Dr Olfat Berro, Area Head Middle East, Roche Pharmaceuticals, examines how healthcare systems across the Middle East are confronting a convergence of ageing populations, rising non-communicable disease burdens, and constrained fiscal environments – and makes the case that investing in health innovation, early intervention, and integrated care pathways is not merely a clinical imperative, but a measurable economic and societal strategy for the decade ahead.
“In many of the conversations we have with our partners and health leaders, I ask one question: are we accounting for the full value of a healthier society?”
Health is nature’s most vital gift. It is something we often take for granted, until it begins to fail. In those moments, healthcare reveals its true meaning. It is not simply a sector, nor only a system of services. It is, fundamentally, a human cause, the collective effort to prevent suffering, preserve dignity, and restore possibility.
For those of us who have spent our careers in healthcare, this is not abstract. It shapes how we think about responsibility. Because the world urgently needs better ways to prevent, diagnose, and treat disease. And improving lives is not only about scientific discovery; it is about ensuring that innovation reaches people in ways that are sustainable, equitable, and impactful.
Today, that responsibility carries even greater weight.
Why does it matter today?
Healthcare systems are entering a decade defined by structural pressure. Demographic shifts, rising prevalence of non-communicable diseases (NCDs), workforce constraints, and fiscal scrutiny are converging simultaneously. These represent long-term transitions that will shape economic resilience and social stability.
Globally, non-communicable diseases account for 41 million deaths annually and are projected to cost the global economy more than $47 trillion between 2011 and 2030. In the Middle East, they claim around 2.5 million lives annually.
But beyond the numbers, chronic disease reshapes everyday life. It means more families adjusting to long-term treatment plans. More individuals navigating years of medication and monitoring. More caregivers quietly stepping into roles that were never planned.
At the same time, populations are ageing. By mid-century, the proportion of people over 60 will double globally, while in the Arab region, our older population is projected to triple by 2050, reaching over 70 million. Yet healthy life expectancy is not increasing at the same pace as longevity. Many people are living longer, but spending more years managing illness and building pressure on health systems and public finances.
This convergence, ageing populations, rising chronic disease, and constrained fiscal space, forces a strategic question: Are we investing in the right places?
Because if healthcare is viewed narrowly as expenditure, reform will focus on containment. But if it is understood as economic and social infrastructure – something that protects both people and productivity – the policy response changes fundamentally.
Reframing innovation: From cost line to economic lever
Scientific progress over the past century has significantly improved life expectancy and disease management. Today, more than 8,000 medicines are in development globally – evidence of continued research ambition and innovation capacity.
But innovation only matters if it reaches the person who needs it at the right time, in the right setting.
Its value depends on system readiness, on whether financing models, regulatory pathways, and delivery mechanisms are designed to adopt and scale it effectively.
The economic evidence is consistent:
- For every $1 invested in cost-effective NCD interventions, returns can reach $7
- Historical analysis shows that one-third of economic growth in advanced economies has been linked to improvements in population health.
When innovation prevents disability, delays complications, and sustains productivity, it protects a person’s health and thus human capital, which remains the most valuable driver of national prosperity. This is why the question is no longer whether innovation is affordable. The question is whether failing to invest is affordable.
The Middle East: Ambition confronts epidemiology
This reframing is particularly relevant in the Middle East. The region faces a high and rising burden of chronic disease. For instance, 6 of the 10 countries with the highest global diabetes prevalence are located here. Similar trends are visible across oncology, cardiovascular disease, neurological disorders, and ophthalmology. They are conditions affecting working-age adults, young families, and aging parents.
At the same time, the region has articulated ambitious transformation agendas.
Across the region, governments are advancing ambitious health transformation agendas. National visions such as Saudi Arabia’s Vision 2030, Qatar National Vision 2030, and Oman Vision 2040 place growing emphasis on prevention, system efficiency, and sustainable healthcare delivery.
At the same time, the UAE continues to advance value-based healthcare frameworks and evidence-based decision-making models to guide long-term investment in health.
In other words, reform momentum exists. What is required now is alignment between epidemiological reality and financing design. To achieve that alignment, systems must look not only at what they fund, but at when and how they intervene.
Moving upstream: Prevention and decentralized care as investment
Chronic diseases develop progressively. Yet historically, many health systems have concentrated spending at advanced stages of illness, when complications are most complex and costly, and often most devastating for patients.
A more sustainable model requires shifting earlier in the patient journey.
This means strengthening systematic screening programs, integrating diagnostics into primary care, expanding decentralized service delivery, and leveraging digital tools to support patients beyond hospital settings.
Meeting patients where they are – in communities, workplaces, and homes – reduces access gaps and improves adherence. More importantly, it protects dignity.
Early detection and timely intervention do more than reduce cost curves. They allow people to remain active participants in their own lives. They prevent avoidable suffering. They reduce the emotional and practical burden on families.
Prevention, therefore, is not an abstract public health objective. It is a structural economic strategy.
The case of diabetes and vision loss: Understanding the socioeconomic impact
One area where the connection between health outcomes and economic impact becomes particularly visible is diabetes and its complications.
Across the Middle East, diabetes continues to rise at an alarming pace, affecting millions of people, many during their most productive years. While managing the disease itself already requires lifelong care, its complications often carry far deeper consequences.
