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.”
 

 


Syria and DP World ink $800 million deal for port development

Updated 16 May 2025
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Syria and DP World ink $800 million deal for port development

  • Syria is seeking to attract foreign investments to boost its struggling economy

CAIRO: The Syrian government and DP World signed a memorandum of understanding  worth $800 million to develop Syria’s port of Tartous, Syrian state news agency SANA said on Friday, after the lifting of USsanctions cleared the way for the deal.
The deal to develop, manage and operate a multi-purpose terminal at Tartous includes cooperation in establishing industrial and free trade zones. DP World is a subsidiary of United Arab Emirates investment company Dubai World.
Syria is seeking to attract foreign investments to boost its struggling economy, and the deal was signed in the same week that US President Donald Trump announced plans to lift of sanctions on Syria during a visit to Riyadh.
Trump said he made the decision to lift sanctions after discussions with Saudi Crown Prince Mohammed bin Salman and Turkish President Tayyip Erdogan, whose governments have both strongly urged the lifting of sanctions.
Trump had also met with Syrian President Ahmed Al-Sharaa ahead of the GCC summit in Riyadh on Wednesday.
US Secretary of State Marco Rubio said on Thursday that Trump intends to issue waivers under the “Caesar Syria Civilian Protection Act,” through which Washington imposed stiff sanctions on former President Bashar Assad’s government and secondary sanctions on outside companies or governments that worked with it.
Removing US sanctions that cut Syria off from the global financial system will also clear the way for greater engagement by humanitarian organizations working in Syria, easing foreign investment and trade as the country rebuilds.


Lebanon’s parliament doubles penalty for celebratory gunfire

Updated 16 May 2025
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Lebanon’s parliament doubles penalty for celebratory gunfire

  • Law change follows injuries during municipal election events

BEIRUT: Lebanon’s parliament on Thursday approved an amendment to the law that aims to curb celebratory gunfire by doubling the penalties for those who fire shots into the air.

The new law imposes stricter penalties for individuals involved in actions that have led to numerous injuries and fatalities in recent years.

The action comes after Lebanese Army Command announced the arrest of eight people as part of efforts to identify those who fired gunshots during last Sunday’s municipal elections in the North Lebanon and Akkar governorates.

Army units, with support from a Directorate of Intelligence patrol, raided the homes of several suspects and seized weapons and ammunition they possessed.

The skies over the North and Akkar governorates were illuminated last Sunday night by gunfire, celebrating candidates’ victories in the municipal elections, where local families traditionally compete for seats on the city councils that govern their affairs.

The celebratory gunfire caused injury to a young man, Mohammed Jihad Khaled, from the town of Ain Al-Dahab in Akkar.

He is still fighting for his life after a bullet struck his head.

He remains in a coma after being moved to the intensive care unit of a hospital.

Journalist Nada Andraos was also injured by celebratory gunfire, as a bullet struck her leg after piercing the car she was in while covering the elections with her team from the Lebanese Broadcasting Corporation International.

Andraos, who seemed stunned by the incident — especially since the bullet could have struck her head instead of her leg — commented on social media: “In Lebanon, a stray bullet represents the value of life.”

Victims’ families often file lawsuits in court and with security agencies against unidentified people.

Many offenders escape punishment, leading to repeated tragedies where celebratory gunfire accompanies even minor school achievements.

The law prohibiting the firing of firearms into the air specifies that if such actions lead to a person’s illness or incapacity that causes them to miss work for fewer than 10 days, the offender will face a prison sentence of nine months to three years, in addition to a fine ranging from 10 to 15 times the official minimum wage.

MP Wadah Al-Sadiq said that the amendment had increased the penalty duration.

Previously, the penalty ranged from six months to three years; now it begins at one year in prison and can go up to six years.

The final decision will be made by the judge who issues the ruling.

Information Minister Paul Morcos, an international human rights defender, welcomed the amendment.

It serves as an additional deterrent, moving toward prohibiting such practices and ensuring accountability for perpetrators, he said.

