• Spending overview
• Policy overview
• Diseases overview

Spending overview

Healthcare spending in Egypt as a proportion of GDP was 5.8% in 2008. This figure is low compared with spending in the US (16.1%) and Germany (10.8%), but compares well with other emerging markets.

Egypt's healthcare system is mainly state-funded, with healthcare dispensation free at the point of delivery. Government health insurance covers all public-sector workers—premiums are automatically deducted from salaries. However, employees can make a claim only when they are treated in government hospitals or in hospitals owned by their companies. A number of private firms provide health coverage in their benefits packages.

In November 2007 the government announced its intention to devise a new healthcare plan that will provide all citizens with full health insurance coverage by 2011. Under the proposal, which is currently being developed, a health insurance fund would be set up for poorer families that are currently not covered. The government has also allocated over US$900m to the development, modernisation and construction of 4,500 local healthcare centres devoted to providing basic healthcare services. So far, 1,500 such centres have been opened, and the remainder are expected to be completed before 2011.

Policy overview

The public sector accounts for the bulk of hospital care in Egypt, but its share is steadily declining. Public-sector hospitals have been underfunded for years and many function poorly. Facilities are often out of date and badly maintained. The quality of healthcare is also compromised by a lack of co-ordination between facilities, since hospitals are attached to a range of state actors, including the Ministry of Higher Education, the military and some of the larger public-sector companies. Conditions for healthcare workers in the public sector are difficult—pay is inadequate and there is a lack of monitoring to ensure that standards are maintained. As a result, doctors are tempted to reserve their best efforts for more profitable private work. Even though public healthcare is provided free or at nominal fees, an estimated 60% of primary healthcare visits now take place in private clinics or hospitals, indicating that only those who cannot afford anything else are willing to trust their healthcare to the state.

The government has drawn up a comprehensive plan to overhaul the delivery of healthcare in Egypt, with the focus shifting from curative to preventive care. The most radical element of this programme is the establishment of the general practitioner as the starting point for healthcare. The idea is that the family doctor will carry out regular check-ups, tracking families through illnesses, births and vaccinations. However, progress on this front will be gradual, because it will take time to overcome the widespread prejudice among the public that only specialists are qualified to treat illnesses, and because significant improvements in the healthcare system will require funding beyond the government's means.

Diseases overview

Egypt's social indicators have improved significantly in recent decades. Infant mortality dropped from 157 per 1,000 live births in 1970 to an estimated 28 per 1,000 in 2008, and life expectancy at birth has shown a steady improvement, reaching 71.8 years in 2008. However, this is mostly attributable to the spread of immunisation and foreign donor-funded programmes to introduce new healthcare methods to rural areas, rather than to a dramatic improvement in treatment and access to hospital care.

There have been 43 cases of bird flu in humans since the disease was first recorded in Egypt in February 2006. Egypt's location on major bird migration routes and the widespread practice of keeping domestic fowl near living quarters have led to its being the hardest-hit country outside Asia. The government says that it is conducting a vigorous campaign to combat the spread of the virus through vaccinations and raising awareness, but experts and officials have warned that people should not drop their guard. Some experts believe that the government has not done enough and tends to react rather than act. According to the World Health Organisation, the risk of the H5N1 virus mutating into a major human threat remains high in Egypt, although the number of new cases stabilised in the second half of 2008.