Diabetic eye disease, particularly diabetic retinopathy and diabetic macular edema (DME), offers a powerful illustration of this broader impact. These conditions do not only threaten vision; they can affect independence, daily functioning, and the ability to remain active in the workforce.
The scale of the challenge is already visible across the region.
- In Saudi Arabia, diabetes affects approximately 4.27 million adults, and one of its most serious complications, DME, is projected to carry a ten-year socioeconomic burden of SAR 19.12 billion. Importantly, that burden extends well beyond direct healthcare costs. It includes SAR 10.87 billion in productivity losses and SAR 8.25 billion in unpaid work losses, reflecting the hidden impact on caregivers, households, and everyday functioning.
- In the United Arab Emirates, the economic burden is equally significant. Direct treatment costs for diabetes in the UAE have been estimated at US$4.16 billion annually, representing 23.25% of total health expenditure and around 1% of GDP.
- A similar pattern can be seen elsewhere in the region. In Jordan, a recent cost analysis found that the average total cost of diabetic retinopathy reached approximately 1,233 Jordanian dinars per patient, once both medical and non-medical expenses were included. Costs rose significantly as the disease progressed, and the presence of DME increased the burden sharply, with patients affected in both eyes facing costs more than three times higher than those without DME.
- In Iraq, the Ministry of Health’s annual spending exceeded 790 million Iraqi dinars. For patients and families, the burden extended well beyond treatment itself: transportation, accommodation, and other non-medical expenses made up more than half of total out-of-pocket spending. The study also found that managing DME was more costly than other stages of diabetic retinopathy, underscoring the economic weight of vision-threatening complications.
- Taken together, these national examples reflect a much broader regional reality. Across the Middle East and North Africa, productivity losses associated with moderate-to-severe vision impairment and blindness were estimated at US$33.6 billion in 2018, equivalent to 0.35% of regional GDP. While this figure includes all causes of vision loss, it illustrates the scale of what is at stake when chronic conditions are detected too late or managed too narrowly.
Yet beyond the economic indicators, the human impact is equally significant.
Vision loss can mean losing the ability to drive, to read, to work with confidence, or simply to move through daily life independently. It can mean relying more heavily on a spouse, a son or daughter, or another caregiver. It can limit not only productivity, but participation in everyday life.
At the same time, this is precisely where the opportunity of health investment becomes clear.
Early detection, timely treatment, and sustained disease management can significantly reduce the progression of diabetic eye disease and its long-term consequences. When health systems invest in screening, access to innovative therapies, and integrated care pathways, the benefits reach far beyond clinical outcomes.
They preserve independence. They protect workforce participation. They reduce pressure on families and caregivers. And they help avoid costs that become far greater once complications take hold.
In Saudi Arabia, intervention modelling shows that effective DME management can generate a societal return of $83,202 per QALY gained, illustrating how early and effective care creates measurable value not only for patients, but for society as a whole.
In that sense, diabetes and diabetic eye disease offer a compelling case study of the broader principle explored throughout this article: when we invest in health innovation, we are not only treating disease. We are protecting human potential and strengthening the resilience of our societies.
Translating reform into system architecture
Recognizing health as investment requires practical implementation tools. These include:
- Integrating societal and productivity impact into Health Technology Assessment (HTA) frameworks
- Designing value-based reimbursement models
- Adopting multi-year budgeting approaches that enable strategic planning
- Reducing inefficiencies, estimated globally at approximately 20% of healthcare spending
- Investing in workforce capability and digital infrastructure
System transformation depends on coordinated partnership between policymakers, providers, payers, academia, and industry. Public-private collaboration is not only a financial mechanism – it is a shared commitment to patients.
The objective is not increased spending in isolation. It is better allocation, stronger measurement, and systems that are designed around people as much as numbers.
A strategic choice for the decade ahead
The demographic and epidemiological shifts underway leave little room for complacency. Healthcare can continue to be debated as short-term expenditure. Or it can be recognized as strategic infrastructure – fundamental to productivity, stability, and growth.
But beyond economics, it is fundamental to dignity.
The Middle East has articulated ambitious economic transformation agendas. Aligning those ambitions with sustained investment in prevention, early intervention, and innovation may prove decisive. Ultimately, the question is not whether innovation has value.
It is whether our systems are prepared to measure and capture it.
About Roche
Founded in 1896 in Basel, Switzerland, as one of the first industrial manufacturers of branded medicines, Roche has grown into the world’s largest biotechnology company and the global leader in in-vitro diagnostics. The company pursues scientific excellence to discover and develop medicines and diagnostics for improving and saving the lives of people around the world. We are a pioneer in personalised healthcare and want to further transform how healthcare is delivered to have an even greater impact. To provide the best care for each person we partner with many stakeholders and combine our strengths in Diagnostics and Pharma with data insights from the clinical practice.
For over 125 years, sustainability has been an integral part of Roche’s business. As a science-driven company, our greatest contribution to society is developing innovative medicines and diagnostics that help people live healthier lives. Roche is committed to the Science Based Targets initiative and the Sustainable Markets Initiative to achieve net zero by 2045.
For over 85 years, Roche in the Middle East has offered comprehensive pharmaceutical and diagnostic expertise through the relevant and appropriate channels in many countries: Bahrain, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Maldives, Oman, Palestine, Qatar, Saudi Arabia, Syria, United Arab Emirates, and Yemen. For more information, please visit www.roche-middleeast.com
