PSK: Our aim is giving PATIENTS the best medical experience POSSIBLE

HCMEA: Give us a brief history of yourself and your organization of pharmacy. We have a code of ethics and we make sure that we are also now self-regulating in terms of making sure that the Pharmacy and Poisons Board (PPB), and the government will manage the law. Ethics is typically handled by professional organizations. In the case of pharmacy, we are the ones responsible for it.

DR. NYABERO: My name is Dr. Lucas Kimanga Nyabero. I went to school in Nakuru and then moved to Nyeri and then I moved to Daystar University. Then I moved to the US, where I did a couple of schools, and then my graduate school was in Doctor of Pharmacy.

By BENJAMIN

I am a holder of a Doctor of Pharmacy from Massachusetts College of Pharmacy and Health Sciences (MCPHS). Before I went to the US, I used to work for AAR, which was in the early 1990s. In the U.S., I worked as a clinical pharmacist in a hospital for a long time. I also owned a couple of businesses in the U.S. Then I was faculty in about five universities. My wife and I have a couple of patented products.

HCMEA: Tell us about the Pharmaceutical Society of Kenya.

DR. NYABERO: Pharmaceutical Society of Kenya is a professional body for pharmacists established in 1964. Its major mandate is threefold: One is the welfare of pharmacists; secondly, the advocacy for pharmacy, making sure that the legal system is actually supportive of pharmacy and pharmaceutical care. Number three is the advancement

HCMEA: What is the link between a doctor and a pharmacist?

DR. NYABERO: The link between the doctor and the pharmacist is something that I think is not quite clearly explained and understood. There are two major links. Nexus number one is to make sure that the patient is getting effective, efficient, safe, quality, and affordable pharmaceutical care. Physicians are very good at doing diagnoses. But in terms of which medication works best, that's the pharmacist’s job.

The second nexus is after the doctor has already prescribed the medicine, the pharmacist explains to the patients clearly what they are taking, why they are taking it, types of food to avoid, the dosage regimen, and how to deal with adverse effects if there are any. Doctors have knowledge of what a particular medication is intended to do, but pharmacists have a deeper understanding as it is a core part of their daily work. It is essential to consult with the pharmacist when taking medications.

HCMEA: Is there a way that pharmacists are involved in the manufacture of medicine?

DR. NYABERO: Yes, they are. Pharmacists are involved in the regulation of packaging to ensure that drugs are not contaminated or damaged, and remain effective when they reach the patient. Here's the other one that is very complex that people don't talk about, disposal. A pharmacist should be involved with all these things from innovation, choice, dispensing, counseling, and disposal. We are putting medications in pit latrines. All it does when it rains is that all that medication goes into the water table, then we drink it. Pharmacists can help in explaining how to deactivate this drug before disposal. That's the complete continuum of a pharmacist. Pharmacy plays a big role in health care.

HCMEA: You mentioned regulatory affairs and I came to realize that pharmacists play a bigger role in determining the types of medicines sold in the market. Please expound further.

DR. NYABERO: They could play a bigger role in getting more involved. However, there is not enough of them in that situation. We can change what we bring into the market. For example, a lot of the drugs we have in this country have been studied in the US and others in the West, and other places. They are perfect drugs for Caucasian males between 18 and 32 years old because those are the ones who do the studies, but not necessarily appropriate for us. Pharmacists can be involved in the actual testing of these medications to make sure that they work with black people.

HCMEA: Do you have any key numbers like the number of people employed by the society?

DR. NYABERO: We represent about 4000 pharmacists. Among those ones are some who work in industry, hospital, community pharmacy, academia, and research among other things. Of those ones we have about 40 to 50% who are our members, and among those, we have a bunch of students who just graduated as pharmacists who don't have jobs. Now, considering what they can do for the economy it's a little sad.