Lawyer Imad Al-Masri, who specializes in criminal cases, said: “Any individual who discharges firearms or fireworks in populated areas or in the presence of a crowd, regardless of whether their firearm is licensed, will face a prison sentence of six months to three years.

“Additionally, they will incur a fine ranging from eight to 15 times the official minimum wage.

“The weapon shall be confiscated in all cases, and the perpetrator shall be referred to the military court for trial.”

Al-Masri said that the military court imposes penalties on individuals who fire bullets into the air, ranging from fines to prison sentences of six months to two years.

A judicial source said that the military court has numerous cases related to firing into the air. These offenses are punishable by law and escalate from a misdemeanor to a felony if the shooting results in casualties.

Al-Masri said: “Increasing the penalty is a deterrent if it is accompanied by strict prior measures and the enforcement of immediate prosecution and, most importantly, changing social behavior regarding this dangerous practice.”

Riots continued for a second day in Roumieh Prison, Lebanon’s largest prison, coinciding with the parliamentary session.

Inmates are demanding the approval of a general amnesty law and a reduction in their imprisonment period.

Tensions ran high among both convicts and detainees, some of whom hung symbolic gallows inside their cells as a form of protest.

Lawyer Rabih Qais, the program manager at the Lebanese Foundation for Permanent Civil Peace and a longtime observer of prison affairs, said: “The law proposal submitted by several MPs addresses the issue of delayed trials for detainees.

“Many of these people have spent years in prison, even though the sentences they might receive if tried could be significantly shorter than the time they have already served.”

Qais said Lebanon “evaluates every decision through the lens of sectarian power-sharing.

“As a result, many of those advocating for amnesty are Islamists and individuals from the Baalbek-Hermel region, many of whom are facing in absentia arrest warrants related to clashes with security forces or drug-related offenses.

“This may explain why the draft amnesty law was sent to parliamentary committees. However, what is truly needed is justice for the oppressed.”


Israeli army kills 5 Palestinians in West Bank shootout as Smotrich calls for razing of towns

Updated 16 May 2025
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Israeli army kills 5 Palestinians in West Bank shootout as Smotrich calls for razing of towns

  • The 'terrorists' were killed in a shootout near the settlement where a pregnant woman was killed earlier
  • Shootout came as Israel's hardline minister called for razing of Palestinian towns

JERUSALEM/RAMALLAH: Israel’s military killed five Palestinian militants in the occupied West Bank on Thursday, hours after a pregnant settler was killed in a shooting, as hard-line pro-settler leaders including a government minister called for Palestinian towns to be razed.
The military said in a statement it had killed five “terrorists” and arrested a sixth who had barricaded themselves in a building in Tamoun, following an exchange of gunfire and the use of shoulder-fired missiles by Israeli soldiers.
The military wing of Palestinian militant group Islamic Jihad later issued a statement saying five of its members were killed while clashing with Israeli forces that surrounded their house in the town of Tamoun, north of the West Bank.
Tamoun is a Palestinian town about 35 km (22 miles) from the Israeli settlement of Brukhin, near which the heavily pregnant woman, Tzeela Gez, was killed on Wednesday night in a shooting that drew strong condemnation from Israeli leaders.
The military said it was searching for those responsible for Wednesday’s shooting — whom it did not identify — though it was not immediately clear whether the Tamoun operation was linked.
There was no immediate claim of responsibility for the shooting, which occurred amid one of the largest Israeli military operations in the West Bank in two decades and while the Israeli military bombards Gaza.
Gunfire could be heard in Tamoun on Thursday, while Reuters footage showed flames and black smoke on the top floor of a house as Israeli soldiers stood on the street outside. The Palestinian WAFA news agency said the Israeli military was demolishing the house where the Palestinian men had been killed.
The Israeli military said soldiers had identified the “terrorists” in a building during an overnight operation in Tamoun and the nearby city of Tubas. It recovered rifles used by the militants in the building in Tamoun, it said.
The military also said that three armed individuals had been arrested in Tubas.
The Palestinian Health Ministry said the military had taken the bodies of four of the deceased. The local Red Crescent said it had recovered a fifth body from a burning building.

