Blog

IntroductionRoad accidents are widely recognized as the primary cause of death, disability, and property damage around the world. This is particularly pronounced in low and middle-income countries where traffic accidents have become a significant contributor to human and economic losses in urban communities (Bhavan, 2019). With increasing rates of transportation and movement through various means such as cars, trucks, bicycles, motorcycles, trains etc., the occurrence of accidents is facilitated leading to loss of life and additionally, economic consequences (Mohamed, 2015).&nbsp; As road safety varies across the Kurdistan Region of Iraq the possibility of being seriously hurt or killed in a collision is substantially higher on highways and in certain regions in comparison to the other parts of Iraq. According to Leidman et al. (2016), the Kurdistan Region of Iraq (KRI) had the greatest number of casualties in Iraq when compared to the rest of the nation between the years 2010 and 2013. Erbil had the highest rate of road traffic related fatalities and severe injuries (Ibid). The rate of traffic-related deaths is significantly elevated when compared to that of other nations. To promote public safety on the road, police officers impose traffic penalties that discourage traffic law offenses and negligent driving behaviors. According to Shinar (2017), the implementation of enforcement as the final option to influence driver behavior indicates the importance of reasons other than safety and suggests that there could potentially be shortcomings in driver training, awareness, and licensing mechanisms. Estimating the economic implications of accidents is a challenging issue but crucial to investigate, therefore, this research attempts to examine the financial implications of road accidents in the KRI and the obstacles that hinder traffic safety advancement. Literature ReviewEconomic Implications and Repercussions on HealthAccording to Hughes et al, (2015), road traffic accidents claim the lives of over 1.2 million individuals every year globally, while approximately 50 million sustain injuries. In the city of Erbil, the capital of the Kurdistan region of Iraq, traffic accidents rank as the second most common cause of mortality (Jrew et al., 2017). This underscores the critical importance of prioritizing road safety for sustainable societal development. As the analysis of the infrastructural aspect of road accidents continues to expand, there remains a dearth of published works discussing the financial implications on an economic system resulting from fatalities caused by these accidents. Research findings have revealed that road accidents impose a significant economic burden on nations, accounting for approximately 1-3% of their gross national product&nbsp; (Kohale et al, 2014). Moreover, the financial consequences experienced by individual households because of these crashes include heightened reliance on borrowing and debt accumulation, which can subsequently lead to reduced expenditure on essential items such as food (Kohale et al, 2014). These incidents may occur due to the driver's insufficient discipline, excessive hesitation to adhere to traffic laws, or inadequate infrastructure, causing these accidents to end in severe injuries or even mortality (Ibid).&nbsp;The monetary effects of road-related injuries and collisions can be assessed by taking into consideration a broad range of elements, such as medical bills, expenses arising from legal, administrative, and law enforcement actions, damages to property along with car expenses for repair associated with repercussions of the accident, and potential revenue loss as a result of absence from work or disability/death. Beyond that, individuals who survive accidents tend to experience a worsening standard of living simply because of experiencing discomfort, pain, or long lasting effects caused by the accident (Kohale et al, 2014). There are different methods used to assess and tackle the economic consequences of road accidents, with a focus on quantifying the financial impacts and gauging how they affect a country's overall productivity. Indicators such as human capital losses or declines are often utilized as approximations for understanding the extent to which these accidents impede economic development. Additionally, costs associated with road accidents can be further broken down into direct and indirect expenses. The former refers to expenditures incurred by public health services, while the latter reflects a broader range of costs that negatively impact the national economy through various channels (Bhavan, 2019). The losses incurred by indirect costs lead to a decrease in national income as a result of decreased productivity and the reduced number of labor hours contributed by the human capital (Jagnoor et al., 2015).Despite the numerous factors that contribute to road accidents, the absence of reliable traffic data poses challenges for professionals and researchers who seek to analyze these issues using scientific methods and make informed decisions based on statistical evidence. Even with the advancements in policies, guidelines, and highway designs, there continues to be difficulty in comprehending the pattern of accidents and driver actions for the purpose of preventing traffic crashes. The acquisition of a dependable database specifically dedicated to traffic accidents is essential in order to gain this understanding. The data gathered by traffic authorities is derived from written reports issued by officials immediately following an accident. These reports include information on the individuals that are involved: driver information, vehicle traits, and the specifics of the setting of the incident. Yet, like in other developing countries, the information incorporated in these police-generated crash reports tend to be limited in comparison to that obtainable in more advanced countries. This lack of complexity can be traced mostly to the crash report form's basic layout (Mohammed et al, 2019). The absence of a comprehensive healthcare system or effective coordination between victims and medical facilities to monitor their well-being has also contributed to the complexity of accurately documenting conditions relating to road accidents. DiscussionUpon the establishment of the Iraqi state in 1921 under British oversight, a government body known as the General Directorate of Police was created by the Ministry of Interior. This organization was assigned various responsibilities including traffic management, formulation and enforcement of driver licensing regulations, vehicle registration processes, adherence to safety standards, implementation of speed limits, as well as issuance and enforcement of fines and penalties for those who violated regulations (Al-Tahafi, 2016).