research topics middle east

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Middle East Research Paper Topics

The hardest part of writing a dissertation or research paper about the Middle East is to decide which topic to give your essay. You need to be creative but also unique, ensuring you come up with a topic that has never been used previously. You must as well understand the subject matter and ensure you use ideas and content that has not been discussed in other essays.

Choose a topic you find interesting and easy to express your views on. Basing the subject of your Middle East research paper on a topic you love and enjoy will ease the way you communicate your ideas as well as amplify your idea base. Likewise, you won’t spend so much time researching the topic and content since you’ll already have an idea on what you are writing. The Middle East has a history that’s so complex and expansive to describe in a single paper. And so there are so many topics and issues you can base your essay writing on, including religion, culture, social values, and social ideas. Here is an expansive range of Middle East research paper topics that university and college students can use in their essay assignments.

• How The Authoritarian Rule Aided Spread of Democracy in the Middle East
• Reasons Turkey Wasn’t Affected by World War II
• A Research Paper on the Raise of Middle East Populace
• The Effects of the Escalating Middle East Populace
• Dreadful Ways the Middle East Was Affected by War
• Fascinating Ways Religious Heritage Affected the Middle East
• Exciting Reasons Saudi Arabia Wasn’t Gravely Affected by World War II
• The Main Triggers of Most Middle-East Political Disputes
• Argumentative Essay on Why Saudi Arabia Grew to Become A Middle East Pacesetter
• The Triggers of Age-Old Issues in the Middle East
• How the Middle East Was Gravely Affected by War
• Research Paper on the Effects of Growing Refugee in the Middle East
• Fascinating Reasons America Gets More Interested in the Middle East Every Day
• Funny Reasons Why Turkey Adopted the Islamic and Western Basics
• How did Turkey adopt Islamic and Western Basics?
• The Indirect Ways Australian Forces Triggered the Palestine-Israel Conflict
• Why Did Jews Choose to Settle In Palestine
• A Research Paper on Middle Eastern Women
• What Historical Problems Originated from the East?
• How Oil Discovery In The Middle East Changed Its Economy?
• How India’s Increasing Need for Oil Changed Its Geo-Politics?
• Why The Egyptian Great Pyramid Remained Unchanged for Over a Century?
• Common Middle East Border Clashes and What Caused Them
• A Research Paper on Computer Exportation to South Arabia
• How The Changing India-China Dynamic Relationship Impacted the World
• Rarely Known Facts On Why India-Sri Lanka Relationship Triggered Both Love and Hate
• How Foreign Countries Stimulated The Current Conflict in the Middle East
• A Research Paper on Software CDs and Music Marketing in South Arabia
• Ways The Ottoman’s Found the Way Out of The Middle East
• Common Historical Problems Originating From the Middle East

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Research Projects

The Center for Middle East Studies (CMES) promotes research, teaching and public engagement on key issues of the Middle East in a historically and culturally grounded manner. Its coverage includes all time periods—from antiquity to contemporary geopolitics—and an expansive geographical imagination in which the Middle East is both a region with changing boundaries and a conceptual entity, part of global discourses. Scholars are encouraged to explore their different research projects in a shared endeavor of better understanding the Middle East.

Gender Studies in the Middle East and Beyond

This research project,  led by  Nadje Al-Ali ,   Robert Family Professor of International Studies, and professor of anthropology and Middle East studies,   is based on the recognition that a gendered intersectional lens is central, not marginal, to a deeper analysis and understanding of political mobilizations, social developments and cultural expressions in the Middle East. A gendered lens also allows for a comparative perspective and collaboration with other regional centers and initiatives at Brown University. The project involves panel discussions, lectures and book talks, as well as relevant research.

Racialization and Racism in the Middle East and its Diasporas

Within Middle East Studies, we are intimately familiar with grinding generational struggles for dignity and freedom of colonized, occupied, disenfranchised and oppressed people in the Middle East. Yet the history of slavery and racism within the region has remained understudied, and not sufficiently engaged with. This initiative, co-organized and led by professors  Nadje Al-Ali  and  Beshara Doumani ,  and supported by  Africana Studies , is committed to to initiating internal conversations and dialogue within Brown and Middle East studies more broadly and to organizing activities which engage with the global issues of structural racism and exploitation.

Gender and Body Politics: Arts in the Middle East and its Diasporas

In conversation with artists from the Middle East and North Africa as well as its diasporas, the Gender and Body Politics: Arts in the Middle East and its Diasporas  series examines intersecting inequalities and body politics expressed, represented and transgressed in both visual and performance art. Against the backdrop of war and conflict, the rise of authoritarian regimes, displacement and diaspora mobilization, Islamophobia, ongoing orientalist depictions, and challenges linked to the COVID-19 pandemic, this series explores the ways in which artists are informed by and/or contribute to anti-racist, transnational feminist, and queer praxis.   The Brown University Center for Middle East Studies (CMES) and the Columbia University Middle East Institute (MEI) joint  series feature artists online and hosted in-person events. Exhibitions and performances complement the series in locations around New York City and Providence.

Kurdish Studies Project

Kurdish studies have historically been sidelined within Middle East studies or reduced to the study of Kurdish nationalism. While there has been a proliferation of Kurdish studies across the US and Europe in recent years, there has been only limited engagement with Kurdish society in its complexity. The aim of this project led by  Nadje Al-Ali , Robert Family Professor of International Studies, is to support and contribute to critical and original Kurdish studies that combine theoretically cutting-edge and empirically grounded work while highlighting creative approaches (films, art, literature) to the study of Kurds and Kurdish societies. Kurdish Studies Events

Arts and Social Change

The arts have played a pivotal role in shaping and transforming Middle Eastern and Muslim societies, past and present. Through annual workshops, curated exhibits and performances, as well visiting professorships and lectures, this research initiative cultivates a network of scholars passionate about the relationship between the arts and social agency. The aim is to support, innovate, work, and shape research agendas in the fields of Islamic art and architecture, Middle Eastern cinema and photography, fine arts and visual culture, and music and dance.  

Digital Islamic Humanities (archived)

The Digital Islamic Humanities Project is a research initiative devoted to supporting data-driven scholarship on the history, literature, and cultures of the Islamic world. Over the past few decades, humanistic inquiry has been problematized and invigorated by technological advances and the emergence of what is referred to as the digital humanities. Across multiple disciplines, from history to literature, religious studies to philosophy, archaeology to music, scholars are tapping the extraordinary power of digital technologies to preserve, curate, analyze, visualize, and reconstruct their research objects. Through the sponsorship of annual gatherings, workshops, symposia, and other kinds of research projects, this initiative aims to support the state of the art in digital scholarship pertaining to Islamic & Middle East Studies. 

Digital Islamic Humanities Website

Displacement (archived)

Displacement is formative of power relations of inclusion and exclusion. This research initiative pushes at the seams of the humanities, social sciences, and the natural and physical sciences by exploring long-term drivers of displacement. The wager here is that focused interdisciplinary conversation about historical, ecological, and subjective dimensions of displacement as an enduring and global phenomenon, can lay the seeds for imagining alternative futures.

MELLON SAWYER SEMINAR ON Displacement: 2016-17 Website

DISPLACEMENT SERIES 

Engaged Scholarship (archived)

Engaged Scholarship explores the politics and ethics of knowledge production in zones of conflict. The aim is to generate critical conversation among scholars from across the disciplines and area studies around the question of what it means to put intellectual work in the service of the social good, broadly defined. 

Engaged Scholarship Website

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Autumn 2023

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10 key events and trends in the Middle East and North Africa in 2021

Paul Salem , Brian Katulis , Gerald M. Feierstein , Gönül Tol , Charles Lister , Ross Harrison , Alex Vatanka , Marvin G. Weinbaum , Khaled Elgindy , Mark A. Heller , Karen E. Young , Mohammed Mahmoud , Eliza Campbell

• A transition in America occurs as the landscape shifts in the Middle East

The GCC turns to diplomacy and dialogue to manage conflict

Facing long odds and growing pressure at home, erdoğan tries a new approach: diplomacy, the year of assad’s normalization.

• The catch-22 of civil wars in the Middle East
• Iran’s hardliners consolidate their hold on power
• The end of the 20-year war in Afghanistan
• The lessons of the May war in Gaza
• Israel’s new government lowers the temperature of the debate
• A year of reckoning in energy markets
• More climate change highs (and lows) for the Middle East

The implications of NSO Group

Looking ahead to 2022, 1) a transition in america occurs as the landscape shifts in the middle east.

Paul Salem President

Brian Katulis Vice President for Policy

The center of gravity for the Biden administration’s overall policy was on domestic issues, with a sharp focus on the pandemic and economic crisis at home. On the foreign policy front, the three C’s — China, climate change, and COVID-19 — along with efforts to rebuild ties with democratic allies in Europe and Asia, dominated the agenda.The transition of power in the United States from the Trump administration to the Biden administration was one of the year’s most important events for the broader Middle East and North Africa, as it resulted in significant shifts in U.S. policy that had ripple effects across the region. The most consequential of these moves were the withdrawal from Afghanistan and the attempt to return to the 2015 nuclear agreement with Iran. Nevertheless, many of the most important trends in the Middle East remain driven by its governments and people, as well as the impact of factors such as the COVID-19 pandemic, climate change, and migration on the regional landscape. Yet, for all of the talk about U.S. disengagement from the region and the rise of China and Russia, the United States remains the most influential outside actor, given its broad network of relationships and ability to influence dynamics.

The Biden administration signaled a more modest approach to the Middle East compared to the Trump administration, prioritizing diplomacy in its rhetoric and actions and stressing that it was moving “back to basics” in avoiding overpromising about the level of U.S. engagement. It worked to adopt a steadier, more predictable policymaking process than its predecessor had on the Middle East.

The Trump administration was focused on the military defeat of the Islamic State, the “maximum pressure” campaign against Iran, and efforts to forge normalization agreements between Israel and Arab states including the United Arab Emirates (UAE), Bahrain, Morocco, and Sudan. By contrast, the Biden administration’s initial stance has been to guard against the deep levels of engagement that had at times overwhelmed the broader agendas of the past three U.S. administrations. It appointed envoys on Yemen, Libya, and the Horn of Africa, and it reengaged Iran in international talks on its nuclear program in Vienna.

The May 2021 war between Israel and Hamas drew the Biden administration back into the Israeli-Palestinian issue more deeply than it had planned. The haphazard withdrawal of U.S. troops from Afghanistan caused a crisis of confidence among America’s partners in the Middle East and prompted more engagement with several of them, especially the Arab Gulf states, than the administration had initially intended.

But it was the common thread between the Obama, Trump, and Biden administrations that made the biggest impression on the region: the desire to limit U.S. involvement in the Middle East. The U.S. posture has incentivized strategic hedging among key countries in the region, which have consequently worked to forge deeper ties with other outside actors, especially China, Russia, and some European countries. It also created incentives for many regional states to adopt a more assertive approach.

Within the region itself a number of dynamics have marked 2021 . The COVID pandemic continued to claim thousands of lives, strain public health resources, constrain economic growth and public finances, and drive up rates of poverty, unemployment, and inequality. Vaccination rates and COVID response efforts have varied widely across the region, from the top performers in the resource-rich Gulf states, to more challenging conditions in the population-rich and resource-poor countries, and desperate conditions in the fully or partially failed states of Yemen, Libya, and Syria.

Despite these challenges, the broader regional economy bounced back: Average GDP growth in 2021 returned to around 4% after contracting by 4% in 2020. Oil prices continued to recover in 2021 after the total collapse in early 2020 and rose steadily over the course of the year; this helped improve growth among oil-producing economies and also boosted remittances and investment flows to some non-oil-rich countries as well. Even as energy prices recovered, key energy producers — including Saudi Arabia — have started on a transition toward a cleaner energy mix, and are trying to position themselves as major players in natural gas, green and blue hydrogen, solar, and wind.

On the political level, the democratic transitions in Tunisia and Sudan — all that remained of the two waves of the Arab Spring in 2011 and 2019 — came to halt; whether that halt is final or merely temporary remains to be seen. Among the civil wars in the region, the Libyan conflict showed the most signs of progress, with ongoing negotiations among the parties, international support, and plans to hold fresh elections. The war in Yemen continued unabated, with the Houthis declining Saudi and international offers to negotiate and focusing instead on trying to take the strategic town of Marib, while the Saudis provided air support to government and local anti-Houthi forces to hold it. In Syria, the conflict remained largely frozen in 2021, with no major military operations, but also no progress toward any solution. Meanwhile, a new civil war erupted in Ethiopia between government forces and Tigrayan groups, with potential ripple effects for the Horn of Africa and the broader region.

At a regional level, key actors took steps to deescalate tensions and build — or rebuild — working relationships. Saudi Arabia took the lead in healing the rift with Qatar and trying to rebuild solidarity within the Gulf Cooperation Council. Saudi Arabia also initiated talks with Iran under Iraqi auspices in Baghdad. The UAE sent Foreign Minister Sheikh Abdullah bin Zayed al-Nahyan to reestablish ties with the regime of Syrian President Bashar al-Assad, Crown Prince Mohammed bin Zayed al-Nahyan visited erstwhile foe President Recep Tayyip Erdoğan of Turkey and offered billions of dollars in economic investment, and UAE National Security Advisor Tahnoun bin Zayed al-Nahyan was dispatched to Tehran to meet with Iranian President Ebrahim Raisi. This came on the heels of the historic Abraham Accords of 2020 and the strengthening of cooperation between the UAE and Israel.

But even as countries in the region took diplomatic steps to de-escalate tensions, heal rifts, and build new bridges, the security landscape continued to grow more complicated and fragmented, with an increasing number of state and non-state actors deploying and using unmanned weapons including aerial systems. The trend toward using armed drones that began before 2021 continued and accelerated — the attempted assassination of Iraq’s prime minister by militia groups and attacks on U.S. military bases in Syria and Iraq were just two prominent examples in the past year. The lower barriers to entry in this arms race complicate regional security dynamics by introducing new threats and increasing the overall uncertainty in the broader environment.

The most significant geopolitical event in the region was the haphazard U.S. withdrawal from Afghanistan, which sparked widespread concern across the region. The Taliban’s resounding triumph plays directly into the jihadist narrative and will reinvigorate the recruitment and ambitions of like-minded groups such as ISIS and al-Qaeda. The U.S. retreat also shook the confidence of America’s partners throughout the region that rely on U.S. backbone in their national security strategies and gave encouragement to states like Iran, reinforcing their view that the U.S. is a paper tiger that will buckle if enough pressure is exerted. Concerns about America’s inability to curb either Iran or the Taliban is part of the reason for the rapprochement between Israel and several Gulf states — which share a common fear of Iran — as well as the growing contacts between Middle East states and other great powers, such as Russia and China. While neither is a viable full strategic alternative for America’s partners in the region — they will remain mainly U.S. allies — hedging of bets and efforts to find areas of common security and economic interest proceed apace.

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2) New regional diplomacy

Gerald M. Feierstein Senior Vice President

After decades of confrontation and the threat of war, the Gulf Cooperation Council (GCC) states, especially Saudi Arabia and the UAE, emphasized in 2021 their desire to “turn a page” and seek to manage, if not resolve, regional conflicts through dialogue and negotiation. Beginning with the al-Ula agreement that ended the intra-GCC feud with Qatar, the two predominant GCC states have expanded their dialogue with Iran, calmed tensions with Turkey, pursued a diplomatic resolution to the conflict in Yemen, and promoted Syrian reintegration into the Arab League. While not all of these initiatives have borne fruit, and several may not produce tangible benefit anytime soon, they are nevertheless a reflection of a changing strategy toward addressing regional challenges and have the added benefit of reducing internal GCC friction over regional policies. The communique released at the conclusion of the 42 nd GCC Summit on Dec. 14 was notable for the change in the tone and tenor of the leaders’ discussion on regional challenges as well as its emphasis on intra-GCC coordination on key political, economic, and social issues.

There are several likely reasons for the changing Gulf approach to conflict. Leaders have been clear that they are exhausted by decades of confrontations that have failed to improve their security materially or benefit their populations. The COVID-19 pandemic, economic and demographic challenges, as well as the threat from climate change have brought home the need to strengthen domestic institutions and reduce external distractions. Uncertainty about the dependability of the U.S. security umbrella, a key pillar of GCC defense strategies since the Carter Doctrine, has reinforced the need in the GCC to move away from long-standing reliance on the U.S. military presence. Although many of the steps (but not all of them) have been welcomed by the Biden administration, nevertheless, the emphasis on finding regional solutions to regional problems will challenge U.S. policies and assumptions going forward.

Gönül Tol Director of Turkey Program and Senior Fellow, Frontier Europe Initiative

In mid-August 2020, a Turkish and a Greek warship were involved in a mild collision during a standoff in the eastern Mediterranean — one many called the most explosive the region had seen in 20 years. The row between the two NATO allies over energy exploration was the latest in a series of aggressive foreign policy moves by Turkey. Since President Recep Tayyip Erdoğan allied himself with the Nationalist Action Party (MHP) to recapture the parliamentary majority his party lost in the 2015 elections, Turkey had been pursuing a militaristic and unilateral foreign policy that has pitted Ankara against almost everyone in the region. 2021 was the year that finally changed.

President Erdoğan is now facing the longest odds of his political career. He has myriad problems but the chief among them is a collapsing economy. The Turkish currency has lost nearly half its value since the start of September. The crisis has driven up the cost of food, gasoline, and medicine, and hit poor and middle-class Turks, who have been key to his two-decade-long rule, hard. In the past, whenever domestic problems seemed overwhelming, Erdoğan turned to aggressive foreign policy moves to divert attention and benefit from a nationalist “rally ‘round the flag” effect. This strategy worked well for years but it has run its course. Nationalism is not doing the trick for Erdoğan anymore and his aggressive, adventurist, unilateral foreign policy, which has left him internationally isolated, has become costlier at a time of growing economic problems. So the Turkish president decided to change course and has been reaching out to regional adversaries as well as Western countries to mend ties.

Erdoğan recently hosted the de facto leader of the United Arab Emirates, Abu Dhabi Crown Prince Sheikh Mohammed bin Zayed al-Nahyan, after years of hostility. Erdoğan also pledged to repair ties with Egypt, Saudi Arabia, Israel, and Armenia and has been trying to have a positive agenda with Europe and the U.S. Erdoğan is hoping that billions of dollars of investment that Emirati officials promised during the crown prince’s visit and other potential economic benefits that normalization with other countries could bring will help ease his economic troubles. 2022 will show how realistic Erdogan’s expectations are.

Follow on Twitter: @gonultol

Charles Lister Senior Fellow, Director of Syria and Countering Terrorism & Extremism programs

In the not-too-distant future, 2021 will stand out as the year when a methodical process began to reintegrate Bashar al-Assad and his regime in Syria into the “international community.” Despite the enormity of the Assad regime’s war crimes since 2011 — prosecutors have more evidence against Syria than the world had against Hitler and the Nazi Party at Nuremberg — a combination of fatigue, disinterest, and resignation has created conditions in which re-engaging with the 21st century’s most notorious war criminal is seen by some as “realist” and “pragmatic” policy.

For many U.S. allies in the Middle East, their decision to re-engage is also being driven by a U.S.-created vacuum resulting from a clear disinvestment in Syria and a policy of no longer confronting Assad’s regime. In addition to Syria’s shocking election to the World Health Organization’s Executive Board and Interpol’s re-integration of Syria into its network, the Assad regime has benefited from signals sent by the Biden administration. A U.S.-facilitated regional energy deal to benefit Lebanon has seen Syria included as an active player and a recipient of foreign gas and electricity; to avoid triggering Caesar Act sanctions, the Biden administration has clarified loopholes. As part of back-channel negotiations with Russia, the U.S. has also softened restrictions on foreign entities, allowing financial engagements with Assad’s regime and funding for early recovery activities in regime areas that go far beyond humanitarian aid and will benefit the regime both directly and indirectly.

