How falling cases of tuberculosis in Iraq reflect a wider health system recovery

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Equipped with new, cutting-edge tools and technologies, health care providers in Iraq can reach more people across the country to test for, treat and prevent the disease. (Photo: Global Fund/Ashley Gilbertson)
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Chest X-ray of human chest or lung to detect tuberculosis. (Getty Images)
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Updated 17 April 2025
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How falling cases of tuberculosis in Iraq reflect a wider health system recovery

  • Iraq has halved its tuberculosis rate over the past decade through tech-driven diagnosis and expanded mobile health services
  • AI-supported X-rays and GeneXpert machines now detect TB faster, even in remote areas and among high-risk populations

DUBAI: Sameer Abbas Mohamed, a Syrian refugee from Qamishli who fled to Iraq in 2013, was terrified when his one-year-old son, Yusuf, was diagnosed with tuberculosis. He knew the disease was life-threatening — and highly contagious.

“I have two older boys, and I was scared they would catch the disease,” said Mohamed, who lives in Qushtapa refugee camp for Syrians in Irbil, home to most of the 300,000 Syrian refugees in the Kurdistan Region of Iraq.

“Yusuf was also very young and I worried about losing him.”




IOM mobile medical teams conduct TB awareness sessions and screening of presumptive cases in settlements hosting displaced and Syrian refugees as well as other hard to reach areas. (Photo: IOM/Raber Y. Aziz)

Mohamed consulted several doctors when Yusuf began coughing. Scans revealed a mass on the right anterior wall of his chest. A diagnosis was finally made when a general surgeon reported the case to Iraq’s National TB Program.

Following surgery to remove the mass, Yusuf returned home, where nurses delivered an all-oral regimen, monitored his treatment, tracked his progress, offered support, and educated the family on isolation measures to prevent the disease’s spread.

Within six months, Yusuf was cured.




An IOM medic checks a little girl at the family's rented house in Kirkuk. (Photo: Anjam Rasool/IOM Iraq, 2019)

His journey reflects the progress made in combating TB in Iraq, especially the drug-resistant variant that has emerged in the conflict-affected country — which until recently had the region’s highest prevalence of TB cases.

Iraq’s NTP, supported by the International Organization for Migration, the Global Fund, and the World Health Organization, is tracking TB among displaced communities using advanced diagnostic technologies and artificial intelligence.

Giorgi Gigauri, IOM Iraq’s chief of mission, told Arab News that TB detection and timely treatment have helped to drive a significant decline in cases in Iraq.




Lab technicians at the Chest and Respiratory Diseases in Erbil use blood samples to test TB patients' tolerance for medication. (Photo: Global Fund/Ashley Gilbertson)

This was achieved, he said, through a tech-driven strategy, including the installation of the advanced 10-color GeneXpert detection machine across Baghdad, Basrah, Najaf and Nineveh, enabling faster diagnoses.

IOM’s mobile medical teams were also equipped with 10 AI-supported chest X-ray devices, known as CAD4-TB, which can detect the disease in seconds — even in high-burden areas such as refugee camps and prisons.




Chest X-ray of human chest or lung to detect tuberculosis. (Getty Images)

Routine screenings by these mobile units helped to increase the detection rate of drug-resistant TB from 2 percent to 19 percent, and drug-sensitive TB from 4 percent to 14 percent between 2019 and 2024, according to IOM data.

FAST FACTS

• TB is caused by the Mycobacterium tuberculosis bacterium that primarily affects the lungs.

• It spreads through airborne droplets when an infected person coughs or sneezes.

• Symptoms include a persistent cough, chest pain, fever, night sweats and weight loss.

• With proper treatment using antibiotics, TB is curable, though drug-resistant strains exist.

After screening, sputum samples are taken to central labs, making testing accessible for those unable to travel or living in areas with limited health care access.

Thanks to these efforts, TB cases in Iraq have fallen dramatically — from 45 to 23 cases per 100,000 people between 2013 and 2023. The current prevalence is 15 per 100,000, with an estimated mortality rate of three per 100,000.




