Countries In Middle East And North Africa Region Research Articles

The puzzle of convex/concave ESG returns and large banks in MENA region countries

This study examines the linear and nonlinear impacts of the environmental, social, and governance (ESG) components on bank stock returns in the region of the Middle East and North Africa (MENA). It also investigates the impact of bank size on the nexus between ESG and bank stock returns. Using a sample of 59 banks from the 12 countries in the MENA region between 2010 and 2021 and applying generalized quantile regression, we find the following. Our results suggest that ESG components and bank stock returns have a nonlinear relationship. In other words, the link between the ESG components and stock market returns could be U-shaped, inverted U-shaped, or both. Additionally, we find that size influences the link between the ESG pillars and bank stock returns. With few exceptions, large banks strengthened the positive link between ESG components and stock returns. Our findings align with the concept of “too little of a good thing” or “too much of a good thing” effects, along with the law of diminishing marginal returns.

Impact of mandatory IFRS adoption on economic growth: the moderating role of Covid-19 crisis in developing countries

Research Question: Does Covid-19 crisis moderate significantly the relationship between mandatory International Financial Reporting Standards (IFRS) adoption and economic growth in developing countries, especially in the MENA (Middle East and North Africa) region and SSA (Sub-Saharan Africa) countries? Motivation: Two sources of motivation are behind this study. First, research works on the impact of mandatory IFRS adoption on macroeconomic indicators such as economic growth are still scarce. Second, studying the impact of mandatory IFRS adoption on economic growth before and during the Covid-19 crisis allows to better understand this relationship in times of crisis. Idea: This article aims to investigate the moderating role of Covid-19 crisis in the relationship between mandatory IFRS adoption and economic growth in developing countries. Tools: The study was conducted based on panel data from 30 developing countries (15 MENA countries and 15 SSA countries) during the period 2017–2020. Collected data were analysed by using the Generalized Least Squares (EGLS/weighted cross-section) with fixed effect estimation technique. Findings: The main results of the study show that mandatory IFRS adoption has a positive impact on economic growth of the full sample, and that this positive impact is reduced during Covid-19 crisis. Contribution: The study results are very useful to policymakers and regulators in developing countries, especially in crisis periods.

Macro determinants of sustainable financial development in the Middle East and North Africa (MENA) region countries

PurposeThis research aims to examine the macro determinants that significantly affect financial development in the Middle East and North Africa (MENA) region, which could be used furtherly to play a major role in economic sustainability since one of the major driving forces for economic development is the financial development.Design/methodology/approachThe significant determinants of financial development should be efficiently used by the MENA region countries for creating huge financial sector development and innovation, stimulating economic development in turn and leading to the completion of the cycle of development and sustainability. To achieve this study's objective, the researcher employed a quantitative method to develop an econometric model.FindingsThis model consisted of two Panel EGLS Cross-Section Random Effects Models (REMs) in which Domestic credit to the private sector as a percentage of GDP (?PCGDP?_it) and stock market capitalization ratio (?SMC?_it) were taken as the dependent variables. In addition, the independent variables included the corruption perception index, financial freedom (FF), political stability (PS) and trade openness (TO). The researcher extracted the data for the analysis from different databases including the World Bank, the Organization for Economic Cooperation and Development and the International Monetary Fund. Throughout the first – Panel EGLS Cross-Section Random Effects Model, it turned out that, while FF, TO and corruption index had a positive relationship with ?PCGDP?_it, PS had an adverse effect on ?PCGDP?_it. The second – Panel EGLS Cross-Section Random Effects Model showed that, while PS and TO had a positive effect on stock market performance, the corruption index and FF had an adverse effect on stock market performance.Originality/valueThroughout the first – Panel EGLS Cross-Section Random Effects Model, it turned out that, while FF, TO and corruption index had a positive relationship with ?PCGDP?_it, PS had an adverse effect on ?PCGDP?_it. The second – Panel EGLS Cross-Section Random Effects Model showed that, while PS and TO had a positive effect on stock market performance, the corruption index and FF had an adverse effect on stock market performance.