Encouraged by this softening of U.S. policy , the United Arab Emirates has dramatically escalated its re-engagement with Assad’s regime: dispatching Foreign Minister Abdullah bin Zayed to Damascus, re-starting bilateral business collaboration, and signing a $300 million power plant deal. Exasperated by U.S. indifference and struggling economically, Jordan has aggressively re-engaged, exchanging multiple ministerial visits and re-opening trade. King Abdullah even took a “brotherly” call from Assad himself. Similarly, Egypt hosted Syria’s General Intelligence chief and Algeria is pushing hard for its re-entry into the Arab League.

Notwithstanding the potent dangers inherent in normalizing a brutal dictator and undermining any chance of a meaningful settlement, moves to reintegrate Assad into the regional architecture are stunningly short-sighted. They will embolden a brutal regime, guarantee Syria’s long-term instability, and in all likelihood, implicate key U.S. allies in indirectly aiding and abetting continued war crimes. For now, Qatar and Saudi Arabia stand vocally opposed to the prevailing regional winds, but for how long that will last is distinctly unclear.

Follow on Twitter: @Charles_Lister

3) The catch-22 of civil wars in the Middle East

Ross Harrison Senior Fellow and Director of Research

Civil wars in the Middle East, while symptomatic of the failure of states to build legitimacy and inclusive governance, also are emblematic of a fractured and failed region. Despite some attenuation of the civil wars in terms of the levels of violence and the degrees of lethality in 2021, these conflicts held the Middle East in a vice-grip of regional dysfunction for most of the year, something that is likely to carry over to 2022.

In 2021, active fighting in many of the civil wars largely abated. In Afghanistan this came about because of the outright victory of the Taliban over the Kabul government and the complete withdrawal of the United States. In Syria, victory was delivered to the Assad government over most, but not all, of the country, but only with Russia and Iran putting their collective thumbs on the scale. In the case of Libya, outside actors have played a role in forging agreement between the antagonists and have brought the country to the cusp of elections, which as of this writing seem to be delayed. In Yemen, there have been attempts by outside powers to move the parties toward resolution, but the Houthis, perhaps with Iranian support, have been resistant.

But despite an apparent reduction in the levels of overall fighting in several of these conflicts, for much of 2021 they persisted in creating regional dysfunction, and have defied attempts to create a permanent resolution that would give comfort to suffering populations.

It is easy to point fingers as to why this happened. Clearly there is no shortage of bad actors who have put their own interests ahead of those of their populations. Focusing on the actors themselves, however, misses a broader structural problem of the “unvirtuous cycle” of regional and international actors feasting on the civil wars, but the civil wars giving back by stoking conflicts between the regional actors, such as Saudi Arabia and Iran or Israel and Iran.

This structural problem manifested for the Middle East in a catch-22, whereby resolution of the wars required some form of regional and international cooperation , but the dynamics of the wars created security dilemmas and conflict traps that made the hurdles to getting to cooperation insuperable, even for actors who might be predisposed to cooperate. Going into 2022, these dynamics could mean that, notwithstanding signs in 2021 of an easing of tensions between the Gulf Cooperation Council (GCC) states and Iran, a broader and more lasting rapprochement could prove elusive.

Let’s look at the following developments in the civil wars which defined 2021, posed a threat to the lives of people residing in the countries at war, and are likely to carry over to 2022:

Syria remains one of the countries on the planet most penetrated by outside powers. In 2021, Russia, Iran, and Turkey became more, not less, entrenched militarily in Syria. Transitioning from where Syria is today to a more stable, inclusive, and de-militarized country free of outside actors seems years, if not decades, away.

Other countries that have transitioned into a post-civil war reality are now at renewed risk of falling back into civil war. Lebanon in 2021 continued to experience the malaise that followed the explosion at Beirut Port in August 2020. This has contributed to further state failure, which could pull the country into civil violence. This would likely intensify the already significant involvement of outside regional actors, with Iran being the most likely protagonist and beneficiary. Iraq too is in a precarious state and remained for much of 2021 at risk of falling back into sectarian violence.

While the civil war in Ethiopia is somewhat removed from the broader Middle East, a prolonged conflict could invite meddling of regional actors like Egypt, which already has disagreements with the government in Addis Ababa over the Grand Ethiopian Renaissance Dam (GERD). It could also add to instability in Sudan, and might invite further involvement from international actors and terrorist organizations as well.

The countries that seem to be in some form of post-civil war state of suspended animation, like Iraq and Afghanistan, have become more, not less, vulnerable to spoilers, such as ISIS and even al-Qaeda, which could be reinvigorated by the U.S withdrawal from Afghanistan.

In 2021, attempts have so far failed to bring the United States back into the Joint Comprehensive Plan of Action (JCPOA), and Iran back into compliance with the terms of the nuclear deal. This has given Iran a greater incentive to double down in the civil war zones instead of working cooperatively with other states to bring the wars to a close.

The Middle East for all of 2021 has been caught in a conflict trap, where civil wars stoked regional tensions and tensions between regional actors made ending the civil wars difficult. While as the year draws to a close, there are several promising signs of a thawing of tensions between regional actors, namely the GCC states and Iran, we need to be cognizant of how the current situation in the civil wars zones of the region could act as a headwind that will slow progress toward ultimate regional security and stability.

4) Iran’s hardliners consolidate their hold on power

Alex Vatanka Director of Iran Program and Senior Fellow, Frontier Europe Initiative

In Iran, the biggest headline of 2021 was the hardliners’ recapture of all centers of power in Tehran. Supreme Leader Ayatollah Ali Khamenei and his armed stalwarts in the Islamic Revolutionary Guard Corps (IRGC) masterminded the installation of Ebrahim Raisi as Iran’s new president in June. Thanks to mass disqualification of any authentic candidates, Raisi won in a sham election that saw the lowest turnout of any vote since the theocratic Islamist system was established in 1979. 

Khamenei and the IRGC choose Raisi for a number of reasons, but the main one was a desire to consolidate power at a critical juncture. At home, the question of  who will succeed  the 82-year-old supreme leader remains open and Khamenei is striving to micro-manage the process. Khamenei essentially preferred the public boycotting the election over taking the risk of having to deal with a moderate figure in the Presidential Palace who could compromise his succession plans. To a lesser extent, the engineering of Raisi’s presidential win is also a signal to the U.S. and the West that any compromise with Tehran — over its nuclear or missile programs or its regional agenda — can only go through Khamenei and the IRGC and must take their interests into account. 

Khamenei’s gambit with Raisi was always bound to be risky. It has effectively finished off the moderate regime faction and its promise that gradual reform of the system is possible. Khamenei’s handling of the June presidential elections is already resulting in more defections from among regime supporters. Meanwhile, Raisi has been given an  impossible hand . He has tried to behave and sound like Mahmoud Ahmadinejad: as a populist and a “people’s president.” The problem is that he does not have Ahmadinejad’s folksy personality or the billions of dollars in oil revenues that Ahmadinejad could dole out in the form of cash and benefits to the lower classes. 

As president, Raisi has discovered that there is  no quick fix for the sanction-hit economy , arguably the Achilles’ heel of the Islamic Republic. One official report recently warned that the government could be  bankrupt  in three years if present trends continue. The solution to that problem is linked to the lifting of sanctions, which in turn is tied to the outcome of the ongoing nuclear talks in Vienna, a negotiation process that on the Iranian side Khamenei oversees more than anyone else. When Raisi was installed as president, many saw him as handpicked to succeed Khamenei as supreme leader when that day arrives. But so far Raisi has only performed the role of a scapegoat as the Iranian economy remains in a historic slump while Khamenei and the IRGC ponder what sort of a compromise in Vienna might be acceptable to their interests. Still, the ever-increasing popular anger seen in 2021, from labor strikes to street protests, also suggests that Khamenei and his cohorts do not have endless time to mitigate against greater public mobilization against the Islamist system. 

Follow on Twitter: @AlexVatanka

5) The end of the 20-year war in Afghanistan

Marvin G. Weinbaum Director, Afghanistan and Pakistan Studies

The 20-year Afghan war, American’s longest, finally ended in 2021. On Aug. 15, fighters of the Taliban movement occupied Kabul , shortly after the president of the Islamic Republic of Afghanistan and his close advisors had fled. The war ended largely as it had begun, with rule by an Islamic Emirate and with many of the same senior leaders that had served in a Talban government during the 1990s. In its first few months, the new regime has chosen domestic policies that closely resemble its previous practices, notably those prescribing acceptable political and social behavior. Less clear and of primary concern to the U.S. is whether the Taliban’s associations that brought U.S. intervention in 2001 will also return.

It was to ensure that global terrorist organizations like al-Qaeda are not harbored in Afghanistan and allowed to plan catastrophic attacks on American soil that the U.S. began its long, costly war in the first place. The U.S. air strikes that dislodged al-Qaeda also swept up a Taliban unwilling to give up Osama bin Laden and dismantle his operations. It is because the Taliban movement, especially its ascendant Haqqani branch, is known to have never severed its close ties to al-Qaeda that the Taliban restoration is worrisome. The Taliban may not share al-Qaeda’s global aims, but the financially hard-pressed regime may well play host to its rebuilding . Although an enemy of al-Qaeda, Islamic State-Khorasan Province, with its own far-flung designs, is expected to gain in strength by capitalizing on dissent within Taliban ranks. U.S. intelligence sources estimate that both organizations could, within two or three years, be capable of sponsoring terrorist attacks on the U.S.

While it is too soon to gauge the full impact of America’s military withdrawal on the broader region, its countries have been forced to reassess U.S. reliability as a partner and resolve as an adversary. The potential for regional instability has meanwhile increased and will almost certainly result should the Taliban regime tolerate or facilitate the export of Islamic insurgency to neighboring countries by such Afghanistan-nested militant groups as the Tehrik-i-Taliban Pakistan (TTP), the Islamic Movement of Uzbekistan (IMU), and the East Turkestan Islamic Movement (ETIM). For all of the U.S. calculations that a strategic shift from Afghanistan and its region can allow a geographic refocus for U.S. foreign policy, the threat from the broader region of global terrorism, nuclear proliferation, humanitarian crisis, and mass migration seems likely to keep the U.S. well engaged.

Follow on Twitter: @mgweinbaum

6) The lessons of the May war in Gaza

Khaled Elgindy Senior Fellow, Director of Program on Palestine and Palestinian-Israeli Affairs

Last May’s  war in Gaza , which left 256 Palestinians and 13 Israelis dead, was the deadliest eruption of violence in the Israeli-Palestinian arena in nearly seven years. The 11-day war was triggered by events some 50 miles away in Israeli-occupied East Jerusalem amid the pending expulsions of several Palestinian families from their homes in the Sheikh Jarrah neighborhood at the hands of  extremist Israeli settlers — a reminder that what happens in one part of the occupied territories seldom stays there. The timing of the war was particularly inconvenient, coming just four months after the arrival of the new U.S. administration of Joe Biden and just one month before the swearing in of the  new Israeli coalition government  headed by Naftali Bennett and Yair Lapid. 

The fallout from the war in Gaza — the fifth in 12 years — would be felt by the Palestinians and in terms of U.S. policy. On the internal Palestinian front, both the war and the Jerusalem crisis that preceded it once again demonstrated Hamas’s ability to seize the political initiative. Despite the heavy human and material toll inflicted on Gaza’s civilian population, the war instantly boosted  Hamas’s  domestic popularity while highlighting the perceived impotence and growing irrelevance of Palestinian President Mahmoud Abbas and the Palestinian Authority.

The crisis was equally problematic for the Biden administration, which had deprioritized and hoped to steer clear of the Israel/Palestine issue. The administration’s lethargic response to the crisis — offering blanket statements of support for Israel’s right to defend itself while attempting to work quietly for a truce, even as it blocked attempts by the U.N. Security Council to secure an immediate cease-fire — further highlighted the administration’s reluctance to challenge the status quo. Ultimately, however, the conflict exposed the dangers of allowing the situation on the ground, whether in Gaza or in East Jerusalem, to fester as well as the futility of disengaging from an issue that the United States has been and remains so deeply invested in. Whether the Biden administration officials have internalized those lessons remains to be seen in 2022.

Follow on Twitter: @elgindy_

7) Israel’s new government lowers the temperature of the debate

Mark A. Heller Non-Resident Scholar

The Israeli election in March 2021 produced what three other elections in the previous two years had failed to deliver: a new government headed by someone other than Benjamin Netanyahu. The governing coalition assembled by Naftali Bennett, leader of the right-wing Yamina Party, is riven by internal contradictions of almost every sort and enjoys only a razor-thin majority. That explains why it has refrained from major initiatives on the most divisive issues on the Israel agenda, including relations with the Palestinians (although the coalition contains left-wing parties that have consistently advocated a two-state settlement of the conflict) and the question of religion and the state (although the coalition, for the first time in decades, includes no ultra-Orthodox representatives).

Still, the coalition has proved more resilient than many expected and has already registered some noteworthy accomplishments. For one thing, it has passed the first new budget in several years, thereby introducing a greater measure of rationality and transparency in economic planning. Secondly, it has formally involved an Arab party (as opposed to Arab individuals) in governing councils, by incorporating the United Arab List and allocating to it chairmanships of some important Knesset committees (but not positions in the Cabinet) — though it should be noted that some credit is due Netanyahu, who legitimized this transformation by declaring his desire to recruit Arab parties to his side, even campaigning on one occasion as “Abu Yair.” Thirdly, and perhaps most remarkably, the new government has practically transformed the tenor of public discourse by removing much of the toxicity that characterized political rhetoric in recent years. Opposition representatives may attack with little restraint, but government spokespeople have stopped demonizing their political adversaries, and policy preferences, some which do not differ that radically from those of preceding governments, are explained and defended with greater civility than before.

By lowering the temperature of the debate, the new government has injected a measure of calm and sobriety into the long-standing turbulence of Israeli politics. This does not just reassure the public as its government grapples with day-to-day challenges; it also reassures Israel’s regional and international partners, from the United Arab Emirates through Egypt and Morocco all the way to the United States, thereby facilitating the search for more cooperative approaches to common challenges.

8) A year of reckoning in energy markets

Karen E. Young Senior Fellow and Director of Program on Economics and Energy

2021 was a year of reckoning in global energy markets. We started to think more globally about climate change policy action with COP 26, even as many found the commitments disappointing.

The Middle East has become ground zero for much of the debate on net zero. Saudi Arabia surprised the world by setting a net-zero emissions target for 2060 , following the UAE's announcement of a 2050 target.

From the supply side of oil and gas exporters, there is a clear argument that their products matter and have a role in the energy transition. Saudi Arabia and its energy minister have made the strongest case that oil still matters, and a messy transition with short supply will be especially dangerous not just for producers, but globally.

Managing the debate and the framing the energy transition has become important for several Middle East producers. Egypt will host a global forum on climate change with COP 27. From the Egyptian government's point of view, defending a role for natural gas in the transition is vital to the ability to attract financing to develop its own industry. The UAE will host COP 28 and has aggressively promoted its diversification efforts, especially its capacity for renewable power production, which includes new nuclear power. The next COP will likely focus on gradations of clean hydrocarbons, making the case for new brandings of both oil and gas products.

Disagreements among producers, including the United States, have been emblematic of some of the domestic politics driving energy policy. The Biden administration has tried to shift the blame for rising gasoline costs — just one part of a large inflationary trend — to OPEC output quotas. Saudi Arabia cleverly countered with a commitment to increased output among OPEC+ members that few are actually able to meet. OPEC members also have some important differences in how they see the timeline of getting their exports to market and how to dominate among Asian buyers, as we saw between the UAE and Saudi Arabia this summer.

Follow on Twitter: @ProfessorKaren

9) More climate change highs (and lows) for the Middle East

Mohammed Mahmoud Senior Fellow and Director of the Climate and Water Program

The global implications of ongoing climate change this year have been especially acute in the Middle East. For a region that is already prone to hot and dry conditions, the suite of climate change impacts that the Middle East experienced this year are potentially an indication that the region is shifting to a new climate regime that will continue to bring more environmental challenges . It was a year of dangerous extremes: extreme heat, extreme weather, and extreme drought.

Extreme heat

The rise in average global temperatures has ramped up the occurrence and intensity of extreme heat events in the region, where many countries experienced daily temperatures that were not only well above average, but in some cases record-breaking. This phenomenon was most evident during the summer when a large number of locations, including major cities (e.g. Aqaba, Doha, and Khartoum), were amongst the hottest places in the world this year, with recorded temperatures close to or exceeding 50 degrees Celsius. Extreme heat events have serious implications for the residents of the Middle East, chief of which is in the domain of public health with an associated rise in heat-related illnesses and death.

Extreme weather

With the rise in global average temperatures also comes an increase in sea surface temperatures, particularly in water bodies around the equator where most of the earth’s incoming solar radiation is absorbed. In this band lies the Indian Ocean (and within it the Arabian Sea), a hotbed of tropical storm activity fueled by rising sea surface temperatures that can generate devastating cyclones with the capacity of making landfall anywhere from Pakistan/Iran and the Arabian Peninsula to the Horn of Africa. One such storm that formed this year was Cyclone Shaheen , a severe cyclonic storm that made landfall in Oman and caused substantial damage and numerous fatalities.

Extreme drought

Persistent drought has plagued the Middle East as a whole this year due to sustained hot and dry conditions brought on by climate change. But one of the hardest-hit areas has been the Levant region and Iraq and Iran in the east. Dwindling surface and groundwater supplies coupled with poor seasonal rainfall and inefficient water conveyance infrastructure (that contributes to substantial water losses) has threatened the water security of these nations, almost to the brink of catastrophic collapse due to water shortages. Inadequate access to potable water has already caused negative consequences for local economies (e.g. rising cost of food due to constrained agricultural activity ), public health (e.g. an increase in waterborne illnesses in rural communities drinking untreated water), and transboundary cooperation (e.g. water hoarding between the riparian nations along the Tigris River system).

10) Technopolitics emerge as a key factor in the new geopolitics

Eliza Campbell Director, Cyber Program

The saga of Israeli technology company NSO Group could fill volumes — and indeed, in 2021, to many observers of the Middle East it might have seemed as if it did. Why, readers might have asked themselves, does this matter? What exactly about a single midsize technology firm, only one of many in a crowded and fast-growing Israeli tech sector with a stunning 6,426 local start-ups, captured so much political and analytical attention this year, and what does this mean for what might be next? The short answer is this: Technopolitics are the new geopolitics, whether observers are ready to accept it or not. The rise of NSO Group, and the growing international outcry this year over its signature product, Pegasus, tells the story of how the Middle East might be the place where this reality is tested for the first time.

Pegasus, NSO’s star product, allows customers to remotely hack and access the mobile phones and communications of those infected by the spyware; NSO has maintained that its purpose is to intercept communications in order to “ prevent terrorism and crime .” Meanwhile, a growing chorus of technologists, activists, scholars, and journalists have repeatedly provided compelling evidence that clients of NSO, which have included many governments in the Middle East, such as Saudi Arabia, Bahrain, Egypt, Morocco, and the United Arab Emirates, are primarily engaging NSO for the purpose of surveilling and intimidating journalists, activists, political dissidents, and others. Blockbuster reporting by a coalition of media organizations called the Pegasus Project revealed this summer that, among other allegations, NSO’s software had potentially been used to target at least 50,000 persons of interest, including more than 180 journalists around the world. The implications of this reality are stunning; for a region in which the fight for human rights and freedom of expression have never been more dire, technology-aided intimidation and surveillance, unchecked by international sanction or rule of law, could be viewed as a game changer. Meanwhile, as Israel took the unprecedented step of officially designating six Palestinian civil society groups as terrorist organizations , and as workers from those organizations were later revealed to have been hacked by Pegasus , and later still, as the U.S. revealed that its own diplomats had been targeted by the software, it became more clear that something had shifted.

