20-05-2019

EDITORIAL MOndAY,
MAY 20, 2019
4
Europe should help Us turn the heat on Iran
Acting Editor & Publisher : Jobaer Alam
Telephone: +8802-9104683-84, Fax: 9127103
e-mail: editor@thebangladeshtoday.com
Monday, May 20, 2019
Emerging health
threat
Drug retail shops are often the first and only source of
healthcare outside home for a majority of patients in
developing countries including Bangladesh. Outside
the public sector, the retail distribution of drugs presents a
totally chaotic situation without any regulatory mechanism.
According to the BCDS (Bangladesh Chemist and Druggist
Samity), there are about 64,000 licensed pharmacies (of which
14,000 are members of the Samity) and around 70,000 unlicensed
drugstores in the country involved in selling drugs
'over-the-counter'. In reality, there are no 'prescription-only'
drugs in Bangladesh. Anybody can buy any drug in any
amount including antibiotics without prescription from these
drugstores.
Most of the salespeople at these drug stores do not have
training in dispensing of drugs, not to speak of diagnoses and
treatment which they frequently do. According to law, the persons
dispensing drugs at the drugstores (community pharmacies)
should have at least a short training of twelve weeks duration
(Grade C pharmacists) before one can apply for a drug
shop (Pharmacy) license. This certificate course is conducted
by the Bangladesh Pharmaceutical Society (BPS) in cooperation
with the BCDS through 45 tutorial centres. The content,
form, and utility of this training remain a matter of grave concern.
As these drugstore salespeople have no other channel of
information from the formal sectors open to them, they fall
easy prey to the aggressive marketing strategies of the pharmaceutical
companies. Irrational use of drugs such as over prescribing,
multi-drug prescribing, use of unnecessary expensive
drugs and overuse of antibiotics and injections are the most
common problems found with these retailers. These shops are
also the main channels through which the counterfeit, substandard
and expired drugs are marketed.
A number of studies have been on the prescribing behavior of
the informal formal sector healthcare providers. In a study
comparing UHCs with Urban NGO Clinics under UPHCP project,
results revealed the extent of prescribing antibiotics for
selected common illnesses e.g., a greater tendency was
observed to prescribe antibiotics for fever and common
cold/cough than for acute respiratory infection (ARI) (including
pneumonia). In all cases, antibiotics were prescribed without
any laboratory investigation.
In another study, besides analgesics, antibiotics were the
most frequently reported drug used in fever (around 80%),
diarrhoea (around 90%) and childhood pneumonia (around
96%) by the unqualified allopathic providers. The CHWs used
antibiotics more frequently while treating children for pneumonia
(69%) than when treating fever (30%) or diarrhea
(43%). The relatively better practices of the CHWs were reflected
in another study of semi-/unqualified allopthc providers
where they were found to have used fewer antibiotics for fever
(11%), diarrhea (30%) and dysentery (22%) but more for ARI
of children (94%). The untrained rural medical practitioners
(RMPs), in many instances, prescribed antibiotics on demand
from the parents, and in inappropriate doses and duration.
Interestingly, in Bangladesh, physicians rarely follow any
protocol for identification of the pathogens and its sensitivity to
the drug before antibiotics is prescribed. In a study of prescription
pattern of the private practitioners of Dhaka city, antibiotics
were prescribed in 70% of the prescriptions and in another
similar study, antibiotics were prescribed in 72% of the
instants.In another population-based study in the rural areas
of Dhaka and Rajshahi divisions of Bangladesh during Jul. -
Dec. 2012, around 44% physicians prescribed antibiotics in
cold and fever before confirmed diagnosis. According to the
physicians, patient non-compliance was the main cause of
antibiotic resistance in the country (68.8%) and more than
50% patients were found to stop taking the antibiotic as soon
as the symptoms disappeared, while only 25.2% patient completed
the full course.
Due to inappropriate and irrational use of antibiotics by both
formal and informal sector healthcare providers, resistance to
antimicrobials has reached an enormous proportion which
need urgent attention. Bangladesh is currently undergoing
double burden of diseases (emerging non-communicable lifestyle
diseases but also, existing communicable diseases) and
antibiotic therapy will remain a mainstay of treatment for quite
some more time to come. This is especially important as the
invention of new antibiotics is not currently keeping pace with
the speed of emergence of drug resistance.
To change prescriber behavior, standard treatment guidelines
supported by prescription audit was found to be highly
effective in Bangladesh. Patient should be made aware about
the harmful effects of using antibiotics for trivial illnesses and
the necessity of completing the course in appropriate dose and
duration. Regulatory authority from the DGDA (Directorate
General Drug Administration) should see that antibiotics are
not sold without prescription as OTC medicines.
