The Middle East is the most neglected health arena in the world today. This is no surprise given it's constant media portrayal as a center of violence and terror. I am sure you agree with me that we need to forge a partnership without looking through a prism of violence. We also need to invite all those working in the privileged world of western medicine to admit the origins of the profession.

Much of the credit for early medical discoveries is owed to physicians from the Middle East in the first millennium. It is a predicament of extraordinary proportions. Doctors must say that loudly and repeatedly. Presently we are largely silent. Unfortunately, the status of health and medicine in the region today is often compromised by political unrest and compounded by public-health, infection control and educational challenges. This complex situation was analysed by the UN in a trio of Arab Human Development Reports that focused on the three deficits of the Arab world: knowledge, women's empowerment, and freedom.

I think another problem that we always turn blind eyes to is the gap in the gross national product per capita for each country. So the challenge is clear. Strong governmental leadership is essential to drive the necessary challenges forward and successful collaborations must be undertaken between the oil rich countries and their less wealthy neighbours. I have a dream I do hope one day to become a reality; it is an embryonic health initiative serving as a catalyst for a true and lasting benefit for all people in region and beyond - The appeal for a Center of Disease Control in the Middle East. I am pleased to present to you the broad outlines of this center.

The center should handle diseases grouped into the following three categories: diseases which cause high levels of mortality; diseases which place on populations heavy burdens of disability; and diseases which owing to the rapid and unexpected nature of their spread can have serious global repercussions.

Among the tasks envisioned for the center are harmonisation of surveillance methodologies across the middle east, providing scientific opinions and technical assistance (WHO's Eastern Mediterranean Regional Office, in the early 2000s, found that disease-surveillance systems were mostly inadequate, with insufficient commitment to the system, lack of practical guidelines, overwhelming reporting requirements, weak involvement of the private sector, lack of transparency, shortage of human resources, poor analysis of data, and lack of qualified doctors. Iraq has 6.2 doctors per 10000 people, compared with 216.6 per 10000 in the UK); supporting preparedness planning for health emergencies and providing a rapid response to health threats.

Let us consider the first group of diseases with high mortality. There are six diseases currently causing 90% of mortality within the region. These are acute respiratory infections, which may lead to pneumonia, HIV/AIDS, diahorreal diseases, tuberculosis, malaria and measles. For only one of these, measles, is there a vaccine that can prevent infection. Drugs exists however to control the remaining five, either to cure the infections and prevent death, or in the case of HIV to prevent infection in children and prolong lives.

Whereas we have at our disposal vaccines and technologies to deal with the vaccine-preventable diseases, and continue to make good use of them, we have not yet done so well in making drugs and products e.g. bed nets and diagnostic tests, available to the poorest of the poor, who are most affected by diseases against which there is no vaccine. If we want to empower these populations to pull themselves out of poverty, we must broaden our thinking to include ensuring access to the drugs and products that will prevent the mortality caused by these diseases. The tools are available, and we must use them today while the windows of opportunity remain open, and before drug resistance closes them.

But the all encompassing need, is the need for raising awareness in the population in which practices such as selling their medicines to vendors of over the counter drugs, and the mafia' to get the basic and urgent needs of their families. What a travesty.

Infectious diseases with severe and long term disability impose on societies a double burden: not only is economic productivity jeopardised, but the costs of care weigh down the health system which is already fragile most of the time. So the Center of Disease Control approach will be alleviating these burdens through a partnership of work both locally and globally.

The third group of diseases - usually described as emerging or re-emerging disease, have economic repercussions well beyond their immediate health costs. They may impede trade and travel, or cause disproportionate alarm, especially if rumours of intentional use become widespread.

The center can answer the international threat from these diseases through well-coordinated global surveillance and response. Finally the center will have the following priorities: ·

• To reduce the impact of communicable diseases through intensified and routine prevention and control.
• To continue to strengthen surveillance and monitoring of communicable disease problems of international importance and effective response to these problems.
• To generate new knowledge, tools, intervention methods, implementation strategies and research capabilities for use in developing endemic countries.