A Middle East Centre of Disease Prevention and control which deals only with communicable disease - is it a dream that is hard to become true? Is it like getting into a hot water?

The proposed Centre will not replace the public health institutions in member states of the Middle East. Instead it will act as a coordination resource and support centre on which these countries can call. Among the tasks for this center will be harmonization of surveillance methodologies across the Middle East providing scientific opinions and technical assistance supporting preparedness, planning for health emergencies and will provide a rapid response to health threats. Since the 1950's, Arabs have made little progress in health related areas for several reasons; the Arab Israeli conflict, the catastrophic health and economic sanctions in Palestine, the embargos on Iraq and the major wars which have erupted in the past few decades, mainly in Lebanon (1975-1991), Kuwait 1990, and Iraq 1980-1988, 1991 and 2003. Military spending by Arabs amounts to about US 60 billion dollars of which only 0.9 billion is allocated to research and development.

Oman, Saudi Arabia and Kuwait spent more than 10% of their gross domestic Product GPD on defense. Iran spent more than 5% of their GDP on defense, than on health at 4%. Historical population and GDP data were obtained from the US Census Bureau (http://www..census.gov/ips/www/idbacc.html)and EconStat (http://econstat .com) respectively.

The stand off between Iran and the security council about it's nuclear program has an alarming extra twist. It will have a detrimental effect on the output of scientific research and endanger more the instability of the region. From a public health prospective, avoidance of violent conflicts is the key objective in international relations. Are there any ways of analyzing such stand-offs, which might suggest ways to resolve them. Commentators have noted similarities between this conflict and that of the USA and the USSR during the cold war, in which game theory was first used to analyze and attempt to predict the behavior of the participants. One such a game is "chicken" when two participants engage into a competition, say a head-on car race, which is bound to end in a disaster unless one swerves. To outsiders the game seems insane but to the participants in whom many complex principles of prestige, honour, territory security and so on are at stake, it can feel as if they have no choice but to take part. International diplomacy is the art of persuading one or both to swerve with out loss of face. Sometimes this is done by introducing a new factor into the game, which both participants can agree on and use as a way out of direct confrontation.

Are there any diversions that might be used to draw the attention of the participants away from the conflict? One might be reassessment of how such games affect the country's economy. So instead of military spending which is draining resources, governments can invest in civil health.

One of the urgent questions is are we prepared for the next pandemic of influenza? As we began the new century did we launch arrangements carefully and thoughtfully in order not to be overwhelmed in the first wave of global infection, while there is still time? There is a window of opportunity open now that will gradually close over the coming months. Remember, the 2 pandemics in 1917 and 1968 the causalities numbered 6 million world wide and the virology community did very little except to observe and record. The coming influenza pandemic will cut huge swathes in the world's community and history will look with jaundiced eyes, should governments hesitate?

The SARS outbreak of 2003 awakened a new aggressive spirit underpinned with molecular science and rapid diagnosis .We would no longer wish to be the audience at macabre theatres of infection, rather, infectious disease experts, mathematicians, virologists ,vaccine specialist's and chemotherapists would be thrown into the fray. The world was lucky with SARS.

In the living memory is the capricious mother nature .The Bam earthquake and the tsunami tragedy in Asia cruelly exposed the citizens of this area to the mercy of nature through lack of planning and scientific planning. The earthquake in South Asia is another example. We should seize the opportunity of the economic boom, achieved by the huge rise in the oil prices which afford a good chance for the countries of the Middle East to improve the public health infrastructure of the region.