Ultimately, the story of NSO Group in 2021 is emblematic of larger questions about the spyware industry, which includes many peers in a growing marketplace . It also tells the story of a Middle East being reshaped by the interests of private capital and a rapidly diminishing sense of political and economic security for the vast majority of citizens, who largely continue to live according to the whims of corruption , crushing authoritarianism , and violent climate change. Cooperation between the Gulf Cooperation Council and Israel on tech issues is the culmination of this shift; Palestine has become, by and large, a symbolic debate, even as the lives of Palestinians grow increasingly desperate , and as Israel imports foreign workers rather than permit Palestinians living under their occupation to share the benefits of the booming local economy. In short, observers should watch the NSO story closely in 2022. What the case of this company tells us about dramatic shifts in regional power-sharing, the future of human rights, and the US’s changing role in the world will not always be so easy to ignore.

This look back at 10 key events and trends that shaped 2021 sets the foundation for thinking about what’s to come in 2022 and beyond in the Middle East. Countervailing trends — de-escalation through diplomacy at a time of continued tensions as actors use force, particularly with weapons enhanced by new technologies, including cyberweapons — demonstrate that the complicated competition for power and influence across the region continues to evolve. This regional competition comes at a time when broader geopolitical tectonic plates are shifting between the United States, China, Russia, and Europe, and these outside actors continue to play important roles in key parts of the Middle East.

The past year was one of many surprises and discontinuities in the Middle East, but some of the trendlines on basic human security, especially the impact of climate change producing extreme heat, weather, and drought, offer signs of the challenges ahead in the coming years. The people and governments of the region are the main actors in shaping outcomes, but countries like the United States can play an important role in turning challenges into opportunities for advancing greater security and prosperity in the Middle East in ways that directly benefit the broader world.

Follow on Twitter: @Katulis

The Middle East Institute (MEI) is an independent, non-partisan, non-for-profit, educational organization. It does not engage in advocacy and its scholars’ opinions are their own. MEI welcomes financial donations, but retains sole editorial control over its work and its publications reflect only the authors’ views. For a listing of MEI donors, please click her e .

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Dana Stroul: The U.S. Defense Strategy in the Middle East

This week on Babel, Jon Alterman speaks with Dana Stroul about the U.S. defense strategy in the Middle East, how the Israel-Hamas war has changed U.S. security partnerships with Arab states, and the lessons Israel should learn from U.S. military experience in the region. 

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Senator Van Hollen on Next Steps in Gaza

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Inside a Gaza IMC Field Hospital | Gaza: The Human Toll

This episode will feature fresh footage from on the ground in Gaza at an International Medical Corps field hospital and surrounding environment.

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A discussion of the War in Gaza with Senator Chris Van Hollen, followed by a discussion of three future scenarios for Gaza with Professor Francesco Checchi from the London School of Hygiene & Tropical Medicine. 

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A discussion of the War in Gaza with Senator Chris Van Hollen, followed by a discussion of three future scenarios for Gaza with Professor Francesco Checchi from the London School of Hygiene & Tropical Medicine.

This week, Leah Hickert speaks with Natasha Hall, senior fellow with the CSIS Middle East Program, about climate financing in conflict-affected countries. 

Harvard CAPS-Harris Poll chairman Mark Penn joins the podcast to discuss the results of his February poll on U.S. attitudes toward Israel and Hamas.

Please join the CSIS Middle East Program, the Humanitarian Agenda, and the Syrian American Medical Society (SAMS) for a conversation with Dr. Amani Ballour about her experience in Syria's underground hospital, holding the Assad regime accountable, and the humanitarian need in Syria.

Event — March 7, 2024

Air Supplies to Gaza: Commendable Political Theater but No Long-Term Solution

Parachuting food into Gaza is an important gesture, but the United States and its allies would need to increase deliveries by a factor of 90 to feed the entire population. The practical solution is delivery by truck, but that requires cooperation among all parties.  

Critical Questions by Mark F. Cancian — March 7, 2024

This week on Babel, Jon Alterman speaks with Amos Yadlin about Israel’s global relationships, and how this war differs from Israel’s previous conflicts. 

This episode will explore the ongoing crisis surrounding the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) operations in Gaza.

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Articles on Middle East

Displaying 1 - 20 of 688 articles.

Whether it’s Trump or Biden as president, U.S. foreign policy endangers the world

Shaun Narine , St. Thomas University (Canada)

Economic forces are at play in Israeli-Palestinian conflict

Afni Regita Cahyani Muis , Universitas Darussalam Gontor

US attempt to ‘revitalize’ Palestinian Authority risks making the PA less legitimate, more unpopular

Dana El Kurd , University of Richmond

Lebanese-Israeli fighting looks set to scuttle plans for historic land border settlement

Mireille Rebeiz , Dickinson College

Plight of migrant laborers killed, held hostage in Middle East exposes Israel’s reliance on overseas workforce

Julie Weise , University of Oregon and Shahar Shoham , Humboldt University of Berlin

Commander of Iran’s elite Quds Force is expanding predecessor’s vision of chaos in the Middle East

Javed Ali , University of Michigan

Israeli peace activists are more anguished than ever − in a movement that has always been diverse and divided, with differing visions of ‘peace’

Atalia Omer , University of Notre Dame

Israeli siege has placed Gazans at risk of starvation − prewar policies made them vulnerable in the first place

Yara M. Asi , University of Central Florida

‘America is the mother of terrorism’: why the Houthis’ new slogan is important for understanding the Middle East

Sarah G. Phillips , University of Sydney

How Iran controls a network of armed groups to pursue its regional strategy

Christoph Bluth , University of Bradford

A two-state solution for Israelis and Palestinians might actually be closer than ever

Benjamin Case , Arizona State University

Middle East crisis: US airstrikes against Iran-backed armed groups explained

Julie M Norman , UCL

US raids in Iraq and Syria: How retaliatory airstrikes affect network of Iran-backed militias

Sara Harmouch , American University and Nakissa Jahanbani , United States Military Academy West Point

Middle East conflict: Joe Biden must weigh the risks of using force in an election year

Andrew Payne , City, University of London

Drone attack on American troops risks widening Middle East conflict – and drawing in Iran-US  tensions

Sara Harmouch , American University

How much influence does Iran have over its proxy ‘Axis of Resistance’ − Hezbollah, Hamas and the Houthis?

Red Sea shipping disruptions could be avoided in the future by using the Arctic – but it could spell trouble for fragile ecosystems

Kemal Akbayirli , Ordu University and Gokcay Balci , University of Bradford

An ancient system that could bring water to dry areas

Gaathier Mahed , Nelson Mandela University

War in the Middle East has put Lebanon on the brink of economic disaster

John Nagle , Queen's University Belfast and Drew Mikhael , Queen's University Belfast

US-UK airstrikes risk strengthening Houthi rebels’ position in Yemen and the region

Mahad Darar , Colorado State University

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The Center for Middle Eastern Studies is home to a diverse group of faculty, students, and other scholars engaged in research and study covering a large variety of fields. In addition to the vibrant faculty and student community, CMES welcomes an annual cohort of visiting researchers from the Middle East, Europe, Asia, and the United States. Current CMES research initiatives include three interdisciplinary working groups addressing the rapid social change ongoing in the Middle East since the beginnings of the 2011 "Arab Spring."

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In the interest of promoting scholarly research in Middle East studies, the Center for Middle Eastern Studies appoints a small number of Visiting Researchers each academic year. There are three appointment types. The title Visiting Scholar may be granted to tenured and tenure-track faculty members on paid leave from other institutions. Visiting Fellows are typically specialists in the region who work outside of academia. Advanced doctoral students with funding from their home institution who wish to conduct research at Harvard University with one or more CMES faculty members may also apply for the position of Visiting Fellow. All categories of Visiting Researcher positions are unpaid.

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CMES supports an array of research initiatives, driven by faculty and student interests that are as diverse and evolving as the politics, cultures, and history of Middle East region. These initiatives bring together scholars from throughout the Harvard community to engage in long and short-term projects that often include preeminent regional and global experts. Many of these projects are interdisciplinary in scope and gain insights from the social sciences, humanities, natural sciences, and professions.... Read more about Projects & Initiatives

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CMES publishes a twice-yearly newsletter highlighting Center activities and the accomplishments of our faculty, students, and other affiliates. Our long-running publications program includes the Middle Eastern Monograph Series, numbering over forty volumes, and the Harvard Middle Eastern and Islamic Review.

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The Middle East Research Hub

  The Middle East Research Hub is a non-profit initiative designed to promote the work of independent researchers and analysts with skills and expertise applied to the Middle East and North Africa (MENA). Its aim is to encourage the development of an alternative research agenda by delivering original research outputs, drawing attention to public issues and evidences of social change that are overlooked by the media and the international community.

Promoting Research Capacity 

The Middle East Research Hub carries out fundraising activities designed to support the development of research capacity in MENA. We advocate for the inclusivity of young analysts in advisory and social sciences through the scope of mentorship and fellowship programmes, creating opportunities for public engagement.

We expand the scope of Middle East research beyond the range of topics commonly addressed in the public debate. 

We offer long-term perspectives to understand recent developments in MENA. We support the inclusion of young voices in applied social sciences across the region.

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Building Democracy on Sand: Israel without a Constitution

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Russia and Its Islamic World

Crosswinds: The Way of Saudi Arabia

Beginning in 1937, when a young Minnesota-born mining engineer by the name of Thomas Barger first arrived in Arabia, that country has been somewhat of a mystery to America.

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In this arab time: the pursuit of deliverance, trial of a thousand years.

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Peter Berkowitz

Peter Berkowitz is the Tad and Dianne Taube Senior Fellow at the Hoover Institution, Stanford University. In 2019-2021, he served as the Director of the State Department’s Policy Planning Staff, executive secretary of the department's Commission on Unalienable Rights, and senior adviser to the Secretary of State. He is a 2017 recipient of the Bradley Prize. He is a columnist for RealClearPolitics. He serves as director of studies for The Public Interest Fellowship. He is the author of Constitutional Conservatism: Liberty, Self-Government, and Political Moderation (Hoover Institution Press, 2013); Israel and the Struggle over the International Laws of War (Hoover Institution Press, 2012); Virtue and the Making of Modern Liberalism (Princeton University Press, 1999); and Nietzsche: The Ethics of an Immoralist (Harvard University Press, 1995). He is the editor of seven collections of essays on political ideas and institutions published by the Hoover Institution: Renewing the American Constitutional Tradition (2014); Future Challenges in National Security and Law (2010); The Future of American Intelligence (2005); Terrorism, the Laws of War, and the Constitution: Debating the Enemy Combatant Cases (2005); Varieties of Conservatism in America (2004); Varieties of Progressivism in America (2004); and Never a Matter of Indifference: Sustaining Virtue in a Free Republic (2003). He has written hundreds of articles, essays and reviews on a range of subjects for a variety of publications, including The American Interest, the American Political Science Review, The Atlantic, The Chronicle of Higher Education, the Claremont Review of Books, Commentary, First Things, Forbes.com, Haaretz, The Jerusalem Post, the London Review of Books, National Journal, National Review, The New Criterion, The New Republic, Policy Review, Politico, The Public Interest, the Times Literary Supplement, The Wall Street Journal, the Washington Post, The Weekly Standard, The Wilson Quarterly, and the Yale Law Journal. In addition to teaching regularly in the United States and Israel, Dr. Berkowitz has led seminars on the principles of freedom and the American constitutional tradition for students from Burma at the George W. Bush Presidential Center and for Korean students at Underwood International College at Yonsei University in Seoul, South Korea. He taught constitutional law and jurisprudence at George Mason University School of Law from 1999 to 2006, and political philosophy in the department of government at Harvard University from 1990 to 1999. He holds a JD and a PhD in political science from Yale University; an MA in philosophy from the Hebrew University of Jerusalem; and a BA in English literature from Swarthmore College.

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Russell A. Berman, the Walter A. Haas Professor in the Humanities at Stanford University, is a senior fellow at the Hoover Institution and a co-chair of the Working Group on Islamism and the International Order. At Stanford, he is a member of both the Department of German Studies and the Department of Comparative Literature at Stanford, and he specializes on politics and culture in Europe as well as in the Middle East. He has served in numerous administrative positions at Stanford, including as chair of the Senate of the Academic Council. He is the author of numerous articles and books including Enlightenment or Empire: Colonial Discourse in German Culture (1998) and The Rise of the Modern German Novel: Crisis and Charisma (1986), both of which won the Outstanding Book Award of the German Studies Association (in 2000 and 1987, respectively). Hoover Institution Press published his books In Retreat: America's Withdrawal from the Middle East (2014), Freedom or Terror: Europe Faces Jihad (2010), and Anti-Americanism in Europe: A Cultural Problem (2004). His other books include Fiction Sets You Free: Literature, Liberty, and Western Culture (2007), Cultural Studies of Modern Germany: Representation and Nationhood (1993), Modern Culture and Critical Theory: Art, Politics, and the Legacy of the Frankfurt School (1989), and Between Fontane and Tucholsky: Literary Criticism and the Public Sphere in Wilhelmine Germany (1983). He has also published numerous articles in the Hoover Digest, most recently "Marx’s Moldering Manifesto" (fall 2018). His writings have also appeared in Defining Ideas and Advancing a Free Society. Berman has received many honors and awards including a Mellon Faculty Fellowship at Harvard University (1982–83), an Alexander von Humboldt Fellowship (1988–89), and the Bundesverdienstkreuz of the Federal Republic of Germany (1997). Berman received his BA in 1972 from Harvard and his doctorate from Washington University in 1979.

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Media Use in the Middle East 2019: A Seven-Nation Survey

Published: 2019.

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Northwestern University in Qatar conducts an annual regional survey in the Middle East of media use patterns, content preferences, and attitudes toward issues such as censorship, digital privacy, freedom of speech, and cultural preservation. 

The 2019 report pays special attention to social media and social media influencers even as it focuses heavily on news media. It offers chapters  covering bias and credibility, digital privacy, free speech, internet use, media use, news, social media, and social media influencers. There is also one section focusing just on Qatar.

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The state of population health research performance in the Middle East and North Africa: a meta-research study

Karima chaabna.

1 Institute for Population Health, Weill Cornell Medicine—Qatar, Doha, Qatar

Sohaila Cheema

Amit abraham, patrick maisonneuve.

2 Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy

Albert B. Lowenfels

3 Department of Surgery and Department of Family Medicine, New York Medical College, Valhalla, NY USA

Ravinder Mamtani

Associated data.

All data generated or analyzed during this study are included in this published article and its supplementary information files.

Population health (PH) research capacity and performance are essential pillars of evidence-based practice to help address health inequalities. Best evidence is provided by systematic reviews (SRs). None of the published bibliometric analysis specifically assess the production of SRs on PH in the Middle East and North Africa (MENA). The aim of our study is to investigate publication patterns and time trends of SRs reporting PH in the MENA region to evaluate the state of PH research performance in the region.

The study protocol was developed a priori (protocol registration number: CRD42017076736). PubMed was searched. Two independent reviewers screened 5747 identified articles. We investigated author affiliation and collaboration, yearly citations of the SRs and journal information. Joinpoint regression was used to explore these characteristics overtime.

Our meta-research included 387 SRs published between 2008 and 2016 which reported data on PH in 20 MENA countries. Publication of SRs increased over time in journals with impact factor < 4 and in the categories of yearly number of citations < 50 ( p values ≤ 0.0024). Authors belonging to the region published increasingly ( p value = 0.0001) over time. Thirty percent of the SRs were from authors solely from the region, while an additional 30% were from the region collaborating with Western country authors. Of these collaborative reviews, 79% were led by authors from the region. However, collaboration in the region (with the exclusion of collaboration with Western country authors) was rare (0.8%). These authors from the region published more in open-access journals while authors from Western countries collaborating or not with authors from the region published more in hybrid or non-open-access journals ( p value < 0.0001). Collaboration between authors from MENA and Western countries led to published SRs in journals with impact factor ≥ 10. Systematic reviews with global coverage were published more by authors from Western countries, while SRs with country-level coverage were published by authors from the region ( p value < 0.0001).

The incremental trend of PH SR publications on MENA likely reflects the ongoing improvement in research performance in the region. Authors from the region appear to be taking a lead role in conducting and disseminating MENA PH research. Open-access journals are a major contributor in facilitating MENA research dissemination.

Systematic review registration

PROSPERO registration number CRD42017076736

Evidence-based practice is not only critical for ensuring the highest quality in patient care but also for policy-making and implementing public health interventions at both local and national levels. Best evidence is generated by well-conducted systematic reviews (SRs), since they critically appraise and synthesize data produced by primary studies addressing a specific research question [ 1 ]. The capability of a country to generate detailed knowledge and understanding of its health challenges is essential for developing and implementing preventative strategies to address health problems through evidence-based decision-making [ 2 ]. This is typically undertaken through published primary studies and thereafter critically synthesized in SRs. Researchers, policymakers, and clinicians should be informed with the best evidence available pertaining to their country’s population health (PH) in order to identify context-appropriate solutions.

Existing bibliometric analyses evaluate research performance at global and country-levels [ 3 – 6 ]. However, none of them specifically assess the production of SRs on PH in the Middle East and North Africa (MENA). The aim of our study is to investigate publication patterns and time trends of SRs reporting on PH topics in the MENA region to evaluate the state of PH research performance in the region. The objectives of our study are to (1) assess publication patterns and time trends of SRs on PH in MENA, (2) evaluate collaboration in published SRs, (3) identify common topics explored in PH research pertaining to MENA, and (4) explore the role of journals’ access policies in research dissemination from MENA.

Our meta-research study is part of the Population Health Publications Assessment Project aiming to assess the methodological quality and the use of gray literature in published SRs on population health in MENA [ 7 – 10 ]. An a priori protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42017076736) [ 11 ] and published ( https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0751-4 ) [ 7 ]. We primarily conducted a SR of SRs to identify the SRs reporting data on PH in MENA published between January 2008 and December 2016 (2008 was chosen as the point of initiation since this was the publication year of the first version of the Cochrane Handbook for Systematic Reviews of Interventions) [ 12 ]. We first published the quality analysis of the literature search conducted in the identified cohort of SRs [ 8 ]. Thereafter, bibliometric analysis, as a statistical evaluation of published scientific articles [ 13 ], was applied to this cohort of SRs.

Inclusion and exclusion criteria

We included SRs reporting data on any PH topic within 20 MENA countries, namely Algeria, Bahrain, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Sudan, Syria, Tunisia, United Arab Emirates, and Yemen. Selection details of the 20 countries have been published [ 7 ]. Based on PRISMA-P terminology [ 14 ], we defined a SR as a review of primary studies reporting a search strategy for at least one electronic database along with eligibility criteria, which were applied during a multi-stage process of study selection. PH was defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group” [ 15 ]. Narrative review or systematic analysis synthetizing primary studies which were not identified and selected following a systematic process were excluded.

Literature search and data management

The literature search was conducted on PubMed [ 16 ], the first public digital archives [ 17 ] including MEDLINE database, which is also included in Embase [ 18 ] and Scopus [ 19 ]. We utilized search criteria combining MENA countries, regions and populations’ names and limited to reviews, systematic reviews, and meta-analyses. By searching PubMed, we likely included most of the SRs on PH in MENA published in peer-reviewed journals during 2008–2016. Details of the search strategy have been published [ 7 ]. Similar search criteria have been utilized for SRs on PH in MENA and published in peer-reviewed journals [ 10 , 20 – 23 ].

A total of 5747 articles were identified. After two independent multi-stage screenings including title/abstract and full-text screening, 387 SRs were included in the analysis (PRISMA flowchart and characteristics of included SRs are in additional files 3 and 4 ). Data extraction was conducted by two reviewers and cross-checked for accuracy. From each SR the research topic, year of publication, journal’s name, MENA country/countries covered by the SR, and authors’ country of affiliation(s) were extracted.

