Bilateral trade, corruption and the role of ICT: evidence from MENA countries

This paper examines the linkages between information and communication technology (ICT) diffusion, renewable energy consumption (REC), and carbon (CO2) emissions across three distinct regions: the South Asian Association for Regional Cooperation (SAARC), Middle East and North Africa (MENA), and Organization for Economic Cooperation and Development (OECD) nations. We explore the causal pathways linking these variables and perform a comparative assessment of region-specific patterns with their policy implications. Utilizing a panel dataset of 28 countries from 1998 to 2019, we employ panel ARDL, FMOLS, DOLS, and D-H causality tests. The comprehensive analysis of the sample reveals that ICT development enhances CO2 emissions, whereas REC reduces emissions. However, the comparative analysis suggests a positive linkage between ICT diffusion and CO2 emissions in MENA and OECD countries but a negative linkage in SAARC countries. Further, REC substantially reduces emissions in MENA and OECD countries but has an insignificant effect in SAARC countries. Our findings corroborate the first-order effect of ICT (negative environmental impact) in MENA and OECD countries, with contextual variations attributed to economic structure, financial sector growth, trade openness, and industrialization. These findings offer pivotal insights for policymakers to leverage ICT capabilities and REC to attain sustainable development and mitigate climate change consequences.

COVID-19 response in the Middle East and north Africa: challenges and paths forward

BackgroundDonor countries in the Middle East and North Africa (MENA) including Saudi Arabia, Kuwait and United Arab Emirates (UAE) have been among the largest donors in the world. However, little is known about their contributions for health. In this study, we addressed this gap by estimating the amount of development assistance for health (DAH) contributed by MENA country donors from 2000 to 2017.MethodsWe tracked DAH provided and received by the MENA region leveraging publicly available development assistance data in the Development Assistance Committee (DAC) database of the Organisation for Economic Co-operation and Development (OECD), government agency reports and financial statements from key international development agencies. We generated estimates of DAH provided by the three largest donor countries in the MENA region (UAE, Kuwait, Saudi Arabia) and compared contributions to their relative gross domestic product (GDP) and government spending; We captured DAH contributions by other MENA country governments (Egypt, Iran, Qatar, Turkey, etc.) disbursed through multilateral agencies. Additionally, we compared DAH contributed from and provided to the MENA region.ResultsIn 2017, DAH contributed by the MENA region reached $514.8 million. While UAE ($220.1 million, 43.2%), Saudi Arabia ($177.3 million, 34.8%) and Kuwait ($59.8 million, 11.6%) as sources contributed the majority of DAH in 2017, 58.5% of total DAH from MENA was disbursed through their bilateral agencies, 12.0% through the World Health Organization (WHO) and 3.3% through other United Nations agencies. 44.8% of DAH contributions from MENA was directed to health system strengthening/sector-wide approaches. Relative to their GDP and government spending, DAH level fluctuated across 2000 to 2017 but UAE and Saudi Arabia indicated increasing trends. While considering all MENA countries as recipients, only 10.5% of DAH received by MENA countries were from MENA donors in 2017.ConclusionMENA country donors especially UAE, Saudi Arabia and Kuwait have been providing substantial amount of DAH, channeled through their bilateral agencies, WHO and other multilateral agencies, with a prioritized focus on health system strengthening. DAH from the MENA region has been increasing for the past decade and could lend itself to important contributions for the region and the globe.

The present study aims to evaluate the impact of information and communication technology (ICT) on the economic growth of selected developing countries in the Middle East and North Africa (MENA) region and the Sub-Saharan Africa (SSA) region by using a panel Generalized Method of Moment (GMM) growth model over the period 2007–2016. The results extracted from the econometric model show that except fixed telephone, other information and communication technologies such as mobile phone, Internet usage, and broadband adoption are the main drivers of economic growth in MENA and SSA developing countries over the recent period 2007–2016. In addition, our findings confirm the superiority of MENA countries over SSA countries in the areas of Internet usage and broadband adoption. From a policy perspective, the results suggest that authorities in MENA and SSA countries should increase investments in ICT infrastructure. To benefit from the ICT drivers of economic growth, policymakers should enact several important policies that permit the development of financial sectors, provide a more convenient regulatory and institutional environment, increase economy openness, prioritize the allocation of resources to the development of ICT infrastructure, and contain the negative effects of inflation and government consumption.