&nbsp;The first traffic regulations were put into effect in Iraq in 1932, as reported by the United Nations (2007). However, The code underwent multiple changes and was subsequently replaced in 1971. In 2004, following the ousting of Saddam Hussein's regime in March 2003, a new traffic code was enacted by the Iraqi Parliament under the Coalition Provisional Authority. This legislation replaced all previous traffic laws that were in place at that time (Mohammed et al, 2019). With the increase in motor vehicle traffic crashes as a major cause of death in the Kurdistan Region of Iraq, legislators and law enforcement agencies have implemented different legal measures to combat this issue. These include imposing more severe penalties, heightened fines, and stricter legal sanctions. However, despite these efforts being undertaken with the intention of improving safety, they have not yielded promising results so far. Inadequately developed road infrastructure, an outdated vehicle fleet, unsuitable financial and logistical support for law enforcement agencies, an insufficient number of traffic enforcement cameras, and other innovative methods aimed at preventing such incidents comprise some of the key economic factors that contribute to the occurrence of road accidents.The region currently experiences a dearth of standardized driver’s license programs that aid novice drivers in developing their driving abilities gradually, providing them with exposure to progressively challenging driving situations through phased approaches (Baker et al., 2006). The traffic agencies in Erbil and Duhok have implemented the driver’s license system utilized in South Korea, whereas Sulaymaniyah and Halabja have embraced the driver’s license system used in Denmark (Othman &amp; Carroll, 2015). In particular, the practical training section of both systems is conducted away from actual traffic conditions, especially in Erbil and Duhok. Instead, it takes place within a controlled environment devoid of other vehicles. Moreover, despite significant investments in the reconstruction, expansion, and upkeep of the road infrastructure in the Kurdistan Region of Iraq during the last ten years, many roads do not meet contemporary operational and safety standards. Inadequate safety measures thus result in poor road conditions (Mohammed et al, 2019).&nbsp;The majority of economists advocate incorporating an economic assessment of the impact on quality of life in the overall costs of road accidents. However, accurately estimating this cost is extremely challenging and comes with significant uncertainty. Despite this difficulty, there is general consensus that even approximate assessments of the costs associated with lost quality of life are preferable to completely ignoring this factor (Elvik, 2000).ConclusionDuring the past decade, there has been relative stability, economic growth, and an increase in population within the Kurdistan Region of Iraq. However, it is important to acknowledge that like many rapidly developing countries worldwide, there have been some unintended negative outcomes because of this growth. Recognizing the diverse economic consequences of traffic related incidents emphasizes the need for thorough road safety measures to reduce the financial burden of traffic collisions. Investments in road precautions and crash avoidance projects is vital to minimizing the monetary consequences of traffic accidents. Infrastructure improvements, including well-kept roads along with effective traffic management techniques, contribute to decreasing fatalities. Awareness campaigns and traffic enforcement actions are also critical to establishing an ethic of responsible driving, which will ultimately reduce the number and the seriousness of collisions (World Health Organization, 2018).&nbsp; References&nbsp;Al-Tahafi, A.-W., 2016. The historical development of traffic police in. Iraq Accessed June 02.<a href="http://www.itp.gov.iq/ar/article/" data-mce-href="http://www.itp.gov.iq/ar/article/"> http://www.itp.gov.iq/ar/article/</a>Baker, S.P., 2006. National evaluation of graduated driver licensing programs. US Department of Transportation, National Highway Traffic Safety Administration.Bhavan, T., 2019. The economic impact of road accidents: the case of Sri Lanka. South Asia Economic Journal, 20(1), pp.124-137.Elvik, R., 2000. How much do road accidents cost the national economy?. Accident Analysis &amp; Prevention, 32(6), pp.849-851Hughes, B.P., Newstead, S., Anund, A., Shu, C.C. and Falkmer, T., 2015. A review of models relevant to road safety. Accident Analysis &amp; Prevention, 74, pp.250-270.Jagnoor, J., Prinja, S., Lakshmi, P.V.M., Aggarwal, S., Gabbe, B. and Ivers, R.Q., 2015. The impact of road traffic injury in North India: a mixed-methods study protocol. BMJ open, 5(8), p.e008884Jrew, B., Msallam, M., Khaled, S. and Abojaradeh, M., 2017. Analysis and evaluation of traffic accidents for principle urban streets in Arbil city in Iraq. Diyala Journal of Engineering Sciences, pp.118-131.Kohale, N.D., Bankar, S.L. and Bagde, N.S., 2014. ROAD ACCIDENTS AND ITS SOCIAL AND ECONOMICAL EFFECTS. International Journal of Mechanical Engineering and Robotics Research, 3(2), p.480.Leidman, E., Maliniak, M., Sultan, A.S.S., Hassan, A., Hussain, S.J. and Bilukha, O.O., 2016. Road traffic fatalities in selected governorates of Iraq from 2010 to 2013: prospective surveillance. Conflict and health, 10(1), pp.1-10Mohamed, H.A., 2015. Estimation of socio-economic cost of road accidents in Saudi Arabia: Willingness-to-pay approach (WTP). Advances in Management and Applied Economics, 5(3), p.43Mohammed, H., Jaff, D. and Schrock, S., 2019. The challenges impeding traffic safety improvements in the Kurdistan Region of Iraq. Transportation Research Interdisciplinary Perspectives, 2, p.100029.Othman, S. and Carroll, J., 2015. A new strategy to enhance traffic safety in developing countries. In 24th International Technical Conference on the Enhanced Safety of Vehicles (ESV) National Highway Traffic Safety Administration (Vol. 15, p. 0059).Shinar, D., 2017. Traffic safety and human behavior. Emerald Publishing LimitedThe Revolutionary Command Council, R, 1971. Traffic Law No. 48 of 1971United Nations, 2007. Road Safety Review in Selected ESCWA Member Countries. 59. UN, New York.World Health Organization. (2018). Global status report on road safety 2018. Geneva: World Health Organization. Retrieved from https://www.who.int/publications/i/item/9789241565684.

