Mental health and substance use problems present a significant burden on health globally, reaching 13% of the total burden of disease, according to WHO reports. This burden can be overwhelming in low- and middle-income countries where effects of these problems are complicated by other environmental factors, including malnutrition, poverty, and poor health care. The situations in Africa and in the Middle East are particularly grim; and they are compounded by ongoing stressors related to social unrest and security threats.
Given the critical need for increasing awareness of and capacity to address mental health and substance use problems in the region, we have been working with multiple institutions in Africa, the Middle East, and Kenya to develop capacity for research in areas related to substance use and associated mental health problems. Our team has championed multiple conferences and training functions in the region through the development of the Africa and Middle East Congress on Addiction (AMECA). These functions have been well received by various groups and stakeholders in the region. We hope to capitalize on this momentum by launching a multi-national initiative focusing on building capacity for mental health and substance use research and services.
This is timely in the light of increasing needs that have emerged as a result of recent political and social challenges in the region. These challenges are likely to severely limit already meager health resources; and they may contribute to escalating threats to health in this region. Furthermore, there is evidence that the recent escalation of violence and social strife has increased stress-related mental health problems and substance abuse in the Middle East and in Africa. An essential step in curbing these escalating risks is devising effective, contextually relevant prevention and intervention strategies; and our team will have to take on these challenges directly.
We are prepared to provide effective coordination and leadership in this region; and we are prepared to build on the internationally recognized successes we have achieved through initiatives such as the Fogarty-International and NIH-supported Khat Research Program (KRP; khatresearch.org; http://www.d.umn.edu/~khat/), AMECA, and the Minnesota-Morocco Stress and Addiction Program (MIMOSA). The KRP includes a consortium of multiple universities in Kenya, Ethiopia, Tanzania, Yemen, Germany, the UK, Sweden, and the US; and the KRP was established as a collaborative, multidisciplinary research program addressing cognitive, affective, and behavioral disorders associated with use of khat and with co-use of khat and other substances. Khat is a natural plant that is widely used in many countries in East Africa and the Arabia Peninsula as well as in countries in Europe and North America. Khat consumption is increasing worldwide, although little research available to understand its effects on brain functions acutely and chronically. The KRP’s goal has been to conduct research critical to our understanding of khat-related cognitive, biobehavioral, and emotion regulation deficits, and risks for mental health problems and to utilize this information to guide the development of prevention and treatment programs. The program includes a team of international experts who are uniquely positioned to develop this program and who possess a combination of research and training expertise in neurobiology, neurotoxicology, psychology, environmental health, medicine, and global health research.