World Bank and Egypt: A bold initiative for an efficient health insurance system

Dina Ezzat , Tuesday 23 Jun 2020

The project's objective is to help Egypt achieve long-term stability in health financing with less dependence on the state budget and less exposure to economic fluctuations

World Bank
WB to support medical sector in Egypt with bold plan (Photo: Reuters)

Egypt and the World Bank (WB) are embarking on a joint project that aims to facilitate and speed up the implementation of a national universal health insurance programme that was started earlier this year.

On 16 June, the WB announced that its Board of Executive Directors had approved providing $400 million to support Egypt’s transformational Universal Health Insurance System (UHIS), which aims to serve as “as the country’s pathway to achieving universal health coverage and improving the health outcomes of its citizens.”

According to a telephone interview with Maria Wes, Egypt country director at the WB, and Amr AlShalakany, a WB healthcare expert, the project’s objective is to help Egypt achieve long-term stability in health financing with less dependence on state budget and less exposure to economic fluctuations.

The project is launched in acknowledgement of the fact that disparities still persist despite the significant improvement that Egypt has been making in its health outcomes.

It is also based on the fact that despite an improving economic performance, Egypt still has one of the lowest government health expenditures per GDP in the region and one of the highest out-of-pocket expenditure rates.

Maria Wes
Maria Wes, Egypt country director at the WB

According to Wes, with a growing population and an increasing life expectancy for women and men in Egypt, it is expected that the demand for healthcare services will be on the rise, and that economically disadvantaged groups, like women and citizens in remote areas, will have to come to the government to access this healthcare, which ranges from access to family planning to the treatment of non-communicable diseases.

Fixing the resources to finance the UHIS is a top priority for the joint work of the WB and the Egyptian government. Essentially, the project aims to spare the budget by securing financing from contributions and premiums, taxes (including road fees, car licensing and tobacco taxes) and copayments by beneficaries at the point of service.

This said, Wes stressed that, as would be the case anywhere in the world, there is no fast fix for the ailments of the healthcare system in Egypt. This, she said, is a typically long reform process that is complicated and takes years.

However, Wes said that while it is strictly up to the government to fully reach out to the most disadvantage groups, it would be purposeful for the UHIS to incorporate the private sector as part of accelerating wider coverage for all.

Essentially, the inclusion of the private sector, Wes argued, would attract larger segments of the population that would otherwise be hesitant to subscribe to the UHIS if it is only operated through public hosptials.

Moreover, Wes added that the inclusion of the private sector inevitably creates competition and promotes best practices.

She said that the government will be the decision-maker on the rules of inclusion of the private sector in the UHIS through benefit packages and pricing systems, to make the things equally attractive to the private sector and the recipients of the services.

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