What I'm trying to suggest is, the U.S. does a study, which they call the economic cost of medication errors, not medical errors, medication errors. In the US, it's about US$20 to US$40 billion a year. If you extrapolate to Kenya, it's between US$3 and US$6 billion a year. The cost of providing healthcare in Kenya is about US$6 billion a year. We are suggesting that if we use the medications correctly, hired all those pharmacists who are not hired, and gave them positions where they actually effect what therapy goes out, the economic output of those people who don't get harmed by medication can actually pay for healthcare without changing anything else!

HCMEA: How does PSK generate its revenues?

DR. NYABERO: Most of our revenues come from memberships and subscriptions from members. We also do events. We have an annual scientific conference. We have a few others like webinars. Every Tuesday and Thursday, we have a webinar, which our partners have actually been able to sponsor, and some of the stuff that we get from that.

HCMEA: Tell us just a brief profile of the founders and key management staff of the PSK.

DR. NYABERO: The founders were pharmacists who decided that we need to have a body that's going to ensure that pharmacy keeps on advancing, ensure that advocacy and the legal system acknowledges and supports the care that we are offering, the difference we make in healthcare, and also support the members who are pharmacists and ensure ethics are up to date. To that end, we have a code of ethics.

As regards management, we have a National Governing Council, which is the supreme body. Under it, there is the National Executive Committee, to which, the CEO reports.

As the CEO, I am in charge of the Secretariat, which runs the programs, communication, finance, and administration. On the other side, we also have standing committees, which include a legal and ethics committee, public relations and advocacy committee. We have an education committee, investment and budget committee, and fellows committee.

Also, our structure includes a president who

NYABERO LEADING A DELEGATION OF PSK MEMBERS DURING A COURTESY VIST AT MOH OFFICES

is elected by the members. We have three vice presidents: The Vice President for advocacy, the Vice President for governance, and the Vice President for pharmacy practice. They all report to the President of PSK, which is the political arm of what we do. We also have 16 branches nationally and each of them has chairs, vice chairs, treasurers, and secretaries.

HCMEA: What are some of the key values and strategies that have enabled PSK to succeed?

DR. NYABERO: I think it's the passion. The passion to make sure that patients are not harmed. I'll give you an example. Every time I talk to a patient about any medication, I strive to ensure that they understand it well enough to go and talk to a three-year-old and explain to them what the condition is, what the medication is, what the side effect is, and why they're taking the medication.

Nearly all medication is actually poison. It is how well you use it. Just like a car, the idea here is how do we operate medication safely. That is the passion that actually has made us develop a love for the common man, to make sure that everyone gets optimum medication care. When you're putting poison into your system, it has to be the right poison at the right dose, the right time, for the right condition.

HCMEA: Are there any other services that PSK offers to its members apart from advocacy and welfare?

DR. NYABERO: Yes, advancement. For example, do training on advanced family planning, sanctioned by the Ministry of Health, where a pharmacist will be able to give advanced family planning services including depo shots, and implants, among other things that you can do in family planning.

We also give training on immunization. Twice a week, we have people coming to talk to us about improving their skills. We are in the process of trying to look for scholarships, and exchange programs to ensure that we grow as a body to make sure that our pharmacists are the best they can be and they can serve the patients as well as they can.

HCMEA: What are some of the investments around technology that PSK has done?

DR. NYABERO: We are in the process of doing a couple of things, which we want to do in the next five years. We want to have a robust data setup, which we do have but it's not as strong as we would like it to be. We want to be the end-all and be-all of all pharmaceutical information in the country. We want to be the first place anyone looking to establish manufacturing operations goes to for information.

Any changes, any policymaking, any political statements that are going to be pharmacy and healthcare in terms of especially pharmaceutical care related, we want to make sure we have that information. We are building a very strong research arm, as I said, a lot of the medicines that we have, have been tested in a different environment. We want to publish our own.

We also want to innovate. We want to explore innovations like what we call pharmacogenetics, which involves using a person's genetic information to personalize medication, ensuring that patients receive the right dosage and treatment without the risk of harm or unnecessary spending.

HCMEA: How is your organization adapting to meet the rising need for more sustainable business operations and a better cleaner planet?