The Streets of the Kurdistan Region: Obstacles Preventing Traffic Safety Advancements and The Economic Implications of Road Accidents

Introduction Political parties are the means by which political elites connect to formal institutions (formal political institutions such as governmental cabinets or parliaments); that is why understanding the nature of political parties is crucial for understanding the relation of the political elite to the public on the one hand, and, for understanding the relation of the political elite to the formal institutions on the other.In the Kurdistan region, the leaders of political parties direct their parties as ideologues and decision-makers. Thus, the political parties can direct their supporters and followers, the relationship is top-down. In none of the parties in the region are the party supporters capable of directing the political parties. <blockquote>Political parties play a central role; it is unlikely that any other type or model of social movements or social networks could replace the role and place of political parties (Huntington, 1996).&nbsp;</blockquote>In the Kurdistan Region, it is possible that the importance of political elites lies in the powers that they hold. Theoretically, the concept of elites is diffused with the concept of power. Here, power is conceptualized in two ways; Potential Power and Actual Power. Potential power refers to a state wherein the political elite in themselves are sources of power. One can picture&nbsp; a party leader who has masses of wealth or enjoys extensive intellectual capacities. However, Actual Power refers to the power that political elites receive from formal institutions, which is a legally defined and senctioned power. <blockquote>Put differently; Potential Power comes from informal institutions, including social structures, political parties, or a particular religion and worldview. But, Actual Power comes from formal institutions, such as a Parliament bestowing powers upon its Parliament Members, or the Council of Ministers bestowing power upon its Ministers.</blockquote> What is the purpose of political institutions?&nbsp;Institutions, according to Huntington (1965:388) are stable and valuable centers in which behaviors and actions are repeated (For example, parliaments and parliament members). Meaning that institutions are the accumulation of rules and organizational behaviors that persist for a certain period, and many of these institutions bring about a political order that more or less makes up a political system. Thus, political institutions shape a political structure and lay the principles and rules of political action. Institutions can be classified in a few ways, three of which include formal, semi-formal, and informal.Formal institutionsFormal institutions refer to those characteristics that define a particular political system. The organizational structure of institutions and their arrangement in relationship to one another determines the type of the political system. To illustrate, both the parliament and the government are two formal institutions; their relation to one another determines the type of the political system. If in a political system, the parliament were to exercise hegemony over the government, then the political structure would be parliamentarian. If the government were to exercise hegemony, then it would be a presidential structure. Thus, the difference between majoritarian and consensus democracy lies in their differences regarding their organizational structures and the relations of institutions to one another. These formal institutions in the region must be reorganized to establish a consensus parliamentary system (consensus democracy). Of the formal institutions in the region, four of them must be reorganized for the establishment of a consensus parliamentary system (consensus democracy). Firstly, the composition of the governmental cabinet must be based on political consensus. Secondly, the relationship between the government and the parliament must be a balanced relationship in which the parliament exercises hegemony. Thirdly, the political party system must be a multi-party system, not a two-party one. Fourthly, the electoral system must be proportionally representative. Meaning that the number of seats in parliament each party has must be proportional to the number of voters they have and have a proportional share in the government. This is what must take place instead of majoritarian representation, where only one or two parties make up the government.Semi-formal institutionsSemi-formal institutions refer to those preliminary agreements that exist between influential party elites that become prerequisites for the organization and functionality of formal institutions. To consolidate a consensus parliamentary system in the region, two semi-formal institutions are needed. First, all influential parties and their leaders must participate in the government. Secondly, extensive autonomy must be given to all governorates in terms of political, cultural, and economic administration.Informal institutionsThose complex social structures that give order to social relations, such as a feeling of togetherness - whether that feeling is based on faith or worldview. In the Kurdistan region, informal institutions include religions and creeds, ideologies, and supporters of political parties (supporters of a political party are united by a sense of belonging to said party). Just as formal and semi-formal institutions compose a political system, in the same way, informal institutions shape political systems and have a notable impact on the effectiveness of formal institutions. To illustrate, in the Kurdistan Region, formal institutions must consider informal institutions. The parliament is a formal institution and party supporters are informal ones; if the parliament does not take party supporters into account, then it is not unlikely that the formal institution would face impediments and suspensions. Or, the legislative branch must take into account the beliefs of the majority and not pass laws that conflict with the beliefs that the majority holds.&nbsp;<blockquote>What exists in the region can be theorized as elite-democracy.&nbsp;</blockquote>Two characteristics of democratic-elite theory include discussing democracy by highlighting both formal institutions as well as the role of political elites. The theory puts forth two hypotheses; first is that, political power lies in formal political institutions. Secondly, political elites are the catalysts of institutions and exercise hegemonic power over formal institutions in times of decision-making.There is a truth that is somewhat neglected in the Kurdistan region. That truth is that supporting political elites is one of the most important prerequisites for the establishment of democratic institutions in transitional phases - such as the one the Kurdistan Region is undergoing. The scientific conclusion here would suggest that the most preliminary step to be taken, is to transform political disagreements into consensus instead. That step must be taken to guarantee one of the most effective prerequisites for political stability and institutional rigidity; Political Consensus.When political elites are in consensus, they reach a degree of unanimity regarding the value and importance of the work of political institutions (ie: all political elites would respect the decisions of the parliament as decisions stemming from a formal institution). Reorganizing institutions in a way that prevents the rise of majoritarian democracy, but rather consolidates consensus-democracy is the only way for the political elite to reach consensus and unanimity. Following a consensus parliamentary system based the principles of public interest and common interest must be attempted.&nbsp; Works CitedC. Wright Mills. The Power Elite.1956.G. William Domhoff. Who Rules America? 1967.Grofman, Bernard, and Arend Lijphart. Electoral Laws and Their Political Consequences.&nbsp; Agathon Press, 1986.Huntington, Samuel P. The Clash of Civilizations and the Remaking of World Order. Riverside, Simon &amp; Schuster, 1996.Mills, C. W. “COMMUNITY POWER STRUCTURE: A STUDY of DECISION MAKERS. By Floyd Hunter. Chapel Hill: University of North Carolina Press, 1953.&nbsp;Schumpeter, Joseph. Capitalism, Socialism, and Democracy. New York, Harper &amp; Brothers, 1942.