SR authors were categorized based on the country of their institutional affiliation. Authors were categorized as: belonging to the MENA countries if one of their institutional affiliations was in one of the 20 selected countries; to be from neighboring countries if their institutional affiliations were in a country not included in the 20 selected MENA countries but from other Middle East countries or South Asia or Africa; and from non-MENA and non-neighboring (NMNN) countries if their institutional affiliations were not from the 20 selected MENA countries, other Middle East countries, South Asia, or Africa. Due to the geographic proximity of the neighboring countries, which often share socio-economic and cultural aspects with some of the 20 selected countries, we differentiated those authors affiliated to institutions located in these countries from authors from NMNN countries located, for instance, in Europe, Australia, or the North American continent. The rationale for this is that a few of the neighboring countries such as Iran [ 24 – 27 ], Turkey [ 27 ], and Somalia [ 25 , 26 ] are sometimes included in the definition of the MENA region.

We discussed the health topics addressed by the included SRs according to the disease burden in MENA. Research topics studied by the included SRs were categorized following Global Burden of Disease (GBD) study classification [ 27 ]. The three main categories were communicable, maternal, neonatal, and nutritional diseases (GBD code: A); non-communicable diseases (NCDs; GBD code: B); and injuries (GBD code: C). A fourth category “other” was used when the topic did not match any of GBD categories. The GBD disability adjusted life years (DALYs) estimates in the MENA region between 2008 and 2016 for these topics were retrieved from the Institute for Health Metrics and Evaluation website [ 27 ].

The journal’s impact factor (JIF) during the year of publication was obtained from the Institute of Scientific Information’s Journal Citation Report (ISI-JCR, ISI http://www.scijournal.org/list-of-impact-factor-journal_I.shtml ). Since citations measured by Google Scholar might more appropriately reflect the impact of a publication in the scientific community and in the society (for instance, in dissertations, websites, non-indexed journals, non-English sources, book chapters), the number of citations were collected on Google Scholar [ 28 ]. Number of citations per year for each SR was calculated as the total number of citations divided by the number of years since publication. A period of at least 1 year was given between the date of publication of a SR (up to December 31, 2016) and the date of the collection of the number of citations (on January 17, 2018). From the journals’ websites, we collected information on the publisher’s name, open access status, and potential affiliation to a society, association, or university.

Publication pattern and time trends analyses were conducted on the basis of author institutional affiliation as per the following categories: (1) “Inside”—authors affiliated to institutions located in MENA and/or neighboring countries, (2) “Outside”—authors affiliated to institutions located in NMNN countries, and (3) “North-South collaboration”—authors affiliated to institutions located in MENA and/or neighboring countries collaborating with authors from NMNN countries. The time trend for yearly number of publications was assessed using linear regression in unstratified and stratified data. We assessed significance of the association using the F test and the goodness-of-fit of the models using adjusted R-squared statistics. We also conducted analyses by yearly number of citations and JIF. Fisher’s exact test was utilized to assess the differences between the number of publications between SRs and journals characteristics. Authors’ affiliation in SRs was used as a proxy for research capacity [ 4 ]. Association statistical significance threshold was at 0.01. We used R-3.3.1 software and SPSS V.25 for our analyses.

Time trends

A linear statistically significant increase in the annual number of published SRs was identified (from 16 in 2008 to 81 in 2016, 406% increase, Table  1 and Additional file 1 ). Systematic reviews were increasingly published by (i) “Inside” authors (two to 29, + 1350% increase), (ii) “Outside” authors (eight to 26, + 225% increase), and (iii) by authors from the “North-South collaboration” category (six to 26, + 333% increase). Similarly, a linear statistically significant increase in the annual number of published SRs at country-level coverage was also identified (Adj. R 2 = 0.71, p value = 0.0024), from five in 2008 to 18 in 2016 (+ 260% increase).

Univariate regression analysis of systematic review production time trend by publication characteristics

* p value of the F test. Association statistical significance threshold was at 0.01. a The time trend for yearly number of publications was assessed using linear regression in unstratified data. “+”: statistically significant increasing trend. “.”: trend not significant

Between 2008 and 2016, a statistically significant linear increase in the number of published SRs was also demonstrated in the categories 0 ≤ JIF < 2 and 2 ≤ JIF < 4, which represents 90% of the journals tracked by ISI-JCR [ 29 ] and for the yearly number of citations n < 10 and 10 ≤ n < 50. However, in the JIF categories 4 ≤ JIF < 6 and JIF ≥ 6 (i.e . , the top 10% and 5% of journals tracked by ISI-JCR, respectively [ 29 ]), the increase was not significant, and in the yearly citations categories 50 ≤ n < 100 and n ≥ 100, only a couple of SRs were published each year. When we excluded studies with global and multi-region coverage, there was also a linear statistically significant increase of published SRs in the JIF < 4 categories (Adj. R 2 = [0.74–0.83], p values < 0.0020). Regarding the yearly number of citations, when we excluded SRs with global and multi-region coverage, the increase in the number of published SRs was statistically significant for the category n < 10 (from eight in 2008 to 26 in 2016; + 225% increase, Adj. R 2 = 0.87, p value = 0.0001) and for the category 10 ≤ n < 50 (from one in 2008 to 23 in 2016; + 2200% increase, Adj. R 2 = 0.64, p value = 0.0058).

Yearly number of citations

Nevertheless, we observed a significant increase of yearly number of citations along with the increase of JIF ( p value < 0.0001, Table  2 ). In the SRs published in journals with a JIF < 2, 79% (139/176) were cited less than 10 times a year. Conversely, the 11 SRs with over 100 yearly citations were all published in journals with a JIF > 7. Therefore, SRs published in high JIF journals are cited more frequently than SRs published in journals with a low JIF.

Journal impact factors analysis

* p value of the Fisher’s exact test. Association statistical significance threshold at 0.05 was corrected using Bonferroni method to address multiple testing problem. As we conducted 29 tests, significance threshold was at 0.0017. NS not significant

Authors’ affiliations

Authors from MENA and/or neighboring countries published 30% (“Inside” category: 115/387) of the SRs and collaborated with authors from NMNN countries in an additional 30% (“North-South collaboration” category: 115/387) of the published SRs (Table  3 ). We identified one SR with authors affiliated solely to institutions located in different MENA countries (Fig.  1 ). Similarly, South-South collaboration between authors affiliated solely to institutions located in MENA and institutions located in neighboring countries were rare (0.5%; 2/387). Authors from MENA and/or neighboring countries collaborating with authors from NMNN countries were leading the research (first and/or last author position) in 79% of the North-South collaborations (53%; 61/115 SRs from MENA and 26%; 30/115 SRs from neighboring countries). In total, authors from MENA and/or neighboring countries were leading the research in 54% (203/387 SRs) of the published SRs on PH in MENA countries (Fig.  1 ).

Analysis of author’s country of affiliation and collaboration productivity

* p -value of the Fisher’s exact test. Association statistical significance threshold at 0.05 was corrected using Bonferroni method to address multiple testing problem. As we conducted 29 tests, significance threshold was at 0.0017. NS: not significant

Contribution, collaborations and leadership by author affiliations during 2008–2016. MENA countries (native): authors affiliated to institutions located in MENA countries covered by the systematic review. MENA countries (non-native): authors affiliated to institutions located in MENA countries not covered by the systematic review

Nevertheless, published SRs reporting data on MENA led by authors from MENA and/or neighboring countries is a recent phenomenon. In 2008–2010, the number of published SRs by “Inside” authors (12%, 7/59) was 2.9 and 4.6 times lower than in the two other categories (“North-South collaboration”: 37%, 22/59 and “Outside”: 51%, 30/59, respectively), while in 2014–2016, “Inside” authors published 34% (70/206) of the SRs, while “North-South collaboration” authors published 32% (66/206) and “Outside” authors 34% (71/206).

Publisher and journal profiles

The vast majority of the top 10 publishers (out of 62 publishers) with the highest average number of published SRs per journals were non-commercial [ 30 ] (90%) and local (70%, data not shown). A wide range of journals ( N = 243) published SRs reporting data on PH in MENA. Among them, 65 journals (17%, 65/243) published SRs reporting data on PH in MENA exclusively when these SRs had a global and multi-region coverage (85 published SRs out of 387, 22%). Most of the journals (87%, 213/243) published one or two SRs covering at least one of the MENA countries. Eighteen journals (7%, 18/243) published at least four SRs reporting data on PH in MENA (publishing 27% of SRs, 106/387). A large proportion of them were open-access journals (72%, 13/18) and 39% of them were specialized in infectious disease.

Author affiliation versus journal profile

A significant difference in the type of journals where SRs were published was observed according to author affiliation (Table  3 ). Most of the SRs by “Inside” authors were published in open-access journals (64%, 74/115), while most of the SRs by “Outside” authors were published in hybrid or non-open-access journals (62%, 98/157). We also observed that journals with an open-access policy have significantly lower JIFs than non-open access journals (Table  2 ). The number of yearly citations of published SRs varies significantly according to journal access, with lower citation frequencies for open and hybrid-access journals than for non-open access journals ( p value < 0.0001, Additional file 2 ).

Among the journals publishing at least four SRs, local journals (28%, 5/18)—which were all open access and with a JIF<2—published the highest number of SRs by “Inside” authors (67%, 22/33 SRs by “Inside” authors), and none published global or multi-regional SRs. Two journals were international with open access, focusing on publishing methodologically sound research regardless of the perceived impact the research may have on their JIF (22%, 23/106 SRs, data not shown). These journals published the second highest number of SRs by “Inside” authors (24%, 8/33 SRs). Additionally, a large proportion of the SRs (61%, 14/23 SRs) published in these journals did not have a global or multi-region coverage.

We also assessed journals with very high impact factors (JIF ≥ 10). Twenty-three SRs (6%, 23/387) were published in journals with a JIF ≥ 10 (data not shown). “Outside” authors published 70% (16/23) of these SRs and the remaining 30% were published by the “North-South collaboration” category. Among the SRs obtaining over 50 citations per year, 78% (21/27 publications) were by “Outside” authors and the remaining 22% were a North-South collaboration. Research collaboration with authors from Western countries appears to be one of the key factors for authors from MENA and/or neighboring countries to be able to publish in high impact factor journals, and thereafter for the articles to be highly cited, likely as a result of being published in such journals.

Systematic reviews’ geographical coverages

Systematic reviews with country-level or MENA subregion coverage were published significantly more in journals with a JIF < 2, the exception being SRs covering the African areas (Table  2 ). While SRs with global or multi-regions coverage were published significantly more in journals with a JIF ≥ 4. Consequently, the yearly number of citations was significantly highest for those SRs, while country-level and MENA sub-regional SRs—including those covering the African areas—were predominantly receiving less than 10 citations per year (additional file 2 ). Systematic reviews with global or multi-region coverage were published significantly more by “Outside” authors (Table  3 ). While country-level and MENA sub-regional SRs were mainly published by “Inside” authors, the exception being the SRs covering the African area, which were more published by authors in the “North-South collaboration” category.

Systematic reviews’ health topics

Between 2008 and 2016, the most common topic addressed in the SRs reporting data on the MENA region was NCDs (48%, 185/387, Fig.  2 ). Among the NCDs, cancer, mental health, metabolic syndrome including diabetes, and cardiovascular disease were commonly researched topics. In 2008, the most common topic addressed in the SRs was infectious disease, including foodborne, blood-borne, and sexually transmitted infections and anti-microbial resistance (44%, 7/16). Between 2008 and 2016, the 18 journals that published at least four SRs reporting data on PH in MENA countries published 41% (54/133) of the SRs on infectious disease. Among these journals, seven specialized in infectious disease topics (39%). Over the years, the proportion of SRs addressing infectious disease topics decreased to 36% (29/81, 2016). Between 2008 and 2016, 86% (133/155) of the SRs addressing the health topic communicable, maternal, neonatal, and nutritional diseases were on infectious disease. No SR was published on maternal disorders. In 2016, three SRs on metabolic syndrome, six on diabetes, three on cardiovascular disease, two on substance use abuses, two on neonatal disorders, and four on nutritional deficiency were published, while in 2008, no SRs on these topics were published. While the ratio between the burden of NCDs and communicable, maternal, neonatal, and nutritional diseases—measured with DALYs—was increasing over time (2.1 in 2008 to 3.2 in 2016), the proportion of published SRs addressing these topics did not change significantly over time and was not proportional to the disease burden (Fig.  3 ).

Population health topics covered by the published systematic reviews reporting data on MENA in 2008–2016

Time trends of DALYs and proportion of published systematic reviews. CD communicable, maternal, neonatal, and nutritional diseases (GBD code: A). NCD non-communicable diseases (NCD, GBD code: B)

The increase in SRs published annually is likely due to an increase in the publication of primary studies conducted in MENA countries. Systematic reviews by authors from the MENA region also increased—both those collaborating with authors from Western countries as well as those not. Our findings suggest ongoing research capacity building and performance improvement in the region. Development of PH research in the region will enhance PH [ 31 ] via evidence-based policy-making and interventions [ 4 ].

International research collaborations, which have been facilitated by globalization [ 32 ], play a major role in the production of population health data and the development of evidence-based solutions pertaining to global health problems [ 31 ]. Collaboration between authors from MENA and/or neighboring countries with authors from Western countries has increased for SRs. North-South research collaboration dynamics have been usually reported as being between unequal partners institutions with power remaining with the North [ 33 – 36 ], which raises ethical concerns in the “social world” of global health [ 37 , 38 ]. Our findings suggest that while published SRs on PH in MENA were previously also dominated by authors affiliated in Western countries, researchers from MENA appear to be taking now the lead by increasingly publishing SRs on topics of importance for the region and collaborating with authors from Western countries. For published SRs, North-South collaboration dynamics appear to be changing in the region with partners from the South identifying their PH research gaps and research capacity needs and addressing them by seeking specific expertise from the North. South-led published SRs are probably not affected by the barriers faced by South-led basic science research, i.e., lack of resources and research skills [ 39 ]. Conducting SRs requires minimal equipment as compared to basic science research conducted in wet laboratories, where more sophisticated and expensive equipment maybe required. Additionally, handbooks and guidelines to support researchers in rigorously conducting and reporting SRs are freely available online since the last two decades [ 12 , 40 , 41 ].

While we observed South-South research partnerships, collaboration between authors from MENA and neighboring countries was rare if the collaboration did not include authors from Western countries. Researchers from MENA appear to seek for peers’ expertise mainly from researchers located in Western countries. However, we believe that MENA and neighboring countries experience similar health challenges and could benefit from future cooperation [ 42 ]. In the context of globalization, some universities and colleges from North America and Europe established campuses within the region and this has contributed to build in the region research capacity at high levels [ 43 ]. Barriers to South-led research previously identified such as donor influence for the choice of research topics and lack of resources and research skills [ 39 ] could be addressed by South-South collaborations established with such imported branches of Western institutions, Regional, and country-level collaboration between researchers from MENA and/or neighboring countries can promote PH development by strengthening research capacity and performance via common objectives and shared local expertise.

In addition to making international research collaborations simpler [ 32 ], globalization has also facilitated communication of scholarly peer reviewed research by allowing accessibility and usefulness of research through open-access [ 32 ]. Authors from the region mainly published SRs that focused on MENA countries or subregions in journals with a JIF < 2 and predominantly in local and international open-access journals. This may be because open-access journals consider methodologically sound research regardless of the perceived impact the research topic may have on their JIF. Journals which are free from JIF dictate play a major role in the global dissemination [ 44 ] of the SRs conducted by authors affiliated to institutions located in MENA reporting epidemiological primary studies conducted in MENA. The peer-review process of these journals appear to show less bias against authors affiliated to institutions located in MENA [ 45 – 47 ] and/or non-native English speakers [ 48 ]. These journals are therefore contributing to the field of global health by supporting ethic of equity [ 37 , 38 ] and encouraging research performance improvement and enabling research culture in the region by giving a voice to authors from MENA countries and highlighting health issues pertinent to the region [ 49 ]. This enhances PH knowledge pertaining to MENA, which may ultimately lead to better-informed policies contributing to national healthcare policy development and implementation of informed evidence-based healthcare practice [ 50 ].

However, while open-access journals enable free reader access to published articles [ 51 ], most require a fee for publishing. This may be a barrier for researchers from MENA without appropriate funding and contribute to unbalanced North-South partnership [ 34 ]. Notably, some international publishers are addressing this issue by waiving fees for authors who are unable to afford the charge [ 44 ]. Publishers located in MENA countries should consider waiving fees for eligible authors to attract additional manuscript submission and to promote wider research dissemination.

Historically, reviews on diseases not prevalent in the “Western world” were unlikely to be of interest to researchers from these countries. This may in turn have resulted in minimal citations of reviews on diseases not prevalent in these countries. Such reviews may then lead to a negative impact on the JIF of a journal if published [ 52 ]. However, our review now identifies an increase in published SRs reporting data on MENA PH with yearly number of citations between 10 and 50. This suggests that there were probably both an increase in the interest of journal readers toward PH in MENA as well as in researchers reuse of data on MENA countries reported by these SRs. The progress and increase in global health research projects by researchers from Western countries studying health issues of low- and middle-income countries may have diminished the bias of international journals against the “diseases of poverty,” which are rare or nonexistent in high-income countries [ 52 , 53 ].

Non-communicable disease is a major PH issue in MENA. The DALYs for NCDs between 2008 and 2016 was at least twice as high as communicable, maternal, neonatal, and nutritional diseases, combined [ 54 ]. In 2017, the death rate from non-communicable diseases was five-times higher than death rate from infectious disease [ 55 ]. Five of the 10 countries with the highest diabetes prevalence worldwide are in MENA [ 56 ]. Additionally, obesity prevalence in MENA countries often exceeds the estimated global average (13%) [ 57 ] and in some countries exceeds the prevalence in the USA (e.g., 41% in Qatar in 2012 [ 58 ] versus 36% in the USA between 2011 and 2014 [ 59 ]). Nevertheless, the proportions of SRs addressing NCDs and communicable, maternal, neonatal, and nutritional diseases topics were similar. This may reflect the development of global health research studying infectious diseases [ 30 ] and funding influence on the selection of research topics [ 39 ]. A substantial proportion of the SRs appearing in the 18 journals that published at least four SRs reporting data on MENA investigated infectious diseases. The dissemination of this data appears to be facilitated by the interest of journals in specific topics. The topics addressed in the SRs reporting population health in MENA do not appear matching the disease burden in the region. Systematic reviews reporting on NCDs and their risk factors would enable the characterization, synthesis, and further understanding the epidemiology of such diseases in the MENA region, and facilitate evidence-based practice in policy-making and public health interventions.

In 2006, a study identified five factors explaining why research from developing countries was underrepresented in international health literature [ 53 ]. Four of these were related to poor research capacity in these countries, while the fifth highlighted the bias of international medical journals. In 2001, under-representation of content on PH in low-income countries in general medical journals with a JIF ≥ 10 was revealed [ 52 ]. Eighteen years later, our overview demonstrates that publication bias on SRs from MENA authors continues to exist in high impact factor (JIF > 10), non-open (or hybrid) access journals pertaining to topics reporting on MENA countries. One explanation for the low acceptance rate of SRs from the region may be the influence the research may have on the JIF [ 60 ]. Our recommendation to journals that publish manuscripts according to the perceived significance of the research work is to ensure double-blind peer review to avoid any discrimination that could arise because of the names and/or the affiliations of the publication authors [ 47 ].

We believe this is the first SR of SRs that investigates research capacity and performance in MENA pertaining to SR publication and explores the role of journals in disseminating SRs on and from MENA. The strength of our report is the large and representative sample of published SRs reporting on all PH topics in MENA. Overall, this study provides objective findings about research performance to researchers, clinicians, and policymakers. Comprehending research performance, its enablers and barriers in MENA may help rationalize staffing decisions and direct appropriate funding from national and international entities [ 61 ] which support knowledge acquisition and research capacity building [ 4 ]. Our findings will help in decision-making and strategy development regarding the publication of research on PH in MENA, and from MENA researchers. Nevertheless, including articles indexed on PubMed between 2008 and 2016 is technically different from those published between 2008 and 2016 [ 62 ]. Therefore, we might have missed some SRs, which were published in 2016 but their indexation was delayed. Additionally, we might have also missed some SRs published in journals not indexed on PubMed. However, the exclusion of those articles would unlikely affect our overall findings and conclusions.

