Balkhy expressed her appreciation for the cooperation and coordination with Egypt to support emergency health plans and transfer humanitarian aid to the Gaza Strip.

She also spoke about the health challenges in the region starting from strengthening health services to developing urgent plans. confronting climate change's impact on health and the antimicrobial resistance threat, all the way to the importance of consensus to activate the international treaty for preparedness for any future diseases or pandemics.

Ahram Online: How is the WHO regional office working to meet the urgent health needs in Gaza?

Dr. Hanan Hassan Balkhy: The situation is extremely critical and is worsening catastrophically. The number of deaths and injuries is increasing, and the number of displaced people forced by the conflict to flee their homes exceeds 1.7 million people.

These people are now living without shelter or in tents that do not protect them from the bitter cold or the rain, or they are sheltering in places that lack the necessities of life. The collapse of the health system and the closure of most hospitals due to a lack of medical supplies and lack of security exacerbate the seriousness of the situation.

Life-saving aid to Gaza is woefully inadequate. We are deeply concerned about the catastrophe if expanded military operations occur in Rafah, where nearly a million people are currently in makeshift tents.

Malnutrition continues to rise throughout the Gaza Strip due to a lack of food, water, and health services.

We are doing our best to save lives, but the challenges are enormous and hinder our efforts to reach the populations most in need. We call on all parties to uphold international humanitarian law and the principles of precaution, distinction, and proportionality, and ensure sustainable access so that hospitals can continue to provide life-saving care.

AO: What is the extent of cooperation and coordination between the organization and Egypt for providing urgent health treatments and assistance?

HHB: Coordination and cooperation relations exist between the organization and Egypt, as it is one of the neighbouring countries with more than one country and region of conflict, and it proceeds on several axes, especially about the Gaza Strip, where Egypt received several cases that were evacuated from the Gaza Strip.

There is a need for organized, safe, and sustainable transport of patients to Egypt and possibly to other locations across Egypt. On 21 February, the World Health Organization announced that it would deliver 80 tons of vital health supplies, including insulin, to the Gaza Strip through its logistics hub in Dubai and by establishing a temporary air bridge between the United Arab Emirates and Egypt.

The World Health Organization is currently evaluating options for transporting laboratory samples to Egypt, enhancing surveillance and detection capabilities, and deploying mobile laboratories.

AO: What is your plan to address health conditions in countries experiencing internal conflicts?

HHB: Since assuming my position, I have carefully reviewed the challenges facing our region, especially the escalation of health emergencies, and the many challenges facing the delivery of aid, including insecurity, deteriorating health systems, and severe funding shortfalls. To confront these challenges, it has established five comprehensive priorities for the organization’s work in emergencies, such as addressing disparities in access to health care, and ensuring that basic services reach the affected areas.

In addition, it is necessary to invest in strong public health systems to prevent diseases through targeted interventions and strategic partnerships. We are committed to strengthening public health initiatives throughout the region, to ensure the ability of health systems to withstand any crisis. We also recognize that teamwork and cooperation are essential to address complex health challenges.

By establishing new partnerships and building on existing ones, we can effectively mobilize resources and strengthen health systems. Finally, the capacities of both the EMRO and the organization's country offices need to be strengthened.

AO: What is your evaluation of maternal and child health care in the region?

HHB: Maternal and child health conditions in the region have witnessed significant developments in the last two decades. The maternal mortality rate decreased between 2000 and 2020 by 50.3 percent at the regional level.

Egypt is among the 10 countries in the world that have the greatest improvement in maternal health care services. However, countries in emergencies continue to face high maternal mortality rates of more than 600 deaths per 100,000 births.

This can be avoided in more than 95 percent of cases. Regarding child health, there has been a steady decline in under-five and neonatal mortality rates in the Region.

However, current estimates are still high, and unfortunately, six countries in the region will not be able to achieve the health-related sustainable development goals, especially for children’s health care which is to reduce the number of deaths of children under five years old. These countries are Afghanistan, Djibouti, Pakistan, Somalia, Sudan, and Yemen.

AO: How should we in the region confront antimicrobial resistance?