DR. NYABERO: We've engaged UNEP in terms of how to start changing the way we dispose of meds. We've had camps and drives where we encourage everybody to bring their expired meds and we collected almost four tons of medications and conducted sessions on how to dispose of them. We've been trying to do that, but we're looking for a more sustainable, continuous way to accomplish this through education.

The other one is also antimicrobial resistance. We are trying to encourage the public to understand the risks of not monitoring the menace before we get to a point where medications that used to treat pneumonia no longer work. To avoid that walk towards infections coming back to be a major part of the cause of death, we have to talk about these things.

HCMEA: How has PSK contributed to the national and regional economy?

DR. NAYBERO: A lot! Let me start with the growth of the economy. If you've got the right medication at the right time, in five days, you're ready to go back to work and build the economy. If you use the wrong medication, because you were not advised appropriately, it takes you maybe 10 or 15 days, those are days that you've lost.

The proper use of medication can significantly reduce the duration of illnesses and slows down the progression of diseases. I'll give you an example of diabetes. If you take your medication for diabetes correctly, you don't get down the road where you start chopping toes and everything else because of gangrene. That's a contribution to the public.

The other one is we do free medical camps. We've done free medical camps and education for both our members and the public. We have talks in schools. We’ve had talks on pharmacy days and pharmacy weeks. We’ve also had several talks everywhere to sensitize people on the importance of using the meds correctly.

PHARMACY DAY

HCMEA: What are PSK’s priority areas in the next five years?

DR. NYABERO: One is to build a solid database. We want a solid database for all pharmaceuticalrelated information. With data we can be able to make informed decisions that are not influenced by emotional bias.

Number two is to get people to trust that local manufacturing is okay, to just believe that the quality in Kenya is also equally as good and it meets the standards that it's supposed to meet.

We want to ensure that graduate pharmacists are ready to contribute to the healthcare system, and give them the skills and support. As I told you earlier on the nexus of healthcare, the last touch point in the healthcare system is the pharmacy. We want to make sure that it is solid, that the information you get there is accurate. We want to make sure we reduce the economic cost of medication errors.

There are also a few things we might launch. There are few studies on how to relieve the congestion in public service hospitals. How do we make sure that the people who will get to the hospital level are folks who really need to be at the hospital level? What are some of those services that can be offered at the pharmacy level, to almost ensure that the people who go into the hospital are really sick enough to go to the hospital so that we can use our resources better? With the need and mandate for UHC, nothing is more crucial than resource management.

HCMEA: Would PSK consider working with other players to advance healthcare

DR. NYABERO: I think one of the biggest potential sources of funding and support for growth is collaboration with other healthcare cadresFor instance, we engage with oncology doctors to explain our capabilities and demonstrate how we can help. By understanding what we can offer, we can then collaborate on funding and conducting studies to further advance the field.

We also are open to working with pharma companies as well as institutions of higher learning, research centers like KEMRI, hospitals, the Ministry of Health, the Ministry of Education, and other ministries .

We are open to working with international organizations, the Bill and Melinda Gates, the Tony Blair Foundation, the WHO to ensure that the pharmaceutical care getting to the patients is appropriate and is actually what is needed, not what is available.

HCMEA: What are some of the opportunities and challenges that PSK sees in the healthcare industry? How do you intend to take advantage of them to enable the pharmaceutical industry and the healthcare industry in general to flourish?

DR. NYABERO: One of the biggest challenges is medication use, which has costs related to the harm that it will cause. This is a hidden cost that really needs to be looked at.

Many people laying in the hospital today are there because they got the wrong medication. That is a big challenge. Several other people die every year because of a doctor or medications that were mixed up. One of the challenges is obtaining the necessary data in this area. Once we have data, we can compare it, implement appropriate mechanisms, and evaluate their effectiveness in achieving the desired outcome.

