1. Drug Abuse Monitoring in Israel, Egypt and the Palestinian Authority Mohamed Afifi, M.D. Richard Isralowitz, Ph. D. Nasser Loza, MD Richard Rawson, Ph.D.

2. Picture Jerusalem

3. Picture Safe Passage to Gaza

5. Project Background 1 1997 Educational program organized by ECF (Oslo Accord Group) with Israeli Foreign Ministry, Palestinian Council of Health and USAID and Dutch Government Group of 40 Palestinians and Israelis met in Beersheva and a Palestinian group of 75 health and religious leaders in Gaza Strip to discuss nature/extent of drug problems in Middle East.

6. Project Background 2 Participants included health, police and political leaders. Israeli side presented some data on heroin and marijuana use. Palestinian presented anecdotal information and concerns. Considerable acrimony/mutual accusations about source of illegal drugs.

7. Project Background 3 Palestinian and Israeli leaders organize a series of bi-lateral meetings in Palestinian/Israeli communities. Week-long training at Al Quds University for 200 Palestinian professionals, attended by senior Palestinian/Israeli/ WHO officials plus 2 day bi-lateral Beersheva workshop

8. Project Background 4 Group of 8 Palestinian and Israeli professionals travel to Los Angeles (funded by Friends Research Institute) for planning session. Decision made to apply for Middle East Regional Cooperation grant to establish a Israeli-Palestinian drug abuse monitoring system, produce an article and edited book.

9. Project Background 5 MERC Application submitted Dec 1999 Book contract (Praeger-Greenwood), Jan 2000; Article to Addiction outlined.

10. MERC Application Drug abuse is important for public health, criminal justice and political reasons. Nature and extent of drug abuse problems poorly documented in Israel (Russian immigrants poorly studied: MDMA use believed extensive, but no data. Drug use in Palestinian Territory unknown but believed to be heroin, marijuana, inhalants.

11. MERC Application 2 Collection of data needs multiple approaches sampling key populations including high school students, arrestees, individuals in health system. Stakeholders need to involve public health, criminal justice and political leaders. Venue for presenting/interpreting data should involve tri-lateral group, with US researchers to provide technical support.

12. MERC PLAN Establish 3 data collection methods (school survey, reporting from hospitals, urine collection/survey from arrestees. Data will be collected from 2 Israeli cities (Haifa and Beersheva), 2 Gaza cities (Gaza City and Khan Younis) and 2 West Bank cities (Ramallah and Hebron)

16. Rick and Pilou at dead sea

17. MERC PROJECT Intifada Began Sept 200 MERC Grant Approved May, 2001 Initial meet in Tel Aviv in June 2001, Afiffi unable to leave Gaza. Afifi travels to Los Angeles, August 2001 All 3 parties meet in Washington DC October 2001 and visit US Agencies.

18. MERC PLAN Budget: $500,000 for 2 years US: (Friends Research Institute) $75K Israel: (Ben Gurion U) $150K Palestinians: (Substance Abuse Research Center, an NGO) $250K

19. MERC I Work Accomplished Book Published 2002 Article in Addiction 2001 Survey of drug use among 1000 Palestinian students in Gaza Survey of 1000 high risk youth in Israel 15 Presentations at national and international Meeting

20. MERC I Work Accomplished 14 Training events with Israelis and Palestinians Identification of an Egyptian team Submission of MERC II: Israel and Egypt MERC II Approved in Dec 2003

22. Great Sphinx

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24. MERC II Israel and Egypt Data collection on drug abuse treatment in Israel and Egypt Extensive training conducted in both countries Another 18 professional trainings and presentations in Israel and Egypt To date, 4 international presentations

25. Israel Group

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28. Recent Developments Conference planned for Cairo Oct 2004 Will include UNODC and its group of 27 regional experts (North Africa and Gulf) Will include WHO and 42 country region (Morroco to Pakistan) National Institute on Drug Abuse Sponsored by UCLA

29. Recent Developments Institute of Peace Grant for conference in Spring of 2005 in region with Arab and Israeli participation Potential involvement of the Rockefeller Institute and Facility in Bellagio, Italy MERC III: Israel and Lebanon under review

30. LESSONS LEARNED Oaks do grow from acorns, if provided the necessary follow up and hard work. Communicate respect Focus on good science Stay flexible and patient Engage necessary scientific advisors

31. LESSONS LEARNED Minimize political discussions Maintain low profile and understand political needs of all parties Relationships matter Don’t do it for the money

32. Jafa Evening

33. Bazaar in cairo

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