An increasing number of SRs reporting epidemiological data from MENA countries are being published, reflecting the ongoing research capacity building and performance improvement in the region. Authors affiliated to institutions located in the region appear to be taking the lead in conducting research and disseminating information related to topics of relevance to PH in MENA. Local and international open-access journals, which give due consideration to methodologically sound research regardless of its impact on the journal impact factor are playing an important role in providing a platform to researchers from the region. Future meta-research assessing the productivity of primary studies in MENA countries is required to better understand PH research capacity and performance in the region.

Supplementary Information

Acknowledgements.

We would like to acknowledge Hekmat Alrouh for his contribution to the literature search and screening and Aida Tariq Nasir for reviewing the tables. Both individuals are previous employees of the Institute for Population Health at Weill Cornell Medicine—Qatar.

Abbreviations

Authors’ contributions.

KC, SC, and RM collectively contributed to the conception of the study. KC and AA were involved in the literature search, screening, and extraction steps. Analysis and manuscript drafting were implemented by KC with support from SC, RM, ABL, and PM. All authors read, edited, and approved the final manuscript.

This work was not supported by any funding agency.

Availability of data and materials

Ethics approval and consent to participate.

Not applicable.

Consent for publication

Competing interests.

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The online version contains supplementary material available at 10.1186/s13643-020-01552-x.

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Middle Eastern Studies

Collecting on the Middle East

Collecting primary source documentation from the Middle East remains a challenge even for the most well-funded institutions. While some commercially available books, serials, and newspapers can be obtained from vendors from country to country with varying levels of ease, much significant content cannot be acquired through mainstream suppliers. Research libraries commonly employ acquisition trips and visits to book fairs throughout the region to supplement commercial acquisition and collect university, government, and NGO publications; street literature; ephemera; and other primary sources.

The Library of Congress operates a field office in Cairo, Egypt, to coordinate the acquisition of commercial materials and government documents from the Middle East and North Africa (supplied through a network of vendors, book dealers, exchange partners, and acquisition trips). It also manages the Middle East Cooperative Acquisitions Program (MECAP) and supplies monographs and serials from commercial sources to libraries and other research institutions.

Changing paradigms

In addition to traditionally collected resources from the region (reports, journals, archival collections), scholars are turning to interdisciplinary studies, with content related to ecology, environment, public health, statistical data sets, first-person accounts, oral histories, popular culture, and audiovisual resources. Recent events have created a burst of interest in social media and Internet resources.

Commercial electronic resources containing Middle East primary sources can be scarce. The past few years, however, have seen rapid development in the types of resources accessible online, both commercially and via Open Access. English-language reference resources such as Oxford Islamic Studies Online , Index Islamicus , and Middle Eastern & Central Asian Studies provide insights into the complex politics and culture of the Middle East. There is growing interest worldwide in digitization of early Middle East manuscripts. Unfortunately, these digital resources are often produced sporadically and contained in information “siloes” that hamper discoverability.

Archiving the Middle East Web

Current web-archiving efforts focus primarily on events (wars, crises, and revolutions), crawled for limited duration and with varying levels of comprehensiveness. The evolving nature of web technologies and increasing reliance on mobile networks (bypassing official web channels) further compound the challenge of documenting contemporary Middle East society.

CRL’s collection of Middle Eastern-related material encompasses significant runs of newspapers from every country, dissertations on the Arab world and Islam, monographs and serials acquired through deposit by member libraries, and archival and microform sets of primary source content.

CRL continues to acquire current newspapers on microfilm as well as historical backfiles from the region, microform sets prioritized through CRL’s purchase programs , and dissertations and archival materials. CRL also supports the Middle East Materials Project in its preservation and digital activities (see the related MEMP collection guide for additional resources of interest).

The references below feature the strengths of CRL’s holdings. Links point to more detailed descriptions in our catalog, and where available point to digital versions of the content or digitized finding aids for microfilm.

Arabic manuscripts

CRL has acquired several components of the collection of Arabic Manuscripts in the British Library. These include:

• Ḥadīth: Collections of traditions and statements of Muhammad, along with commentaries and critical works. Catalog Record .
• Kalām: theological debates and texts on the Qur'an. Catalog Record .
• Prayers & sermons. Catalog Record .
• Mysticism & pietics. Catalog Record.
• Philosophy. Catalog Record.
• Ethics and polity. Catalog Record.

Over 400 manuscripts, including traditional Islamic disciplines as Tafsir, Hadith, and Fiqh as well as works on mathematics, astronomy, medicine, falconry, archery, and military equitation. A sizeable portion of the collection relates to Shi'ah literature.

Books and monographic collections

English translations of primary source texts chosen from published and unpublished sources to reflect the chronological, geographical, and linguistic diversity of Islamic societies. Includes folk and oral literature, poetry, geography and travel writing, legal and commercial texts, and many other genres (including texts from Europe, South/Southeast Asia, and other areas).

This set includes over 3,000 titles filmed from the collections of the Harvard University Library and the School of Oriental and African Studies Library at the University of London. It includes works printed between the 16th and the early 20th centuries. Over half of the titles filmed for this collection are printed in English, with the remainder in other Western languages including French, German, Italian, and Spanish. It includes memoirs, travel literature, biographical and bibliographical works, guide books, historical studies, and texts. It also includes works in translation from regional languages, such as legal texts, chronicles, and collected letters. Each unit has guide; a cumulative guide will be published when the project is completed.

CIA Studies

 From the microfilm series “CIA research reports.”

GUIDE: A guide to “Middle East, 1946-1976.” at CRL call no. B-39832.

From the microfilm series O.S.S./State Department intelligence and research reports; pt. 12.

GUIDE: “Middle East: 1950-1961 supplement” available at CRL call no. B-39747.

This collection focuses on contemporary political issues and offers in-depth research on topics from leading public and private policy research facilities. Titles cataloged individually.

GUIDE: Guide to Special Studies series available at CRL call no. B-39802.

Instructions sent to and correspondence received from diplomatic posts relating to Egypt's internal affairs. CRL has the following sets:

• Despatches from United States consuls in Alexandria, 1835-1873 [NARA; T45]. Catalog Record .
• Despatches from U.S. consuls in Cairo, 1864-1906. [NARA; T41]. Catalog Record .
• Despatches from United States consuls in Port Said, 1870-1876 [NARA; T658]. Catalog Record .
• Records of the Department of State relating to internal affairs of Egypt, 1910-29 [NARA; M571]. Catalog Record . Guide .
• Records of the Department of State relating to internal affairs of Egypt, 1930-1939 [NARA; T1251]. Catalog Record . Guide .
• Confidential U.S. State Department Central Files. Egypt, 1945-1949. Catalog Record . Guide .
• Confidential U.S. State Department Central Files. Egypt, 1950-1954. Catalog Record . Guide .
• Confidential U.S. State Department Central Files. Egypt, 1955-1959. Catalog Record . Guide .

Contains gazetteers and handbooks, military reports, route books, and other printed correspondence collected by the Government of India Foreign Department and U.K. Foreign Office.

Contains general correspondence (1906–66) of the Foreign Office’s Political Departments relating to Persia (Iran). From shelfmark FO 371. See record for details on particular subseries included.

Contains over 14,000 pages of government documentation, much of it once-classified, pertaining to U.S. political, military, and economic involvement in Iran, 1977–80. Collected by the National Security Archives. The two-volume guide provides document-level access to names, organizations, and subjects. Volume II contains an events chronology, glossaries of names and organizations, a chronological document bibliography, and a bibliography of secondary sources.

Instructions sent to and correspondence received from diplomatic posts relating to Iran's internal affairs. CRL owns the following sets (printed guides available):

• Notes from the Persian Legation in the United States to the Department of State, 1867-1906. [NARA; M511]. Catalog Record .
• Despatches from United States Ministers to Persia, 1883-1906. [NARA; M223]. Catalog Record
• Records of the Department of State relating to internal affairs of Persia, 1910-1929. [NARA; M715]. Catalog Record .
• Records of the Department of State Relating to Political Relations Between the United States and Persia, 1921-1929.  [NARA; M716]. Catalog Record . Guide .
• Records of the Department of State relating to political relations between Persia and other states, 1918-1929. [NARA ; M717]. Catalog Record . Guide .
• Records of the Department of State relating to internal affairs of Iran, 1930-1939. [NARA; M212]. Catalog Record . Guide .
• Confidential U.S. diplomatic post records: Iran, 1942-1944. Catalog Record . Guide .
• Confidential U.S. State Department central files: Iran, 1945-1949. Catalog Record . Guide .
• Confidential U.S. State Department central files: Iran, 1950-1954. Catalog Record . Guide .

India Office Political & Secret Department confidential reports, memoranda, maps, and handbooks, as well as policy files describing the background and practicalities of the creation of a political administration, as well as of a social and an economic infrastructure, of the former Ottoman territories known as Turkish Arabia. Arranged in 10 groups:

BII-1 Gazetteers and handbooks; BII-2 Outbreak of the First World War: situation in Turkish Arabia; BII-3 Wartime military and civil administration; BII-4 Wartime economy: trade and communications; BII-5 Post-war administration and constitution for the state of Iraq; BII-6 Local government and education; BII-7 Kurdistan; BII-8 Iraqi boundaries; BII-9 Post-war economic development; BII-10 The oil industry Summary

Records of the Department of State diplomatic post files relating to Iraq’s internal and political affairs. CRL has the following sets (guides available):

• Records of the Department of State relating to internal affairs of Asia, 1910-1929 [NARA; M722]. Catalog Record .
• Records of the Department of State relating to internal affairs of Iraq, 1930-1944 [NARA; T1180]. Catalog Record . Guide .
• Confidential U.S. diplomatic post records. Iraq, 1942-1944. Catalog Record . Guide .

Israel and Palestinian territories

GUIDE: A guide to confidential U.S. State Department central files, Palestine and Israel internal affairs, 1945–49, and foreign affairs, 1945–49. B-38282 c. 13,000 items. “Decimal Files 867N.00-867N.92511.”

GUIDE: A guide to Confidential U.S. State Dept. central files, Palestine and Israel internal affairs, 1950–54 and foreign affairs, 1950–54. B-38281

The file covers 1926–40, and contains the Blue Book of statistics.

National Archives microfilm publications. T ; microcopy no. 1181

Records of the Department of State diplomatic post files relating to Lebanon’s internal and political affairs. CRL has the following sets (guides available):

• Despatches from United States consuls in Beirut, 1836-1906. [NARA; T367]. Catalog Record .
• Records of the Department of State relating to internal affairs of Asia, 1910-1929. [NARA; M722]. Catalog Record . Guide
• Records of the Department of State relating to internal affairs of Lebanon, 1930-1944. [NARA; T1178]. Catalog Record .
• Confidential U.S. diplomatic post records. Lebanon, 1942-1944. Catalog Record . Guide .

News Resources

CRL holds extensive runs of newspapers from the Middle East, encluding Arabic, English, and French resoruces. Examples of major series include:

• Ahrām (Alexandria,Egypt) 1880-2010
• Egyptian gazette  1930-98
• Ittilaat (Tehran, Iran)  1926-2010
• Baghdad Observer  1964-1992
• Ha-Arets (Tel Aviv, Israel)  1964-75, 1987
• Palestine Post / Jerusalem Post  1932-2010
• Dustūr (Amman, Jordan)   1967-2000
• Nahār (Beirut, Lebanon)   1962-2002
• Riyạ̄d (Riyadh, Saudi Arabia) 1972-1994
• Tishrīn (Damascus, Syria) 1987-2002
• Cumhuriyet (Istanbul, Turkey) 1925-2002
• CRL also holds a variety of press digests, as well as a complete run of reports from the Foreign Broadcast Information Service for the period 1941-1995. This includes Middle Eastern coverage as part of the Daily Reports (1941-74) and subsections for Middle East & North Africa (1974-80), Middle East & Africa (1980-87), and Near East & South Asia (1987-95). See the News Topic Guide for more details.

Saudi Arabia

Records of the Department of State relating to Saudi Arabia’s internal and political affairs. CRL has the following sets (guides available):

• Records of the Department of State relating to internal affairs of Asia, 1910-1929. [NARA; M722]. Catalog Record .
• Records of the Department of State relating to internal affairs of Saudi Arabia, 1930-1944 [NARA; T1179]. Catalog Record .
• Confidential U.S. State Department central files: Saudi Arabia, 1945-1949. Catalog Record . Guide .
• Confidential U.S. State Department central files: Saudi Arabia, 1950-1954. Catalog Record . Guide .

Records of the Department of State relating to Syria’s internal and political affairs. CRL has the following sets (guides available):

• Records of the Department of State relating to internal affairs of Syria, 1930-1944. [NARA; T1177] Catalog Record .

This set includes 294 titles of early western books found in the Library of the School of Oriental and African Studies at the University of London. The emphasis is on the Eastern Mediterranean and the Ottoman Turks. The collection brings together Western source material together describing European attitudes to the East in the sixteenth Century, and in tracing the development of the study of oriental history in Europe.

GUIDE: Forbes, Lesley. Early Western books, 1500-1599 : the Ottoman Empire and the Mediterranean. Fiche. Cumulative list of titles filmed by IDC. E-895

General correspondence (1780–1905) from the political and other departments relating to the Ottoman Empire. From Series F.O. 78. See catalog record and guide ofr specific Subseries included. [CRL has partial set.]

Records of the Department of State relating to Turkey’s internal and political affairs. CRL has the following sets (guides available):

• Despatches from United States ministers to Turkey, 1818-1906. [NARA; M46] Catalog Record .
• Notes from the Turkish legation in the United States to the Department of State, 1867-1906. [NARA ; T815] Catalog Record .
• Despatches from United States consuls in Alexandretta, 1896-1906. [NARA; T504] Catalog Record .
• Despatches from United States consuls in Constantinople, 1820-1906. [NARA; T194] Catalog Record .
• Despatches from United States consuls in Erzerum, 1895-1904. [NARA; T568] Catalog Record .
• Despatches from United States consuls in Harput, 1895-1906. [NARA; T579] Catalog Record .
• Despatches from United States consuls in Sivas, 1886-1906. [NARA; T681] Catalog Record .
• Records of the Department of State relating to internal affairs of Turkey, 1910-29. [NARA; M353] Catalog Record .
• Records of the Department of State relating to internal affairs of Turkey, 1930-1944. [NARA; M1224] Catalog Record .
• Records of the Department of State relating to internal affairs of Turkey, 1945-1949. [NARA; M1292] Catalog Record .
• Records of the Department of State relating to political relations between the United States and Turkey, 1910-29. [NARA; M365] Catalog Record .
• Records of the Department of State relating to political relations between the United States and Turkey, 1930-1944. [NARA; M1223] Catalog Record .
• Records of the Department of State relating to political relations between Turkey and other states, 1910-29. [NARA; M363] Catalog Record .
• Records of the Department of State relating to political relations of Turkey, Greece and the Balkan states, 1930-1939. [NARA; T1245] Catalog Record .
• Records of the Department of State relating to political relations of Turkey, Greece and the Balkan states, 1940-1944. [NARA; T1246] Catalog Record .
• “Inquiry documents”: special reports and studies, 1917-1919. ( Records of the American Commission to Negotiate Peace). [NARA; M1107] Catalog Record .

Related CRL resources

Webinar: Middle East & Islamic Resources (CRL) - August 2011

Middle East Microform Project (MEMP)

• Guides to Collections
• Holdings List
• Alspach, Judith. " A Collection-Level Analysis of the Middle East Materials Project ." MELA NOTES : Journal of Middle Eastern Librarianship. Number 88 (2015), pp. 7–23.

FOCUS on Global Resources Articles

• The Middle East Microform Project: Past, Present, and Future    
• The Arab-American Press    
• Mining the Middle East Political Web for Research  
• The Ottoman Turkish Collection    
• MERJ: The Middle East Research Journals Project    
• Improving Access to Middle East Serials: OACIS for the Middle East

Middle Eastern Political Parties Web Harvesting and other efforts A paper presented to the “International Collections Development Workshop” February 27, 2006

Middle East Research Journals project   Sponsored by the Council of American Overseas Research Centers to provide indexing and preservation for a number of journals held in overseas institutions.

Collection Development issues

Hirsch, David. “Middle Eastern Collection Development in Academic Libraries” ( Building Collections for Area Studies , Harassowitz Verlag, 2007).

Related reviews (electronic resources)

Encyclopedia of Islam ( The Charleston Advisor )

CRL Programs

Past events.

Further Reference

Don’t see your topic of interest listed here? We also provide Reference Consultations to help you identify material in our collection that is relevant to your field. You can get help from Marie Waltz , CRL’s Head of Access Initiatives.

• Open access
• Published: 08 June 2022

Pharmacy practice and clinical pharmacy research in the Middle East: a scoping review of studies from Bahrain, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, United Arab Emirates, and Yemen

• Daneh Obaid 1 ,
• Faris El-Dahiyat   ORCID: orcid.org/0000-0002-5264-8699 1 , 2 &
• Zaheer-Ud-Din Babar 3  

Journal of Pharmaceutical Policy and Practice volume  15 , Article number:  40 ( 2022 ) Cite this article

4428 Accesses

5 Citations

5 Altmetric

Metrics details

Pharmacy practice research publications has increased significantly in the last decade. This is also true for Middle Eastern countries.

The aim of this study was to document and review pharmacy practice literature in the Middle Eastern Arab countries.

Materials and methods

A scoping review was conducted using PRISMA-ScR guidelines. Medline/PubMed and Scopus were used to screen the articles. All published original research articles concerning any facet of pharmacy practice in 12 Arabic Middle Eastern countries during 2009–2019 were included. A thematic analysis was performed to classify the articles.

Nine hundred and eighty-one articles were included in this study. Eight themes emerged from the selected articles. Medication use was the predominant theme 30.78% (302), followed by pharmacy practice and pharmacist services 22.94% (225), and then pharmacy education and professional development 16.31% (160). The KSA, Jordan, Qatar, and the UAE were the leading countries to publish pharmacy practice research.

Conclusions

Pharmacy practice research is growing and significantly adding to enhance pharmaceutical health services in the Middle East Region. There is a need to develop a research agenda. This will help in enriching the practice, as well as to avoid repetitive ideas.

Pharmacists, the medication experts, have a dynamic role in the health sector [ 1 ]. A remarkable change has endured in pharmacy practice throughout the past decade. The pharmacist role has expanded beyond traditional practice into more clinical patient-centered practice [ 2 , 3 , 4 , 5 , 6 ].

This dynamic shift ascends the necessity of having evidence that evaluates pharmacy services, assesses the need for new services or enhancement of the available services, and specify the benefit and cost of the new advanced pharmacists’ role; which overall emphasize the importance of pharmacy practice research development [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].

Pharmacy practice research endorses the value of the potential pharmacist’s role and services [ 10 , 14 , 15 ], generates ideas for new pharmacy services; in addition, it also supports policymakers and regulatory affairs decisions [ 7 , 10 , 15 , 16 ].

Up to date, there is no global or universally accepted definition of pharmacy practice or pharmacy practice research. Several studies aimed to figure out a comprehensive definition of pharmacy practice and its disciplines [ 17 , 18 ]. In 2019, Hasan et al. conducted an exploratory study to define pharmacy practice and it’s research, where several definitions were collected and analyzed. In conclusion, Hasan et al. illustrated the major themes comprising pharmacy practice and pharmacy practice research, which were medicines use, patient-centered care, and health services delivery [ 18 ].