In the long run, preventing the emergence of antimicrobial
resistance requires the overhauling of the health systems in the
country to make it more accessible and affordable to the poor
and the disadvantaged sections of the population, and for
pharmaceutical system to be placed under regulatory mechanisms
for compliance with GMP and prevent entry of sub-standard
medicine or counterfeit medicines in the market.
Intensive monitoring is needed for assuring that the code of
conduct for marketing pharmaceutical products is strictly followed
and proper dispensing of medicines etc. is in place with
active and informed participation from the pharmacist community.
Attendants at drug retail outlets should be trained in dispensing
through the pharmacy council and drug shops brought
under regulatory supervision for preventing sale of antibiotics
without prescription. Besides, a surveillance system for monitoring
the sensitivity of microbials against common pathogens
should be in place to guide the practitioners in using the appropriate
antibiotics. Strict enforcement of hospital infection control
mechanism will help prevent transmission of resistance
strains in the community.
A
s summer approaches in the
Arabian Gulf, geopolitical tensions
are rising as fast as the temperature.
Saudi Arabia says it has suffered
drone attacks on land-based oil pumping
stations, and that two of its oil tankers
were sabotaged. Two other tankers,
including one flagged to Nato ally
Norway, were also reportedly damaged
by small explosive devices. The seaborne
incidents all occurred off the coast of the
UAE at a maritime oil-bunkering station.
Each attack ripped a five-to-ten-foot hole
in the hull of the tanker near or at the
waterline, suggesting the saboteurs
attached mines to the ships' sides.
In response, the United States military
is exploring options to deter Iran, which is
thought to be behind the tanker attacks.
This has included increasing the level of
operational readiness of US troops
throughout the region; deploying longrange
B-52 Bombers and F-15 fighters to
the US base in the Gulf; sending a carrier
strike group, led by the nuclear-powered
Abraham Lincoln, into the waters of the
Arabian Gulf; exploring options to deploy
up to 120,000 new troops to the region;
and issuing strong statements from the
White House, promising significant military
retaliation if Iran provokes an incident.
All of this comes as the US further
pressures the Iranian economy through
harsh sanctions, which are having a significant
effect.
Given the upcoming election in the US,
it seems highly unlikely that President
Donald Trump will want things to escalate
to a full-on military confrontation. He
The ruling US establishment selectively
ignores certain vital aspects when it
comes to protecting and preserving
human rights. Sometimes human rights are
looked at purely from a religious or racist
angle. American lawmakers exhibit blatant
hypocrisy in this matter, but it's rarely
reported.
Take the case of the US State Department
that released a report to the US Congress
identifying any criticism of Israel as anti-
Semitism, warning that anti-Jewish attitudes
and incidents were on the rise worldwide.
This was based on a study conducted
by Tel Aviv University's Stephen Roth
Institute. The study found an increase in
anti-Semitic incidents across the globe,
encompassing physical attacks and vandalism,
from 406 in 2005 to 1932 in 2018.
The report went further and talked at
great length about the intensification of
anti-Semitic rhetoric among governments
and international elites. Assessing the
report, the State Department did not think
twice before declaring that attacks on Israel
are anti-Semitism - a bold statement indeed
from an organ of the government that generally
refrains from making extravagant
statements.
"Anti-Semitism has proven to be an adaptive
phenomenon," the report said. "New
forms of anti-Semitism have evolved. They
often incorporate elements of traditional
anti-Semitism. However, the distinguishing
feature of the new anti-Semitism is a criticism
of Zionism or Israeli policy that -
whether intentionally or unintentionally -
has the effect of promoting prejudice
successfully ran on the idea of pulling the
US out of the region, so the odds of him
approving significant military action,
especially a land invasion, seem low.
The worry on which the world should
focus is not a deliberate and overt Iranian
attack, but a miscalculation that spirals
into war. That possibility certainly has the
full attention of the new US Ambassador
to Saudi Arabia, retired General John
Abizaid, who was previously commander
of US Central Command, which includes
the Middle East. Few people know better
the way both cost and escalation are difficult
to control in the region, and he is calling
for a gathering of facts, not a military
attack. "We need to do a thorough investigation
to understand what happened,
why it happened, and then come up with
reasonable responses short of war,' he
said in Riyadh on Tuesday. "It's not in
[Iran's] interest, it's not in our interest,
and it's not in Saudi Arabia's interest to
have a conflict," he added.
How could things escalate? Quite easily,
JAMEs sTAvRIdIs
The worry on which the world should focus is not a deliberate and
overt Iranian attack, but a miscalculation that spirals into war.
That possibility certainly has the full attention of the new Us
Ambassador to saudi Arabia, retired General John Abizaid, who
was previously commander of Us Central Command, which
includes the Middle East. Few people know better the way both
cost and escalation are difficult to control in the region, and he is
calling for a gathering of facts, not a military attack.
against all Jews by demonising Israel and
Israelis and attributing Israel's perceived
faults to its Jewish character."