The other one is the scope of practice. All the healthcare cadres need to be brought together to ensure that each person’s contribution is felt in the healthcare spectrum of caregiving. The challenge is coordinating all the different aspects of healthcare to provide comprehensive care. One way to address this is through collaboration and cooperation. We are actively working towards building collaborations and highlighting the capabilities of pharmacists as a way of enhancing communication and information sharing.

This is a declaration. Without proper pharmaceutical care, which means the right medication, and people understanding what to do with all that comes with it including interactions and side effects, you will not have UHC. It will not succeed without that.

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By BENJAMIN OPUKO

Egypt is the most populous country in North Africa and 2nd most populated country in the Middle East and North Africa region with over 100 million people. It ranks 14th in the world in terms of population, accounting for 1.3% of the global population.

The population, which is growing at a 1.8% annual rate, contributes to increased demand for infrastructure and services, including healthcare.

The country has attempted to increase healthcare access in recent decades with significant strides. The most glaring milestone is a generally healthier population enjoying longer overall life expectancy, which has increased from 64.5 to 70.5 years over the past two decades. The journey of healthcare transformation has not been a smooth ride either because of numerous obstacles, a good example being the 2011 Arab Spring which had cataclysmic effects on healthcare provision in the country.

In 2014, Egypt adopted a new constitution that emphasizes health as a fundamental human right and commits to expanding coverage and access to quality services for all Egyptians. In 2018, the Egyptian government focused on providing Universal Health Coverage through the Universal Health Insurance Law. It intends to restructure the system by providing coverage to all citizens and making health care more affordable. The new law is being implemented in six stages, with the goal of encompassing all states by 2030.

A national emphasis has also been placed on public health interventions to improve all health indicators. These initiatives have received international acclaim, and Egypt continues to receive humanitarian aid from a variety of organizations around the world to improve public health. However, there are still significant challenges facing Egypt's healthcare system with the disease burden worsening a situation that is already compounded by equity and social injustice. Lifestyle diseases form the bulk of the disease burden and collectively they contribute negatively to the citizenry through loss of independence, years of disability, or death, and impose a considerable economic burden on health services. Non-communicable diseases (NCDs) are the main cause of death estimated to be over 82% of total deaths in Egypt.

Mental health and substance use are becoming one of the most serious and rapidly growing phenomena in Egypt. A 2018 report by the Ministry of Health and Population showed that one-quarter of Egyptians have mental health problems. According to the report, there is a high prevalence of depression and anxiety disorders, with nearly 44% of the population experiencing mental health issues. Around 31% of Egyptians suffering from mental health conditions "suffer from depression linked to substance abuse." Mental health progress is hampered by a lack of mental health awareness and high treatment costs.

LOW PHYSICIAN-PATIENT RATIO AN IMPEDIMENT TO QUALITY HEALTHCARE DELIVERY

According to the World Health Organization's most recent data, Egypt had 445,000 physicians working in the country in 2018, nearly five doctors for every 10,000 citizens. That ratio is too low by regional standards when compared to Saudi Arabia's 26 physicians per 10,000 people, Jordan's 23, Iraq's and Morocco's seven, and Turkey's 17. Brain drain further compounds the already dire situation causing concern that the quality of healthcare in the country could deteriorate further. The Economist reported that there were fewer than five doctors for every

10,000 people in 2018, compared to 11 per 10,000 in 2014. During the same time period, the number of doctors working in public hospitals fell by onethird. According to a mid-2019 study conducted by the Supreme Council of Universities and the Technical Office of the Egyptian Ministry of Health, only about 82,000 — or 38% — of Egypt's 213,000 registered physicians are still in the workforce.

COVID-19 exposed the weakness in Egypt’s healthcare system. To many, it was ironical that the country with the largest population in the Arab region and one of the region's most prolific medical schools has one of the region's lowest physician-to-population ratios. The Egyptian Centre for Economic Studies (ECES), links the country’s significant shortage of healthcare personnel in Egypt to doctors emigrating.

