury outcomes and other issues.

That kind of centralized, linked data is difficult to come by in the U.S., for example, where data often has to be extracted from different insurers and then pieced together, notes Morlock, a professor of Health Policy and Management.

“I want people to know that in Abu Dhabi there are hard- working and very ambitious people looking forward to seeing their country reach a place where it can be compared to the most developed countries.”

— Nadia Younis, Drug Registration and Pricing Section Head, Ministry of Health

Having a single health system regulator with accurate and comprehensive public health data is important, “but you also need the management and leadership skills to use those data to design, implement and evaluate good public health programs,” says Morlock.

The Abu Dhabi program, she says, is designed to train health care leaders to do just that.

Great Resources vs. Great Challenges

  • Population: 1.7 million (about 450,000 are citizens; the rest are expatriates)
  • Life expectancy: 74.5 women / 73.4 men
  • Infant mortality rate/1,000 live births: 8.7
  • Under-5 mortality rate/1,000 live births: 10.7
  • Hospitals: 33
  • Health centers: 389
  • Clinics: 188

Leading causes of death (rate/100,000 population):

  • Accident and poisoning: 37.5
  • Cardiovascular disease: 29.8
  • Cancer: 21.7
  • Diabetes mellitus: 11.9
  • Congenital anomalies: 10.7


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