The introductory article of this special issue looks at the genesis, characteristics and challenges of social protection schemes in the Middle East and North Africa (MENA). It argues that social protection policies in the MENA should be seen as a key ingredient of the social contract that governments offered to their citizens after independence. To compensate for the lack of political participation and accountability, free public health and education systems, generous food, energy and water subsidies, social insurance and assistance schemes and mass public‐sector employment were established. This was possible because MENA countries benefitted from substantial windfall profits (from the export of oil, gas and minerals; Suez Canal user fees), as well as from income from remittances from migrant workers and income from politically motivated aid. The decline of income from some of these sources and population growth has led MENA governments to focus more closely their social protection spending on strategically important social groups: typically, the urban upper middle class. As a result, social protection systems in MENA countries currently suffer from severe weaknesses in terms of social fairness, efficiency and sustainability. Although MENA countries still spend a very considerable share of gross domestic product on their social protection schemes, these have only very limited effects on the reduction of poverty, vulnerability and inequality – and some even exhibit perverse “bottom‐up” redistributive outcomes. The articles that comprise this special issue selectively spotlight a number of opportunities and challenges for the development of sustainable social protection in the MENA countries.

BackgroundThe populations of the Middle East and North Africa countries (MENA) are predicted to contribute to the world’s sharpest increases in rates of Alzheimer’s disease and related dementias (ADRD) in the coming years (GBD 2022), yet this group is underrepresented in health studies. The UK Biobank provides one of the largest and well‐characterized datasets on aging immigrants in the UK. We compare risk factors for ADRDs between UK immigrants from MENA countries to those of immigrants from other countries.MethodImmigrants from MENA countries (N = 3557), India (N = 2959), Germany (N = 1103), and genetically‐determined British individuals (N = 1929) born outside of the UK in any of the three areas of interest were included in the study. There are multiple definitions of MENA: here, MENA was defined broadly to include the union of all included countries; Figure 1 highlights the distribution in this sample. We focused on variables associated with suboptimal brain aging and ADRD risk: APOE genotypes; education; an algorithmically defined diet quality score (Zhuang, 2021); BMI; incidence of parental death before 65 years; and the Townsend deprivation index (TDI) as a proxy of socioeconomic status (SES). Chi‐squared or Mann‐Whitney tests provided statistics on distribution discrepancies for categorical or continuous data, respectively. We also charted hippocampal volumes with age for the subset of each ethnic group who underwent neuroimaging.ResultFigure 2 highlights group demographics and distributions. Compared to all other groups (Figure 3), MENA groups had higher TDI (lower SES), lowest diet quality, and highest BMIs; these differences remained even in college educated individuals. MENA also reported a greater incidence of maternal deaths before age 65. German immigrants were more highly educated than all other groups. ApoE4 alleles were significantly less prevalent in MENA and Indian countries than groups of European ancestry (Figure 4). Hippocampal volumes, adjusted for intracranial volume, had similar age‐trends across groups.ConclusionMany ADRD risk factors differ substantially across different ethnic groups, even when the proportion with a college education is not different. It is imperative to understand underlying lifestyle and sociological factors associated with immigration, to provide adequate healthcare for all aging individuals.

