Epidemiological Challenges and Health Disparities in the Eastern Mediterranean Region: A Region in Crisis.

Abstract

Background: The World Health Organization's (WHO) Eastern Mediterranean Region (EMR) is marked by socioeconomic diversity, political instability, displacement, and environmental risks. With nearly 745 million people across 22 countries, the region faces a complex "triple burden" of non-communicable diseases (NCDs), communicable diseases (CDs), and injuries. Objective: This paper provides an updated overview of the epidemiological landscape of the EMR by linking current disease burdens with socioeconomic, behavioural, environmental, and health system determinants. It highlights regional disparities and identifies priority areas for health system strengthening. Methods: A descriptive narrative review of secondary data and published literature was conducted. Publicly available datasets, institutional reports, and peer-reviewed sources were purposively selected from WHO, WHO-Regional Office for the Eastern Mediterranean (WHO EMRO), the World Bank, Global Burden of Disease/Institute for Health Metrics and Evaluation (GBD/IHME), and related literature. The review focused mainly on data published between 2015 and 2022 and included indicators on demographics, mortality, disease burden, risk factors, health system capacity, and health financing across EMR countries. Findings were organised narratively to describe regional patterns, disparities, and policy-relevant gaps. No systematic review, meta-analysis, or inferential statistical modelling was undertaken. Findings: The review shows substantial health inequalities across income groups. Life expectancy reaches 79.7 years in high-income countries but only 63.7 years in low-income countries. NCDs are now the leading cause of death, driven by obesity, hypertension, tobacco use, and other behavioural risks. Meanwhile, CDs and injury-related mortality remain major challenges, particularly among young people and populations affected by conflict and displacement. Health systems are constrained by fragility, high out-of-pocket expenditure, and a projected workforce shortfall of 2.1 million by 2030. Conclusion: Addressing the EMR's epidemiological challenges requires stronger primary healthcare and progress towards universal health coverage through integrated strategies targeting social determinants, sustainable financing, and improved surveillance.