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Egypt’s philosophy of development: The health Sector

Developing Egypt’s health sector has been a top priority for President Abdel-Fattah Al-Sisi ever since he came to power in 2014, being one of the most vital sectors affecting the bulk of Egypt’s population. Egypt’s efforts in this aspect were directed towards two main areas: 1) rehabilitation of the health infrastructure, development of rural health clinics to keep pace with the development of health services, and developing the health workforces and 2) introducing a package of urgent health reforms, consisting of numerous health initiatives aimed at raising efficiency and improving service level provided to citizens targeting citizens of all ages, starting from children to elder population.

Achievements in the health sector

Between 2014 and 2020, Egypt managed to implement 960 projects in the health and population sector, with total investments of about EGP 82 billion. The most notable achievements in this area have been the implementation of about 200 projects for developing general hospitals and medical institutions, 40 projects directed towards the Egyptian Ambulance Organization, and 19 projects aimed at developing model hospitals, in addition to  developing health clinics and undertaking about 25 initiatives inside Egypt and 13 others to support the health sector in Africa. Above and beyond, the following steps have been taken to bolster the health sector:

●    Directing massive investments of more than EGP 120 billion into improving the health sector.

●    Brining about an increase in investments directed toward the Ministry of Health’s (MoH) projects the next fiscal year 2022/2022, to reach EGP 47.5 billion – a 205% increase compared to 2020/2021 (Decent Life initiative projects included).

●    Completing 632,027 surgeries under the presidential “Waiting Lists” initiative, making a total of 632,677 beneficiaries.

●    Developing University Hospitals (113 university hospitals were developed up from 88 in 2014).

●    Launching health-related initiatives aimed at strengthening the capacity of health facilities to provide outstanding medical services while combating the coronavirus, increasing university hospitals’ coverage in governorates, and establishing an electronic health register for hospital admissions.

●    Achieving self-sufficiency of locally-produced insulin and localization of oncologic drugs, serums, and vaccines industry.

●    Launching and implementing a universal health insurance scheme in selected governorates, with 3.6 million citizen registered, so far, on the system.

●    Issuing more than 2.913 million treatment decisions at the State’s expense.

●    Providing 20 million formula packs and having a strategic stockpile of five million packs.

Presidential initiatives under “100 Million Healthy Lives” campaign

According to the statement of Dr. Hala Zayed, Egypt’s Minister of Health, to the plenary session in the Parliament, the number of beneficiaries of the Presidential health initiatives reached nearly 90 million citizens, with a total of 102 million visits to hospitals. The most notable health initiatives are:

1- “100 Million Healthy Lives” initiative to eradicate hepatitis C and early detect non-communicable diseases

For years, Egypt has been one of the countries with the highest prevalence rates of hepatitis C. With President Al-Sisi taking office, Egypt waged a war against hepatitis C by launching the “100 Million Healthy Lives” initiative for early detection of hepatitis C and free treatment of HCV patients. Efforts of the initiative brought hepatitis C prevalence rate to 7 percent in 2018, down to 2 percent in 2020, which puts Egypt on track to get the international recognition of being hepatitis-free. Further to this, under the initiative aimed at early detection of non-communicable diseases, 50 million citizens have undergone a comprehensive medical survey, where treatment was provided to 1.8 million of the screened citizens diagnosed with diabetes and 10 million diagnosed with high blood pressure. The total cost of the initiative was estimated at EGP 4 billion.

2- The Presidential initiative for early detection of anemia, obesity and dwarfism and improvement of maternal and fetal Health

Under this initiative, 22 million school students were examined, where 3, 4000,367 cases of obesity, 7,594,357 cases of anemia, and 10,657,036 cases of dwarfism were discovered, and treatment has been provided to all cases by linking 300 clinics to the initiative’s online system. Additionally, medical services were provided to 498,837 women and an integrated system for detection of vertically transmitted infection has been developed at a cost of EGP 31 million. Yielded tangible results of the initiative included protecting 2.5 million children from hepatitis-B diseases, spirochetes, and HIV and reducing rates of vertically transmitted infections from 45 percent to 2 percent only.

3- The Presidential initiative for screening and treatment of chronic diseases and early detection of kidney diseases

This initiative was launched in parallel with efforts to combat the coronavirus pandemic. Under the initiative, 24 million citizens were screened and provided free treatment, 180 dialysis units were either replaced or renewed, and 2600 dialysis machines and 1000 wheel chairs were provided in collaboration with the Tahya Misr Fund. The total cost of the initiative was estimated at EGP 714 million. The outcome of the initiative resulted in provision of medical services to patients of chronic diseases with a total cost of EGP 3 billion per year and providing treatment to patients with those diseases at EGP 13 billion per year.