The Impact of Financial Inclusion on Economic Development

The importance of an inclusive financial system is considered a priority all over the world. The importance of financial inclusion raised from the problem of financial exclusion were most of the Middle east and North Africa (MENA) region countries didn’t have enough formal financial services and most of the population didn’t have access to formal bank accounts. Financial inclusion not only helps individuals and families, but collectively it develops entire communities and can help drive economic development. The purpose of this study is to assess the effects of financial inclusion on economic development in the MENA region. The aim of this study is to investigate the impact of financial inclusion on the economic development of MENA region countries. To achieve this aim, a three-dimension Financial Inclusion Index (FII) was created using Principal Component Analysis (PCA) to measure each country’s level of financial inclusion. These dimensions are access, usage, and quality of financial services. Data was collected from 18 MENA region countries using a sample period from 2004-2019. Based on a 2-step Generalized Method of Moments (GMM) system, the results showed that an increase in the level of financial inclusion leads to the increase of MENA region countries’ economic development.

Critical appraisal of simulated patient methodology to assess the practice of community pharmacist in the Middle East and North Africa region: A systematic review.

The use of simulated patient (SP) methodology in pharmacy practice settings has increased recently. However, its applications can vary significantly within a region, hence affecting the quality of the SP methodology. The purpose of this systematic review is to critically assess the use of the SP methodology for assessing the practice of community pharmacists (CP) in the Middle East and North Africa (MENA) region. A comprehensive literature search was conducted using EMBASE, MEDLINE, ProQuest, and SCOPUS to identify articles published from 2011 to 2022. The selection of relevant studies for inclusion in the systematic review was based on the pre-determined inclusion criteria. The Mixed Method Appraisal Tool (MMAT) was used to assess the methodological quality of the included studies. Electronic search yielded 478 publications. A total of 45 studies were reviewed. The studies were conducted in 12 countries of the MENA region. The sample size between the reviewed articles ranged from 20 to 1000 (median= 129). A greater number of the included studies measured the adequacy of skill (pre-dispensing and/or post-dispensing) 38 (84.4%). The vast majority of the studies reported unsatisfactory results regarding the competencies of CP. The number of the SP ranged from 1 to 37 (median= 2). Most of the studies recruited only one SP per pharmacy 35 (77.8%). The most common data collection method was written data collection form 42 (93.3%). Few studies only had a detection system for SP visits 11 (24.4%), and only six studies incorporated performance feedback (13.3%). More than two-thirds of the studies provided a training session for SP 37 (82.2%). There was variation in the symptoms and drugs used in the SP scenarios in the studies. Although the results demonstrate the growth in the use of the SP method in MENA region countries, studies showed high variability in the level of reporting the study methodology. Consequently, we argue the need for standardized reporting of these studies.

The Drivers and Barriers of Corporate Social Responsibility: A Comparison of the MENA Region and Western Countries

(1) Although numerous articles have been published to address the drivers or barriers of corporate social responsibility (CSR), some parts of the world have received less attention. In this study, I reviewed the literature from 2010 to 2021 to identify drivers and barriers of CSR in the Middle East and North Africa (MENA) region and compare them with the findings in Western countries. (2) Methods: For this study, I used a structured literature review method. By setting the inclusion and exclusion criteria, only 28 articles remained from the selected database. (3) Results: The findings revealed that some CSR drivers, such as leadership styles, profitability, reputation, moral commitment, and environmental conservation, are common in both regions. There are also some differences between CSR drivers, for example, religious beliefs, low concentration of ownership, and company characteristics are some of the drivers in the MENA region. Maintaining social license to operate, and avoiding the risks of community opposition, pressure from the government, and consumer demand tend to be more important in Western countries. Common barriers in both regions are lack of financial resources, cost, lack of CSR knowledge and awareness, and ownership concentration. This review also highlighted that lack of law enforcement, lack of stakeholder communication, lack of management commitment, lack of interests, corruption, and financial debts are some of the barriers of CSR addressed in the MENA region, whereas cost/benefit ratio, lack of customer interest, and lack of scientific frameworks are special barriers in Western countries. (4) Conclusions: Although researchers in Western countries have more focus on the energy sector, there is a lack of research about the drivers and barriers of CSR in the MENA region in several industries, including oil and gas.

Korea’s official development aid to MENA region countries

The aim of this study is to increase the effectiveness of Korean aid provision for countries in the Middle East and North Africa (MENA) region, which are important ODA recipient countries from a Korean perspective, but have not been studied extensively in Korea. Although there are twenty countries in the MENA region, in this study five countries, Egypt, Algeria, Libya, Iran and Iraq, which are considered important from a Korean perspective, are targeted. The analysis includes an examination of the regional characteristics and the long-term development plans of these five countries, and the size and contents of aid projects provided by Korea to these countries. It is expected that as a result of this analysis Korea will be able to carry out aid projects involving these countries more effectively in the future.

