A close look at the healthcare scenario in the Middle East would invariably indicate that the dice is heavily loaded against the region.And, facts speak for themselves.Nearly 60% of the adult population is obese, with cases of diabetes fast picking up momentum amongst the younger generation.According to the International Diabetes Foundation (IDF), in the United Arab Emirates (UAE) and Kuwait 38% of the population in the age group of 20-39 years is diabetic in some form or the other. Infact, given the dietary habits of residents in the region – liberal doses of fat and sugar, thanks to the growing volume of petro-dollars – coupled with the lack of exercise, IDF has recently labelled the scenario as “out of control”.”With temperature averaging 40 degrees Celsius [104 degrees Fahrenheit] over six months in a year, obesity, diabetes and lack of exercise are all in a way linked to the geo-physical parameters of the region,” commented Raouf Ghali, president of project management group for New Jersey-based Hill International. “Economic well-being, coupled with a tolerant tax system encourages car ownership; indeed, over 90% of the residents drive cars. Without a developed public transport system, walking as in Europe and the US is not common practice. Thus, there is not much physical activity, on a daily basis, and if an individual does not actively pursue to ‘move’, one can find himself practically motionless and that is inducing health issues in the young population.”Added to it, is yet another factor and probably more lethal: the low price of tobacco products in the Middle East that has helped in high smoking levels.”Cigarettes are still nearly 35-45% cheap compared with the US and Europe and lots of offices still allow smoking,” he hastened to add.Besides weather, dietary habits and tobacco, there are two other issues – rising cases of non-communicable diseases (NCD) and deaths due to traffic incidents that further add to the woes.According to a Persian Gulf-based industry executive: “In the past few years, there has been a major transition from infectious diseases to NCDs and this is mostly related to individual behaviors, such as what people eat and drink and how they spend their time.”(NCDs are non-infectious and include cancer, diabetes, cardio-vascular disease and obesity).World Health Organization (WHO) has recently predicted that 47% of the disease burden of the Middle East is caused by NCDs and by 2020 it will rise to 60%.It also stated that Saudi Arabia has the world’s highest number of deaths from road accidents, which currently makes up for the country’s principal cause of death in adult males aged 16 to 36. A study revealed that 6,485 people had died and more than 36,000 were injured in over 485,000 traffic accidents in 2008 and 2009.It is not all gloom and doom, however.Spending on healthcare across the region is set to increase. According to independent estimates some US$26 billion-30 billion is targeted for investment by end 2011. And, looking ahead WHO has projected that figure will rise to US$60 billion by 2025.Leading the pack will be Saudi Arabia, which is making the biggest commitment with a healthcare spend of 3.7% of its gross domestic product (GDP). This compares to 2.5% in Kuwait, 1.9% in Qatar and 0.3% in the UAE. Comparative to the developed countries of Europe, Asia and North America, these figures are low. Health expenditure is 15.3% of GDP in the US, 10.4% in Germany and 7.9% in Japan.While laws are being enacted to discourage smoking, some of the governments in the Gulf are also updating their existing public health legislations.Cases in point are Bahrain and the UAE that have banned smoking in restaurants, hospitals, schools and universities, while in Jordan similar orders have been issued for all government offices and public institution.Meanwhile, in late February Hill International announced it had received a contract expansion from SEHA Abu Dhabi Health Services Company to provide project management services during construction of multiple healthcare facilities located in Abu Dhabi and Al Ain in the UAE.The heathcare facilities include Al Wagan Hospital and the Al Mushreef, Khalifa B, Al Falah and Al Towaya Ambulatory Healthcare Centres. The five projects have an estimated total construction cost of US$73 million.