A Brief Discussion on Political Systems: Institutions and Political Elites

Tackling Breast Cancer in Kurdistan: Epidemiology, Early Detection, and Intervention Strategies

<h3>Introduction</h3>The Covid-19 pandemic has resulted in significant alterations to healthcare practices, including increased infection prevention measures, changes in diagnostic procedures, and the reallocation of healthcare resources. Subsequently, this pandemic placed an enormous strain on healthcare systems worldwide, resulting in the redirection of resources and attention away from antimicrobial stewardship programs. This article explores the repercussions of COVID-19 on antimicrobial resistance and highlights the importance of addressing this emerging threat.<h3>Discussion&nbsp;</h3>Antimicrobial resistance is the broader term for resistance in different types of microorganisms (eg, bacteria, viruses, parasites, or fungi). It encompasses resistance to antibacterial, antiviral, antiparasitic, and antifungal drugs. Resistant microorganisms emerge either by mutations or the procurement of mobile genetic elements that carry the resistance gene. Therefore this can occur irrespective of the presence of antimicrobials. However, it is the exposure to these drugs that gives rise to the growth and spread of resistant pathogens (Prestinaci, 2015). Inappropriate prescribing (whether caused by obsolete guidelines or pharmaceutical pressures), over-the-counter antibiotic availability, and self-medication reflect a general lack of awareness of the global threat that antibiotic resistance poses to our society. Medical procedures such as surgery could become exceedingly difficult, or even impossible, due to antimicrobial resistance (Ibid). Common infections may become untreatable, which could lead to death.&nbsp;Director-General Margaret Chan stated in the foreword to the Global Action Plan that "Antimicrobial Resistance is a crisis that must be managed with the utmost urgency. As the world enters the ambitious new era of sustainable development, we cannot allow hard-won gains for health to be eroded by the failure of our mainstay medicines" (2015).&nbsp; However, clinical trials worldwide implemented the use of antimicrobial agents for the treatment of Covid-19 infections. A plethora of drugs have been used in prophylaxis and treatment of covid infections including several antivirals (lopinavir/ritonavir combination, remdesivir, and favipiravir); two antimalarials (chloroquine and hydroxychloroquine); ACE2 inhibitor (losartan); immunosuppressive agents (tocilizumab, leronlimab and corticosteroids); TMPRSS2 inhibitor (camostat mesylate); anti-parasitic drugs (ivermectin and nitazoxanide); a gold-containing drug, auranofin, an immunomodulator used in sepsis and leprosy (Sepsivac, mycobacterium w (heat-killed) injections); allogeneic Placental expanded (PLX) cells; and convalescent plasma (Breining, 2019; Evan, 2019; Caly, 2020; Diederich, 2020; Smith, 2020; Barkama, 2020; Patel, 2021; Mirjalili, 2022; Massai, 2022). In addition, during the COVID-19 pandemic, soaps and antimicrobial disinfectants have been increasingly used by hospital staff. If these products are based on chlorhexidine digluconate or quaternary ammonium compounds, this can also lead to antibiotic resistance.&nbsp;The uncertainty surrounding the early stages of the pandemic and the lack of specific antiviral treatments contributed to clinicians prescribing antibiotics empirically to manage suspected bacterial co-infections. In addition, the clinical presentation of Covid-19 can mimic bacterial infections, leading to diagnostic uncertainties. Delayed diagnosis or misdiagnosis of bacterial co-infections may result in suboptimal antibiotic management, potentially fueling antimicrobial resistance (Ha et al, 2017). Therefore the frequent use of antibiotics for the antiviral therapy of covid patients further aggravated the antibiotic resistance crisis. Antiviral drugs like remdesivir, favipiravir, and others have been used frequently to manage COVID-19 patients (Smith, 2020; Eroglu, 2021).&nbsp;A study by Yale Schools of Medicine and Public Health has conveyed a remdesivir-resistance variant of SARS-CoV-2 in an immunocompromised patient who was being treated with remdesivir (Gandhi et al, 2022). Patients with Covid-19 have weakened and compromised immune systems, making them reliant on antiviral therapy to control the virus, and subsequently making them more prone to developing resistance to the treatment they receive. The focus on managing Covid-19 cases may have led to reduced monitoring of antimicrobial prescribing practices, hindering efforts to prevent inappropriate antibiotic use.&nbsp;Antibiotic prescriptions for inpatients and outpatients led to a setback in the combat against antibacterial resistance (Ha et al, 2017; Hodoșan et al, 2023). The prevalence of antibiotic-resistant pathogens among patients with laboratory-confirmed Covid-19 and bacterial infections emphasizes the urgency of antimicrobial stewardship. Research findings show that approximately 72% of COVID-19 patients admitted to hospitals received antimicrobial treatment, despite only 8% of them having bacterial or fungal co-infections (Rawson et al, 2020). Moreover, various antibiotics such as azithromycin have been suggested for COVID-19 treatment. The mass public concern, in addition to the inappropriate use of antibiotics, directly affects antibiotic access without a prescription, especially in developing countries with weak antibiotic control systems. For instance, it was reported that nearly 69% of COVID-19 patients had used antibiotics like ceftriaxone and azithromycin before hospital admission (Zavala-Flores et al, 2020).ConclusionThe indiscriminate use of antibiotics in the management of COVID-19 patients, combined with diagnostic uncertainties and empirical prescribing, has contributed to the rise of antimicrobial-resistant pathogens. This emerging crisis demands urgent action and strengthened antimicrobial stewardship programs. The prevalence of antibiotic-resistant pathogens among COVID-19 patients underscores the need for prudent antibiotic use and careful monitoring of prescribing practices. Efforts should be directed towards promoting awareness about the global threat of antimicrobial resistance and the importance of appropriate antibiotic use. Collaborative efforts between healthcare providers, policymakers, researchers, and the pharmaceutical industry are crucial in addressing this issue and safeguarding the threatened utility of antibiotics for future generations. References&nbsp;“No Time to Wait: Securing the Future from Drug Resistant Infections.” IACG Report to the Secretary General of the United Nations, April 2019. Geneva: The UN Interagency Coordination Group on AMR; 2019.Barkama, R., Mayo, A., Paz, A., Solopov, A., Mann, T., Vadasz, Z., Appel, T., Ofir, R., Shani, L., Sheleg, M., Allen, H., Shaked Nitzan, R., Tsarfaty, N., Gilad, H., Birch, T., Kachel, E., Reinke, P., Volk, H.