Approximately 7,000 doctors left Egypt to work elsewhere during the first wave of the pandemic, while 400 died from Covid-19. Many doctors have blamed the government for failing to follow the provisions of the 2014 Egyptian Constitution, which require the state to spend 3% of its annual GDP on healthcare. The dissatisfaction on the part of doctors has seen Egypt face an unprecedented wave of emigration, causing concern that the quality of healthcare in the country could deteriorate further.

According to the Egyptian Medical Syndicate, a body that represents the country's doctors, the doctor-to-citizen ratio improved to 9.2 doctors for every 10,000 citizens by March 2022 but remained far below the global average. The syndicate also notes that 11,536 doctors resigned from the Egyptian public health sector between 2019 and March 2022. Though these figures represent less than 5% of all practicing physicians in the country, they have prompted many members of the public to call on the government to improve working conditions and pay for doctors in order to prevent any doctors’ emigration - real or imagined - and any acute shortages that could harm the health system. In response to these public calls, the government has increased the number of Medicine Faculties in recent years in order to graduate more physicians. It has also increased spending on health to EGP 128 billion (US$ 4.32 billion) in the FY 2022/23 budget, up from EGP 108 billion (US$3.64 billion) in 2021/2022, an 18.5 percent increase.

FUNDING-GAP RENDERS CARE IN PUBLIC HOSPITALS PRECARIOUS

Despite the incremental funding allocation for health witnessed in recent years, Egypt’s healthcare system lags behind its MENA counterparts. In the 2021 Worldwide Health and Health Systems ranking of countries by Statista, Egypt with a score of 67.5 was outperformed by fellow MENA countries Libya (67.7), Tunisia (71.4), Morocco (71.7), and Algeria (72.5). Egypt’s poor performance vis-à-vis its neighbors can be directly linked to meager spending on healthcare. With only 5% of its GDP spent on healthcare in 2018, Egypt has one of the lowest healthcare spending rates in the Middle East and North Africa (MENA) region.

The level of government health expenditure is low, accounting for only 2% of GDP. With government spending on healthcare being extremely low, people still have to pay large outof-pocket expenses for all types of care. Outof-pocket health spending is a pressing issue in Egypt, accounting for more than half of total health spending and jeopardizing Egyptian households' economic viability and long-term sustainability. A 2022 peer review paper on healthcare financing published in the Journal of the Egyptian Public Health Association reported that 60% of primary healthcare financing came from out-of-pocket (OOP) spending. The level of OOP payment also suggests that many of the Egyptians who may be covered under government schemes opt instead for private treatment where they can afford to. While universal health insurance is the talk of the town in Egypt currently, private healthcare groups, which serve up to 40% of the population in both the insurance and out-of-pocket markets continue to play an important role.

In other programs, the International Finance Corporation (IFC), the private sector development arm of the World Bank, is working with the Egyptian government and private firms, to invest in the development of Egypt’s healthcare sector. In 2020, Investment Fund for Developing Countries (IFU) invested DKK 290 million (US$38.9 million) in Humania, which builds and operates private hospitals in Egypt and Morocco, on behalf of the Danish SDG Investment Fund. The investment is meant to increase capacity and introduce high-quality healthcare in accordance with international standards. When fully implemented, it will add approximately 600 hospital beds and serve 1.6 million patients per year.

THE PRIVATE SECTOR’S INDISPENSABLE ROLE IN EGYPT’S HEALTHCARE MARKET

Private healthcare players in Egypt are aware of the worrying gap between demand and supply of healthcare services and are eager to assist the government. Cleopatra Hospitals Group, Egypt's largest hospital group and a publicly traded company on the Egyptian stock exchange, is one such entity. Since 2018, the Group has acquired both greenfield and brownfield sites, and it now has six fully operational hospitals, three polyclinics, an in-vitro fertilization (IVF) center, and a rehabilitation and physiotherapy facility. Cleopatra manages 1,200 beds across all of its facilities. Alameda Healthcare is similarly dominant, with approximately 1,000 beds spread across 128 clinics, four hospitals, a home healthcare brand, and eight centers of excellence. Furthermore, the healthcare system is becoming more privatized, with the government encouraging further privatization. Between 2005 and 2019, the number of government hospitals in Egypt fell by 40.7%, from 1,167 to 691. In contrast, the number of private sector hospitals increased from 652 to 1,157, a 77.4% increase, according to the Central Agency for Public Mobilization and Statistics' 2019 health bulletin.