Home-Based urban commute and Non-Commute trip generation in Less-Studied Contexts: Evidence from Cairo, Istanbul, and Tehran

The determinants of travel demand, i.e., commute and non-commute trip generation, in the Middle East and North Africa (MENA) region are unknown, while the main factors behind travel generation in high-income countries have been studied since the 1990 s. This paper aims at shedding light on these determinants and comparing them in Cairo, Istanbul, and Tehran as case-study cities. Three research questions were answered by this paper: (1) are there any significant differences between urban travel generation levels of the three cities? (2) which factors determine urban travel generation, including commute trips and non-work activities in the large agglomerations of the MENA region? and (3) how similar or different are these determinants in the three mentioned cities? The analysis was based on a mobility survey undertaken in 2017 in 18 neighborhoods of the three cities. The data resulted from 8284 face-to-face interviews (Cairo: 2786, Istanbul: 2781, Tehran: 2717). Weighted Least Squares models showed that 19 and 18 variables related to individual and household status, socioeconomics, attitudes, the built environment, and accessibility define commute and non-commute trip generation, respectively. The results of Analysis of Variance indicate that these determinants are almost similar in a holistic view, but there are some relative differences between them in the three cities. This study addresses the contextual differences between the determinants in the MENA region and high-income countries and concludes that travel demand is context sensitive. The findings specially show how street network configuration and neighborhood-level facilities can be a tool for urban planners to control mobility demand. Highly connected street networks with adequate neighborhood amenities are associated with the frequency of commute and non-commute trips in the case cities, thus planners and decisionmakers in the MENA region are encouraged to use land use and street connectivity to gain control on trip generation for attaining a more sustainable travel modal share.

Prosperity, Gender Equality and Economic Development in the MENA Region

In this study, the effects of macroeconomic fundamentals, prosperity, and gender equality factors on economic development are examined in 18 Middle East and North Africa (MENA) countries. Even though the MENA region countries have gone through advancements in the average wealth and prosperity levels in recent years, these positive changes have not been sufficient to prevent the region to fall behind other world regions in the rankings of development and economic growth. A panel data analysis is carried out for the time duration 2009 and 2019. This period coincides with both before and after the Arab Spring period. A wide spectrum of indicators is used to understand how different aspects of prosperity and gender equality can affect growth in the MENA region. In this way, a collective and comprehensive approach is adopted in the empirical analysis. One of the dependent variables, the productive capacity is calculated as a compound indicator which accounts for resource rents, GDP and working-age population. Two composite indicators, economic environment and institutions are used in the main estimations. Market access and infrastructure, investment environment, enterprise conditions, and economic quality are integrated to generate the variable economic environment. Governance, safety and security, and personal freedom are compounded to create the variable institutions. Later, these two composite indicators’ components are controlled individually in the estimations in order to carry out a robustness check analysis. It is found that female labor force participation, foreign direct investment, social capital, natural resource rents, education, a better economic environment, and improvements in safety-security can positively affect economic growth, total factor productivity and productive capacity. On the other hand, the overall quality of institutions and proportion of women representatives in national parliaments do not seem to significantly impact economic development in these MENA countries.

Working capital and financial performance in MENA region

PurposeThis paper aims to investigate the possible non-linear effect of net working capital (NWC) level on profitability for Middle East and North Africa (MENA) region listed companies. Furthermore, the study tests the possible interactive effect of cash levels on the relationship between NWC and profitability.Design/methodology/approachNWC level is the independent variable and profitability is the dependent variable using two proxies, return on assets (ROA) and returns on equity (ROE). Control variables are size, leverage, gross domestic product growth and sales revenue growth. The generalized method of moments was used to analyze the data of 134 consumer-goods listed firms in 12 MENA countries for the period 2013–2019.FindingsThe results demonstrate that NWC levels had a non-linear effect on profitability using ROA as a profitability proxy while results were insignificant using ROE as a profitability proxy. Furthermore, results show the absence of interactive effects between NWC, cash levels and both profitability proxies.Originality/valueThe study fills a gap in the working capital management (WCM) literature by providing new evidence on WCM’s non-linear effect of corporate performance in the MENA region emerging markets using the consumer-goods industry sample. The study contributes to the financial managers’ working capital optimization efforts in the MENA region by providing evidence on the usefulness of WC optimization efforts in the region from a financial performance point of view. According to the researchers’ knowledge, a few studies attempted to investigate this non-linear relationship for neither MENA region countries nor the consumer-goods industry.