-D., Zalts, R., &amp;amp; Raz Pasteur, A. (2020, September 15). Placenta-derived cell therapy to treat patients with respiratory failure due to coronavirus disease 2019. Critical care explorations. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498138/" data-mce-href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498138/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498138/</a>&nbsp;Breining P, Frølund AL, Højen JF, et al. Camostat mesylate against SARS-CoV-2 and COVID-19—Rationale, dosing and safety. Basic Clin Pharmacol Toxicol. 2021;128:204–212. <a href="https://doi.org/10.1111/bcpt.13533" data-mce-href="https://doi.org/10.1111/bcpt.13533">https://doi.org/10.1111/bcpt.13533</a>Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDA-approved drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Res. 2020Diederich S. EurekAlert, AAAS; Washington, DC, USA: March 5, 2020. Preventing spread of SARS coronavirus-2 in humans: Göttingen infection researchers identify potential drug.Eroglu, E., &amp; Toprak, C. (2021). Overview of favipiravir and remdesivir treatment for COVID-19. International Journal of Pharmaceutical Sciences and Research, 12(4), 1950-1957.Evan M Bloch and others, Guidance on the Use of Convalescent Plasma to Treat Immunocompromised Patients With Coronavirus Disease 2019, Clinical Infectious Diseases, Volume 76, Issue 11, 1 June 2023, Pages 2018–2024, <a href="https://doi.org/10.1093/cid/ciad066" data-mce-href="https://doi.org/10.1093/cid/ciad066">https://doi.org/10.1093/cid/ciad066</a>Gandhi S, Klein J, Robertson AJ, Peña-Hernández MA, Lin MJ, Roychoudhury P, Lu P, Fournier J, Ferguson D, Mohamed Bakhash SAK, Catherine Muenker M, Srivathsan A, Wunder EA Jr, Kerantzas N, Wang W, Lindenbach B, Pyle A, Wilen CB, Ogbuagu O, Greninger AL, Iwasaki A, Schulz WL, Ko AI. De novo emergence of a remdesivir resistance mutation during treatment of persistent SARS-CoV-2 infection in an immunocompromised patient: a case report. Nat Commun. 2022 Mar 17;13(1):1547. doi: 10.1038/s41467-022-29104-y. PMID: 35301314; PMCID: PMC8930970.Getahun, H.; Smith, I; Trivedi, K.; Paulin, S.; Balkhy, H.H. Tackling antimicrobial resistance in the COVID-19 pandemic. Bull. World Health Organ. 2020, 98, 442.&nbsp;Antimicrobial resistance. Ministry of Health NZ. (n.d.). <a href="https://www.health.govt.nz/our-work/diseases-and-conditions/antimicrobial-resistance" data-mce-href="https://www.health.govt.nz/our-work/diseases-and-conditions/antimicrobial-resistance">https://www.health.govt.nz/our-work/diseases-and-conditions/antimicrobial-resistance</a>&nbsp;Getahun H, Smith I, Trivedi K, et al. Tackling antimicrobial resistance in the COVID-19 pandemic. Bull World Health Organ. 2020; 98:442.Ha, D. R., Haste, N. M., &amp; Gluckstein, D. P. (2017). The Role of Antibiotic Stewardship in Promoting Appropriate Antibiotic Use. American journal of lifestyle medicine, 13(4), 376–383. <a href="https://doi.org/10.1177/1559827617700824" data-mce-href="https://doi.org/10.1177/1559827617700824">https://doi.org/10.1177/1559827617700824</a>Hodoșan, V., Daina, L. G., Zaha, D. C., Cotrău, P., Vladu, A., Dorobanțu, F. R., Negrău, M. O., Babeș, E. E., Babeș, V. V., &amp;amp; Daina, C. M. (2023, May 3). Pattern of antibiotic use among hospitalized patients at A level one multidisciplinary care hospital. MDPI.&nbsp;Prestinaci, F., Pezzotti, P., &amp; Pantosti, A. (2015). Antimicrobial resistance: a global multifaceted phenomenon. Pathogens and global health, 109(7), 309–318.&nbsp;Smith T, Bushek J, Prosser T. Elsevier; Amsterdam, The Netherlands: 2020. COVID-19 Drug Therapy – Potential Options. Clinical Drug Information | Clinical Solutions.Zavala-Flores, E.; Salcedo-Matienzo, J. Medicación prehospitalaria en pacientes hospitalizados por COVID-19 en un hospital público de Lima-Perú. Acta Méd. Peru. 2020, 37,393-395.Khuroo, M. S. (2020, September). Chloroquine and hydroxychloroquine in coronavirus disease 2019 (COVID-19). facts, fiction and The hype: A critical appraisal. International journal of antimicrobial agents. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366996/" data-mce-href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366996/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366996/</a>&nbsp;Mahmoudi H. Bacterial co-infections and antibiotic resistance in patients with COVID-19. GMS Hyg Infect Control. 2020;15:1–6.Massai L, Grifagni D, De Santis A, Geri A, Cantini F, Calderone V, Banci L, Messori L. Gold-Based Metal Drugs as Inhibitors of Coronavirus Proteins: The Inhibition of SARS-CoV-2 Main Protease by Auranofin and Its Analogs. Biomolecules. 2022 Nov 11;12(11):1675. doi: 10.3390/biom12111675. PMID: 36421689; PMCID: PMC9687241.Mirjalili, M., Soodejani, M.T., Raadabadi, M. et al. Does Losartan reduce the severity of COVID-19 in hypertensive patients?. BMC Cardiovasc Disord 22, 116 (2022). <a href="https://doi.org/10.1186/s12872-022-02548-2" data-mce-href="https://doi.org/10.1186/s12872-022-02548-2">https://doi.org/10.1186/s12872-022-02548-2</a>Patel PS, Patel S, Shah V, Aswani V, Narwaria M. Early Experience of High-dose Intravenous Mycobacterium w in Critically Ill Patients of COVID-19. Indian J Crit Care Med 2021;25(9):1066–1068.Prestinaci, F., Pezzotti, P., &amp; Pantosti, A. (2015). Antimicrobial resistance: a global multifaceted phenomenon. Pathogens and global health, 109(7), 309–318.&nbsp;Rawson TM, Moore LSP, Zhu N, Ranganathan N, Skolimowska K, Gilchrist M, et al. Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing. Clin Infect Dis. 2020. May 2.Smith T, Bushek J, Prosser T. Elsevier; Amsterdam, The Netherlands: 2020. COVID-19 Drug Therapy – Potential Options. Clinical Drug Information |Clinical Solutions.<a href="https://www.elsevier.com/__data/assets/pdf_file/0007/988648/COVID-19-Drug-Therapy_Mar-2020.pdf" data-mce-href="https://www.elsevier.com/__data/assets/pdf_file/0007/988648/COVID-19-Drug-Therapy_Mar-2020.pdf">https://www.elsevier.com/__data/assets/pdf_file/0007/988648/COVID-19-Drug-Therapy_Mar-2020.pdf</a>

