Recent months have seen ongoing strike action from doctors in the public sector, who are demanding better pay and an increase in the state’s healthcare budget.
Next week, the doctors – who have been striking repeatedly since 2011 – will be joined by other medical professionals.
Starting on 8 March, doctors, dentists, pharmacists and veterinarians working in the public sector will go on a partial, open-ended strike. Nurses' representatives have yet to announce whether they will participate.
The move comes in response to an attempt to appease healthcare professionals by President Adly Mansour, who passed a decree last month raising bonuses but not basic pay, seen by many striking doctors as an inadequate solution.
Pharmacists were the first to join the doctors in reaction to the decree. On 12 and 19 February, pharmacists joined doctors in a partial strike that has been held on two days of every week since early January.
But pharmacists say that they have their own issues with government policies that also need to be addressed.
“We [the pharmacy syndicate] have a committee that coordinates with the doctors’ syndicate but our problems are much more [than the demands of the joint strike],” said pharmacist syndicate deputy Mohamed Seoudi.
On 26 February, pharmacists who work in government hospitals were joined by their counterparts working in the private sector in a one day strike, entering a battle that extends beyond a demand for better wages.
Pharmacists fight tax changes
According to pharmacist syndicate member Ahmed Abu Doma, more than 1,600 pharmacists who own their own pharmacies were surprised to learn this year that their tax cases were sent to the tax authority for inspection, leaving them facing investigation.
A 2005 agreement between the syndicate and the finance ministry estimates costs and profit margins of pharmacies at fixed rates derived from revenues, and taxes are calculated accordingly. The pharmacy, under this agreement, does not need to submit formal bills to tax authority.
“A tax agreement set in 2005 should protect pharmacists from false accusations of tax evasion as it avoids random estimations...but the government ignored it,” said Abu Doma.
Revoking the 2005 agreement would require the pharmacists to submit detailed documents proving revenues and costs, and pharmacists fear it could increase their tax burden. It would also require a certified accountant, which would entail more costs for the pharmacy owner.
In 2009, when Mubarak-era minister of finance Youssef Boutros Ghali attempted to cancel the agreement and demanded detailed documents be submitted to the tax authority, pharmacists held the first major strike, forcing him to revoke his decision.
Pharmacists also complain of a new tax applied under former president Mohamed Morsi setting a 1 percent tax on all medications purchased by pharmacies before they are sold. Pharmacists are arguing that it be reduced to only 0.5 percent.
Negotiations on the issue of changing the 2005 agreement have been ongoing for six months, said syndicate member Ahmed Ebeid, and are still ongoing.
The current suggestion made by the syndicate is to segment the pharmacists by income, applying the 2005 flat rate taxation to those with revenues below LE1 million per year, while requiring those who exceed it to submit detailed accounts.
Negotiations with the tax authority are however being obstacles from one group of pharmacists – those who control major pharmacy chains. Those pharmacists, who are registered under the chamber of commerce and not the syndicate, oppose the newly negotiated agreement.
“Owners of big pharmacy chains have frequently talked on our behalf arguing against the new agreement...they do not represent us,” said Abu Doma.
“There is a crucial difference with how we [syndicate pharmacists] and them [chamber of commerce pharmacy owners] view pharmacy...we see it as a profession, they see it as trade,” he added.
Calls for a central drug administration
Abu Doma says that the pharmacists’ syndicate is also demanding the creation of a centralised drug administration body to manage registration and pricing of medicine, “like that which exists in the US, Saudi Arabia, Jordan and other countries.”
“The health ministry is occupied with too many other issues and is not paying enough attention to the medical sector, and that affects not only our work, but the health of patients and investment in the medicine sector…it takes at least a year and a half to get a medicine registered in Egypt,” he added.
Pharmacies blame the health ministry for repeatedly refusing to take their side in disputes with medicine companies.
“The medicine companies refuse to refund expired medications…the health ministry refuses to force them, while on the other hand it forces us to set a price cap. Pharmacies are stocked with expired medicine,” said Abu Doma.
“We met with the new finance minister [on Tuesday] and he seems understanding and willing to cooperate...we are putting on hold a [general pharmacists’] strike until we see where this takes us [regarding taxes related demands],” said Ebeid.
Meanwhile, pharmacists working in government hospitals will take part in the open-ended strike with doctors, which is due to restart on 8 March.
“This strike will be focusing on our rejection of the presidential decree which only increases bonuses and not basic pay,” Ebeid said.
Several pharmacy owners who are registered with the chamber of commerce released a statement last week opposing the 26 February strike.
“It is time we moved from the streets and squares to the work field to compensate the harm that has been done to the Egyptian economy...It is about time we changed our work mentality and linked income with productivity and profitability,” the statement read.
However, Abu Doma insisted to Ahram Online “we cannot continue negotiations over the tax issue longer than 10 March, as we need to settle our taxes with the authority before 30 March,” hinting that if negotiations fail a general pharmacists strike is likely to take place again soon.