4- The Presidential initiative to detect and treat hearing loss and impairment in newborns

Since the launch of this initiative in September 2019, a total of 2,298,095 children were examined, 81,794 children were moved to the second phase of medical assessment, and 7,922 children were transferred to hospitals for further evaluation. Additionally, an integrated infrastructure for early detection of hearing impairment have been developed where health clinics have been provided with 3,500 tone-emitting otoscopes and 3 audiometers at a cost of EGP 120 million.

5- The Presidential initiative to improve Egyptian Women’s Health

The initiative is intended to decrease the mortality rate of breast cancer, reduce the economic burden on the government through early detection of the disease, spread of health awareness, setting up the infrastructure for oncology treatment in Egypt as a complement to Egypt’s Universal Health Insurance System, and enhancing women’s outreach to the primary care units. Since the launch of the initiative in July 2019, 11,504,037 women were examined, 2,848 women of whom have received treatment, up from only 2.5 million women in the period from 2007 to 2019, where there has been no system for follow-up.

Egypt’s Universal Health Insurance System (UHIS) project

Egypt’s UHIS project was first launched in Port Said governorate. Currently, 600,000 citizens are registered on the system and 3 million medical services have been provided, including 2.2 million family medicine services, 500,000 outpatient clinics services, and 30,000 surgeries. A pilot operation of the system has been initiated in the rest of phase-one governorates, with a total of 3,635,000 registered citizens.

Supportive legislation

The most important legislation that were issued toward developing the health sector were: 1) the Health Professions Amendment Act which provides for increasing allowances given to medical professionals, 2) establishment of the Compensation Fund for the Risks of Medical Professions, 3) the Medical Practitioners Amendment Act to ensure physicians get necessary training to obtain a medical license, ensuring patient safety, 3) a cabinet resolution to identify the poor for premium exemption, 4) the Mental Health Amendment Act, and 5) the Emergency Response Fund Bill, aimed at securing sustainable  funding for providing prevention, treatment, and rehabilitation services to citizens.

Preventive services

Under the Expanded Programme on Immunization, preventive services were supported. The outbreak of COVID-19 has materially affected Immunization programs in most countries; however, Egypt was able to maintain routine immunization services and managed to secure a sufficient stockpile of formula packs. Moreover, hepatitis C compulsory vaccination was introduced with a coverage rate of over 90 percent, where, during the year, 17 million children were routinely vaccinated against Measles and Rubella under the national campaign for immunization. 

In conformity with the World Health Organization’s advocacy in May 2016, Egypt switched from the trivalent oral polio vaccine (tOPV) to the bivalent oral polio vaccine (bOPV). In this respect, the MoH decided to vaccinate children born in the period from 1/1/2016 to 22/3/2018 with Salk vaccine. In February 2020, the MoH started vaccinating Egyptian and foreign children under five with the bivalent oral vaccine where over 16.5 million children were vaccinated through a door-to-door vaccination campaign implemented by more than 45,000 mobile teams with a total cost of EGP 1.186 billion during the fiscal year 2019/2020.

The Egyptian Genome Reference

The Genome Reference project, launched by the President in March 2021, in considered of the largest and most significant medical projects that would  bring about a paradigm shift in Egypt’s health sector and improve the quality of life and public health of the Egyptians. The project leverages the latest technology to determine the genetic basis of many diseases, making it easier to diagnose and treat genetic diseases and some of the most common non-communicable diseases, such as cardiovascular diseases and cancer.

The launch of this project is an important step toward building a comprehensive knowledge base on the Egyptian Genome, through which personal genomes and common and unique Egyptian genes can be studied and their relation to the molecular basis of genetic diseases can be identified. The end outcome would be the ability to address these diseases and develop precision medicine tools and treatments. After five months of careful examination of the plan, President Al-Sisi gave the go-ahead for the project, realizing its substantial importance. The project shall be carried out collaboratively between the Academy of Scientific Research, Ministries of Defense, Health and Communications, over 15 universities and research centers, and civil society institutions, with a total budget of EGP 2 billion for studying the genetic material of thousands of Egyptians.

Confronting COVID-19 pandemic and the local manufacturing of COVID vaccine

The outbreak of the Coronavirus pandemic has posed a major challenge to health systems worldwide. In Egypt, the government made every possible effort to face this crisis, taking proactive and preventive measures to respond to the pandemic. Some hospitals have been set aside for screening and isolating infected and suspected COVID cases. In regards to the vaccine, a committee, chaired by the Prime Minister and comprising representatives of relevant ministries, has been set up to study the agreements signed with vaccine manufacturers. Additionally, a memorandum of understanding has been signed between Egypt and China to promote bilateral cooperation between the two countries in research, development, and production areas. Egypt has also succeeded in taking the first step toward locally manufacturing an anti-coronavirus vaccine, and it received the first batch of raw materials for the local manufacture of the Chinese Sinovac vaccine, with a total of 1400 liters, sufficient to produce about 2 million doses.

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