With privatization on high gear, the number of public hospital beds has declined by thousands over the last decade. Comparatively, the number of private sector hospitals increased by 20%, from 942 to over 1100 between 2009 and 2019, increasing their market share from 58.8% to 63.4%. Private beds increased by nearly 70% from 21,000 in 2009 to just under 36, 000 in 2020. Cumulatively, the country currently has a bed capacity totaling 130,000 out of which about 36,000 are available in the private sector, with nearly half of these concentrated in greater Cairo. This total number of beds translates to about 1.28 hospital beds per 1,000 people, which is less than half of what planners consider ideal and considerably lower than the MENA counterparts. This significantly low number of hospital beds per 1,000 population pits Egypt in a low cadre against developed countries and even the global average of 2.9 beds/1,000 population, suggesting room for growth. Canadian-based investment management company, Colliers International projects that Egypt will require approximately 38,000 new beds with an estimated investment of US$8 to US$13 billion by 2030. This represents a lucrative market share opportunity for private investors to tap into.

Attracting Private Investors To Bridge The Funding Gap

Egypt has one of the lowest healthcare spending rates in the Middle East and North Africa (MENA) region, with only 5 percent of GDP spent on healthcare in 2018. To make up for its low public spending, the country is implementing a wideranging program of reforms to attract privatesector investment and to improve access to quality healthcare services across the country. For instance, the Egyptian government has proposed a number of hospitals affiliated with the Ministry of Health for private sector investment, including the right to usufruct, manage, or develop. Among the hospitals available for private-sector investment include Coptic Hospital, Heliopolis, and Sheraton. This privatization move by the government is meant to attract private-sector investment to the state-owned hospitals as part of a larger plan to open up the healthcare sector to private-sector players.

The offering comes as the government seeks to double private sector participation in the economy over the next three years and exit up to 79 industries. Over the next four years, the strategy aims to raise US$40 billion by selling stakes in state-owned assets to domestic and international investors. An early draft of the state ownership document identified healthcare as a strategic sector in which the government wants to maintain a strong presence, while also encouraging the private sector to increase its involvement.

Government’s push for greater private participation in healthcare is already bearing fruits. According to government figures, the private sector's investment in healthcare in FY2018-2019 reached EGP 9.3 billion (US$0.31 billion), accounting for 42% of total investment in the sector during the fiscal year. Total implemented investments in the private healthcare sector increased 1.5x between 201516 and 2018-19 in nominal terms, totaling EGP 9.3 billion (US$0.31 billion) in private and EGP 9.8 billion (US$0.33 billion) in public investments in 2018-2019 according to a joint report by Dcode Economic and Financial Consulting and The American University in Cairo.

More investments are expected over the next decade, as evidenced by the surge in healthcare Merger & Acquisitions activity in 2020 and the first quarter of 2021. For instance, in 2020, 19 healthcare transactions were completed, making it the most active sector after banking and finance, which had 32 transactions. Some of the top deals included Al-Ahly Capital’s acquisition of El Nada Hospital and Ezdehar Egypt Mid-Cap Fund’s minority stake in Al Tayseer Healthcare Group. Al Tayseer also increased its stake in Mansoura Medical Center while Alta Semper raised its stake in Macro Holding to 80%. Companies are also bidding for the 51.4% stake in Alexandria Medical Services held by Abu Dhabi Commercial Bank. A mega-merger between Cleopatra Hospital Group (CHG) and Alameda Healthcare was also planned, but it recently fell through.

The government has also indicated that private medical providers will play an important role in the World Bank-funded universal healthcare program, which received a US$400 million injection in 2020. The Universal Health Insurance Agency, a new government agency, will contract private hospitals and clinics to provide care to Egyptians alongside public counterparts.