Hussain Khader Ismael is screened for TB inside a mobile lab parked outside a home for elderly people in Mosul. (Photo: Global Fund/Ashley Gilbertson)

In many ways, these numbers reflect Iraq’s wider public health recovery after decades of instability, including the crippling sanctions of the 1990s, the successive bouts of violence that followed the 2003 US-led invasion, and the 2014 rise of Daesh.

“Despite years of instability, progress made in the detection, treatment and prevention of the spread of TB restored trust in health care services by strengthening infrastructure and extending care to vulnerable groups like prisoners and displaced populations,” Gigauri told Arab News.

“It also supports upskilling of health professions and creates sustainable systems that can support responses to other communicable diseases.




Abdi was transported to a TB center for urgent examination as soon as he showed symptoms of TB. (Photo: IOM/Raber Y. Aziz)

“Efforts made by all partners under NTP have contributed to national recovery by addressing urgent health needs and laying a foundation for timely detection of preventable and treatable diseases.”

Despite a period of relative stability, Iraq still faces considerable humanitarian pressures amid a fragile economy and an unpredictable security landscape. According to UNHCR, more than 1 million Iraqis remain internally displaced, with 115,000 living in 21 camps across the Kurdistan Region.

Roughly five million displaced people have returned to their towns and villages since Daesh’s territorial defeat in 2017. But these areas often lack basic infrastructure, increasing the risk of TB outbreaks.




Qayara Airstrip Camp, south of Mosul, was built by IOM as an emergency site to host displaced persons from Mosul. (Photo: Raber Y. Aziz/IOM Iraq, 2016) 

In Mosul — Iraq’s second-largest city, which endured three years under Daesh — those unable to afford housing live in overcrowded settlements, where malnutrition and exposure to the elements weaken immunity.

The mobile medical teams have been a game-changer for these vulnerable communities.

Digital X-rays equipped with CAD4-TB, powered by AI, now enable quick and accurate TB detection — a stark improvement from the three-month wait many patients once faced for CT scans.




The CAD4TB system uses AI to instantly analyze digital X-rays for signs of TB. (Photo: Global Fund/Ashley Gilbertson)

This technology also reduces radiation exposure. A single CT scan can expose patients to the equivalent of 300 X-rays, according to Dr. Bashar Hashim Abbas, manager of the Chest and Respiratory Diseases clinic in Mosul.

Abbas said that mobile medical teams and digital X-ray devices have been vital for reaching remote communities and detainees who lack clinic access.

“The mobility of these machines helped us examine prisoners who were difficult to bring into the clinic due to complex security protocols. We discovered many cases, especially multidrug-resistant TB patients, in this way,” Abbas told Arab News.

“We conduct X-rays and take sputum samples for further lab investigations. Therefore, we take the diagnostic tools to them as much as we can, scaling up TB prevention and providing treatment.”




IOM maintains seven Mobile Medical Teams in five crisis-affected governorates with high numbers of IDPs, returnees and vulnerable host community members. (Photo: Global Fund/Ashley Gilbertson)

A centralized disease surveillance system, District Health Information Software 2, allows lab results to be registered and coordinated across labs, facilities, and the Iraqi Ministry of Health, improving routine TB reporting.

IOM’s TB services reached 6,398 people in 2024, with 120 drug-resistant TB cases treated. These efforts have been bolstered by $11 million in Global Fund support since 2022.

A key breakthrough has been shifting the treatment of multidrug-resistant TB from a burdensome series of injections to a simpler, all-oral regimen, which shortened recovery time from two years to six months and significantly improved outcomes.




An all-oral regimen has shortened recovery time from two years to six months and significantly improved outcomes.. (Photo: IOM/Raber Y. Aziz)

“Previously, treatments involved daily injections for at least six to eight months, which were difficult to sustain for patients and treatment outcomes were relatively poor at 50 percent,” Grania Brigden, senior TB adviser at the Global Fund, told Arab News.

“However, the innovation in treatment through the all-oral regimen has reduced treatment to six months with a 75 percent to 80 percent success rate.”

