30 September 2024, Cairo, Egypt – The Eastern Mediterranean Region grapples with a formidable challenge: the rising tide of noncommunicable diseases (NCDs), with chronic kidney disease (CKD) precariously perched at the forefront. The region’s constant whirl of humanitarian crises—including violent conflicts, natural calamities, and public health emergencies—exerts a staggering pressure on already strained healthcare systems, complicating the delivery of vital specialized care like renal dialysis.
During these tumultuous times, the continuity of care for chronic kidney disease patients—particularly those reliant on dialysis and organ transplants—spirals into a complex dilemma. They find themselves at the mercy of interrupted treatments, often life-threatening, due to a collapsing healthcare infrastructure, critical shortages of essential medications and supplies, and erratic access to water and electricity, not to mention the dwindling number of healthcare professionals available to assist them.
Take Sudan, for instance. The violent conflict that erupted in April 2024 has thrown over 8,000 dialysis patients into jeopardy, as by August the number of operational dialysis facilities plummeted to a mere 44 from the previous 102. This shortfall has left an alarming 5,000 patients without proper care. And in Gaza, where relentless destruction from ongoing conflict has birthed a catastrophic humanitarian crisis, the urgency to maintain care for CKD patients reaches an unprecedented peak.
In light of these overwhelming challenges, the World Health Organization’s Regional Office for the Eastern Mediterranean has sprung into action, launching a regional expert network dedicated to chronic kidney disease management with a particular emphasis on dialysis and renal care amid crises.
This initiative is designed to empower Member States to unearth innovative strategies for sustaining dialysis services and fortifying healthcare systems across the region. The goal? Even amidst the most harrowing conditions, to ensure that patients receive the critical, life-sustaining care and medications they so urgently need.
The network held its inaugural meeting on 10 September 2024, uniting preeminent nephrologists, regional and global experts, and professionals with firsthand experience in crisis management, alongside focal points from the three organizational tiers of WHO. The agenda was robust, featuring discussions on both regional and global approaches, insights from the International Society of Nephrology regarding kidney disease in emergency settings, and an exploration of the specific hurdles faced in maintaining dialysis services in Sudan and the occupied Palestinian territories.
Participants pinpointed several crucial domains deemed essential for preserving dialysis services amid emergencies. These focal areas spanned the necessity of operational dialysis machines, strategic stockpiling of dialysis and supportive supplies, ensuring dependable water and treatment systems, stable electricity supplies, and ongoing infection prevention and control measures.
Acknowledging the critical nature of technical support for maintaining equipment and ensuring high-quality long-term care, the conversations were guided by a regional framework designed to address NCDs in emergencies. Key domains such as governance, information systems, human resources, financing, community engagement, and logistics—including transportation and evacuation for patients and supplies—were collectively recognized as vital for sustaining dialysis services in these high-stakes environments.
As the meeting drew to a close, participants reached a consensus to form sub-working groups, each focusing on the vital domains spotlighted during discussions. These groups will be charged with implementing targeted actions informed by a clear action plan, aimed at coordinating efforts to ensure continuity of dialysis services during crises.
