Authors' Reply to Ibrahim and Nair's Comment on: "Health Literacy: The Common Denominator of Healthcare Progress".

Dear Editor-in-Chief,

We thank Ibrahim and Nair [1] for their thoughtful comments on our paper, “Health Literacy: The Common Denominator of Healthcare Progress.” [2] They affirm that health literacy is not just a Western phenomenon. (Over 60% of the population surveyed in the United Arab Emirates possessed inadequate health literacy. [3]) Health literacy afflicts people of all races, nationalities, and socio-economic conditions. However, unlike a vaccine that can be safe and effective across borders and other divides, there is no inoculation that can eradicate the problems associated with low rates of health literacy. While there are likely common techniques that could be considered “best practices” (the involvement of local healthcare providers and other trusted local voices, a common lexicography) [4], every nation and community of nations (such as the United Arab Emirates, the broader Gulf region, the Levant, the Mashriq, and the Maghreb) will have to consider and design programs specifically suited to their own populations and unique domestic circumstances. A unique “Arab” health literacy strategy will not be unique enough. Granularity is essential. We must also recognize that in nations such as India, it will be impossible to address health literacy without also addressing literacy. (As per the 2021 census, the literacy rate of India is 74.04% [5] and 90% of the people in India have low health literacy. [6]) But the most important problem for every nation (after, of course, recognition of the problem) is resources. Speeches at conferences by astute and dedicated thought leaders, peer-reviewed papers in prestigious journals, and enhanced academic curricula for healthcare professionals are a good start, but without appropriate financial and human resources (on a continuing basis), any efforts to successfully advance health literacy will fail. As we have learned from the COVID-19 experience, developing the tools to combat the virus are for naught if we do not recognize the logistical, societal, and financial barriers to success.