Although no new TB vaccines are currently available, researchers are optimistic about developing more effective ones in the next five years. The existing BCG vaccine offers only partial protection and is less effective for adults and adolescents, who are more prone to transmission.




The innovation in treatment through the all-oral regimen has reduced treatment to six months with a 75 percent to 80 percent success rate. (Photo: Global Fund/Ashley Gilbertson)

New vaccines are vital for achieving the WHO’s End TB Strategy goals — reducing TB mortality by 95 percent and incidence by 90 percent by 2035. Brigden said ongoing investment is key to meeting these targets.

Meanwhile, the Global Fund is focused on halting TB’s spread in Iraq. “We have invested significantly in commodity security to ensure that everyone who tests positive or is notified of TB is put on treatment,” said Brigden.

Thanks to these steps, many — like young Yusuf — are alive today who might otherwise have succumbed without proper care.




WHO and partners join WHO mission to the Iraqi National TB institute in Baghdad. (Photo: WHO) 

“The discussions of tuberculosis we had with the nurse who gave the medication had a positive impact on us,” said Yusuf’s father, Mohamed.

“The nurse gave us information on how to isolate him after the first two to three weeks. He reassured us that if we gave him the medication regularly and made sure there were no gaps, everything would be getting well.

“This made us less scared.”
 

 


Israeli strikes across Gaza overnight kill at least 103 people, hospitals and medics say

Updated 32 min 51 sec ago
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Israeli strikes across Gaza overnight kill at least 103 people, hospitals and medics say

  • Israel has intensified its war in the territory that, after more than 19 months, shows no signs of abating
  • ore than 48 people were killed in airstrikes in and around the southern city of Khan Younis

DEIR AL-BALAH, Gaza Strip (AP) — Israeli strikes across the Gaza Strip killed at least 103 people overnight and into Sunday, hospitals and medics in the battered enclave said, as Israel intensifies its war in the territory that, after more than 19 months, shows no signs of abating.
More than 48 people were killed in airstrikes in and around the southern city of Khan Younis, some of which hit houses and tents sheltering displaced people, according to Nasser Hospital. Among the dead were 18 children and 13 women, hospital spokesperson Weam Fares said.
In northern Gaza, a strike on a home in the built-up Jabaliya refugee camp killed nine people from a single family, according to the Gaza health ministry's emergency services. Another strike on a family's residence, also in Jabaliya, killed 10, including seven children and a woman, according to the civil defense, which operates under the Hamas-run government.
The Israeli military had no immediate comment on the overnight strikes. Israel blames civilian casualties from its operations on Hamas because the militant group operates from civilian areas.
The bloodshed comes as Israel ramps up its war in Gaza with a new offensive named “Gideon's Chariots,” in which Israel says it plans to seize territory, displace hundreds of thousands of Palestinians to Gaza's south and take greater control over the distribution of aid.

Gaza health ministry says all public hospitals in north ‘out of service’

The health ministry in Hamas-run Gaza said Sunday that all public hospitals in the north of the territory were now “out of service” after Israeli forces besieged the Indonesian hospital.
“The Israeli occupation has intensified its siege with heavy fire around the Indonesian hospital and its surroundings, preventing the arrival of patients, medical staff, and supplies — effectively forcing the hospital out of service,” the ministry said.
“All public hospitals in the North Gaza governorate are now out of service,” it added.

Israel's new offensive
Israel says the new plan is meant to ramp up pressure on the militant Hamas group to agree to a temporary ceasefire on Israel's terms — one that would free Israeli hostages held in Gaza but wouldn't necessarily end the war. Hamas says it wants a full withdrawal of Israeli forces from Gaza and a pathway to ending the war as part of any new ceasefire deal.
Israel had said it would wait until the end of US President Donald Trump's visit to the region before launching its new offensive, saying it was giving a chance for efforts to bring about a new ceasefire deal. And while teams are still negotiating a potential truce in the Qatari capital Doha, there appears to have been no breakthrough. Trump did not visit Israel on his trip, which wrapped up on Friday.
Israel shattered a previous 8-week ceasefire in mid-March, launching fierce airstrike that killed hundreds. Days before the end of that ceasefire, Israel also halted all imports into Gaza, including food, medicine and fuel, deepening a humanitarian crisis and sparking warnings of an increasing risk of famine in the territory — a blockade that continues.
Israel says that move is also meant to pressure Hamas.
The war in Gaza began on Oct. 7, 2023, when Hamas-led militants attacked southern Israel, killing 1,200 people and abducting 251 others. Israel’s retaliatory offensive has killed more than 53,000 Palestinians, many of them women and children, according to Gaza’s Health Ministry, which doesn’t differentiate between civilians and combatants.
 

