Healthcare & Medicine
Obesity fight seen as major investment trend
Increasing efforts to tackle obesity over the coming decades will form an important new investment theme for fund managers, according to a new BofA Merrill Lynch report. "Global obesity is a mega-investment theme for the next 25 years and beyond. Obesity may be the most pressing health challenge facing the world today and efforts to tackle it will shape thinking by policy makers and in boardrooms around the world," said Sarbjit Nahal, equity strategist at BofA Merrill Lynch Global Research. The report comes after it was revealed that Qatar, the UAE, Kuwait, and Bahrain were ranked among the world’s top ten fattest nations with obesity rates expected to severely affect global food security. It said the average person in Kuwait, the second fattest country in the world behind the United States, weighs in at approximately 77.5 kg, 15.5kg heavier than the global average, according to a research report published by BMC Public Health. Gas-rich Qatar was ranked third globally with the average adult consuming just over 3,000 calories per day, followed by the UAE in fifth place (3017 calories) and Bahrain in tenth position (2889 calories). BofA Merrill Lynch said efforts to reduce obesity were a "megatrend" with a shelf-life of 25 to 50 years. Globally, 500 million people are obese and 1.4 billion are overweight. Obesity is the fifth greatest cause of death, leading to 2.8 million fatalities each year. Worldwide prevalence of obesity doubled between 1980 and 2008, according to the World Health Organization. By 2030, 65 million more Americans will be obese if current trends continue. While its impact is well-known in the West, obesity is rising quickly around the world. BofA Merrill Lynch said investors should take a long term view and a broad perspective in selecting stocks across pharmaceuticals & healthcare, food, commercial weight loss, diet management & nutrition and sports apparel & equipment.
Diabetes: the dark side of the Gulf economic boom
Dhari al-Fadli, a patient being treated at a diabetes clinic in Kuwait, is a victim of the dark side of his country's economic boom. After his weight hit a peak of 123 kg (271 pounds), Fadli developed such serious diabetes that he had to inject himself with insulin before every meal. Helped by the insertion of a gastric balloon into his stomach to reduce hunger, he has now lost enough weight to stop the injections, but still has to take diabetic medication. "We're all overweight in my family...We have a saying that if you don't have diabetes, you're not a Kuwaiti," said Fadli, a 49-year-old father of five. In fact, more than one in five Kuwaitis suffer from the disease. Oil wealth has given Kuwait and nearby countries in the Gulf some of the highest per capita incomes in the world. But it has also created lifestyles - overeating, high-sugar diets, cushy jobs, and heavy reliance on automobiles for transport - that are leading to an explosion of diabetes in the region, experts say. Five of the 10 countries where diabetes is most prevalent are located in the six-nation Gulf Cooperation Council, according to the International Diabetes Federation (IDF), an umbrella organization of more than 200 national associations. Kuwait is No. 3 while Qatar is sixth, Saudi Arabia seventh, Bahrain eighth and the United Arab Emirates No. 10. The rest of the top 10 are Pacific island nations with much smaller populations, apart from Lebanon which comes in fifth. A staggering 21.1 percent of people in Kuwait are diabetes sufferers while prevalence rates are around 20 percent in other GCC countries, IDF figures show. In the United States, the rate is 9.6 percent; worldwide, it is 8.5 percent. The problem is so widespread in Kuwait, said Abdulmuhsen al-Shammari, an endocrinologist working at Mubarak al-Kabeer Hospital in the country, that "it is now normal for half a dinner party to be diabetic and for them to ask for each other's medication after they eat". Genetic factors apparently contribute to the Gulf's high incidence of diabetes, an incurable disease in which the body has difficulty absorbing sugars and which is closely associated with obesity, scientists say. It can lead to cardiovascular problems, blindness, strokes, and kidney disease. "Research suggests that people (in the Gulf) have a lower set-point at which their body-mass index levels trigger the onset of diabetes," said Maha Taysir, endocrinologist at the Imperial College London Diabetes Clinic (ICLDC) in Abu Dhabi. However, even expatriates living in the Gulf have a higher incidence of diabetes than they do in their home countries, Taysir said. This suggests lifestyles are a major reason for the region's problem. Just two or three generations ago, many inhabitants of region made their living through strenuous work such as fishing, goat-herding and pearl-diving. The development of the Gulf's oil riches changed lifestyles drastically, luring tens of thousands of people into comfortable jobs at lavishly funded state enterprises, or allowing them to live on ample unemployment benefits. Physically tough jobs in the GCC, such as construction and oil field operation, are almost entirely done by millions of foreign workers. Gulf rulers responded to last year's political unrest in the Middle East by increasing welfare benefits for their citizens to buy social peace, which some officials in the Gulf have conceded privately risks further reducing the pressure on people to work. "Exercise is the single most important factor for reducing diabetes ... but it takes a lot of work to get patients here to follow a lifestyle they really don't want to," Taysir said. Some Gulf residents believe the first Gulf War against Saddam Hussein in 1990-1991 may have contributed indirectly to the spread of obesity by fostering a junk food culture. Fast food outlets blossomed in Kuwait, Saudi Arabia and other countries where thousands of US troops were stationed, and remained part of daily life after the troops withdrew. "The lifestyle, the luxury we live in, the lack of activity and our fatty junk food culture are all contributing factors... Food is delivered, kids play sitting down at their computers... even physical education is a written exam," said Fadli. Even for the wealthy Gulf oil exporters, the financial costs of diabetes are unwelcome. Medical care is heavily subsidized, and the UAE spends $272 million on diabetes treatment annually. A study by Abu Dhabi health authority estimated the overall social costs of the disease at about $1.9 billion. "Now people are getting in to the later stage of the disease where it really