Abu Dhabi's health care sector moving preventative care to top of the agenda

In February 2016 the UAE Ministry of Health’s title was changed to include the word prevention. The alteration underlined the importance given at both the national and the emirate level to encouraging citizens to make healthier lifestyle choices, as well as reducing the impact of non-communicable diseases (NCDs) on society. In Abu Dhabi vaccination programmes, mobile health screening units and awareness campaigns are all being used to reduce the incidence of illness and promote fitness.

Non-Communicable Diseases

In 2015 diseases of the circulatory system, including strokes and heart attacks, caused 35% of all deaths in Abu Dhabi; followed by injuries (21% of deaths) and cancers (16% of deaths). Fatalities caused by diseases of the circulatory system were particularly prevalent in male nationals over the age of 60, and among foreign workers aged 30 and above. Cardiovascular diseases accounted for 11.7% of all in-patient care and 7.5% of all outpatient visits to hospital in 2015. Data from the International Diabetes Federation shows that in 2015, 19.3% of people in the UAE aged 20 to 79 had Type 2 diabetes. The high prevalence in Abu Dhabi of NCDs and the factors likely to cause them has been noted in several academic studies and international reports. In 2010 a special report by the World Health Organisation (WHO) noted that body mass index data for the year 2000 showed that 50% of men and women in the country were overweight or obese.

A subsequent study conducted by UAE University in 2008 reported that 25% of the UAE’s children between the ages of eight and 12 were overweight. At the emirate level, 15.1% of school students in Abu Dhabi were obese in 2014-15, and 16.7% were overweight. The same study found that only 27% of school students engaged in an hour of physical exercise every day. Efforts to change attitudes and behaviour patterns around food and exercise are being made by individuals and health organisations alike.

Treatment Centre

Imperial College London Diabetes Centre (ICLDC) marked its 10th anniversary in 2016. The Centre opened its doors with the mission of providing a one-stop outpatient facility, which specialised in diabetes treatment, research, training and public awareness. Encouraging exercise to reduce the risk of diabetes is a key focus of health professionals at ICLDC in Abu Dhabi. From 2009 to 2015 the number of patients seen at the Centre increased five-fold for an annualised growth rate of 32%.

In November 2016 ICLDC announced the opening of its third branch, co-located with Healthpoint in Zayed Sports City to address the growing demand. The specialist branch will help provide continual care for patients preparing and recovering from bariatric surgery, along with services such as cardiology.

“Outside of surgeries, diabetes has grown into one of the biggest health care expenditures in the emirate. ICLDC is seeing some 30-50 new patients a week, most of them nationals, which should attend the Centre three to four times per year for care,” Dr Ihsan Almarzouqi, associate director at Mubadala Healthcare – a specialist division of the Abu Dhabi-based investment and development company – and board member of ICLDC and Healthpoint, told OBG.

ICLDC has also developed an innovation and research fund with Imperial College London in the UK that will invest in companies focusing on diabetes. With diabetes one of the costliest segments of health care in the emirate, the Centre is focusing on treatment, education, research and prevention. “Eventually, if applicable to the emirates and if it is relative to diabetes, innovation funds will allow us to build an intellectual property (IP) bank abroad. Leveraging international IP is the best solution as intensive research and development locally may take 30 years to finalise,” Almarzouqi told OBG.

Anti-Obesity Campaign

In December 2016 the Abu Dhabi Childhood Obesity Task Force launched a six-point plan to tackle the problem. It will organise promotional campaigns and school lessons about the importance of healthy eating and physical exercise targeted at children, as well as help families understand the issues by integrating diet and exercise advice into the guidance given to families expecting a child and to those with preschool-aged children, in addition to offering support to parents of schoolchildren. Representatives of 12 different government entities will be involved with the initiative, including Health Authority - Abu Dhabi (HAAD), Abu Dhabi Health Services Company (SEHA), the Abu Dhabi Education Council (ADEC) and the Abu Dhabi Food Control Authority (ADFCA). Its work is informed by a scientific advisory committee that includes representatives from both public and private universities in Abu Dhabi. In 2015 HAAD, ADEC and ADFCA issued guidelines on nutrition and menus to school canteens, and in February 2016 a new promotional campaign targeting children was launched with Bidaya Media, producers of the Iftah Ya Simsim television programme. The agreement meant that characters from the programme would be used in new educational material encouraging children to take more exercise and eat healthily.

Food Labelling

HAAD and the ADFCA have been working together since September 2013 on the Weqaya Nutrition programme. Weqaya means prevention in Arabic, and restaurants have been encouraged to use the term on menus to help customers choose healthy options. In December 2016 HAAD announced that the Weqaya logo would be used as part of the food certification process for pre-packed foods, starting with dairy and bakery products. Specifications for use of the logo include items that are low in fat, saturated fat, salt and sugar, and high in fibre. In the same month, Etihad Aviation Group (EAG) agreed to promote Weqaya food and standards in its staff restaurants. More than 50 EAG chefs were trained in food handling and preparation. Since its inception, 18 entities and food outlets have become involved in the programme.

Smoking

The dangers of smoking have been flagged by HAAD, which revealed in 2016 that lung cancer was the most deadly form of cancer in Abu Dhabi, accounting for 14.1% of all cancers in 2015. HAAD warned that, according to WHO data, tobacco was the primary cause of nine out of 10 lung cancer cases. Lung cancer was found to be particularly prevalent among men in Abu Dhabi, accounting for 20.3% of all male deaths from cancer. HAAD runs tobacco cessation clinics at Sheikh Khalifa Medical City in Abu Dhabi, at two health care centres in Al Ain and at a third in Al Dhafra. Data from HAAD showed that 29% of all UAE nationals between the ages of 30 and 39 smoked, and that of couples in prenatal screening, 23% were smokers.

Screening

HAAD ran a cancer awareness campaign from October 2016 to March 2017, with separate campaigns for breast, colorectal, cervical and lung cancer, timed to coincide with the international days for each condition. Data released by the authority for 2015 showed breast cancer caused the most deaths among women, 28% of the total cancer-related deaths in the emirate that year; followed by colorectal, with 10.8%; leukaemia, at 8.6%; and ovarian cancer, with 7.5%. HAAD advises all women aged 40 and above to have a mammography screening every two years and a clinical examination once a year. The public health service SEHA also runs mobile screening services as part of its Ambulatory Health-care Services, sending staff into the workplace to carry out clinical screenings on Emirati employees for blood pressure, blood sugar, cholesterol and vitamin D levels, and kidney functions.

Vaccinations

To prevent the spread of communicable disease, HAAD, SEHA and ADEC carried out vaccination programmes for grades one to 11 in 2014/15. The programme resulted in 95% of students receiving the measles, mumps, rubella (MMR) and varicella injection, 94% receiving the polio vaccine and 91% of female students vaccinated against human papillomavirus, which causes several forms of cervical cancer. To increase the chance of eradicating measles, the MMR vaccine was given to everyone aged 34 or under in two phases; UAE nationals and residents aged 18 and under were treated in November 2015, followed by older residents a year later.

Accident Prevention

The country is also looking to mitigate contributing risk factors to deaths caused by accidents. HAAD statistics for 2015 showed that road traffic accidents accounted for 57% of all fatal injuries suffered by children. Of all road traffic deaths in the emirate in 2015, 21% of the total number of people killed were pedestrians. Road accidents, meanwhile, were the cause of 47% of accidental deaths in Abu Dhabi in 2015. During GCC Traffic Week in 2016 HAAD mounted a three-day campaign with the UAE’s Ministry of Interior to promote the use of children’s car seats in compliance with regulations.