Strikes pound Gaza
In northern Gaza, parts of which have been flattened by Israel's onslaught, at least 43 people were killed in multiple strikes, according to first responders from the health ministry and the civil defense. Gaza City's Shifa Hospital said among the dead, 15 were children and 12 were women.
In Jabaliya, a built-up refugee camp in northern Gaza, 10 people, including seven children and a woman were killed, according to the civil defense, which operates under the Hamas-run government. Among the dead were two parents and their three children and a father and his four children, it said.
In central Gaza, at least 12 people were killed in three separate strikes, hospitals said. One strike in the Zweida town killed seven people, including two children and four women, according to according to the Al-Aqsa Martyrs hospital in the town of Deir al-Balah. The second hit an apartment in Deir al-Balah, killing two parents and their child, the hospital said. In Nuseirat camp, a strike hit a house and killed two people, said the camp’s Awda hospital,
Nasser Hospital said it struggled to count the dead because of the condition the bodies were brought in.


Morocco unveils policies it hopes bolster the care and management of stray dogs

Updated 18 May 2025
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Morocco unveils policies it hopes bolster the care and management of stray dogs

EL AARJATE: A mutt with a blue tag clipped to her ear whimpers as she’s lifted from a cage and carried to a surgery table for a spay and a rabies vaccine, two critical steps before she’s released back onto the streets of Morocco’s capital.
The “Beldi,” as Moroccan street dogs are called, is among the hundreds taken from Rabat to a dog pound in a nearby forest. As part of an expanded “Trap, Neuter, Vaccinate and Return” program, dogs like her are examined, treated and ultimately released with tags that make clear they pose no danger.
“We have a problem: That’s stray dogs. So we have to solve it, but in a way that respects animals,” said Mohamed Roudani, the director of the Public Health and Green Spaces Department in Morocco’s Interior Ministry.
Trying to balance safety and animal well-being
Morocco adopted “Trap, Neuter, Vaccinate and Return,” or TVNR, in 2019. One facility has opened in Rabat and more are set to be launched in at least 14 other cities, aligning Morocco with recommendations from the World Organization for Animal Health. The government has spent roughly $23 million over the past five years on animal control centers and programs.
Roudani said Morocco’s updated approach balanced public safety, health and animal well-being. Local officials, he added, were eager to expand TVNR centers throughout the country.
Though population estimates are challenging, based on samples of marked and tagged stray dogs, Moroccan officials believe they number between 1.2 to 1.5 million. Some neighborhoods welcome and care for them collectively. However, others decry their presence as a scourge and note that more than 100,000 Moroccans have needed rabies vaccinations after attacks.
A draft law is in the works that would require owners to vaccinate pets and impose penalties for animal abuse.
Inside the center
On a visit organized for journalists to a TNVR center in El Aarjate, enclosures for dogs appear spacious and orderly, with clean floors and the scent of disinfectant. Food and water bowls are refreshed regularly by staff who move between spaces, offering gentle words and careful handling. Some staff members say they grow so attached to the dogs that they miss them when they’re released to make space to treat incoming strays.
Veterinarians and doctors working for the Association for the Protection of Animals and Nature care for between 400 and 500 stray dogs from Rabat and surrounding cities. Dogs that veterinarians deem unhealthy or aggressive are euthanized using sodium pentobarbital, while the rest are released, unable to spread disease or reproduce.
Youssef Lhor, a doctor and veterinarian, said that aggressive methods to cull dogs didn’t effectively make communities safer from rabies or aggression. He said it made more sense to to try to have people coexist with dogs safely, noting that more than 200 had been released after treatment from the Rabat-area center.
“Slaughtering dogs leads to nothing. This TNVR strategy is not a miracle solution, but it is an element that will add to everything else we’re doing,” he said, referring to “Treat, Neuter, Vaccinate, Return.”
It’s designed to gradually reduce the stray dog population while minimizing the need for euthanasia.
It’s a program that Morocco is eager to showcase after animal rights groups accused it of ramping up efforts to cull street dogs after being named co-host of the 2030 FIFA World Cup last year.
Animal rights groups protest
Animal rights groups routinely use large sporting events to draw attention to their cause and similarly targeted Russia in the lead-up to the 2018 FIFA World Cup there.
Citing unnamed sources and videos it said were shot in Morocco, the International Animal Welfare and Protection Coalition claimed in January that Morocco was exterminating 3 million dogs, particularly around cities where stadiums are being built. The allegations, reported widely by international media lacking a presence in Morocco, triggered anti-FIFA protests as far away as Ahmedabad, India.
“These dogs are being shot in the street, often in front of children, or dragged away with wire nooses to die slow, agonizing deaths,” Ian Ward, the coalition’s chairman, said in a statement.
Moroccan officials vehemently deny the claims, say they’re implementing the very programs that activists propose, including TNVR. They rebuff the idea that any policy is related to the World Cup. Still, critics see their efforts as publicity stunts and are skeptical such programs are as widespread as officials claim.
Instances of mistreatment and euthanasia by gunshot have been reported in local media but Moroccan officials say, despite international attention, they’re isolated incidents and don’t reflect on-the-ground reality nationwide.