In its introductory overview, the report
singles out governments with whom the US
administration has no relations (Iran for
example), or Syria and Venezuela with
whom Washington's relations are in a parlous
state. The report, however, cites pronounced
examples of anti-Semitism among
TARIq A. Al MAEEnA
unfortunately. I commanded the Carrier
Strike Group Enterprise in the Gulf in the
summer of 2003. Every day I watched
Navy warships under my command operate
with restraint as small Iranian Navy
and Revolutionary Guard boats circled us,
made high-speed runs in our direction,
and broadcast dire warnings through
propaganda. In 2016, two small US riverine
patrol boats and their crews were
seized by Iran. While the sailors were
released shortly after, that kind of incident
in today's hair-trigger environment
could easily cause the administration to
launch strikes against Iranian ships. Iran
could retaliate with mines against commercial
shipping, threatening to close the
Strait of Hormuz, through which flows 30
per cent of the world's oil.
This would very likely lead to the US
and its allies to forcibly reopen the strait,
an operation that would almost certainly
require cruise missile and air strikes
against the entire Iranian naval force,
the nations that the United States has cultivated
as allies, including Russia, Ukraine,
and Iraq. This report followed years of
research launched after US lawmakers
passed a bill commissioning it. The 94-page
report suggests at length that Holocaust
denial is a vehicle for anti-Semitism, focusing
on the role Iran's government has taken
in its propagation. It also targets the United
Nations, suggesting that some of its constituents,
criticising Israel, promote a hostile
environment for Jews.
"Regardless of the intent, disproportionate
criticism of Israel as barbaric and
unprincipled, and corresponding discriminatory
measures adopted in the UN against
Israel, have the effect of causing audiences
to associate negative attributes with Jews in
general, thus fuelling anti-Semitism," it
says.
Naturally, Jewish groups, including the
Anti-Defamation League and the American
Jewish Committee, welcomed the report, as
did some members of Congress. "All too
often, legitimate criticism of the State of
Israel can veer into naked anti-Semitism
characterised by vile hate speech," said Rep.
Howard Berman, the chairman of the
House of Representatives Foreign Affairs
Committee. "When hate speech arises, we
should call it what it is - and do what can be
done to stop it." Considering how the
Israeli-fuelled Zionist lobby has throttled
the US and other western legislative bodies,
no US politician would dare say otherwise.
But what about the hate generated against
Muslims because of their faith or attire? In
the UK, a drive by some members of
Parliament who called on the government
to accept a formal definition of
which would necessitate pre-strike operations
against the Iranian air force.
Inexorably, the forces of escalation would
push both sides to employ ever-higher
levels of military action.
The best approach for the US now is to
return to a greater focus on allies, partners
and friends. This means continuing to
build an anti-Iran coalition that includes
not only Saudi Arabia and the other Gulf
States, but also the European and Nato
partners. The role for the Europeans is to
help force Iran back to the negotiating
table through economic sanctions. It's
unfortunate that some of them don't
seem to be taking the increased Iranian
threat seriously, even the usually reliable
Brits.
The US must continue to step up its
intelligence efforts in the region, especially
in offensive cyber operations. Iran is a
very capable cyber-opponent, and will
certainly use that ability against the
Saudis regionally and the US more broadly.
Additional missile-defence capabilities
should be deployed to the region as well.
A century ago, Europe managed to
sleepwalk into a four-year war set off by
an assassination in the Balkans, which led
to the automatic execution of war plans
and mobilisation of forces on both sides.
The world can avoid stumbling into
another war in the Middle East. But, as
Abizaid put it, it will require using other
tools "short of war".
Source : Gulf News
The fight over anti-semitism is political
Afew days ago, this newspaper
published an editorial calling for
surgical strikes against Iran and
its agents who recently attacked Saudi
oil pipelines and commercial ships in
Fujairah.
Incidentally, our editorial was followed
by military strikes against
Houthi targets by the Saudi-led coalition
to restore the legitimate government
in Yemen. It was also followed by
news that the US has obtained the
approval of several Gulf countries to
redeploy troops in the region.
On social media, there were many
who criticized our position and labeled
us as warmongers. They also slammed
the collective view of our top editors as
irresponsible. They wondered - in a
one-sided manner - how one could call
for a Muslim country to attack another
Muslim country during the month of
Ramadan.
Putting aside the few commentators
who had a genuine concern - as we do -
regarding a large-scale war erupting,
much of the criticism is coming from
well-known pro-Iran and pro-
Hezbollah propagandists.