In this review, we adopted the International Pharmaceutical Federation (FIP), Pharmacy Practice Research Special Interest Group (2019), pharmacy practice research definition as it is the most recent universal definition. The FIP Definition states: “a component of health services research that emphasizes the impact of the practice of pharmacy on the healthcare systems, medicines use and patient care. It’s scope has expanded over the past 50 years to encompass aspects, such as the clinical, behavioral, economic and humanistic implications of the pharmacy practice as well as practice change and implementation of innovations and new services in routine practice.” [ 19 ].

For centuries, Arabs intensively influenced the science and art of pharmacy, which subsequently contributed to the evolution of pharmacy in Europe, and eventually, the rest of the world [ 20 , 21 ].

Pharmacy education and pharmacy practice in Arabic-speaking Middle Eastern countries continue to evolve. However, there is no published comprehensive review that outlines the overall status of pharmacy practice research in this region. Hence, this paper aimed to provide an inclusive review and explore the gaps in pharmacy practice research.

Study rationale

To the best of our knowledge obtained from the literature search, no published review covered pharmacy practice research in the Middle East comprehensively; however, few studies have outlined few domains of pharmacy practice research, such as education [ 22 ], medication safety [ 23 , 24 ], pharmacovigilance [ 25 ], and pharmacoeconomics [ 26 ].

Study significance

Pharmacy practice research in the Middle East is in the developing stage. Exploring the current status of pharmacy practice research in several practice domains will highlight the drawbacks and help in drawing a roadmap for the upcoming research studies in this region.

This study aims to evaluate the current status of pharmacy practice research in 12 Arab Middle East countries by retrieving related published articles.

Specific objectives

The study was conducted to:

Explore, review, and synthesize literature published in the 12 Arab Middle East countries, related to pharmacy practice in its major domains (Community, Hospital, Clinical, Educational, Economics, and Social and Administrative aspects).

Explore topics and themes covered in the literature.

Identify the limitations and areas that needed further development.

Provide suggestions to develop and improve the pharmacy practice research.

Study design

A Scoping review using PRISMA-ScR guidelines [ 27 ] was conducted to retrieve published literature in the field of pharmacy practice in 12 Arabic Middle East countries. The countries included Bahrain, Iraq, Kingdom of Saudi Arabia, Kuwait, Lebanon, Oman, Palestine, Qatar, Syria, United Arab Emirates, Yemen, and Jordan. The method steps of this study is shown in Fig.  1 .

Method steps

Eligibility criteria

Literature published in the English language within 10 year interval [Jan. 2009–Dec. 2019] covering pharmacy practice domains in the selected Middle East countries; (Bahrain, Iraq, Kingdom of Saudi Arabia, Kuwait, Lebanon, Oman, Palestine, Qatar, Syria, United Arab Emirates, Yemen, and Jordan), were included in the review. Only original articles were involved excluding non-original articles as: letters, commentaries, systematic reviews, editorials; in addition, studies-related to other pharmacy aspects, such as pharmaceutics and drug formulation, pharmacology studies, pharmaceutical chemistry, and pharmacognosy were excluded.

Information resources

PRISMA-ScR guidelines for scoping review were followed. The databases were searched from Aug.-2019 till Jan.-2020. The Database included: The Medline database using PubMed and Scopus database. In the search process, “Boolean Operator” rules were employed. The terms used were searched utilizing “AND” to combine the keywords listed and “OR” to remove search duplication where possible.

Results details included; the database, publishing journal, article title, authors, and the publication date. The detailed search strategy conducted is clarified in Table 1 .

Search strategy

A search strategy was developed and implemented. The search was restricted to the English language using the following keywords: “Pharma*” AND (“The Middle East” OR “Gulf cooperation council” OR “Emirates” OR “Saudi Arabia” OR “Oman” OR “Kuwait” OR “Bahrain” OR “Qatar” OR “Yemen” OR “Iraq” OR “Jordan” OR “Syria” OR “Lebanon” OR “Palestine”). The keywords were combined and incorporated in database searches to collect the findings that contain the selected terms in the title or the abstract of the articles published from 1st Jan-2009 till 31st Dec. 2019.

Studies selection

Duplicate articles were screened and removed. The title and abstract of the studies were screened by two reviewers to test their eligibility and relevancy. The articles were categorized into three groups: included, excluded, and uncertain. In case of uncertainty about an article’s inclusion, the full text was retrieved and reviewed by the two authors/reviewers independently to decide the eligibility state of the article. However, if the conflict remains, assistance from a third expert was acquired. After excluding the irrelevant articles, the eligibility of all included articles was assessed by full-text screening. Articles were excluded for the following reasons; if published in a non-English language, in different practice settings irrelevant to pharmacy practice, conducted in countries other than the ones listed, unoriginal articles, such as comments, letters, case reports, surveys, editorials, review articles, unpublished articles, or articles in-press.

Data charting process

Two investigators were assigned to extract data from the articles and categorize them according to the pharmacy practice domain it covers, independently. In a calibrated excel sheet, the data was presented based on the following; Title, authors, study design, the study aim, study setting, related countries, pharmacy practice domain it covers, and date of publication. By reviewing the studies’ aim/objectives, similar articles with comparable objectives were collected in one category, and after analyzing the categories; the themes were generated.

Title, authors, type of research or study design (research methodology if any), site of study setting (Hospital, Community pharmacy, General pharmacy, Educational Institution, or Public setting), related countries, pharmacy practice domain it covers, date of publication, publishing journal, study aim, are the data that were collected and tabulated from each study. After the extraction of relevant information, a thematic synthesis was undertaken of the study objectives, types, and pharmacy practice domain it covers; to identify themes based on frequencies (No. of source found) for each.

Synthesis of results

The data were thematically analyzed according to the pharmacy practice domain. Frequencies and percentages were used to present the synthesized results.

Study selection

A total of 3858 ‘hits’ were generated from the electronic search of both databases. 2521 and 1337 items were identified from Scopus and PubMed, respectively. 1142 of which were duplicates and omitted. Out of 2716 articles; 270 articles were classified as book chapters, conference papers, editorials, letters, notes, literature reviews, and Meta-analyses, thus did not meet the inclusion criteria and were excluded. Overall, 2446 articles were analyzed for inclusion, from which 981 were classified as pharmacy practice research papers in the selected countries and included in the review, as shown in Fig.  2 .

Included studies characteristics

Of the 981 reviewed articles, around 31% ( n  = 302) of studies were conducted in the KSA, followed by Jordan with almost 22% ( n  = 215) of the total included studies. Qatar comes in the third-place n  = 114 articles, whereas n  = 82 studies were conducted in the UAE.

The rest of the countries had fewer number of pharmacy practice research and can be arranged in descending order; Lebanon n  = 71, Iraq n  = 46, Kuwait n  = 39, Yemen n  = 35 and similarly in Palestine n  = 33, Oman n  = 22, Syria n  = 9, and Bahrain n  = 6.

A scarcity of pharmacy practice research articles was observed in Bahrain, only six articles were found for this review. One article was published in both 2009 and 2010, whereas two articles were in both 2012 and 2018. Only nine articles included in this review were conducted in Syria. One of them is interventional, while the rest are non-interventional. Twenty-two articles were recognized as “pharmacy practice research” in Oman. Yemen, and Palestine, despite the unstable political situation 35, 33 articles were noted in each, respectively. Whereas, 39 articles were affiliated in Kuwait; the majority of the articles were in the last 3 years of the decade 2017–2019. While 46 studies were conducted in Iraq and 71 in Lebanon.

KSA, Jordan, Qatar, and the UAE were the frontrunners in terms of the number of articles published in pharmacy practice. Coordination between different Middle East countries was observed in seven studies. One between Jordan and the United Arab of Emirates, the other in Qatar and Kuwait, two between Qatar and Lebanon. Table 2 demonstrates the percentage (Number) of articles identified in each country.

An increase in the number of publications was observed in the last 4 years, almost 15% increment of the publications in 2019, 18.25% ( n  = 179) compared to 2009 2.96% ( n  = 29). Table 3 and Fig.  3 present the included articles’ distribution through the years.

Articles distribution through the years

The thematic analysis generated eight themes;

Theme 1: Pharmacy Practice and Pharmacist Services.

Theme 2: Medication Use and Pharmacogenomics.

Theme 3: Medication Safety and Pharmacovigilance.

Theme 4: Pharmacy Education and Professional Development.

Theme 5: Medicines Information and Public Health Promotion.

Theme 6: Pharmacoeconomics and Pharmaceutical Policies Studies.

Theme 7: Pharmaceutical Marketing Studies.

Theme 8: Clinical research.

The article classification among the themes is demonstrated in Tables 4 . Table 5 shows the article distribution between countries per theme, while Table 6 shows the themes distribution per country.

The predominant theme was Theme 2: Medication Use and Pharmacogenomics which incorporated n  = 302 papers. Approximately, one-quarter of the studies (22.94%) discussed the pharmacy practice and pharmacist services in different settings which were combined in theme 1; community pharmacy, hospital pharmacy, and clinical pharmacy.

One hundred and sixty articles were included in Theme 4 that covers the educational aspects of pharmacy in addition to the professional development concerns.

However, Theme 3: Medication Safety and pharmacovigilance included n  = 133 studies. The last three themes have the lowest number of articles in ascending order; Theme 5: Medicines Information and Public health promotion n  = 19, Theme 7: Pharmaceutical Marketing studies n  = 27, Theme 6: Pharmacoeconomics and Pharmaceutical Policies n  = 50, and Theme 8: Clinical Research n  = 65.

Comparing the studies conducted in each country, it was noticed that the prominent theme in several countries was theme 2 “medication use”. Iraq, the KSA, Lebanon, Palestine, Syria, Oman, and Jordan were among these countries. Theme 1: Pharmacy Practice and Pharmacist Services was the second most common theme in the majority of these countries. However, Kuwait and the UAE were found to have Theme 1 as their dominant theme in the pharmacy practice research. In addition, it was found that Theme 4: Pharmacy Education and Professional Development is the most frequently published theme in Qatar. Table 6 presents the thematic classification of the articles in each country.

Theme 1: Pharmacy Practice and Pharmacist Services

The research articles concerning pharmacy practice and pharmacist services were covering different pharmacy settings and were classified accordingly, as shown in Table 7 .

Community pharmacy

Hospital pharmacy

Clinical pharmacy

Community pharmacy was the dominant setting in which pharmacy practice research studies were conducted ( n  = 107), this was followed by the hospital ( n  = 68) and clinical ( n  = 46) settings correspondingly.

Nine sub-thematic headings were observed and these are listed in Table 7 .

Pharmacy practice review.

Management aspects of pharmacy practice.

Assessment of pharmacy services.

Evaluation effectiveness of pharmacists’ interventions.

Implementing and developing pharmacy services.

Public perception and attitude to pharmacy practice.

Physician and Health Care Provider (HCP)s’ Perception to Pharmacy Practice.

Pharmacists’ knowledge, attitude, and practice (KAP) to Pharmacist services.

Physician–Pharmacist collaboration (multidisciplinary practice).

Six studies portrayed the pharmacy practice in general, two of these studies were about the community pharmacy. Regarding management aspects in pharmacy practice, nine studies were classified under this field in the community pharmacy. However, three studies assessed the management aspects of hospital pharmacy practice.

Forty-three studies assessed pharmacy services provided in community pharmacy settings and 13 studies were about hospital settings, only three articles discussed clinical pharmacy. Fourteen articles investigated the development and implementation of pharmacy services. However, none of this was about community pharmacy services, five were regarding hospital pharmacy, and 9 were about clinical pharmacy.

On the other hand, studies intended to evaluate the effectiveness of pharmacist intervention were mainly about clinical pharmacists n  = 22 and hospital pharmacists n  = 17 to a less extent about community pharmacists’ interventions n  = 8.

Numerous studies highlighted the perceptions and attitudes of health care providers’ n  = 17. Two concerning community pharmacy, seven concerning hospital pharmacy, and eight about clinical pharmacy. Pharmacists’ perceptions were observed in twenty-three studies n  = 23: 15 were about community pharmacy, Thus, only seven about hospital pharmacy and one about clinical pharmacy. Public perceptions regarding pharmacy practice was observed in n  = 32 studies: 26 regarding community pharmacy, and 6 regarding hospital pharmacy.

Inter-professional collaboration between the pharmacist and physician or in other words, multidisciplinary care, has gained increasing interest in the last decade n  = 15. Two of these studies focused on the physician–community pharmacist collaboration. In addition, 10 studies were about the hospital pharmacists. Only three studies highlighted physician–clinical pharmacist collaboration.

Theme 2: Medication Use and Pharmacogenomics

The vast majority of the included studies shed the light on medication use aspects. Nearly, one-third ( n  = 302) of the total included articles were classed under the medication use themes. Each of the KSA and Jordan sheltered approximately 25% of the total articles under this theme (Table 5 ).

Five subheadings were identified under this theme:

Public behavior in regards to medication use.

Prescribing and dispensing practice.

Intervention to improve medication use.

Pharmacists and Health care providers' knowledge, attitude, and practice.

Pharmacogenomics studies.

The most utilized topic was the public behavior and practice in medication use ( n  = 116). A lack of studies assessing and discussing interventions used to enhance the medication use practice was observed n  = 12. Table 8 shows the sub-themes of the articles.

Theme 3: Medication Safety and Pharmacovigilance

Around 13% of the included articles were about medication safety, and two fifths (44.36%) of these articles were conducted in the KSA. Jordan was the second in regards to the number of articles published about medication safety ( n  = 24), while in Qatar, ten articles were published (Table 6 ).

Medication error:

Prevalence of medication error

Prescribing error

Dispensing error

Administration error

Medication error reporting

Interventions to prevent medication error

Factors affecting medication error.

Drug interaction

Drug-related problems—DRP

Medication safety—assessment

Medication safety knowledge and awareness

Pharmacovigilance studies

Studies depicting pharmacovigilance covered 36% of the articles followed by medication errors with almost one-third of the studies ( n  = 41) 30%. Table 9 demonstrates the sub-themes of the articles.

Theme 4: Pharmacy Education and Professional Development

One hundred and sixty articles were identified and classified under the pharmacy education and professional development theme. Forty-nine papers were found in Qatar, while 38 studies were conducted in the KSA. However, no studies were found for Oman and Bahrain. Refer to Table 5 .

Five sub-themes were identified including:

Curriculum and teaching strategies.

Pharmacy students’ perception toward pharmacy practice and pharmacy as a career.

Knowledge and competency evaluation.

Continuous education.

Below, Table 10 illustrates the sub-themes of the articles under theme 4: Pharmacy Education and Professional development.

Theme 5: Medicines Information and Public health promotion

Medicines information resources and public health promotion aspects were investigated in 19 studies that either investigated the available and utilized medicines information resources n  = 6, or evaluated the medicines Information and health promotion services provided by the pharmacists n  = 7, in addition to six more studies examined public health awareness.

These studies were conducted in the Gulf Cooperation Council Countries; the KSA n  = 9, the UAE n  = 2, Qatar n  = 2, and one in Kuwait, and Bahrain, in addition to Jordan n  = 4 (Table 6 ). Table 11 illustrates the sub-theme classification of the articles under theme 5.

Theme 6: Pharmacoeconomics and Pharmaceutical Policies Studies

Almost 5% of the included articles were classified as pharmacoeconomics and pharmaceuticals policies studies. The majority of these studies were conducted in the KSA followed by Jordan, Lebanon, UAE, and Qatar, respectively. In addition to two collaborative studies from Qatar and Lebanon (Tables 5 and 6 ). Table 12 illustrates the sub-thematic classification of the articles.

Theme 7: Pharmaceutical Marketing Studies

Pharmaceutical marketing was a prevalent topic in the literature and was covered by 27 papers. Yemen had the majority of these studies with 11 research papers followed by the KSA and Jordan with six and four studies, respectively, whereas Iraq and Lebanon had three studies each (Tables 5 , 6 ).

Five sub-themes emerged from this theme. More than the half of included studies were about the physicians’ and/or pharmacists’ perception of the interaction between medication representatives and HCP 55% (15). Table 13 presents the sub-themes heading included in theme 7.

Theme 8: Clinical research

A limited number of clinical studies with a pharmacist’s role was observed in the literature n  = 65. The majority of these studies were in the KSA n  = 23 followed by Jordan n  = 15 and Iraq n  = 8. Fewer studies were observed in Qatar n  = 4, Oman n  = 4, the UAE n  = 4, Syria n  = 3, Lebanon n  = 2, and Kuwait n  = 1 (Tables 5 and 6 ).

Four domains were listed under this theme; Pharmacotherapeutic evaluation studies were the most frequently conducted studies in this theme n  = 45, followed by Etiology and Risk Factor Studies n  = 11, Clinical Pharmacokinetics studies n  = 6, a Disease Prevalence Studies n  = 3. Table 14 illuminates the sub-thematic classification of the articles.

This study highlighted the status of pharmacy practice research in the Middle East. KSA, Jordan, Qatar, and the UAE were the leaders in terms of the number of articles published in pharmacy practice, the KSA as the largest country amongst the included ones. The increasing number of published papers might be an influence of the Kingdom 2030 vision [ 28 ], that aims to enhance the development in different sectors including health, education, and economics and consequently lead to support the scientific research as well as pharmacy practice and health research. The UAE and Qatar are high income countries that place a great emphasis on scientific research [ 29 ]. Jordan is considered one of the key countries in pharmacy education and practice. This is with great number of pharmacy colleges, and advanced pharmacy practice policies. The unstable political situation in several Arab countries such as Lebanon, Iraq, Palestine, Yemen, and Syria may explain the less number of articles published in these countries.

An increasing number of publications was observed in the past 3 years that may show the trend towards academic institutions ranking and accreditation requirements from regulatory bodies [ 30 ]. This may also explain the increase in the number of publications.

Duplicated studies with repetitive ideas were observed throughout the studies analyzed, that may lead to saturation in certain fields and a gap may be observed in other fields.

Pharmacy practice and pharmacist services

Regarding studies concerning pharmacy practice and pharmacist services, the bulk of studies was in community pharmacy settings; this can be elucidated by the popularity of community pharmacies [ 31 ]. Studies investigating the developing and implementing pharmacy services are needed in all pharmacy settings, especially in community pharmacies. A bibliometric study published in 2014 has also indicated the negligence of this field in the Arab world [ 32 ].

Medication use

Medication use is included in many research articles, and the most frequent topic is the use of antibiotics and antimicrobial stewardship programmes [ 33 ]. Socio-behavioral aspects in medication use and specially self-medication was a common area of focus from different authors. An expected reason might be the importance of assessing self-medication and ensuring its appropriateness the need for law reinforcement to manage the medication dispensing and distribution. A systematic review in the Middle East about the self-medication also supports this recommendation [ 34 ] and enhances the public awareness toward this issue. A limited number of studies discussed the interventions and solutions to improve medication use. A systematic review about the safety of medication use in the GCC also supports this view [ 35 ].

Medication safety

Medication safety was the fourth most utilized topic, and pharmacovigilance related studies covered almost 40% of the literature. This is due to the fact that pharmacovigilance is still considered in its infancy in several Arab and Middle East countries [ 24 , 35 ].

Medication error was the second most topic in the field of medication safety. The majority of studies were regarding the prevalence and factors affecting this practice. However, there was a shortage of studies that assess and evaluate the interventions to prevent and improve pharmacy practice in this regard. This is in line with a systematic review published in 2013 about medication errors in the Middle East [ 23 ].

Pharmacy education

Qatar was the first in studies concerning pharmacy education programmes and curriculum development and evaluation, followed by the KSA and Jordan.

