A Guide to Egypt's Challenges: Healthcare & Hepatitis

Bassem Sabry , Thursday 16 Aug 2012

Bassem Sabry provides a multi-pronged overview of the political, economic and social challenges facing Egypt's first post-Mubarak president, with an emphasis on the everyday problems facing average Egyptians

El-Kasr el-Einy Hospital
El-Kasr el-Einy Hospital

In 2011, Egyptians had a life expectancy at birth of 72.93 years, ranking 121st globally, compared to world leader Monaco at 89.68 years, and Chad at the bottom of the list at 48.69, though surprisingly a bit ahead of Turkey at 72.77 and even Russia at 66.46.

Estimates of both public spending and state allocation on healthcare are currently around five per cent of GDP and the budget respectively (public demands have been made to raise health spending to 15 per cent of the budget).

Public hospitals are limited compared to patient load, often poorly equipped, overcrowded, and buildings and facilities are in dire need of renovation and expansion, doctors are underpaid and often resort to debatable external means to supplement their income.

Patients complain of the limited availability of medical specialists in state hospitals and clinics, and modern standards are still a distance away in several fields, such as overall patient care and infection control.

At the moment, around 57 per cent of the population — according to one somewhat questionable 2008 official estimate — receives some form of health insurance or another, which primarily covers public sector employees and students (in 2010, the National Democratic Party tried to bring farmers under the national health insurance service, while farmer-representing groups have addressed the Constituent Assembly this year for the same purpose).

But the overall national health insurance system itself is financially strained, and many reform bills attempt to politically expand coverage without sufficient consideration to the allocation of resources.

More important, the entire philosophy and structure of the national health insurance system needs a genuine overhaul, including on the selection of diseases that fall under its overall blanket, the lack of conceptual uniformity over who is covered or not, the fate of the Nasser-instated “free treatment” state hospitals and clinics, and the lack of a continuous secure supply of basic and critical medication (many complain of the quality of the Egyptian variants of common medications).

According to a news report in February 2012, the (then) head of Parliament's Health Committee stated that a recent poll suggested that 65 per cent were unhappy with the country's national health insurance scheme.

In particular, special attention has to be given to deciding the future of the problematic “state-funded treatment” scheme to which uninsured citizens can apply.

The scheme has been subject to abuse by medical professionals, institutions, MPs aiming to gain favour with their constituencies, and government officials, and was in debt by more then LE2 billion by 2010.

As current national insurance does not cover all citizens, the need for the state-funded treatment system only kept growing, though it is poorly planned and reforming the entire system became more complex.

The most recent reform effort aims at bringing an estimated 13 million children below the age of 6 properly under the current national Health Insurance service, setting detailed regulations for finance. 

According to a Dr. Mohsen George, a state health official, the disorganised treatment of this segment under current laws caused the state a deficit of more than LE150 million annually over the past 15 years, for a total of LE1.3 billion. Critics argue that while the effort is positive, it might lead to delaying a much-needed overall reform of the entire healthcare system.

Egypt also has an estimated nine million citizens suffering from diabetes, one of the leading national diseases. Most disastrously, Egypt has undisputedly the worst international epidemic of Hepatitis C, with an estimated 15-20 per cent (if not more) of the population testing positive for the disease, and with 165,000 new people getting infected with it annually.

Other than the tragic human impact, treating the epidemic costs the health ministry a reported LE2 million a day, and costs national health insurance LE250 million annually, according to news reports. Some have linked the Hepatitis outbreak to the country’s Bilharzia treatment campaign, one that has been tradtionally promoted  by the former regime as a national achievement.

See also:

The Economy

Subsidies & the Budget

Food Security

Fuel & Electricity Shortages


Slums & Random Housing

Religious Freedoms, Minorities

Judiciary & Education

The Interior Ministry

Freedom of Speech, Media & the Arts


Women's Rights, Street Children

The Public Sector & Privatisation



Saving Cairo!

National Reconciliation



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