Very recently, this has begun to change in Lebanon, says El-Jardali. The government is now using his policy papers, for example. “The hard lesson is that you need to have policy makers already in touch with public health experts before an epidemic in order to minimize delays in taking action,” he says.
El-Jardali’s experience is in stark contrast to that of Abdul Rahim, in Qatar, “I know there are examples where scientists have to fight with politics and I’m not just saying this to be politically sensitive, but it’s simply not the case here.”
If there’s a spectrum of government engagement with public health academics and Qatar is at one end, then Lebanon is somewhere in the middle. The region’s most vulnerable countries, such as Yemen and Syria, have close to zero collaboration between policy makers and public health professionals, academics say.
Syria Is Suspected of Denial
Yazan Douedari, originally from Syria, is a research assistant at the London School of Hygiene and Tropical Medicine who specializes in studying Syria’s health system governance. “At the moment I’m of course focused on the response to Covid-19,” he says. “There weren’t many public health researchers in Syria in first place before the conflict. The few that we did have are mostly outside the country now, and the experts who are left in the country are not taken seriously and they’re not included in response planning.”
Iran is the most heavily infected country in the region, with more than 50,000 reported cases as of early April, putting nearby countries, such as Iraq and Syria, at high risk.
The first official case of Covid-19 in Syria was reported last week, but Douedari doubts the credibility of that announcement and says there are accusations that Damascus has tried to downplay the situation.
“It’s highly likely, although it’s hard to say for sure, but we suspect the virus has been in Syria for several weeks,” he says. “Iran is a hotspot and the relationship with Iran means there are plenty of fighters going back and forth and I find it unlikely that it hadn’t been spread by them.”
Officially, there were just 16 confirmed cases of Covid-19 in Syria as of April 2, and two deaths.
The quality of public health infrastructure in Syria is dependent on who is in charge of a particular area, says Douedari. Some opposition-controlled areas do have a rudimentary testing procedure in place where they send swab samples to a laboratory in Turkey to get testing results. That’s not because the opposition areas don’t have a suitable laboratories, but rather it’s the consequence of an absence of test kits. “At least they’re entertaining the fact that the virus has reached the area and they’re trying to do something,” says Douedari.
In some governorates of Syria there are no ventilators and camps for refugees and displaced persons often don’t even have the basics of soap and running water to wash hands.
“It’s just about one of the least prepared countries in the region, and denying the problem, which is often the temptation of authoritarian regimes, doesn’t help,” laments Douedari.
Back in Beirut, El-Jardali hopes this crisis will help those in charge to realize the importance of public health research in the long run.
“It has taken a pandemic to get policy makers to consider public health researchers to be important,” he says. “Late is better than never, but we still have a long way to go. This could be an opportunity to reimagine our public health strategies for the future.”