begins to cost money, which is why governments are now pushing for prevention and early intervention," said Andrew Miles, Gulf regional director at global medical products and services supplier MSD. Beyond the immediate financial costs, diabetes may threaten Gulf countries' long-term plans for development. Aware that their dependence on oil leaves them vulnerable to global markets, the countries are trying to diversify their economies and bring more of their people into the workforce. "How can you develop your economy if one-fifth of your people are sick?" Miles said. Governments are reacting to the problem by launching public awareness campaigns to encourage healthy diets, exercise, and early medical testing. Since 2007, the ICLDC has worked on a national campaign in the UAE which includes a series of public talks, free blood tests, an annual walkathon, and arranging sports activities in workplaces. In Kuwait, Qatar, Saudi Arabia and the UAE, MSD has worked with authorities to introduce a training programme for nurses on counseling diabetics, a diabetic cookbook, and a Ramadan iPhone application to advise diabetics who fast during the Muslim holy month. But it may take many years to change the culture which is fostering diabetes, experts acknowledge. "You need greater coordination between the different government ministries so that the road traffic authority is thinking about pavements to facilitate walking at the same time as the health authorities are thinking about encouraging activity to decrease obesity and diabetes," said Miles. "There is more awareness of the need to coordinate between the various ministries and planners, but this will undoubtedly take some time to come into effect... In the meantime, we need as much exposure and awareness of this disease as possible." (Additional reporting by Tony Faddoul and Sylvia Westall in Kuwait; Editing by Andrew Torchia and Sonya Hepinstall)
Special sickle cell facility sought in Bahrain
Bahrain MPs have renewed calls for a fully operational 24-hour facility to treat sickle cell patients, following the death of seven patients in less than two weeks. Campaigners have blamed authorities for ignoring patients and providing inefficient treatment. The patients can only seek treatment at Salmaniya Medical Complex (SMC), they said. Health Ministry officials earlier accused sickle cell patients of causing chaos at Ebrahim Khalil Kanoo Community Centre, saying they had been caught trafficking drugs and sleeping pills, indulging in inappropriate behavior with women, and injecting themselves with illegally procured painkillers. Some were also accused of damaging property, refusing to adhere to hospital rules, going missing from the facility only to return at will, and endangering themselves and the lives of others. However, MPs say having a negative attitude towards these patients will not solve the sickle cell crisis the country is currently going through. "Who likes to go to the hospital and then be treated like addicts?" questioned MP Ali Shamtoot, who is also a sickle cell patient. "There are no specialized hematologists and doctors to deal with sickle cell patients. This is one of the reasons the ministry is now seeking assistance from US experts to help them deal with this big issue." He was speaking at a Press conference yesterday held at the parliament building in Hoora along with the Bahrain Bloc members. Campaigners have also urged authorities to back an initiative to provide sickle cell patients with special identity cards to help them get preferential treatment at health centers. The move is part of efforts to help patients get better and prompt services in the country, but it has not been well received by the Health Ministry, said Bahrain Society for Sickle Cell Anemia Patients Care member Samah Hussain. The cards would have details of a patient, including blood type, CPR information and other health- related details. "We understand that patients' records are stored electronically, but what if the system is down in the hospital," she said. "This card can be carried at all times by sickle cell patients and allows a doctor to know about their health condition. In emergency cases, this card which is similar in size like a smart card will be useful and could save lives." According to ministry figures, 18,000 sickle cell patients receive treatment at Salmaniya Medical Complex, said Hussain. "The total number of carriers of the disease excluding those being treated according to us is about 65,000," she added. "There is no study or survey done to actually find out the number of people living in Bahrain with sickle cell anemia." She added that the society was campaigning to introduce a draft law in Bahrain on patient rights which has been prepared by Cyprus-based Thalassaemia International Federation.
Source: TradeArabia News Service
GCC diners don’t want healthy fast food – pizza boss
Consumers in the Middle East are not interested in healthy fast food alternatives, the founder of US pizza chain Papa John’s told Arabian Business. The Kentucky-based firm, which operates 84 outlets in the GCC, expects to grow its regional business by 15-25 percent over the next two years, said John Schnatter, who is also CEO. “People say they want [a health-conscious pizza], but then they do not eat it. They always go back to the original product,” he said. Schnatter said that the chain has investigated healthier alternatives in terms of ingredients. “We have the ability to do a whole wheat crust. We have looked at the cheese and [other ingredients], so we are experimenting with it, and we have tested it,” he added. Papa John’s, which competes with Pizza Hut and Domino’s Pizza, said it expects revenues in the UAE to top AED100m (US$27.2m) by 2014. “I think we are going to be around 15-25 percent growth this year, and in the next two years,” he said. “The UAE is a great market, we love this market. I wish I had more like it,” he added. The Middle East has seen a surge in fast food chains entering the market and expanding in recent years as international brands look to bolster sales amid increased competition in their domestic markets. High demand from locals and expats make the region a strong market for a wide range of concepts, especially in Gulf countries such as the UAE, Saudi Arabia, and Kuwait. Fast food sales in Saudi Arabia are expected reach US$4.5bn in the next three years, driven by orders from the young and affluent, according to a recent report by Euromonitor. Papa John’s, the world’s third largest pizza chain, said revenues reached US$1.2bn in 2011, an eight percent increase compared to the previous year.