Conversely, Qatar has a single higher educational institute that offers a pharmacy degree that has been launched in 2007 [ 36 ], but pronounced support for pharmacy education is noticed in the fast growth. The KSA pharmacy education dates back to 1959 with only one college and after that in the first decade of the second centenary, 23 government colleges, and seven private colleges had been lunched [ 37 ], as per the descriptive study conducted in 2018, this increase in educational institutes raise the demand of research in the pharmacy education field [ 38 ]. Jordan has the second oldest pharmacy programme in the region starting from 1979, and today several pharmacy schools offer bachelor’s, master’s, and doctorate programs. This may explain the huge number of publications in Jordan [ 39 ]. The establishment of the first pharmacy college in the UAE was in 1992, afterward, numerous pharmacy programs were established [ 40 ]. The maturity of the pharmacy education programme has played an affirmative role in enhancing the pharmacy practice research in these countries. This is in addition to the strong economics as well as a political stability.

Related to other topics a scarcity of studies about continuous education for pharmacists and health care providers n  = 20 and scientific research ( n  = 11) was identified. High interest in scientific research was observed in Qatar and Jordan compared to the other countries.

The most commonly utilized method in studies was to assess the knowledge and perception through quantitative questionnaire-based studies. The least used methods were simulated patient or mystery shopper-based qualitative methods.

In agreement with the bibliometric review pharmacy education literature published in 2013, several gaps in the literature were outlined to develop a research agenda in the region [ 41 ].

Pharmacoeconomics and pharmaceutical marketing research

KSA, Jordan, Yemen, Lebanon, and Iraq, respectively, had the greatest number of studies in pharmacoeconomics and pharmaceutical marketing. According to the United Nations World Bank; the KSA is considered a high-income country, thus Jordan, Lebanon, and Iraq from the upper-middle-income countries. However, Yemen is among the low-income countries [ 42 , 43 , 44 ]. It is justified why middle and low-income countries emphasize pharmacoeconomic research studies as it will help in the allocation of inadequate health resources [ 45 ].

Pharmaceutical marketing was a dominant topic in Yemen, this might be due to the lack of regulations that govern the relationship between the pharmaceutical industry and the health care providers as elucidated in a review article discussing the pharmacy practice challenges in Yemen [ 46 ].

Most studies were conducted in the KSA, followed by Jordan, Qatar, and the UAE. Syria and Bahrain have comparatively a smaller number of studies being conducted. Coordination between Jordan, the United Arab of Emirates, Qatar Kuwait, and Lebanon was observed in several articles. The prominent themes were medicines use, pharmacy practice and pharmacist services, pharmacy education and professional development, and clinical research. It was concluded that the published pharmacy practice research in the included countries have a similarity of themes, and some ideas were repetitive. There is a need to develop a research agenda based on the findings. This would be helpful to enhance the status of the pharmacy practice research in the Middle East.

Recommendations

The recommendations coming from this work are separately published [ 47 ]. These include identifying research gaps, research collaboration between academic researchers and practitioners, and focusing on applied, interventional, and implementational research [ 47 ].

Availability of data and materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Obaid, D., El-Dahiyat, F. & Babar, ZUD. Pharmacy practice and clinical pharmacy research in the Middle East: a scoping review of studies from Bahrain, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, United Arab Emirates, and Yemen. J of Pharm Policy and Pract 15 , 40 (2022). https://doi.org/10.1186/s40545-022-00434-y

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Middle East Youth Bulge: Challenge or Opportunity?

Subscribe to global connection, navtej dhillon nd navtej dhillon former brookings expert.

May 22, 2008

The youth challenge is the most critical 21st century economic development challenge facing the Middle East. Navtej Dhillon, Fellow/Director of the Middle East Youth Initiative, co-presented at a panel of experts to congressional staffers from the Foreign Relations Committee on the implications and opportunities of the youth bulge and how states and outside organizations are trying to respond. Joining him were Honorable Marwan Muasher, Senior Vice President at the World Bank, and Ellen Laipson, President/CEO of the Stimson Center.

In my brief remarks today, I would like to make one central point: The youth challenge is the most critical 21st century economic development challenge facing the Middle East. In a region where almost 65% of the population is under the age of 30, long term prosperity and stability hinges on the opportunities afforded to this generation. While radicalism and terrorism remain critical security concerns, the majority of Middle Eastern youth are involved in a different fight: a fight for better education, jobs and affordable housing. It is on the back of this generation that the Middle East will build a future middle class – a middle class which can be a catalyst for more open and democratic societies. Therefore to advance U.S. interests in the Middle East, we need more than anti-radicalization strategy; we need a strategy that elevates youth-development alongside defense and diplomacy both in principle and practice.

Drawing both on our research at Brookings and a recent trip to Jordan, Syria and Lebanon where I worked with young people I would like to elaborate on this main thesis by focusing on three areas: first, to show that the Middle East is at a critical juncture and how a large youth bulge presents opportunities for growth and prosperity; second, to outline the main challenges facing youth in the region; and third, to showcase some of the implications for policy, especially U.S. policy with regards to the region.

Recognizing that the Middle East is at crossroads, we have to realize that there is a narrow window of opportunity to build a foundation for lasting prosperity. The region faces a scenario of double dividend or double jeopardy: for the first time in its modern history, the Middle East is simultaneously experiencing an economic boom and a demographic boon. The region is experiencing its best economic performance in three decades – oil and non oil producing countries alike are showing record growth. Second, the region has a large youth bulge, presenting a large pool of human capital which if used productively can usher growth and prosperity. If countries can take advantage of the confluence of these two historic gifts, they can create a virtuous cycle of higher growth, higher incomes and savings. Failure to do so will result in a double jeopardy: the economic and social exclusion of youth drains growth and creates social strife. But the time for securing this double dividend is now. The window of opportunity – where countries have fewer dependents – will close in the next ten to fifteen years.

Middle Eastern economies can seize this opportunity as many Asian economies have done. However, without urgent reform, the region risks missing this historic opportunity. Already, there are some alarming signs. Despite good economic growth, prospects for young people are not improving significantly or rapidly. This has been a central pre-occupation of the Middle East Youth Initiative – to understand why young people continue to be excluded.

I will be sharing some of the concepts and ideas that our studies and work have led to.

The majority of 15-24 and 25-30 year olds in the region are confronted with a new life phase we have termed waithood – a concept that refers to the bewildering time in which large proportions of Middle Eastern youth spend their best years waiting. It is a phase in which the difficulties youth face in each of these interrelated spheres of life result in a debilitating state of helplessness and dependency. Waithood can be best understood by examining outcomes and linkages across five different sectors: education, employment, housing, credit, and marriage.

Poorly prepared for the labor market by their educational systems, Middle Eastern youth face unemployment rates that are nearly twice the world average (20-40 percent compared to 10-20 percent). Furthermore, their queuing time for their first job is measured in years rather than months compared to their counterparts in Asia and Latin America. I’ve met many youth in the region who have waited 3-4 years for a public sector job.

With regards to housing – all the oil money flowing into the region has sent the costs of real estate soaring in urban cities. This often compromises young people’s ability to get married and lead independent lives. Furthermore, while credit allows youth in other parts of the world to smooth their future consumption, in many Middle Eastern countries, poorly functioning credit markets fail in their basic purpose.

As a result of not being able to afford a dowry, or a house, young Middle Eastern men are involuntarily delaying marriage, which in the region, is a rite to passage for adulthood, independence and legitimate sexual relationships. Today, the average age of marriage is on the rise in most Middle Eastern countries, imposing economic and social costs which have yet to be fully understood. All this compounds the dependency of youth on their parents.

So we get back to the question: why does this waithood persist even in good times? The root cause lies in the economic and social institutions and the signals they send which shapes behavior and decisions. Think of this as the invisible infrastructure – the rules of the game which organize society. In the Middle East, this invisible infrastructure is based on an education system which prepares youth for public sector employment, thereby reinforcing three problematic ideas. First, that a university education is the only prize worth pursuing. Second, the notion of a lifetime secure desk job. Third, that readiness for marriage is largely contingent upon both a university education and a stable job which only perpetuates the lure for degrees and desk jobs. But with globalization and privatization, this invisible infrastructure is no longer functioning as it should. Let me illustrate this concept with some examples and facts from the ground.

Parents in the region invest billions of dollars in private tutoring to increasingly prep their children for standardized tests, so children end up learning a narrow set of skills. Then donors and governments must spend resources re-training these very youth to given them a wider range of skills because of the limitedness and poor quality of their initial education. Public policy would be infinitely more effective if parents had the incentives to invest in broader skills, rather than governments and donors undoing the investment of parents.

Through a focus group we held in Jordan, we found that young men are willing to continue waiting for public sector jobs which may never materialize. They are not incentivized to search for a job in the private sector (informal or formal) because they feel the wait is much better than the stigma and insecurity attached to work in the private sector.

Why do youth who have lower opportunity costs not undertake more voluntary work? A Gallup poll in 2006/2007 asked Middle Eastern youth “in the last month, did you volunteer your time to an organization”. The regional average was just 11%; in countries like Jordan, only 4% of respondents answered yes. The reason is because youth and their families have no incentives to invest in volunteerism; neither public nor private sector jobs value these experiences, and universities base their decisions on nothing but national rankings on standardized testing.

But all is not lost – because here you have a region where parents are willing to do anything for their children; most youth are in school and spend years working for their future; and policy makers are increasingly more concerned about these issues.

Now I will touch upon the implications these challenges pose for policymaking with a particular focus on the U.S. perspective.

First, the youth challenges that the region is facing are driven by economic and social incentives, which in turn shape the decisions taken by millions of families and youth. Youth transitions constitute outcomes across several interconnected markets, most importantly in education, labor, credit, and marriage. Program and Policies need to exploit these inter-linkages. For example, if programs are going to provide credit to young people to start their own businesses, it is important to build-in clear criteria which are based not only on their diplomas but what they have achieved outside school to incentivize volunteerism and extracurricular activities.

Second, the chasm in U.S.-Middle East relations has emerged amidst greater convergence in ideas and aspirations. Triggered by a large youth cohort, the Middle East is undergoing change where it is aligning with fundamental drivers of globalization. The region has embraced the idea of market economy and values education. Middle Eastern youth ascribe to the fundamental pro-growth norms of behavior such as hard work and high investment in children including girls. There is a strong foundation to build a future middle class. These are all areas where the U.S. is a leader. As the country with the world’s best record in harnessing the energy of youth, there is much the U.S. can offer the Middle East. The U.S. relationship with the region should be cast on broader terms, making youth development as a template for exercising smart power.

Key recommendations include exporting soft technology for institutional reform of education. Youth in the U.S. have a relatively smooth transition to adulthood compared to most advanced countries. Transitions to adulthood in the US are facilitated because of the close integration between the education system and the labor market. The U.S institutional set up may not fit the Middle East perfectly, but as with all exports, soft technology exports can be adapted to fit local conditions. The educational system in the U.S. has already provided the region with great institutions of higher education – such as the American Universities of Beirut and Cairo—which have produced many of the region’s leaders. The US can extend assistance on a broader scale encompassing curriculum reform for high schools, the transition from high school to university (reforms of university admission practices), and the transition from school to work. Government should create incentives for greater collaboration between Middle Eastern and U.S. non governmental organizations, research institutes and universities.

The challenge is how the U.S. can build on its strengths and can be seen as genuinely interested in economic development. At the moment, there is a lack of instruments for such an exchange. In fact, currently, the Foreign Assistance Act does not have an explicit window to target funds for youth. The language of the Foreign Assistance Act should be changed to overcome this policy flaw. Youth development should be given priority, particularly in countries experiencing “youth bulge” and high rates of youth unemployment.

And finally, the discourse on the Middle East is highly and exclusively political and lacks an economic development focus. Addressing Middle Eastern youth solely through the prism of potential extremism misses the opportunity for aligning U.S. policy with the aspirations of the majority of the moderate citizens in the Middle East. It alienates the very people we are trying to help. Currently, there is re-negotiation of the rules of the game in the region, and it is being spurred by youth, who we should be empowering and supporting.

Global Economy and Development

Middle East & North Africa

Kevin Dong, Mallie Prytherch, Lily McElwee, Patricia M. Kim, Jude Blanchette, Ryan Hass

March 15, 2024

Amna Qayyum, Claudia Hui

March 7, 2024

Surjit S. Bhalla, Karan Bhasin

March 1, 2024

Read our research on: TikTok | Podcasts | Election 2024

Regions & Countries

What can improve democracy, ideas from people in 24 countries, in their own words.

This Pew Research Center analysis on views of how to improve democracy uses data from nationally representative surveys conducted in 24 countries across North America, Europe, the Middle East, the Asia-Pacific region, sub-Saharan Africa and Latin America. All responses are weighted to be representative of the adult population in each country.

For non-U.S. data, this analysis draws on nationally representative surveys of 27,285 adults conducted from Feb. 20 to May 22, 2023. All surveys were conducted over the phone with adults in Canada, France, Germany, Greece, Italy, Japan, the Netherlands, South Korea, Spain, Sweden and the United Kingdom. Surveys were conducted face-to-face with adults in Argentina, Brazil, Hungary, India, Indonesia, Israel, Kenya, Mexico, Nigeria, Poland and South Africa. In Australia, we used a mixed-mode probability-based online panel. Read more about international survey methodology .

In the U.S., we surveyed 3,576 adults from March 20 to March 26, 2023. Everyone who took part in this survey is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way, nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Researchers examined random samples of English responses, machine-translated non-English responses, and non-English responses translated by a professional translation firm to develop a codebook for the main topics mentioned across the 24 countries. The codebook was iteratively improved via practice coding and calculations of intercoder reliability until a final selection of 17 substantive codes was formally adopted. (For more on the codebook, refer to Appendix C .)

To apply the codebook to the full collection of open-ended responses, a team of Pew Research Center coders and professional translators were trained to code English and non-English responses. Coders in both groups coded random samples and were evaluated for consistency and accuracy. They were asked to independently code responses only after reaching an acceptable threshold for intercoder reliability. (For more on the coding methodology, refer to Appendix A .)

There is some variation in whether and how people responded to our open-ended question. In each country surveyed, some respondents said that they did not understand the question, did not know how to answer or did not want to answer. This share of adults ranged from 4% in Spain to 47% in the U.S. 

In some countries, people also tended to mention fewer things that would improve democracy in their country relative to people surveyed elsewhere. For example, across the 24 countries surveyed, a median of 73% mentioned only one topic in our codebook (e.g., politicians). The share in South Korea is much higher, with 92% suggesting only one area of improvement when describing what they think would improve democracy. In comparison, about a quarter or more mention two areas of improvement in France, Spain, Sweden and the U.S.

These differences help explain why the share giving a particular answer in certain publics may appear much lower than others, even if it is the top- ranked suggestion for improving democracy. To give a specific example, 10% of respondents in Poland mention politicians, while 18% do so in South Africa – yet the topic is ranked second in Poland and third in South Africa. Given this discrepancy, researchers have chosen to highlight not only the share of the public that mentions a given topic but also its relative ranking among all topics coded, both in text and in graphics.

Here is the question used for this report , along with coded responses for each country, and the survey methodology .

Open-ended responses highlighted in the text of this report were chosen to represent the key themes researchers identified. They have been edited for clarity and, in some cases, translated into English by a professional firm. Some responses have also been shortened for brevity.

Pew Research Center surveys have long found that people in many countries are dissatisfied with their democracy and want major changes to their political systems – and this year is no exception . But high and growing rates of discontent certainly raise the question: What do people think could fix things?

We set out to answer this by asking more than 30,000 respondents in 24 countries an open-ended question: “What do you think would help improve the way democracy in your country is working?” While the second- and third-most mentioned priorities vary greatly, across most countries surveyed, there is one clear top answer: Democracy can be improved with better or different politicians.

People want politicians who are more responsive to their needs and who are more competent and honest, among other factors. People also focus on questions of descriptive representation – the importance of having politicians with certain characteristics such as a specific race, religion or gender.

Respondents also think citizens can improve their own democracy. Across most of the 24 countries surveyed, issues of public participation and of different behavior from the people themselves are a top-five priority.

Other topics that come up regularly include:

• Economic reform , especially reforms that will enhance job creation.
• Government reform , including implementing term limits, adjusting the balance of power between institutions and other factors.

We explore these topics and the others we coded in the following chapters:

• Politicians, changing leadership and political parties ( Chapter 1 )
• Government reform, special interests and the media ( Chapter 2 )
• Economic and policy changes ( Chapter 3 )
• Citizen behavior and individual rights and equality ( Chapter 4 )
• Electoral reform and direct democracy ( Chapter 5 )
• Rule of law, safety and the judicial system ( Chapter 6 )

You can also read people’s answers in their own words in our interactive data essay and quote sorter: “How People in 24 Countries Think Democracy Can Improve.” Many responses in the quote sorter and throughout this report appear in translation; for selected quotes in their original language, visit this spreadsheet .

The survey was conducted from Feb. 20 to May 22, 2023, in 24 countries and 36 different languages. Below, we highlight some key themes, drawn from the open-ended responses and the 17 rigorously coded substantive topics.

How politicians can improve

In almost every country surveyed, changes to politicians are the most commonly mentioned way to improve democracy. People broadly call for three types of improvements: better representation , increased competence and a higher level of responsiveness . They also call for politicians to be less corrupt or less influenced by special interests.

Representation

“Bringing in more diverse voices, rather than mostly wealthy White men.” Woman, 30, Australia

First, people want to see politicians from different groups in society – though which groups people want represented run the gamut. In Japan, for example, one woman said democracy would improve if there were “more diversity and more women parliamentarians.” In Kenya, having leaders “from all tribes” is seen as a way to make democracy work better. People also call for younger voices and politicians from “poor backgrounds,” among other groups. The opposing views of two American respondents, though, highlight why satisfying everyone is difficult:

“Most politicians in office right now are rich, Christian and old. Their overwhelmingly Christian views lead to laws and decisions that not only limit personal freedoms like abortion and gay marriage, but also discriminate against minority religions and their practices.”

– Man, 23, U.S.

“We need to stop worrying about putting people in positions because of their race, ethnicity or gender. What happened to being put in a position because they are the best person for that position?”

– Man, 64, U.S.

“Our politicians should have an education corresponding to their subject or field.” Woman, 72, Germany

Second, people want higher-caliber politicians. This includes a desire to see more technical expertise and traits such as morality, honesty, a “stronger backbone” or “more common sense.”

Sometimes, people simply want politicians with “no criminal records” – something mentioned explicitly by a South Korean man and echoed by respondents in the United States, India and Israel, among other places.

Responsiveness

“Make democracy promote more of the people’s voice. The people’s voice is the great strength for leadership.” Man, 27, Indonesia

Third, people want their politicians to hear them and respond to their needs and wishes, and for politicians to keep their promises. One man in the United Kingdom said, “If leaders would listen more to the local communities and do their jobs as members of Parliament, that would really help democracy in this country. It seems like once they’re elected, they just play lip service to the role.”

Special interests and corruption

Concerns about special interests and corruption are common in certain countries, including Mexico, the U.S. and Australia. One Mexican woman said, “Politicians should listen more to the Mexican people, not buy people off using money or groceries.” Others complained about politicians “pillaging” the country and enriching themselves by keeping tax money.

Calls for systemic reform

For some, the political system itself needs to change in order for democracy to work better. Changing the governmental structure is one of the top five topics coded in most countries surveyed – and it’s tied for the most mentioned issue in the U.S., along with politicians. These reforms include adjusting the balance of power between institutions, implementing term limits, and more.

Some also see the need to reform the electoral system in their country; others want more direct democracy through referenda or public forums. Judicial system reform is a priority for some, especially in Israel. (In Israel, the survey was conducted amid large-scale protests against a proposed law that would limit the power of the Supreme Court, but prior to the Oct. 7 Hamas attack and the court’s rejection of the law in January .)

Government reform

The U.S. stands out as the only country surveyed where reforming the government is the top concern (tied with politicians). Americans mention very specific proposals such as giving the District of Columbia and Puerto Rico statehood, increasing the size of the House of the Representatives to allow one representative per 100,000 people, requiring a supermajority for all spending bills, eliminating the filibuster, and more.