US embassy in Tripoli denies report of planned relocation of Palestinians to Libya

Updated 18 May 2025
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US embassy in Tripoli denies report of planned relocation of Palestinians to Libya

  • Palestinians vehemently reject any plan involving them leaving Gaza

TRIPOLI: The US embassy in Libya denied on Sunday a report that the US government was working on a plan to relocate Palestinians from the Gaza Strip to Libya.
On Thurdsay, NBC News said the Trump administration is working on a plan to permanently relocate as many as one million Palestinians from the Gaza Strip to Libya.
NBC News cited five people with knowledge of the matter, including two people with direct knowledge and a former US official.
“The report of alleged plans to relocate Gazans to Libya is untrue,” the US embassy said on the X platform.
The Tripoli-based interionationally-recognized Government of National Unity was not available for immediate comment.
Trump has previously said he would like the United States to take over the Gaza Strip and its Palestinian population resettled elsewhere.
Palestinians vehemently reject any plan involving them leaving Gaza, comparing such ideas to the 1948 “Nakba,” or “catastrophe,” when hundreds of thousands were dispossessed of their homes in the war that led to the creation of Israel.
When Trump first floated his idea after taking the presidency, he said he wanted US allies Egypt and Jordan to take in people from Gaza. Both states rejected the idea, which drew global condemnation, with Palestinians, Arab nations and the UN saying it would amount to ethnic cleansing.
In April, Trump said Palestinians could be moved “around to different countries, and you have plenty of countries that will do that.”
During a visit to Qatar this week, Trump reiterated his desire to take over the territory, saying he wanted to see it become a “freedom zone” and that there was nothing left to save.
Trump has previously said he wants to turn Gaza into the “Riviera of the Middle East.”