HHB: Antimicrobial resistance is a major global threat especially for our region, as we are the largest consumers of antibiotics. Antimicrobial resistance rates are also high, accompanied by a high related mortality rate and an increased burden of enormous costs. We have strategies to address antimicrobial resistance in countries of the region to lay the foundations for strengthening infection prevention and control.

All countries of the region have national action plans to combat antimicrobial resistance, and the “One Health Approach” plan includes antimicrobial resistance. All countries of the region are registered in the global antimicrobial resistance surveillance system. This is a good foundation on which we can build to achieve more effective results in addressing this problem.

In addition, we need to start by addressing the major challenges in the region, including the lack of antimicrobial legislation and the lack of financial resources to fund the national programmes.

I intend to support the input of the EMRO in the field of combating antimicrobial resistance by disseminating guidelines about infection prevention, diagnosis and management systems, strengthening quadripartite cooperation with organizations concerned with human, plant, animal and environmental and increasing community awareness.

AO: What is your vision of the impact of climate change on health issues in the region?

HHB: Although the region emits only 8.25 percent of the world's greenhouse carbon emissions, temperatures in the region and other climate hazards are changing twice as fast as in the rest of the world.

Climate risks exacerbate environmental degradation, natural disasters, extreme weather events, food and water insecurity, economic disruption, and conflicts. As for the health consequences, they are significant and include more deadly extreme weather events such as the floods in Libya in 2023 and Pakistan in 2022, and an increase in the incidence and spread of infectious diseases.

This is already affecting the region's health workforce and health infrastructure, reducing the ability to achieve universal health coverage. To reduce these health impacts in the future, EMRO approved the Regional Framework for Action on Climate Change and Health, which aims to build environmentally sustainable health systems that are resilient to climate change. Prioritizing health in climate change policies. Effectively engage the health sector to support climate action by other sectors. Improving health sector access to climate change financing.

AO: The World Health Assembly will be discussing a new pandemic treaty next May. What is needed to reach an effective treaty as such?

HHB: What we have witnessed that the COVID-19 pandemic, especially with the global disparity in access to vaccines, forced the WHO member states to talk about a global accord on pandemic prevention, preparedness and response, as a basis for negotiating an agreement to protect nations from future pandemic emergencies and possible future diseases or disease “x.” So far countries have not reached a consensus on a group of points in the treaty.

For this agreement to succeed, it is necessary to find a strong political commitment at the highest level, follow a comprehensive approach that includes all sectors of government and society, and make sufficient financial resources available. Activating the treaty also requires strengthening resilience to epidemics, supporting the prevention, detection and response to disease outbreaks, ensuring equitable access to treatments and preventive measures, and strengthening global cooperation through a more accountable World Health Organization.

The treaty also emphasizes cooperation between states parties at the bilateral and regional levels, and the adoption of a coherent One Health approach to developing and strengthening epidemic prevention, public health surveillance, and response capabilities. A key aspect of the treaty is to strengthen health systems, including primary health care, to achieve sustainable epidemic prevention, preparedness and response.

It must also be done with equity in mind, with a focus on protecting, protecting, investing in and retaining a skilled and committed health and care workforce. Other critical commitments to operationalize the treaty include implementing comprehensive, comprehensive and well-resourced national plans and strategies for epidemic prevention, promoting equitable distribution of vaccines and medicines globally, and establishing multilateral mechanisms for technology transfer and knowledge exchange.

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*Dr Hanan Balkhy is a Saudi Medical Doctor. She is the first-ever female the World Health Organization’s (WHO) Regional Director for the Eastern Mediterranean Region (EMRO).

She has served as Assistant Director-General for Antimicrobial Resistance at WHO headquarters since 2019. Previously, Dr Balkhy had a distinguished career in medicine and public health research at the national, regional and international levels.

She was the first Executive Director for Infection Prevention and Control at the Ministry of National Guard, Saudi Arabia.

For more than 10 years, she successfully led the Gulf Cooperation Council Centre for Infection Control and the WHO Collaborating Centre for Infection Prevention and Control and Antimicrobial Resistance in Riyadh, Saudi Arabia.