In addition, the International Finance Corporation (IFC), the World Bank's private sector development arm, is collaborating with the Egyptian government and private sector firms to invest in the development of Egypt's healthcare sector. IFC has invested US$400 million in Egypt's healthcare sector since 2007, with plans to invest another US$400 million in the next 2-3 years. The vast majority of investments have gone into services such as hospitals, clinics, and diagnostic centers. IFC is also investing in pharmaceuticals and insurance services.

The Rollout Of Uhc Attracts Private Investors

Egypt has implemented a number of reforms in recent years to encourage start-ups and private investment in healthcare. The country has announced plans to implement universal healthcare coverage by 2032, which is expected to fuel the sector's growth even further and create a flood of opportunities for private healthcare providers and start-ups. The UHC would provide all Egyptians with access to affordable health care by directly subsidizing care for low-income households, which account for roughly onethird of the population, according to the World Health Organization. The UHC has a mandate from the Universal Health Insurance (UHI) Law of 2018 to provide health coverage to citizens with implementation having begun in July 2019. When fully implemented, it is expected that all Egyptians will be covered under the UHI scheme, with a benefits package of quality health services and financial security. Egyptian citizens can obtain insurance through private insurers with government assistance. Because of the high penetration of the insurance market, as well as the rollout of the universal healthcare plan, an investor's potential market in the sector will grow. This ensures the demand for — and return on — healthcare services.

In addition, significant organized investment has been made in infrastructure and the development of new cities that will require medical services. Having more people covered by insurance and new areas in need of healthcare services translates into increased demand, which bodes well for investors' returns-on-investment (ROI) expectations. However, a fundamental issue persists: some governorates continue to be underserved in terms of healthcare services, owing to a lack of talent outside of cities with university medical faculties, and private investors failing to meet ROI targets beyond urban centers such as Cairo and Alexandria.

A Thriving Pharmaceutical Industry

The push for Universal Healthcare Coverage creates a glut of investment and business opportunities in the Egyptian healthcare market. This has encouraged industry players to be optimistic about Egypt's private healthcare system, which has grown steadily in recent years. According to the Egypt private sector diagnostic, the universal health care law could be a catalyst for public-private partnerships in hospital construction, diagnostic services, specialist care, information technology, and insurance claim administration. As Egypt moves towards universal healthcare coverage for its 100 million-plus population, the country has become the fastest-growing pharma market in the Middle East and Africa region with a value of US$6.3 billion. Pharmaceutical sales have already increased from US$2.3 billion in 2017 to US$5.2 billion by 2028. According to the MoHP, approximately 80% of pharmaceuticals are manufactured locally, positioning Egypt to become the leading manufacturer and exporter in the MENA region.

Conclusion

The healthcare market continues to grow in Egypt, primarily due to the demand from the rapidly expanding population, which is expected to reach 151 million by 2050. With its large population and prevalence of chronic diseases such as high blood pressure, diabetes, and Hepatitis C, Egypt is a market primed to absorb healthcare services. With the growing population and legislation shifting toward a greater proportion of citizens having access to health insurance, the demand for hospital services and space will rise, creating opportunities for new market entrants. At the same time, Egypt's healthcare infrastructure requires significant investment in both general and specialized medical facilities.

It is expected that the privatization move by the government will attract new investments and particularly make it easier for private investors to enter Egypt’s healthcare space. This represents a significant opportunity for investors in the medium to long term. Attracting new market participants will be critical in meeting new demands caused by changing hospital visit patterns as the government implements universal health insurance coverage. In order to improve the healthcare services in Egypt both in terms of quality and quantity, Egypt needs to increase the beds ratio per 1,000 population and physicianpatient ratio. Lastly, the surging demand for healthcare will create a need for more "Doctor's Clinics" in Egypt. According to Colliers research, Egypt will require approximately two million square meters of medical clinic space by 2030, at a cost of US$1 billion, providing opportunities for developers to develop and sell clinics to doctors/ investors.