Using Dynamic Panel Data Modeling to Study Net FDI Inflows in MENA Countries

Foreign direct investment (FDI) plays a critical role in providing financial capital needs, technology transfer, and creating more jobs in the host country. It also helps economies to increase competitiveness and productivity, thereby increasing exports and enhancing opportunities for growth and development. Middle East and North Africa (MENA) countries are in desperate need of more FDI inflows to resolve their economic problems. This paper investigates the determinants of net FDI inflows to 23 countries in MENA region during the period from 1995 to 2017 by using static and dynamic panel data analysis. The results indicate that macro determinants, such as gross domestic product (GDP) growth rate, openness, the inflation rate, and public expenditure have a significant impact on net FDI inflows. In addition, we observe that rents from natural resource (oil), exchange rate, and total reserves of foreign exchange and monetary gold do not significantly influence FDI.

The International Financial Reporting Standards and Firm Performance: A Systematic Review

This study reviews the accounting literature which investigates the effects of International Financial Reporting Standards (IFRS) on firms’ financial performance to answer a debating question of how effective are the accounting standards in affecting financial performance and to provide guidance for future studies. The focus of the review is three primary streams, first, reasons and evidence of differences between countries in accounting practices; second, theories justifying the transition from local Generally Accepted Accounting Principles (GAAP) to IFRS; Third, the effect of accounting standards on firms’ financial performance regarding three broad groups: (1) Common law countries (2) Civil law countries, and (3) Middle East and North Africa (MENA) region countries affected by both sharia law and civil law. The review demonstrates that the transition from local GAAP to IFRS has been successful in affecting firms’ financial performance measures in less shareholder-oriented civil law and MENA region countries. This was attributed to the IFRS fair value orientation, which causes volatility in the statement of financial position and financial performance figures. These impacts, however, usually vary between countries, depending on the pre-transition differences between local GAAP and IFRS. The more the difference, the more volatile the financial performance measures, particularly the profitability ratios. This review’s findings have implications for other jurisdictions, particularly developing countries, where IFRS adoption is already underway. In addition, managers, investors, practitioners, and standard setters can use this review to identify the factors that have been found to influence firm performance, especially in a globalized economy that is increasingly cross-listed.

The Profile of Non-Communicable Disease (NCD) research in the Middle East and North Africa (MENA) region: Analyzing the NCD burden, research outputs and international research collaboration.

ObjectivesDespite the rising risk factor exposure and non-communicable disease (NCD) mortality across the Middle East and the North African (MENA) region, public health policy responses have been slow and appear discordant with the social, economic and political circumstances in each country. Good health policy and outcomes are intimately linked to a research-active culture, particularly in NCD. In this study we present the results of a comprehensive analysis of NCD research with particular a focus on cancer, diabetes and cardiovascular disease in 10 key countries that represent a spectrum across MENA between 1991 and 2018.MethodsThe study uses a well validated bibliometric approach to undertake a quantitative analysis of research output in the ten leading countries in biomedical research in the MENA region on the basis of articles and reviews in the Web of Science database. We used filters for each of the three NCDs and biomedical research to identify relevant papers in the WoS. The countries selected for the analyses were based on the volume of research outputs during the period of analysis and stability, included Egypt, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Turkey and the United Arab Emirates.ResultsA total of 495,108 biomedical papers were found in 12,341 journals for the ten MENA countries (here we consider Turkey in the context of MENA). For all three NCDs, Turkey's output is consistently the highest. Iran has had considerable growth in research output to occupy second place across all three NCDs. It appears that, relative to their wealth (measured by GDP), some MENA countries, particularly Oman, Qatar, Kuwait and the United Arab Emirates, are substantially under-investing in biomedical research. In terms of investment on particular NCDs, we note the relatively greater commitment on cancer research compared with diabetes or cardiovascular disease in most MENA countries, despite cardiovascular disease causing the greatest health-related burden. When considering the citation impact of research outputs, there have been marked rises in citation scores in Qatar, Lebanon, United Arab Emirates and Oman. However, Turkey, which has the largest biomedical research output in the Middle East has the lowest citation scores overall. The level of intra-regional collaboration in NCD research is highly variable. Saudi Arabia and Egypt are the dominant research collaborators across the MENA region. However, Turkey and Iran, which are amongst the leading research-active countries in the area, show little evidence of collaboration. With respect to international collaboration, the United States and United Kingdom are the dominant research partners across the region followed by Germany and France.ConclusionThe increase in research activity in NCDs across the MENA region countries during the time period of analysis may signal both an increasing focus on NCDs which reflects general global trends, and greater investment in research in some countries. However, there are several risks to the sustainability of these improvements that have been identified in particular countries within the region. For example, a lack of suitably trained researchers, low political commitment and poor financial support, and minimal international collaboration which is essential for wider global impact.