Background It is widely perceived that little is known about the epidemiology of HIV infection among people who inject drugs (PWID) in the Middle East and North Africa (MENA). The primary objective of this study was to assess the status of the HIV epidemic among PWID in MENA by describing HIV prevalence and incidence. Secondary objectives were to describe the risk behavior environment and the HIV epidemic potential among PWID, and to estimate the prevalence of injecting drug use in MENA. Methods This was a systematic review following the PRISMA guidelines and covering 23 MENA countries. PubMed, Embase, regional and international databases, as well as country-level reports were searched up to December 16, 2013. Primary studies reporting 1) the prevalence/incidence of HIV, other sexually transmitted infections, or hepatitis C virus (HCV) among PWIDs; or 2) the prevalence of injecting or sexual risk behaviors, or HIV knowledge among PWID; or 3) the number/proportion of PWID in MENA countries, were eligible for inclusion. The quality, quantity, and geographic coverage of the data were assessed at country level. After multiple level screening, 192 eligible reports were included in the review. There were 197 HIV prevalence measures on a total of 58,241 PWID extracted from reports, and an additional 226 HIV prevalence measures extracted from the databases. Findings We estimated that there are 626,000 PWID in MENA (range: 335,000-1,635,000, prevalence of 0.24 per 100 adults). We found evidence of HIV epidemics among PWID in at least one-third of MENA countries, most of which are emerging concentrated epidemics and with HIV prevalence overall in the range of 10-15%. Some of the epidemics have however already reached considerable levels including some of the highest HIV prevalence among PWID globally (87.1% in Tripoli, Libya). The relatively high prevalence of sharing needles/syringes (18-28% in the last injection), the low levels of condom use (20-54% ever condom use), the high levels of having sex with sex workers and with men who have sex with men (15-30% and 2-10% in the last year, respectively), and of selling sex (5-29% in the last year), indicate a high injecting and sexual risk environment. The prevalence of HCV (31-64%) and of sexually transmitted infections suggest high levels of risk behavior indicative of the potential for more and larger HIV epidemics. Conclusions Our study identified a large volume of HIV-related biological and behavioral data among PWID in the MENA region. The coverage and quality of the data varied between countries. There is robust evidence for HIV epidemics among PWID in multiple countries, most of which have emerged within the last decade and continue to grow. The lack of sufficient evidence in some MENA countries does not preclude the possibility of hidden epidemics among PWID in these settings. With the HIV epidemic among PWID in overall a relatively early phase, there is a window of opportunity for prevention that should not be missed through the provision of comprehensive programs, including scale-up of harm reduction services and expansion of surveillance systems.

Rapid urbanization, economic dependency on natural resources, and ecological damage are major obstacles to environmental sustainability in the Middle East and North Africa (MENA). This paper examines the dynamic interactions among Information and Communication Technology (ICT), technical innovation, financial inclusion, natural resource rent, and environmental sustainability using ecological footprints and load capacity factors as main indicators. The research finds linear and asymmetric correlations using panel data from 2001 to 2022 and sophisticated econometric approaches like Cross-sectionally Autoregressive Distributed Lag (CS-ARDL) and Nonlinear ARDL (NARDL) models. The results expose that by encouraging energy efficiency and sustainable resource use, ICT and technical innovation significantly help to reduce environmental damage. Financial inclusion, however, has two different effects: if not properly controlled, it may encourage unsustainable spending habits even while it helps to provide cash for green ventures. Moreover, natural resource rents greatly worsen environmental damage, supporting the resource curse theory, especially in areas with inadequate government systems. The asymmetry approach emphasizes the varied impacts of positive and negative shocks in ICT and technological innovation on sustainability, thus implying the need for customized policy responses. With a comprehensive view of sustainability in MENA and strong econometric modeling incorporating environmental, technical, and financial components, this paper adds to the body of knowledge. Emphasizing the requirement of legislative frameworks that support green funding, improve institutional quality, and stimulate the use of digital and clean technology, the findings provide policymakers with practical insights. Aligning economic resilience with environmental sustainability would depend mostly on strengthening governance and sustainable investment policies, guaranteeing long-term ecological and economic stability.

Background and objective The Middle East and North Africa (MENA) is home to the world's largest producer of opioids, as well as to major drug trade routes. Over 80% of the global supply of heroin is produced in Afghanistan, and over 75% of this is trafficked through Iran and Pakistan. The increased availability and purity of inexpensive heroin in MENA appears to have led to a subsequent rise in injecting drug use. The objective of this sub-study was to estimate the proportion and number of people who inject drugs (PWID) in MENA, as part of a larger study of HIV epidemiology among PWID in this region. Methods This was a systematic review of literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Sources of data included PubMed, Embase, regional databases, conference abstracts, as well as a large body of country-level reports. A generic "drug use" search of these databases was performed. Data on PWID population size estimates in the 23 MENA countries were extracted from relevant studies. Estimates were weighted by adult population size. When more than one such estimate was available per country, we used their mean. Adult population size was extracted from the United Nations World Population Database. Results After screening 4,985 citations, we extracted 121 and 105 measures on the number and proportion of PWID, respectively. We estimated that there are 0.6-1 million PWID in MENA. Pakistan, Iran, and Egypt have the largest number, with an average of about 210,000, 180,000 and 89,000 PWID, respectively. The weighted mean prevalence of injecting drug use was estimated at 0.23 per 100 adults (range 0.03-0.50%), and was highest in Iran (0.43%). Studies of sub-national populations showed geographical heterogeneity in the proportion of PWID. Data on the prevalence of female PWID were scarce. Overall, the mean proportion of females among PWID in included studies was 3.6% (range: 0-35%). Conclusion The mean prevalence of injecting drug use in MENA (23 in every 1000 adults) is comparable with global figures which range from 0.06% in South Asia to 1.50% in Eastern Europe. The prevalence of injecting drug use varied between MENA countries, being higher in the eastern part of the region; and appeared to be heavily concentrated among men. With recent evidence suggesting emerging HIV epidemics among PWID in several MENA countries, these findings take on additional importance. There is an urgent need to scale up harm reduction services for the nearly one million individuals who form this vulnerable population group in MENA.