One simply has to ask why these critics
were silent when Iran and its agents
attacked Saudi Arabia. Not only is
Saudi Arabia a Muslim country, it is the
land of the Two Holy Mosques. Surely,
an attack on its soil - by a fellow
Muslim country - demanded severe
The report, however, cites pronounced examples of antisemitism
among the nations that the United states has cultivated
as allies, including Russia, Ukraine, and Iraq. This report followed
years of research launched after Us lawmakers passed a
bill commissioning it. The 94-page report suggests at length that
Holocaust denial is a vehicle for anti-semitism, focusing on the
role Iran's government has taken in its propagation.
Pick up the phone, Rouhani!
condemnation.
Furthermore, why aren't these supposed
peace-lovers urging Iran to stop
its meddling and to take up the US
offer of talks?
Where were all these critics when
Houthi missiles fell near the holy city
of Makkah, and in civilian neighborhoods
of Riyadh?
Saudi Arabia does not want a war. It
has and will always work with the US
and other allies to try and avert it.
However, Saudi Arabia - like any sovereign
country - also has the right to
defend itself.
After all, Iranian Education Minister
Mohammed Bathaee may very well say
he wants to sacrifice 14 million innocent
Iranian schoolchildren as "martyrs"
should a war happen, but here in
the Kingdom, we see it as our duty to
protect our children, not the other way
around. Of course, critics will say the
FAIsAl J. AbbAs
Arab coalition has made mistakes in
Yemen in terms of civilian casualties.
This is true, but these mistake were
always investigated, admitted and
apologized for. It must be stressed that
the same cannot be argued for the
malicious Houthi militias, whose leadership's
declared policy is to attack
civilians and airports.
That said, the Kingdom is definitely
Of course, critics will say the Arab coalition has made
mistakes in Yemen in terms of civilian casualties.
This is true, but these mistake were always investigated,
admitted and apologized for. It must be stressed
that the same cannot be argued for the malicious
Houthi militias, whose leadership's declared policy
is to attack civilians and airports.
not perfect and has its flaws, but the
reality is that today, there are no Arab
militias in Persian lands. However, the
same cannot be said about Iran and its
agents in Arab countries. After all, it is
Tehran's declared policy to destabilize
Iraq, hijack Lebanon, sabotage
Palestinian peace efforts and support
Syrian President Bashar Assad as he
gasses and barrel-bombs his people.
Hearing what Iranian Foreign
Minister Mohammad Javad Zarif
recently said does not suggest that his
Islamophobia was rejected by the Home
Office Minister who said there was "no need
for a definitive definition".
An incredulous explanation by Britain's
police chief, Martin Hewitt, that "defining
Islamophobia risked heightening community
tensions and could hinder counterterrorism
policing powers and tactics" defies
all logic. The Parliamentary group on British
Muslims wanted to define it to tackle what it
called a "social evil".
In Austria, a law has been passed to ban
Muslim girls from wearing a headscarf in
primary schools. The Jewish yarmulke and
Sikh headgear are not included in the new
ban. In justifying their actions, the government
said that the head covering worn by
Sikh boys or the Jewish yarmulke would not
be affected because the law refers to head
garments that "cover all of the hair or large
parts of it." How bloody absurd! Have they
seen a Sikh with their hair partially uncovered?
Islamophobia is well tolerated in
these countries. But when a hint of anti-
Semitism rears up, everyone howls. It is
unquestionably Israel's policy of land grabbing
and ethnic cleansing that generates
criticism of the country. Isn't the Holocaust
being perpetrated against the Palestinian
people during the last 70 years a cause for
unflattering rhetoric against a country
whose raison d'etre seems to be the illegal
thievery of others' land and murder and
oppression of its rightful owners? Bringing
up Israel's crimes to the fore is not anti-
Semitism. It is a call for justice.
Source : New York Times
regime understands that the rope is
tightening around its neck.
"Nobody can confront Iran," said
Zarif (whose name in Arabic means
"cute"). Such an attitude reminds us of
Iraq under Saddam Hussein prior to
the 2003 war. Of course, we all know
what fell upon Iraq because of this
stubbornness and shortsightedness.
With the current sanctions, a collapsing
economy and superior foes, the
Mullahs don't stand a chance.
Still, the Iranian regime has a golden
opportunity to avert a war at worst, or
an economic disaster at best.
One simply has to ask why these critics
were silent when Iran and its agents
attacked Saudi Arabia. Not only is
Saudi Arabia a Muslim country, it is the
land of the Two Holy Mosques. Surely,
an attack on its soil - by a fellow
Muslim country - demanded severe
condemnation.
It can simply commit to not being a
rogue state, stop supporting terror,
recall its militias and shut down its
nuclear program. This will not only be
beneficial for Iran itself, but for the
whole region and the world at large.
So, for everyone's sake, let us hope
President Hassan Rouhani picks up the
phone and calls the White House,
before it is too late!
Source : New York Times