From Pandemic to Resistance: The Unintended Consequences of COVID-19 on Antimicrobial Practices

<blockquote>Film as dream, film as music. No art passes our conscience in the way film does, and goes directly to our feelings, deep down into the dark rooms of our souls.- Ingmar Bergman (1) </blockquote>Cinema, often referred to as The Seventh Art, is one of the more recent arts in terms of emergence. That is in contrast to the large human history with the other forms of art. It has been a part of our world for some 130 years. The most progressive and leading nations in the world, the likes of France and America, have been an integral part of cinema’s invention, progression and evolution. However, each nation has contributed to cinema in a particular way. Several countries have their own distinct cinematic schools or cinematic universes which hold different values and methods in comparison to the other countries. Russia, Italy and Germany are good examples. A nation or a country can produce numerous films and still not be able to call itself “a country that has it’s own cinema”. Because for cinema to exist, it has to either become an independent industry or an independent school of cinema (like a school of thought). Only then can cinema be used as a tool to represent, display and spread a nation’s culture and identity.The leading countries of the world, recognized the importance of cinema early on. They acknowledged the fact that cinema can be a powerful tool for a nation to represent and identify it’s culture and identity. Europe is regarded as the cradle of cinema. However, The United States of America established it’s place in the cinema medium firmly by creating a whole cinematic industry in Hollywood. We have witnessed numerous historical events which were initially influenced by cinema. The French students revolution of 1968 is widely known to have been influenced by the French cinema of that period.(3) Italy, Sweden, Russia, Japan, The United Kingdom, etc.. have all been involved in contributions to cinema for more than 100 years. The impacts of cinema on each of these countries are recognized in the cultural, political and economical aspects. Naturally, none of these were achieved overnight or without a clear plan and strategy to make cinema a great soft weapon of each of the aforementioned countries.Thus far, we Kurds can not have a real claim to cinema. It is true that we do have films here and there, there have been several attempts at creating a distinct Kurdish cinema, but none have succeeded in doing so. The first Kurdish film to be made was (Zare). Directed in 1926-1927 by Hamo Bag Nazarian. The film can be summarized as such: Immediately prior to the Russian Revolution, a young shepherd Seydo and his girlfriend Zare struggle for their right to a happy love in a Yazidi Kurdish village in Russian Armenia.(2).<blockquote> But just what can be regarded as a Kurdish film? This question is a rather puzzling and multidimensional one. We can not put a finger on one aspect of a film and use it as a defining factor to answer the question.</blockquote> As we are, unlike other nations, still without a sovereign country to protect and identify our culture and identity inside it’s borders. Thus far, we merely have different attempts by different individuals with the aim to create and establish what can be called “Kurdish Cinema”. These attempts at cinema to tell Kurdish tales and represent the Kurdish cause have all been partially impactful. Yilmaz Güney is a great example. He made many films, most of which were made in the Turkish language, by Turkish filmmaking tools and a mostly-Turkish cast and crew. Yet we can not label his films as Turkish for at their core his films have a Kurdish sense and discourse.Of the main properties that can make a film ‘Kurdish’ are: A Kurdish discourse, a Kurdish narrative or an attempt at showcasing the Kurdish history and it’s identity. Apart from Güney, other directors (Bahman Ghobadi, Kazim Oz, Taha Karimi, Shewket Amin, Huner Selim) and many others have contributed to Kurdish cinema.In Southern Kurdistan’s four provinces (Erbil, Suleymaniyeh, Duhok and Halabja), the number of cinema halls are very limited. In Kurdistan, as in everywhere else, cinema now is more of a ‘home display’ medium. Individuals tend to watch films on their private electrical gadgets such as computer, TVs and mobile phones. This is one of the contributing causes that makes cinema less attainable. For without cinema halls, a cinematic culture can not be built. Without a cinematic culture, cinematic awareness can not exist and without cinematic awareness cinema itself can not be created. Although, there are other factors that contribute to the absence of cinema in Kurdistan.Another reason for Kurdish cinema’s lack of progression is the absence of cinematic academies and institutions in which filmmaking students in different aspects of filmmaking can learn. Although Kurdistan has college and university of arts, in which there is a cinema department, but these institutions have not succeeded at providing and developing cinematic movements. The art history of the different nations of the world can be regarded as a shared and universal history, this is evident that we Kurds can be beneficial of the vast and rich history of the other nations and use that to our advantage to establish our own cinema and use it as a tool to build a stronger nation. Another one of the helpful factors that can provide us with assistance in building and establishing our own cinema is the fact that we are an ever-present Mesopotamian nation and that our roots are planted deep in this whole region’s history and the history of civilization. In spite of all the historical and political events, invasions and being divided into several parts, we have managed to protect and distinguish our language and culture from the neighboring nations of the region, like Arabs, Turks and Persians. This long history of dispute and violent events has led to a vast world of interesting stories that can make for interesting cinematic ideas. Aside from this, the many uprisings, revolts and revolutions by the different political movements of the different historical periods of Kurdistan, have brought forth a universe of diverging stories.Building cinema in this technological era seems more attainable and more achievable than ever. In order to start building a Kurdish cinema we need: social cinematic awareness, cultural and intellectual foundation for cinema, educating filmmakers, importing and creating an electronic infrastructure, building an economical infrastructure, a strategy to develop cinema by governmental institutions, building cinema halls, governmental support and facilitation to filmmakers. Individual and social awareness may automatically fall behind all these simple strategies. Because previous attempts have proved to us that like any other place in the world, there is a vast and lively audience, hungry and thirsty for more Kurdish productions.