Waste to energy potential in middle income countries of MENA region based on multi-scenario analysis for Kafr El-Sheikh Governorate, Egypt

The environmental risks of traditional waste disposal methods, together with the resource and energy value of waste, had established the foundation for waste-to-energy (WTE) technologies. WTE is rarely implemented in developing countries, mostly due to the lack of knowledge and experience under their specific local conditions. The present research investigates the feasibility of WTE strategies in middle income developing countries of the Middle East and North Africa (MENA) region. Multiple waste management scenarios, involving incineration and anaerobic digestion, were evaluated based on energy, economic, and environmental parameters. A multi-criteria assessment was conducted for the Governorate of Kafr El-Sheikh (Egypt); a 3.2-million rural-urban agro-industrial population with socio-economic and demographic features similar to those of the selected MENA countries. The actual waste generation rates and characteristics of Kafr El-Sheikh were measured through a comprehensive field study. It was found that anaerobic digestion with recycling is the optimum strategy for Kafr El-Sheikh, with annual energy potential of 1170-kWh per ton of waste and net economic savings of 6.5 million USD. This optimum waste management scenario was extended to the selected MENA countries to investigate potential benefits of shifting to WTE-based waste management strategies. The total annual energy production was estimated to be 103,000-GWh, which translates to 17% of the total energy consumption. Moreover, greenhouse gas emissions were reduced by around 98,500-Gg CO2 annually, which represents around 6.5% of the total annual CO2 footprint generated by the selected countries. Furthermore, the overall economic benefits ranged between −12 and 200 million USD for the selected countries.

Can the Youth Bulge Pose a Challenge for Turkey? A Comparative Analysis Based on MENA Region-Driven Factors

One common characteristic of Middle East and North Africa (MENA) countries that have experienced internal conflicts in recent decades is their large youth cohorts, known as the youth bulge. As Turkey also has a youthful population, it raises the question of whether this will represent a threat rather than an opportunity for the society. This study investigates this question by identifying the major factors that can transform a youth bulge into a threat and analyses them comparatively for the specific case of Turkish youth. A novel set of factors is proposed that can be also used by further studies. The discussion related to these factors is organized under four major situations, namely (a) economic situation, (b) educational situation, (c) political situation and (d) cultural situation. The study concludes that while Turkey differs from most of the MENA region countries in terms of these structural factors, it tends to lag behind the average international standards, which leave young people in Turkey in a limbo between becoming an opportunity for the future of society or a challenge.

Institutional Discontinuity and Business Creation in MENA Region countries

What happens to entrepreneurship and attitudes towards entrepreneurship when institutions change due to conflict (e.g. revolutions, uprisings, wars, etc.)? We explore this question by investigating how recent institutional changes related to the Arab Spring revolutions influence decisions to start a business in Algeria, Tunisia, and Egypt. The Arab Spring Revolutions created a change in the political and economic fabric in the Middle East and North Africa (MENA) region. Thus, the choice of these countries is primarily based on the recent political and economic changes that have taken place since the revolutions started in 2010. We utilize the Global Entrepreneurship Monitor (GEM) Adult Population Survey (APS) data for the following years 5 years: 2008, 2009, 2010, 2011 and 2012. Using multinomial logistic regressions, we measure the relationship between being an entrepreneur and personal characteristics of individuals in the sample post change associated with the Arab Spring. Keywords: GEM; Institutional Discontinuity/Change; Arab Spring; Personal Characteristics