Purpose This paper aims to investigate bank-specific determinants affecting the dividend policy of commercial banks listed in the Middle East and North Africa (MENA) region countries. Design/methodology/approach The study uses pooled and panel tobit and logit regression analyses based on 16-year unbalanced data with 1,593 firm-year observations collecting from 117 commercial banks listed in 11 MENA countries. Findings The results indicated that the main bank-specific factors affecting dividend payment decisions are bank size, profitability, capital adequacy, credit risk and bank age in the context of the MENA emerging markets. In addition, the analysis showed that the yearly dummy for the global financial crisis (2008–2009) has a significant negative effect, while the yearly dummy for the Arabic spring crisis (2010–2011) has no significant effect on the dividend payment decision of banks listed in the MENA region. Furthermore, the growth opportunity is not one of the key factors affecting dividend policies by banks in MENA emerging markets. Considering this information, it is reasonable to conclude that MENA region banks’ dividend decisions follow investment decisions. In other words, the dividend decisions and investment decisions are independent of each other. The findings support theories (hypotheses) of dividends such as residual, signalling, regulatory pressures, transaction cost and lifecycle. Research limitations/implications This study is restricted to a sample of one type of financial firm, conventional commercial banks listed in the MENA markets because of the problem of missing data and limited information on other financial firms for the same period, particularly Islamic banks. Moreover, the focus of this study was on factors that are considered bank fundamentals. However, ownership variables were not included in the study because of unavailability. Practical implications The results of this study have several important implications for banks’ dividend policymakers, regulators, analysts and investors. Dividend policymakers in MENA emerging markets seem to use residual dividend policy, in which they distribute dividends according to what is left over after all acceptable investment opportunities have been undertaken. These inconsistent, unstable dividend policy trends make it difficult for investors to predict future dividend decisions. Further, this practise may convey information to shareholders about a lack of positive future investment opportunities. This may negatively affect the share value of banks. Acquiring a broad understanding of the dividend behaviour of MENA banks enables regulators to take more effective regulatory actions to protect shareholders and depositors. Finally, the results of this study can help analysts and investors build their dividends predictions and investment strategies. Originality/value The banking sector plays a disproportionately large role in the development of emerging economies. Therefore, this study is one of the first to examine a large cross-country sample of MENA banks (117) for an extensive period (2000–2015). The study includes both the Global financial crisis and Arab uprising periods, including after the liberalization and recent economic reforms and structural changes in financial sectors across MENA countries.

This paper analyzes the impact of global integration on the dynamics of economic growth and business cycles in the emerging economies of Middle East and North Africa (MENA) and Asia. In particular, the paper examines the evolution of structural characteristics, growth dynamics, and business cycle properties of these countries during the 1960-2000 period. Although both groups of countries became more open and were able to diversify their industrial structures and export bases over time, the MENA countries lagged behind the Asian economies in both trade integration and the extent of diversification of exports during the globalization period (1986-2000). Although economic growth slowed in both groups during the period of globalization, the extent of the slowdown was much sharper in the MENA countries. Moreover, business cycle fluctuations in the MENA countries were much more volatile than in the Asian economies. In addition, although both groups of countries witnessed a moderation in the amplitude of macroeconomic fluctuations during the globalization period, the decline in the volatility of cyclical fluctuations in the MENA countries was relatively small, partially because of the inability of these countries to utilize the benefits of global integration.