Cinema and Identity: The Case for Kurdish Cinema

According to a longitudinal study of 135 countries, one fact comes to the surface; the total duration/lifespan of those democratic countries where the GDP per capita is one thousand dollars or less is merely 13 years old; however, the duration/lifespan of those democracies becomes 60 years when the GDP per capita is measured 3,000 or 6,000 dollars. Likewise, no democratic system with 6,000 thousand dollars in GDP per capita has ever collapsed. This study conducted by Adam Przeworski has concentrated on democratic systems but it is possible that the findings apply to non-democratic systems as well, indicating the possibility that - a&nbsp;low-income&nbsp;authoritarian regime is more likely to collapse than a&nbsp;high-income&nbsp;authoritarian regime. Put briefly, one could establish a correlation between political stability and the state of the economy. This implies that to extend the lifespan/duration of a political system, efforts must be made to ensure a robust, stable economic system. Moreover, two other scientifically valid conclusions could be established.&nbsp;Firstly, for political structures to be long-lasting, they must be aided by a robust economy. Secondly, contra, if one is to maintain a robust economy, the political structure must be built in a manner that accommodates and fosters economic development.&nbsp;<blockquote>Simply put, economic growth refers to the strengthening of economic structures in the production of goods, creating job opportunities, and increasing the country's Gross Domestic Product, to build a strong and independent economic system. Economic growth, on the other hand,&nbsp;refers to income inflation; when income does arrive in the country but is not conducive to improving the economic system or changing the economic structure.&nbsp;</blockquote> Economic development is measured by GDP per capita. Reliable data that measures GDP per capita in the KRI is not available, indicating that the extent of economic development in the region remains questionable.&nbsp;What does take place in the Kurdistan Region is economic growth, not economic development. Because, although the number of&nbsp;capitalists has increased, the economic system and structure remain the same as before. The number of wage earners has increased and not decreased, as have unemployment and poverty; the same goes for low levels of domestic production and high levels of imports.&nbsp;Creating a market for foreign products weakens the economy and does not strengthen it. Attracting foreign investment and not encouraging domestic investment does not strengthen the economy either, because in times of crisis, with the slightest threat, foreign investors retract their payments and capital.&nbsp;In discussing the social prerequisites of a democratic system that make a country more receptive to democracy, Seymour Martin Lipzd prescribes four main dimensions: capital, industry, education, and urbanization. For a country with substantial capital, which also has developed industry and a proper, modern education system, as well as a healthy urbanization process, the possibility of democratization is much stronger, compared to a country that does not encompass these four dimensions. These four principles, because they are the four dimensions of civil society in the modern state, make the middle class&nbsp;efficient and impactful.&nbsp;&nbsp;Democracy as a system denotes a two-dimensional relationship between the people and the power-holders. The first dimension is - that those in power must respond to the demands of the people, and secondly, the people can, relatively, influence decision-making. The aforementioned principles serve to bring the people closer to the power holders and the political structure. In that, a form of stability is achieved, wherein neither of the two main constituents (the people and the power-holders) are a threat to one another; neither does the political structure threaten the people's welfare, nor do the people threaten the stability of the political structure.&nbsp;&nbsp;According to IMF and World Bank figures, at least four of the Gulf countries are among the world's richest in terms of GDP Per capita – the lowest being Bahrain at 49,020$ and Amman at 4,3847$ US dollars. According to global statistics on democracy and freedoms, the Gulf countries are all undemocratic and unfree. One could ask why have the Gulf countries not stepped towards democracy and freedom. Does capital really affect changes in the political system? The answer is that the oil-rich Gulf countries are rentier states, which means that most or all of the national income comes from renting domestic assets to foreign customers. (Hussein Mahdavi used this theory for the first time in the 1960s).&nbsp;&nbsp;There are four characteristics that qualify a country as a rentier state, as the political scientists Hazim Bablawi and Giacomo Luciani have detailed:&nbsp; First, the country is dominated by foreign rents, second, the the entire economy relies on foreign income, thus the country does not require a strong domestic investment sector. Third, only a small portion of the labor force participates in generating income. Fourthly and most importantly, the government or the state is the main beneficiary of&nbsp;external rents.&nbsp;This also hinders economic development, seeing that economic development requires domestic revenue, the existence of a domestic investment sector, a labor force, and a free market. These four attributes of a rentier state distort the order of the political structure, Why exactly does that occur? Because the natural relationship between the economic system and the political structure is disrupted.&nbsp;Consequently, the 23 countries with the largest oil and gas revenues have&nbsp;stagnant&nbsp;and undemocratic political structures.&nbsp;In a rentier state, there are two factors that hiddenly weaken state institutions: first, that the revenues come from&nbsp;abroad,&nbsp;and second, that the incoming revenue goes directly to the state.