Last weekend, Dr. Farida Al Hosani, Director of the Communicable Diseases Department at Abu Dhabi’s Department of Health, reported in a televised interview that the United Arab Emirates (UAE) had confirmed 13 cases of the coronavirus disease (COVID-19). According to reports from the Institute of International Finance in Washington DC, the outbreak of the deadly corona virus has so far not had a direct effect on the Middle East and North African economies. Further, the report states that any future impact will be milder than in other emerging economies. Nevertheless, at this point in time, it is paramount for governments, the private sector, funders and citizens to seize the opportunity to be more vigilant and agile, in line with what WHO recommends for the rest of the world. Key strategic partners and stakeholders in the UAE such as the Ministry of Health and Prevention, the local (Emirate level) air, land and sea port authorities, local health authorities including the Department of Health – Abu Dhabi and the Dubai Health Authority (DHA), need to be more agile in their respective approaches to responding to the threat of outbreak. Recently, numerous alerts have been issued, which have informed hospitals, centres and clinics about the ongoing support and collaboration offered by their Strategic Partners to improve the provision of healthcare services in the entire Emirates. As you can imagine, a key focus of these alerts has been the Novel (new) Coronavirus (nCov-2019), which currently seems unstoppable.
In recent research conducted by Professors from the Mohammed Bin Rashid School of Government- Dubai (MBRSG), three tension areas were identified as needing to be managed by agile governments: 1. fluidness and foresight; 2. versatility, collaboration and resilience; and 3. harmonization and legitimacy. The findings of the research project were further discussed at the United Arab Emirates Public Policy Forum 2020 #UAEPPF2020 which was held between 16-18th February in Dubai, and was themed “Agile Government: Becoming Future-Proof.” The graph below shows what each of the three pillars entails.
‘Agility’ refers to “the ability of an organization to react to changes in its environment faster than the rate of these changes.” As a sub-discipline of public administration, agile government is not a new field, however, there are few scholarly papers on the subject, suggesting that it an area that is ripe for more research. In the government sector, the field has overlapped with digital transformations, under new public management thinkin[CA1] g; however, the high failure of e-government projects in the region and worldwide, and “the unrelenting waves of technological and social changes that show no signs of easing off”, have resulted in renewed focus on the need for ‘Agile Governments’, to better prepare for the future. When the concept of ‘agile government’ is applied to the health sector, it becomes clear that the threat of Covid-19 outbreak is not only a challenge, instead it represents an opportunity for the health sector to become more agile, both in the UAE and elsewhere.
The concept of agility has spread widely in the last few years, becoming more and more commonplace, even in the more service-oriented and traditional industries. Agility can help healthcare providers, whether private or public, to become more adaptive and resilient to a dynamic global market where the status quo is no longer the norm. It is crucial for such a strategic sector to possess the ability to create sound health policies that can encompass the inevitable uncertainty accompanying such dynamism. This sort of adaptation will further enhance policy makers’ foresight and visions. With respect to the sudden outbreak of the recent coronavirus, the UAE healthcare sector acknowledged that some capacities are indispensable. These include: 1) transparency and ubiquitous inter-industrial connections 2) mobility of human resource capacity 3) timely responsiveness to market demand 4) flexible organization structures and contingently; 5) management endorsement.
Agility in the health care sector
Let’s now have a look at the three abovementioned pillars of an ‘Agile Government’ in more detail, and how the UAE (and its health care sector in particular) are doing in this respect.
As mentioned, according to the model proposed in MBRSG’s latest report, 2019, one of the three pillars of agile government – and sectors within this government – is fluidness and foresight. The UAE actually prepared for the (unexpected) outbreak well in advance, also with a view on Expo 2020. In fact, as early as 2017, the Dubai Health Authority announced that it would set up a citywide Emergency and Crisis Management Nerve Centre. A memorandum of understanding (MOU) was signed with Avanza Solutions to implement the project using global software solutions specializing in e-health services and healthcare innovations and applications. The MoU ratified Avanza’s Smart City Medical Management Platform, “Acuity”, as a smart platform and application that would help to save lives. The application has been providing the DHA with timely data about what is happening across the city. The project is meant to address clinical emergencies and aims to fully utilize available data to make timely evidence-based decisions. With the indispensable support of artificial intelligence, prompt reception of patients in critical conditions in proximity-based healthcare centres will help mitigate the impact of a contagious virus that may cause panic to spread even faster than the virus itself. With the fluidness and flexibility such an initiative provides, this UAE project satisfies one of the crucial aspects of agility in the healthcare sector.
Collaboration and resilience
“If healthcare industries are to maintain agile structures, they need to prepare for persistent pressure from patients and citizens who are continuously seeking improvement in quality levels, efficiency of services offered, and overall satisfaction”. With the threat and possibility of a rapidly spreading virus, it is only logical to anticipate fluctuations in demand and supply of the necessary medications. As one of multiple precautionary measures adopted, the UAE Health Minister confirmed the country has stocked sufficient medicines to deal with the outbreak of the virus, regardless of the number of people affected. The ministry of health and prevention (MOHAP), declared that more than 500 staff members are onboard, working round the clock to deal with any emergency situation regarding the new Coronavirus. As you can imagine, this sort of staff mobilization required the collaboration of numerous entities and service providers from both the private and public sectors. Such smooth collaboration is further evidence of the agility of the sector and required the creation of transparent and reliable communication channels across all stakeholders involved. The collaboration assisted providers from both sectors to be better prepared and enhanced their alert levels to the highest possible. Laboratories from both sectors were also invited to participate in the containment of the outbreak, through partnerships. For instance, medical suppliers have contributed, by ensuring a sufficient quantity of the necessary protective gear is available on the market. The undeniable efforts of the UAE Federal Competitiveness and Statistics Authority, an official source of statistics and monitoring of competitiveness performance indicators for international reports, have served to connect the diverse efforts of all stakeholders by feeding information to a centralized database which makes decision-making processes even more agile.
Harmonization and legitimacy
“This area is concerned with creating stability in the face of rapidly changing environments and disruptive markets in creating complementary blends across the health sector system itself. A truly agile healthcare sector is always prepared to blend, complement and deal with unpredictable volatility by steering away from chaos while at the same time breaking bureaucratic restrictions to reach a much-needed state of flourishing stability” (MBRSG, 2020). In line with this, the UAE’s ministry of health and prevention has confirmed its active and permanent relationship with the World Health Organization, keeping track of the latest developments and changes taking place in light of the crisis. The strong link with WHO guarantees the sound management of any sudden events, and sustains the harmony and legitimacy required amongst involved stakeholders.
In the UAE, the health sector is thus leveraging this opportunity to become more agile, continuously improving and strengthening the health system. COVID-19 might be a huge challenge, but it is also an opportunity.