Term limits for elected officials are a particularly popular reform in the U.S. Americans call for them to prevent “career politicians,” as in the case of one woman who said, “I think we need to limit the number of years politicians can serve. No one should be able to serve as a politician for 40+ years like Joe Biden. I don’t have anything against him. I just think that we need limits. We have too many people who have served for too long and have little or nothing to show for it.” Term limits for Supreme Court justices are also top of mind for many Americans when it comes to judicial system reform.

Electoral reform

“There are many parts of the UK where it’s obvious who will get elected. My vote doesn’t count where I live because the Conservative Party wins every time. Effectively it means that the majority is not represented by the government. With proportional representation, everybody’s vote would count.” Man, 62, UK

The electoral system is among the top targets for change in some countries. In Canada, Nigeria and the UK, changing how elections work is the second-most mentioned topic of the 17 substantive codes – and it falls in the top five in Australia, Japan, the Netherlands and the U.S.

Suggested changes vary across countries and include switching from first-past-the-post to a proportional voting system, having a fixed date for elections, lowering the voting age, returning to hand-counted paper ballots, voting directly for candidates rather than parties, and more.

Direct democracy

Calls for direct democracy are prevalent in several European countries – even ranking second in France and Germany. One French woman said, “There should be more referenda, they should ask the opinion of the people more, and it should be respected.”

In the broadest sense, people want a “direct voting system” or for “people to have the vote, not middlemen elected officials.” More narrowly, they also mention specific topics they would like referenda for, including rejoining the European Union in the UK; “abortion, retirement and euthanasia” in France; “all legislation which harms the justice system” in Israel; asylum policy, nitrogen policy and local affairs in the Netherlands; “when and where the country goes to war” in Australia; “gay marriage, marijuana legalization and bail reform” in the U.S.; “nuclear power, sexuality, NATO and the EU” in Sweden; and who should be prime minister in Japan. (The survey was conducted prior to Sweden joining NATO in March 2024.)

The judicial system

Of the systemic reforms suggested, few bring up changes to the judicial system in most countries. Only in Israel, where the topic ranked first at the time of the survey, does judicial system reform appear in the top 10 coded issues. Israelis approach this issue from vastly different perspectives. For instance, some want to curtail the Supreme Court’s influence over government decisions, while others want to preserve its independence, as in these two examples:

“Finish the legislation that will limit the enormous and generally unreasonable power of the Supreme Court in Israel!”

– Man, 64, Israel

“Do everything to keep the last word of the High Court on any social and moral issue.”

– Man, 31, Israel

Is the grass always greener?

Notably, some respondents propose the exact reform that those in another country would like to do away with.

For example, while some people in countries without mandatory voting think it could be useful to implement, there are respondents in Australia – where voting is compulsory – who want it to end. People without mandatory voting see it as a way to force everyone to have a say: “We have to get everyone out to vote. Everyone complains. Voting should be mandatory. Everyone has to vote and have a say,” said a Canadian woman. But the flip side one Australian expressed was, “Eliminate compulsory voting. The votes of people who do not care about a result voids the vote of somebody who does.”

The ideal number of parties in government is another topic that brings about opposing suggestions. In the Netherlands, which has a relatively large number of parties, altering the party system is the second-most mentioned way to improve democracy. Dutch respondents differed on terms of the maximum number of parties they want to see (“a three-party system,” “four or five parties at most,” “a maximum of seven parties,” etc.) but the tenor is broadly similar: Too many parties is leading to fragmentation, polarization and division. Elsewhere, however, some squarely attribute polarization to a system with too few parties. In the U.S., a man noted, “The most egregious problem is that a two-party system cannot ever hope to be representative of its people as the will of any group cannot be captured in a binary system: The result will be increased polarization between the Democratic and Republican parties.”

Even in countries with more than two parties, like Canada and the UK, there can be a sense that only two are viable. A Canadian man said, “We need to have a free election with more than two parties.”

For many respondents, fixing democracy begins with the people

Citizens – both their quality and their participation in politics – come up regularly as an area that requires improvement for democracy to work better. In most countries, the issue is in the top five. And in Israel, Sweden, Italy and Japan, citizens are the second-most mentioned topic of the 17 coded. (In this analysis, “citizens” refers to all inhabitants of each country, not just the legal residents.)

In general, respondents see three ways citizens can improve: being more informed, participating more and generally being better people.

Being more informed

“More awareness and more information. We have highly separated classes. There are generations who have never read a newspaper. One cannot be fully democratic if one is not aware.” Man, 86, Italy

First, citizens being more informed is seen as crucial. Respondents argue that informed citizens are able to vote more responsibly and avoid being misled by surface-level political quips or misinformation.

In the Netherlands, for example, where the survey predated the electoral success of Geert Wilders’ right-wing populist Party for Freedom (PVV), one woman noted that citizens need “education, and openness, maybe. There are a lot of people who vote Geert Wilders because of his one-liners, and they don’t think beyond those. They haven’t learned to think beyond what’s right in front of them.” (For more information on how we classify populist parties, refer to Appendix E .)

Participating more

“Each and every one of us must go to the polls and make our own decisions.” Woman, 76, Japan

Second, some respondents want people in their country to be more involved in politics – whether that be turning out to vote, protesting at key moments or just caring more about politics or other issues. They hold the notion that if people participate, they will be less apathetic and less likely to complain, and their voices will be represented more fully. One woman in Sweden noted, “I would like to see more involvement from different groups of people: younger people, people with different backgrounds, people from minority groups.”

Being better people

“People should walk around rationally, respecting each other, dialoguing and respecting people’s cultures.” Woman, 29, Brazil

Third, the character of citizens comes up regularly – respondents’ requests for their countrymen range from “care more about others” to “love God and neighbor completely” to asking that they be “better critical thinkers,” among myriad other things. Still, some calls for improved citizen behavior contradict each other, as in the case of two Australian women who differ over how citizens should think about assimilation:

“We need to be more caring and thoughtful about people who come to the country. We need to be more tolerant and absorb them in our community.”

– Woman, 75, Australia

“We need to stop worrying that we are going to offend other nationalities and their traditions. We should be able to say ‘Merry Christmas’ instead of ‘happy holidays,’ and Christmas celebrations should be held in schools without worrying about offending others in our so-called ‘democratic society.’”

– Woman, 70, Australia

It’s difficult to please everyone

One challenge is that people in the same country may offer the exact opposite solutions. For example, in the UK, some people want politicians to make more money; others, less. In the U.S., while changes to the electoral system rank as one of the public’s top solutions for fixing democracy, some want to make it significantly easier to vote by methods like automatically registering citizens or making it easier to vote by mail. Others want to end these practices or even eliminate touch-screen voting machines.

Economic reform and basic needs

People in several countries, mostly in the middle-income nations surveyed (Argentina, Brazil, India, Indonesia, Kenya, Mexico, Nigeria and South Africa) stand out for the emphasis they place on economic reform as a means to improve democracy. In India and South Africa, for example, the issue ranks first among the 17 substantive topics coded; in Argentina, Brazil, Indonesia and Kenya, it ranks second. These calls include a focus on creating jobs , curbing inflation , changing government spending priorities and more.

“When education, roads, hospitals and adequate water are made available, then I can say democracy will improve.” Man, 30, Nigeria

Sometimes, people draw a causal link between the economy and democracy, suggesting that improvements to the former would improve the latter. For example, one woman in Indonesia said, “Improve the economic conditions to ensure democracy goes well.” People also insinuated that having basic needs met is a precursor to their democracy functioning. One South African man noted that democracy in his country would work better if the government “created more employment for the youth, fixed the roads and gave us water. They must also fix the electricity problem.” A man in India said, “There’s a need for development in democracy.”

Indeed, specific policies and legislation – particularly improvements to infrastructure like roads, hospitals, water, electricity and schools – are the second-most mentioned topic in Brazil, India, Nigeria and South Africa. Some respondents offer laundry lists of policies that need attention, such as one Brazilian woman who called for “improving health care, controlling drug use, more security for the population, and improving the situation of people on the streets.”

Priority differences in high- and middle-income countries

Beyond economic reform , other changes to living conditions also receive more emphasis in some middle-income countries surveyed:

• In South Africa and Nigeria, both middle-income countries, mentions of economic reform tend to reference jobs . In other, high-income countries, calls for economic change generally refer to other economic issues like inflation and government spending priorities.
• When bringing up the issue of money in politics, respondents in middle-income countries generally cite corruption more than those in high-income countries. Those in high-income countries tend to bring up special interests more broadly.
• People in middle-income countries also focus more on issues related to public safety – including reducing crime and supporting law enforcement – than those in high-income countries.
• For their part, people in the 16 high-income countries surveyed tend to focus more on political party reform, direct democracy, government reform and media reform than those in the eight middle-income nations.

No changes and no solutions – or at least no democratic ones

“Democracy is fine because you have the freedom to express yourself without being persecuted, especially in politics.” Man, 26, Argentina

People sometimes say there are no changes that can make democracy in their country work better. These responses include broadly positive views of the status quo such as, “I am very happy to live in a country with democracy.” An Indian man responded simply, “Everything is going well in India.” Some respondents even compare their system favorably to others, as one Australian man said: “I think it currently works pretty well, far better than, say, the U.S. or UK, Poland or Israel.”

“Our current system is broken and I’m not sure what, if anything, can fix it at this point.” Woman, 41, U.S

But some are more pessimistic. They have the sense that “no matter what I do, nothing will change.” A Brazilian man said, “It is difficult to make it better. Brazil is too complicated.”

And some see no better options. In Hungary – where “no changes” was the second-most cited topic of the 17 coded – one man referenced Winston Churchill’s quote about democracy, saying, “Democracy is the worst form of government, not counting all the others that man has tried from time to time.”

In many countries, a sizable share offer no response at all – saying that they do not know or refusing to answer. This includes around a third or more of those in Indonesia, Japan and the U.S. In most countries, those who did not answer the question tended to have lower levels of formal education than those who offered a substantive solution. And in some places – including the U.S. – they were also more likely to be women than men.

Few call for ending democracy altogether

Despite considerable discontent with democracy , few people suggest changing to a non-democratic system. Those who do call for a new system offer options like a military junta, a theocracy or an autocracy as possible new systems.

Related: Who likes authoritarianism, and how do they want to change their government?

Road map for this research project

One other way to think about what people believe will help improve their democracy is to focus on three themes: basic needs that can be addressed, improvements to the system and complete overhauls of the system. We explore these themes in our interactive data essay and quote sorter: “How People in 24 Countries Think Democracy Can Improve.”

You can also explore people’s responses in their own words, with the option to filter by country and code by navigating over to the quote sorter .

In the chapters that follow, we discuss 15 of our coded themes in detail. We analyze how people spoke about them, as well as how responses varied across and within countries. We chose to emphasize the relative frequency, or rank order , in which people mentioned these different topics. For more about this choice, as well as details about our coding procedure and methodology , refer to Appendix A .

Explore the chapters of this report:

Why this report focuses on topic rank order in addition to percentages

There is some variation in whether and how people responded to our open-ended question. In each country surveyed, some respondents said that they did not understand the question, did not know how to answer or did not want to answer. This share of adults ranged from 4% in Spain to 47% in the U.S.

These differences help explain why the share giving a particular answer in certain publics may appear much lower than others, even if the topic is the top mentioned suggestion for improving democracy. To give a specific example, 10% in Poland mention politicians while 18% say the same in South Africa, but the topic is ranked second in Poland and third in South Africa. Given this, researchers have chosen to highlight not only the share of the public who mention a given topic but also its relative ranking among the topics coded, both in the text and in graphics.

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Report Materials

Table of contents, freedom, elections, voice: how people in australia and the uk define democracy, global public opinion in an era of democratic anxiety, most people in advanced economies think their own government respects personal freedoms, more people globally see racial, ethnic discrimination as a serious problem in the u.s. than in their own society, citizens in advanced economies want significant changes to their political systems, most popular.

About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .

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Oil Market Report - March 2024

About this report

The IEA Oil Market Report (OMR) is one of the world's most authoritative and timely sources of data, forecasts and analysis on the global oil market – including detailed statistics and commentary on oil supply, demand, inventories, prices and refining activity, as well as oil trade for IEA and selected non-IEA countries.

• Global oil demand is forecast to rise by a higher-than-expected 1.7 mb/d in 1Q24 on an improved outlook for the United States and increased bunkering. While 2024 growth has been revised up by 110 kb/d from last month’s Report, the pace of expansion is on track to slow from 2.3 mb/d in 2023 to 1.3 mb/d, as demand growth returns to its historical trend while efficiency gains and EVs reduce use.
• World oil production is projected to fall by 870 kb/d in 1Q24 vs 4Q23 due to heavy weather-related shut-ins and new curbs from the OPEC+ bloc. From the second quarter, non-OPEC+ is set to dominate gains after some OPEC+ members announced they would extend extra voluntary cuts to support market stability. Global supply for 2024 is forecast to increase 800 kb/d to 102.9 mb/d, including a downward adjustment to OPEC+ output.
• Refinery crude runs are forecast to rise from a February-low of 81.4 mb/d to a summer peak of 85.6 mb/d in August. For the year as a whole, throughputs are projected to increase by 1.2 mb/d to average 83.5 mb/d, driven by the Middle East, Africa and Asia. Refining margins improved through mid-February before receding, with the US Midcontinent and Gulf Coast as well as Europe leading the gains.
• Global observed oil inventories surged by 47.1 mb in February. Offshore stocks dominated gains as seaborne exports reached an all-time high and shipping disruptions through the Red Sea tied up significant volumes of oil on water while onshore inventories declined. Global stocks plunged by 48.1 mb in January, with OECD industry stocks at a 16-month low.
• ICE Brent futures rose by $2/bbl during February as ongoing Houthi shipping attacks in the Red Sea kept a firm bid under crude prices. With oil tankers taking the longer route around Africa more oil was kept on water, further tightening the Atlantic Basin market and sending crude’s forward price structure deeper into backwardation. At the time of writing, Brent was trading at $83/bbl.

Oil on water

Benchmark crude oil prices were range bound in early March, as the market had already priced in the announced extension of OPEC+ voluntary production cuts through 2Q24. North Sea Dated rose by $2.13/bbl to $84.66/bbl during February as continued tanker attacks in the Red Sea lengthened supply routes and global on-land oil inventories fell for a seventh consecutive month to reach their lowest level since at least 2016.

Global onshore oil stocks fell a further 38 mb last month, taking the draw down since July to 180 mb, according to preliminary data. Over the same period, oil on water surged. Trade dislocations from the rerouting of Russian barrels and more recently due to unrest in the Middle East, have boosted oil on water by 115 mb. In February alone, oil on water surged by 85 mb as repeated tanker attacks in the Red Sea diverted more cargoes around the Cape of Good Hope. At nearly 1.9 billion barrels as of end-February, oil on water hit its second highest level since the height of the Covid-19 pandemic.

Trade flow disruptions also boosted bunker fuel use. Longer shipping routes and faster vessel speeds saw Singapore bunkering reach all-time highs. That, along with surging US ethane demand for its petrochemical sector underpins a slight upward revision to our global oil demand expectations for this year by 110 kb/d compared with last month’s Report. World oil demand growth is now forecast at 1.3 mb/d in 2024, down sharply from last year’s 2.3 mb/d expansion.

The slowdown in growth, already apparent in recent data, means that oil consumption reverts towards its historical trend after several years of volatility from the post-pandemic rebound. A weaker economic outlook further tempers oil use, as do efficiency improvements and surging electric vehicle sales. Growth will continue to be heavily skewed towards non-OECD countries, even as China’s dominance gradually fades. The latter’s oil demand growth slows from 1.7 mb/d in 2023 to 620 kb/d in 2024, or from roughly three-quarters to half of the global total, under the gathering weight of a challenging economic environment and slower expansion in its petrochemical sector.

As in 2023, non-OPEC+ oil supply growth will eclipse the oil demand expansion by some margin. Led by the United States, non-OPEC+ production is forecast to rise by 1.6 mb/d in 2024 compared to 2.4 mb/d last year when global oil output climbed by 2 mb/d to 102 mb/d. Substantial gains will also come from Guyana, Brazil and Canada, all forecast to pump at record-highs this year. Together, the non-OPEC+ Americas quartet is set to add 1.3 mb/d of new oil production in 2024.

Iran, which last year ranked as the world’s second largest source of supply growth after the United States, is expected to increase production by a further 280 kb/d this year. Output policy for the remainder of the OPEC+ bloc will be revisited when ministers meet in Vienna on 1 June to review market conditions. In this Report, we are now holding OPEC+ voluntary cuts in place through 2024 – unwinding them only when such a move is confirmed by the producer alliance (see OPEC+ cuts extended). On that basis, our balance for the year shifts from a surplus to a slight deficit, but oil tanks may get some relief as the massive volumes of oil on water reach their final destination.

1. Includes extra voluntary curbs where announced. 2. Capacity levels can be reached within 90 days and sustained for an extended period. 3. Excludes shut in Iranian, Russian crude. 4. Angola left OPEC effective 1 Jan 2024. 5. Iran, Libya, Venezuela exempt from cuts. 6. Mexico excluded from OPEC+ compliance. 7. Bahrain, Brunei, Malaysia, Sudan and South Sudan.

Definitions of key terms used in the OMR, access the OMR Glossary here.

For more info on the methodology, download the PDF below.

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IEA (2024), Oil Market Report - March 2024 , IEA, Paris https://www.iea.org/reports/oil-market-report-march-2024

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Blinken Heads to Middle East a Sixth Time in Gaza Diplomacy Push

U.S. Secretary of State Antony Blinken departs Philippines en route to Saudi Arabia, at Ninoy Aquino International Airport in Pasay City, Metro Manila, Philippines, March 20, 2024. REUTERS/Evelyn Hockstein/Pool

By Humeyra Pamuk and Simon Lewis

JEDDAH, Saudi Arabia/WASHINGTON (Reuters) - U.S. Secretary of State Antony Blinken returns to the Middle East on Wednesday for his sixth visit since the start of Israel's war with Hamas to push for a deal to secure a temporary pause in fighting and the release of hostages held by Hamas.

Blinken will meet Saudi leaders in Jeddah and Egyptian leaders in Cairo to discuss talks brokered by Egypt and Qatar on an agreement as well as efforts to get more aid into Gaza, State Department spokesperson Matthew Miller said in a statement.

Talks on a ceasefire are resuming this week in Qatar, but weeks of tough negotiations have yet to forge an agreement between Israel and Hamas that Washington hopes will help alleviate the humanitarian crisis gripping Gaza.

War in Israel and Gaza

Blinken said he would also pursue conversations on arrangements for governance, security and redevelopment of post-conflict Gaza.

"We’ve been doing a lot of work since January, particularly with our Arab partners, and we’ll be pursuing those conversations, as well as discussing what is the right architecture for lasting regional peace," Blinken said at a news conference during at a previous stop in Manila.

The war was triggered when Hamas fighters crossed into Israel on a rampage on Oct. 7, killing 1,200 people and capturing 253 hostages, according to Israeli tallies.

Nearly 32,000 people have been confirmed killed in Israel's retaliatory onslaught, according to Palestinian health officials in Hamas-run Gaza, with thousands more feared lost under the rubble.

Blinken is not scheduled to visit Israel on this trip, despite multiple visits to the U.S. ally on his previous regional swings since Oct. 7.

Tensions have heightened between U.S. President Joe Biden's administration and the government of Israeli Prime Minister Benjamin Netanyahu, who on Tuesday rebuffed Biden's plea to call off a planned ground assault in the southern Gaza city of Rafah, where more than a million displaced Palestinians are sheltering.

(Reporting by Simon Lewis and Humeyra Pamuk; Editing by Howard Goller)

Copyright 2024 Thomson Reuters .

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Tags: United States , Israel , Middle East , Saudi Arabia , Egypt , Qatar

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