Demand for retribution
Gez, the pregnant woman, was shot near the Brukhin settlement while traveling to hospital with her husband to give birth. She was pronounced dead at the hospital where her baby was delivered by caesarean section, Israeli media reported.
The baby was reportedly in serious but stable condition, while Gez’s husband Hananel was lightly injured.
As retribution, Israel’s far-right Finance Minister, Bezalel Smotrich, said the nearby Palestinian towns of Bruqin and az-Zawiya should be destroyed, just as cities in Gaza have been.
“Just as we are flattening Rafah, Khan Younis and Gaza (in the Gaza Strip), we must also flatten the terror nests in Judea and Samaria,” Smotrich said on social media, employing the term often used in Israel for the West Bank.
Israeli Prime Minister Benjamin Netanyahu said he hoped security forces would quickly find those responsible for Gez’s death, while President Isaac Herzog expressed his condolences to her family.
The chief of Israel’s general staff, Lt. Gen. Eyal Zamir, visited the troops searching for Gez’s killer on Thursday near Brukhin.
The Israeli military has killed dozens of Palestinians and destroyed many homes since it launched an operation in January in the West Bank city of Jenin to root out militants.
Those killed have included members of Hamas and other militant groups but also some civilians, including women and children.


Turkiye FM meets Russia delegation in Istanbul

Updated 16 May 2025
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Turkiye FM meets Russia delegation in Istanbul

ISTANBUL: Turkiye’s foreign minister was on Thursday meeting with the Russian delegation that is in Istanbul for their first direct peace talks with Ukraine in three years, a ministry source said.
“The meeting between Foreign Minister Hakan Fidan and the Russian side, headed by Vladimir Medinsky has started,” the source said of talks taking place at Istanbul’s Dolmabahce Palace.
The talks had been announced earlier in the evening by a foreign ministry spokesman.
Russia and Ukraine had been expected to meet on Thursday in Istanbul for their first direct peace talks in more than three years at the Dolmabahce Palace on the banks of the Bosphorus.
But as the day wore on without any concrete indications of timings, it remained unclear whether the delegations would meet later in the evening or leave it until Friday.
US Secretary of State Marco Rubio, who was in southern Turkish city of Antalya for a NATO summit Thursday, was due in Istanbul on Friday.
He told reporters he would meet Ukraine’s top diplomat, Andriy Sybiga there, while a lower-level US official would meet with the Russian delegation.
The minister was not thought to be part of the Ukrainian delegation to the talks.
Rubio also expressed hope that Turkiye would work to bring the two delegations together.
Earlier on Thursday, Fidan and Rubio held talks on the sidelines of the NATO meeting, with the pair agreeing that “efforts would continue to be made to ensure direct negotiations between the parties,” a source at the Turkish foreign ministry said.
Ukrainian President Volodymyr Zelensky, who was in Ankara earlier on Thursday, has sent a pared-down team to the Istanbul talks after Russia showed up with a relatively low-level delegation.
The Ukrainian delegation is headed by Defense Minister Rustem Umerov, while the Russian side is being led by Medinsky, a hawkish adviser to Russia’s Vladimir Putin who has questioned Ukraine’s right to exist and led failed talks in 2022 at the start of the war.


ICC says Libya recognizes authority of war crimes, repression probe

Updated 16 May 2025
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ICC says Libya recognizes authority of war crimes, repression probe

UNITED NATIONS: Libya has accepted the authority of the International Criminal Court (ICC) to investigate alleged war crimes in the country despite not being party to the Rome Statute, the court’s founding treaty, ICC chief prosecutor Karim Khan said Thursday.
“I strongly welcome the courage, the leadership and the decision by the Libyan authorities” to recognize the ICC’s jurisdiction over possible war crimes and repression committed since 2011 until the end of 2027, Khan added.