Myelodysplastic syndrome (MDS) describes a group of bone marrow malignancies with variable morphologies and heterogeneous clinical features. The aim of this study was to systematically appraise the published clinical, laboratory, and pathologic characteristics and identify distinct clinical features of MDS in the Middle East and North Africa (MENA) region. We conducted a comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases from 2000 to 2021 to identify population-based studies of MDS epidemiology in MENA countries. Of 1935 studies, 13 independent studies published between 2000 and 2021 representing 1306 patients with MDS in the MENA region were included. There was a median of 85 (range 20 to 243) patients per study. Seven studies were performed in Asian MENA countries (732 patients, 56%) and six in North African MENA countries (574 patients, 44%). The pooled mean age was 58.4 years (SD 13.14; 12 studies), and the male-to-female ratio was 1.4. The distribution of WHO MDS subtypes was significantly different between MENA, Western, and Far East populations (n = 978 patients, p < 0.001). More patients from MENA countries were at high/very high IPSS risk than in Western and Far East populations (730 patients, p < 0.001). There were 562 patients (62.2%) with normal karyotypes and 341 (37.8%) with abnormal karyotypes. Our findings establish that MDS is prevalent within the MENA region and is more severe than in Western populations. MDS appears to be more severe with an unfavorable prognosis in the Asian MENA population than the North African MENA population.

Our study aims to assess the prevalence of COVID-19 in the Middle East and North Africa (MENA) region. It aims also to examine the various factors that have led to the unequal distribution of the confirmed cases among the different MENA countries. Data was retrieved from the World Health Organization situation reports issued between January 29 and June 5, 2020. It included the numbers of cumulative cases, new cases, and cumulative deaths reported by MENA countries. Similarly, we searched for relevant articles in PubMed and Medline. A total of 481,347 cases and 11,851 deaths occurred in the MENA region, accounting for 7.37% and 3.06% of the global cases and deaths respectively. Iran had the highest number of cases and deaths accounting for 34.1% and 68.1% of the MENA cases and deaths respectively. Together the Gulf Cooperation Council (GCC) countries accounted for 52.2% and 10.6% of MENA cases and deaths respectively. Egypt had the highest number of confirmed cases and deaths among the African countries of the region. Syria, Libya and Yemen (countries at war) had the lowest numbers of reported cases. The MENA region overall case fatality rate (CFR) was estimated at 2.46%. The highest CFR (22.75%) occurred in Yemen, and the lowest (0.07%) in Qatar. The unequal distribution of wealth among the MENA countries, the lack of sociopolitical stability, and the high number of undetected and underreported cases in some of them have resulted in varied incidences of COVID-19 related morbidity and mortality.

Cancer is one of the biggest health burdens for women in the Middle East and North Africa (MENA), with the incidence of breast, cervical and colorectal cancer on the rise. Although preventive measures such as the HPV vaccination and population-based screening are available, access to them remains very unequal. Women in rural, low-income and refugee communities face additional barriers, cultural stigmatisation, low health literacy, gender norms and fragile health systems, leading to delayed diagnoses and poorer outcomes. This review summarises the results of 724 peer-reviewed publications to assess the current situation of cancer screening in MENA and Mediterranean countries. The studies were classified into four dimensions: cancer type (breast, cervical, colorectal), behavioural constructs (awareness, uptake, education), vulnerability factors (e.g., migrants, refugees, low-literacy groups), and geography (indigenous MENA populations versus diaspora and Mediterranean immigrant communities). The results show large inequalities in access and participation due to fragmented policies, socio-cultural resistance and infrastructure gaps. Nevertheless, promising approaches are emerging: community-led outreach, mobile screening programmes, AI-assisted triage and culturally appropriate digital health interventions. Comparisons between the local and diaspora populations make it clear that systemic and cultural barriers persist even in well-equipped facilities. Closing the screening gap requires a culturally sensitive, digitally enabled and policy aligned approach. Key priorities include engaging religious and community leaders, promoting men’s engagement in women’s health and securing sustainable funding. With coordinated action across all sectors, MENA countries can build inclusive screening programmes that reach vulnerable women and reduce preventable cancer mortality.

Dynamic Impacts of Climate Changes and Environmental Sustainability on FoodWater Poverty in a Panel of Selected MENA Countries