Libya’s PM says eliminating militias is ‘ongoing project’ as ceasefire holds

Updated 18 May 2025
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Libya’s PM says eliminating militias is ‘ongoing project’ as ceasefire holds

  • The United Nations Support Mission in Libya expressed concern on Friday about the escalation of violence in Tripoli, calling on parties to protect civilians and public property

TRIPOLI: Libyan Prime Minister Abdulhamid Al-Dbeibah said on Saturday that eliminating militias is an “ongoing project,” as a ceasefire after deadly clashes this week remained in place.
“We will not spare anyone who continues to engage in corruption or extortion. Our goal is to create a Libya free of militias and corruption,” Dbeibah said in a televised speech.
Dbeibah is the country’s internationally recognized leader in the west, based in Tripoli.
After Dbeibah on Tuesday ordered the armed groups to be dismantled, Tripoli was rocked by its fiercest clashes in years between two armed groups. The clashes killed at least eight civilians, according to the United Nations.
The government announced a ceasefire on Wednesday.
It followed Monday’s killing of major militia chief Abdulghani Kikli, widely known as Ghaniwa, and the sudden defeat of his Stabilization Support Apparatus group by factions aligned with Dbeibah.
SSA is under the Presidential Council that came to power in 2021 with the Government of National Unity of Dbeibah through a United Nations-backed process.
SSA was based in the densely populated Abu Salim neighborhood.
GNU’s Interior Ministry said in a statement that nine decomposed corpses were found in a morgue refrigerator in Abu Salim-based Al-Khadra hospital. It said SSA never reported them to authorities. The PM’s media office posted a video of Dbeibah greeting the security force protecting the Prime Ministry Building. It said he later received delegations from elders to discuss Tripoli’s situation and what he called “successful security operation in Abu Salim.”
“The Prime Minister stressed that this operation falls within the state’s fixed vision to eliminate armed formations outside the police and army institutions,” the media office said.
On Friday, at least three ministers resigned in sympathy with hundreds of protesters who took to the streets calling for Dbeibah’s ouster.
Dbeibah did not comment on their resignations. “The protests are annoying, but I’ve put up with them. I know some of them are real, but a lot of them are paid,” he said.
The United Nations Support Mission in Libya expressed concern on Friday about the escalation of violence in Tripoli, calling on parties to protect civilians and public property.
Libya has had little stability since a 2011 NATO-backed uprising ousted longtime autocrat Muammar Qaddafi. The country split in 2014 between rival eastern and western factions, though an outbreak of major warfare paused with a truce in 2020.
While eastern Libya has been dominated for a decade by commander Khalifa Haftar and his Libyan National Army, control in Tripoli and western Libya has been splintered among numerous armed factions.
A major energy exporter, Libya is also an important way station for migrants heading to Europe, while its conflict has drawn in foreign powers including Turkiye, Russia, Egypt and the United Arab Emirates.
State-oil firm NOC said on Friday that its operations at oil facilities are proceeding as normal, with oil and gas exports operating regularly.


Israel says intercepted missile from Yemen, Houthis claim attack

Updated 18 May 2025
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Israel says intercepted missile from Yemen, Houthis claim attack

CAIRO: The Israeli military said Sunday it had intercepted a missile fired from Yemen, where the Iran-backed Houthis claimed launching two missiles at Israel’s main airport.
“A missile that was launched from Yemen was intercepted,” the Israeli military said in a statement, adding that air raid sirens had sounded in several areas of the country.
The Houthis later said they had fired “two ballistic missiles” toward Israel’s Ben Gurion airport, near Tel Aviv.
The Iran-backed militants have regularly fired missiles and drones at Israel since the war in Gaza broke out in October 2023, following an attack on Israel by the Houthis’ Palestinian ally Hamas.
Earlier this month, a Houthi missile struck the area of the Tel Aviv airport, gouging a hole near its main terminal building and wounding several people in a rare penetration of Israeli air defenses.
On Friday, Israel bombed the Houthi-held Red Sea ports of Hodeida and Salif following three missile attacks in as many days. It threatened to target the Houthi leadership if the attacks continued.
In response to the strike that landed near Ben Gurion, Israel has struck the airport in Yemen’s rebel-controlled capital Sanaa and three nearby power stations.
On Sunday, Houthi military spokesman Yahya Saree said the group would continue targeting Israel until the “siege is lifted” on Gaza.
The Houthis, who control swathes of Yemen, have also targeted Red Sea shipping throughout the Gaza war, saying they act in solidarity with Palestinians.
Their attacks on the vital shipping route drew retaliatory strikes by the United States, which in early May sealed a ceasefire with the group that did not include Israel.