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Medical journal issue seeks to resuscitate Israel’s image

From left, doctors Mark Clarfield and Karl Skorecki, with Lancet editor Richard Horton. RAMBAM HEALTH CARE CAMPUS PHOTO

Two Canadian-born doctors have played key roles in attempting to rehabilitate Israel’s image in the medical community and beyond.

The Lancet, among the world’s most prestigious medical journals, devoted its entire latest issue to Israel’s health-care system, with help from Toronto-born physicians and professors Karl Skorecki of the Rambam Health Care Campus in Haifa and Mark Clarfield of Ben-Gurion University of the Negev.

Published on May 8 and titled Health in Israel, the issue contains 11 English-language articles written by Israeli doctors and researchers on the achievements of Israel’s health-care system and the challenges ahead. Clarfield was one of three guest editors.

Launched at a news conference at the the annual meeting of the Israel National Institute for Health Policy Research, the issue of The Lancet is fraught with meaning.

In July 2014, at the height of Israel’s Operation Protective Edge in Gaza, The Lancet published an Open Letter to the People of Gaza, signed by doctors from several countries. In it, they accused Israel of committing a “massacre” in Gaza, noting that “only” five per cent of Israeli doctors signed appeals opposing the war.

The letter provoked intense protest and debate in academia and medicine worldwide. The Lancet’s editor-in-chief, Richard Horton, later wrote that he regretted the resulting controversy, but he did not retract the allegations.

However, in a statement posted May 9 to the website of Ben-Gurion University of the Negev, Horton wrote: “We have learned lessons from this unfortunate episode. Our collaboration seeks to undo the harm and tarnish of this episode by transforming those experiences into constructive practice.”


According to the Rambam Health Care Campus, Skorecki, director of medical and research development at the facility, who was educated and later taught at the University of Toronto, invited Horton to Israel, in the wake of the 2014 controversy. Horton arrived in August of that year.

The all-Israel issue examines several aspects of the country’s health and delivery of services, noting that since 1993, life expectancy has risen from 75.3 to 80 years for men and from 79 to 84 years for women (it’s much lower among Arab-Israelis); infant mortality has dropped by over 50 per cent since 1993; death from strokes, heart disease and cervical cancer is lower for Israeli women than the average seen in the 35 other countries examined, though incidence of breast cancer is higher; and smoking prevalence is twice as high among Israeli Arab men (44 per cent) as Israeli Jewish men (22 per cent) and lung cancer is much more common among Israeli Arabs, as are rates of diabetes and heart disease.


The issue also makes various recommendations for improving the health system, including boosting government spending, ending the drift from public to private health care, providing more hospital beds, extending maternity leave from 14 weeks to six months and providing free contraceptives as part of the national health insurance program.

In an email to The CJN, Clarfield, director of the Medical School for International Health at Ben-Gurion University and also an adjunct professor at McGill University’s medical school, called Rambam’s invitation to Horton and Horton’s acceptance of it “a very courageous step. Not surprisingly, he was impressed with the Israeli health-care system.”

In a statement, Clarfield said that while Israel has made progress in health, “troublesome disparities” in outcomes among ethnic groups reflect “inequalities.”

Skorecki noted that The Lancet issue shows that there’s “an enormous opportunity to leverage the universally accepted principles of health as a sanctuary against conflict and inequity, to achieve a brighter future for a deeply troubled region.”