&nbsp;&nbsp;Citizens of these countries rely solely on the state and resort to the state's institutions to find employment, secure wages, and improve their living conditions. This puts the official institutions of the state under pressure (the main function of the state is thus reduced to salary distribution). In such circumstances, the survival of the state relies on one thing; buying legitimacy. That takes place through selling oil to foreign buyers. Such a political system is completely weak because to secure&nbsp;public revenues&nbsp;and protect itself, the state relies on external income and power. The source of economic and political stability is not its market, its people, or its legitimacy, but it is another power.&nbsp;<blockquote>Therefore, oil can improve the quality of life, but it leaves the economic structure weak. This is what distinguishes most oil-rich countries; significant economic growth without economic development.</blockquote>There are many factors that hinder economic development, but the most important is the phenomenon of (owner and buyer) or (master and customer). Such a phenomenon is what prevents the existence of a free market because it prevents a fundamentally independent private sector. In the Gulf countries, this unhealthy dynamic prevents the emergence of an independent private sector. (It is also the reason why Gulf countries do not head towards&nbsp;political liberalization).&nbsp;&nbsp;What has happened, both in the Kurdistan Region as a preliminary process and in the Gulf countries as a result of this process has been the transfer of jobs and investment in areas previously monopolized (in the Kurdistan Region, they were monopolized by the government or political parties) to partners, collaborations/assistants of the state or those who administer it.&nbsp; The private sector has certainly become more prosperous in the Kurdistan Region, but because it is not independent, and because it is not self-sufficient, it has not been able to&nbsp;take charge&nbsp;in times of political crisis. What is especially remarked in the Kurdistan region is that, instead of providing aid, the private sector is responsible for some of the economic issues that the region suffers from.&nbsp;&nbsp;If the private sector and the power center become closer with the goal of operating together, contrary to what is understood, both will suffer losses; Neither the government can perform its functions to ensure legitimacy, nor can the private sector strengthen the economic structure, which is again the goal of the private sector.&nbsp;Both will suffer instead.&nbsp;As is clear in the region, the collapse of one will ensure the collapse of the other. The main reason is that the private sector has expanded haphazardly and without restriction, becoming an extension, and even a replacement of the public sector.&nbsp;The private sector has not been independent in the sense that many units of the private sector were either directly or indirectly owned by those in power, meaning those in power did not permit the private sector to be independent. Rather, the private sector has been, more or less under their dominion,&nbsp;and the private sector has been dependent on the rulers.&nbsp;&nbsp;Therefore, it became apparent that when the government faced an income crisis, it had an immediate impact on all units of the private sector in the region. Most projects in development were stopped and an increasing number of contractors declared bankruptcy. So, to protect the region, we must look at the economic system and the political structure, and more importantly, how they relate and interact,&nbsp;by reorganizing&nbsp;the functions of the public sector and the services and investments delivered by the private sector.&nbsp;The most important point is to draw a line between the private and public sectors. Neither should cross the boundaries of the other. Currently, the private sector has crossed the boundaries of the public sector, which must be amended. The second point is to limit foreign investment, Taking into account the political situation in the region, it is a guaranteed loss to bring foreign investment into the country at the expense of domestic investments. It was seen that most foreign investors fled at the sight of emerging threats.&nbsp;&nbsp;The fundamental solution is to support and encourage domestic investment, and for the government to fulfill its main function, which is monitoring the work of domestic investors. Because the government can take a number of measures against domestic investors, but it cannot do so with foreign investors. The economic system of the region needs a fundamental overhaul, but any kind of reform must take two things into account; first, the social structure, and second, the political structure. Without a proper reading and understanding of these two issues, it is unlikely that any economic reform will have remarkable results.&nbsp; Works CitedBeblawi, Hazem. “The Rentier State in the Arab World.” Source: Arab Studies Quarterly, vol. 9, no. 4, 1987, pp. 383–398,&nbsp;Hazem Beblawi, and Giacomo Luciani. The Rentier State. Routledge, 16 July 2015.“IMF ELibrary.” Imfsg, <a href="http://www.elibrary.imf.org/" data-mce-href="http://www.elibrary.imf.org/">www.elibrary.imf.org</a>.Lipset, Seymour Martin. “Some Social Requisites of Democracy: Economic Development and Political Legitimacy.” The American Political Science Review, vol. 53, no. 1, 1959, pp. 69–105.Mahdavy, H. The Patterns and Problems of Economic Development in Rentier States: The Case of Iran. 1963.“Open Knowledge Repository.” Worldbank.org, 2019, openknowledge.worldbank.org.Przeworski, Adam. Democracy and Economic Development*. 2000.&nbsp;

An analysis of the Economic System of the Kurdistan Region of Iraq

NSI - ENG

research

Open Sans

Work Sans

Nishtman Strategy Institute uses cookies to ensure you get the best experience on our site.

Research Articles

The Streets of the Kurdistan Region: Obstacles Preventing...

A Brief Discussion on Political Systems: Institutions and...

Tackling Breast Cancer in Kurdistan: Epidemiology, Early ...

From Pandemic to Resistance: The Unintended Consequences ...

Cinema and Identity: The Case for Kurdish Cinema

An analysis of the Economic System of the Kurdistan Regio...