Long-run analysis of Environmental Kuznets Curve in the Middle East and North Africa

The main originality of this paper is to empirically investigate the long-run relationship between carbone dioxide (CO2) emissions, energy use and real GDP per capita in the Middle East and North Africa (MENA) during the last three decades. Using panel cointegration tests (Westerlund, (2007) and DOLS estimation method, we validate the Environmental Kuznets Curve (EKC) hypothesis in the long run for the MENA region countries. Therefore, we conclude that oil producer countries have adopted several policy decisions in favor of CO2 emissions reduction. The estimated turning point of the EKC confirms our intuitions that only oil producer countries achieve CO2 emissions reduction goal.

A meta-frontier assessment of bank efficiency in Middle East and North Africa countries

PurposeThe purpose of this paper is to evaluate and compare the efficiency ratios and the technological gaps of banking industries in seven countries of the Middle East and North Africa (MENA) region.Design/methodology/approachThe meta-frontier model was used to evaluate efficiency across countries that may have different production technologies.FindingsThe results of the meta-frontier analysis of banking systems over the period from 1991 to 2011 showed that Tunisian banks were the most efficient in terms of cost and profit. For the cost (profit) model, the analysis of the technological gap showed that Egyptian (Tunisian) banks used the most advanced technology in offering financial services to clients. The comparison of efficiencies confirmed that most efficient banks in terms of cost are not necessarily the most efficient in terms of profit and vice versa. The authors also concluded that cost efficiency analysis provides a partial view of banking efficiency and hence, profit efficiency analysis is as important.Originality/valueThe study is relevant for policymakers, regulators and monetary authorities and for researchers to know more about the real differences of efficiency of banks across countries in MENA region and to clarify the sources of this inefficiency to better adapt to the new environment, to make strategic decisions and to reference the performance of banking institutions.

Linking Environmental Water Scarcity and Options for Adaptation in the MENA Region

Contamination of surface and underground water by sea level rise, surface runoff, and land use activities such as industrial and agricultural activities can lead to water scarcity. Water could be available and accessible but not suitable for human use. In the Middle East and North Africa (MENA) region countries, the agriculture sector depends massively on water for farming activities, which consumes about 80% of the available water resources. In this context, the issue of environmental water scarcity is under highlighted, though the use of this term itself is still lacking in an international context (FAO). Meanwhile, the international goal of universal access to clean freshwater is included in global development targets (SDGs). This study provides some insights and deepens our understanding on environmental water scarcity, particularly MEN-A region countries. This review paper begins with an introduction to water scarcity and continues with a discussion of environmental issues associated with water scarcity in MENA region countries. Finally, we suggest some adaptive measures in two distinct areas such as agriculture sectors and policy makers and conclude that the lack of implementation of this particular term is hindering sustainable development in MENA region countries.

Early initiation of antiretroviral treatment: Challenges in the Middle East and North Africa.

New World Health Organization guidelines recommend the initiation of antiretroviral treatment (ART) for asymptomatic patients with CD4+ T-cell counts of ≤ 500 cells/mm(3). Substantial reduction of human immunodeficiency virus (HIV) transmission is addressed as a major public health outcome of this new approach. Middle East and North Africa (MENA), known as the area of controversies in terms of availability of comprehensive data, has shown concentrated epidemics among most of it's at risk population groups. Serious challenges impede the applicability of new guidelines in the MENA Region. Insufficient resources restrict ART coverage to less than 14%, while only one fourth of the countries had reportable data on patients' CD4 counts at the time of diagnosis. Clinical guidelines need to be significantly modified to reach practical utility, and surveillance systems have not yet been developed in many countries of MENA. Based on available evidence in several countries people who inject drugs and men who have sex with men are increasingly vulnerable to HIV and viral hepatitis, while their sexual partners - either female sex workers or women in monogamous relationships with high-risk men - are potential bridging populations that are not appropriately addressed by regional programs. Research to monitor the response to ART among the mentioned groups are seriously lacking, while drug resistant HIV strains and limited information on adherence patterns to treatment regimens require urgent recognition by health policymakers. Commitment to defined goals in the fight against HIV, development of innovative methods to improve registration and reporting systems, monitoring and evaluation of current programs followed by cost-effective modifications are proposed as effective steps to be acknowledged by National AIDS Programs of the countries of MENA Region.