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In the ancient world, it is said, there was no better place to receive medical care than Egypt. Whether you suffered from kidney stones or an eye infection, or had your leg shattered by a racing chariot, a treatment could be found in the “Land of Abundance.” Herodotus, the fourth-century BCE Greek historian, wrote that Egypt “is full of physicians: some treat the eye, some the teeth, some of what belongs to the abdomen, and others internal diseases.”
Recently discovered evidence from mummified human remains and papyrus texts confirms this laudatory report. It shows that Egyptians as early as the third millennium BCE knew how to care for head wounds, set fractured bones, and even perform rudimentary (though successful) brain surgery. That knowledge eventually found its way to Greece and the Western world through physicians in Alexandria.
Since the early modern era, advances in Western medicine have completely transformed how diseases are diagnosed and treated. Based on new chemical, anatomical, and physiological knowledge, and guided by novel clinical and experimental practices, modern medicine has saved millions from early death and improved the quality of life for countless others.
But today even the most essential drugs and technologies are not available everywhere, to everyone. Each year people in underdeveloped countries suffer or perish from illnesses that could be easily treated through access to affordable interventions.
According to the United Nations, about half the medical equipment in developing countries is non-functioning, either because it has broken down or there are simply too few properly trained technicians to operate it. That figure is much higher in Africa, where close 85 percent of hospitals report difficulty in finding qualified medical engineers.
Pharmaceuticals, on the other hand, are in great supply. The problem, though, is that many are counterfeit—concocted to turn a quick profit with few or no active ingredients. Today, the global trade in counterfeit drugs is second only to the illicit arms trade.
In Egypt the social price is enormous. And its impact is only deepening as the country’s demographics change. With more than 88 million people, Egypt is one of the most populous countries in North Africa and the Middle East. The UN estimates that by 2050 the country will be home to 140 million people. More than 40 percent will live in urban and overcrowded areas, and the population overall will be older since the proportion of dependent seniors is growing faster than the working-age cohort.
While medical care in Egypt has gradually improved over the past thirty years, an expanding and aging population, coupled with deficiencies in the public healthcare system, presents enormous challenges. Costs are rising, and so too are non-communicable diseases, including cancer, diabetes, cardiovascular diseases, and chronic respiratory diseases.
It is no surprise, then, that the country’s new government has moved healthcare to the top of its national, social, and economic development agenda. Multinational companies like Pfizer, Merck, and GE Healthcare see this as an opportunity to help make a difference.
Pfizer, the world’s largest pharmaceuticals firm and one of the oldest in America, has a long history in Egypt. It entered the country over half a century ago, in 1961. Since then it has grown to become Egypt’s seventh-largest drug provider, employing more than 600 people between its corporate headquarters on the western bank of the Nile, across from downtown Cairo, and its high-tech manufacturing and packing plant in Almaza.
Pfizer has a dual focus in Egypt. One is its anti-infectives portfolio, which includes antibiotics in multiple forms and antifungals. The other is its cardiovascular portfolio, which encompasses mature products for hypertension and dyslipidemia. These are just the start, for Pfizer is moving quickly into other product areas in high demand, such as biologics, vaccines, and targeted-therapy oncology medicines.
The company is also working to reshape Egypt’s clinical research environment by promoting better investigative methods and compliance procedures. Its latest initiative applies a pioneering concept for R&D directive called INSPIRE, which stands for “Investigator Networks, Site Partnerships and Infrastructure for Research Excellence.” Through INSPIRE, Pfizer has set up strategic partnerships with the Ministry of Health and a number of top Egyptian universities and hospitals. These are intended to focus clinical studies on areas where they can have the biggest impact.
Merck is another multinational pharmaceutical giant operating the country. It arrived in the Egyptian market in 1965, shortly after Pfizer, and since then has introduced important new drugs, such as Rebif (Interferon beta 1a), one of the most effective treatments for certain forms of multiple sclerosis, which helps to decrease the frequency of relapses and delay the occurrence of some of the physical disability associated with the disease.
Both companies have become active training partners in the country, providing ongoing medical education to local physicians, pharmacists, and paramedics, designed to close knowledge gaps and improve clinical competence.
Still, Egypt’s public healthcare system faces huge obstacles. Many state-run hospitals and clinics are in disrepair, government doctors receive low wages, and the national medical insurance program covers only public workers and schoolchildren. Nearly three-quarters of all healthcare expenses are paid privately out-of-pocket. For many Egyptians, that means essential and even life-saving medicines remain out of reach.
“The main challenges,” says Ashraf El-Khouly, Pfizer’s corporate affairs director for Egypt, “is the pricing of pharmaceutical products, taking into consideration the devaluation of the Egyptian pound, as well as intellectual property rights and data exclusivity.”
El-Khouly believes these challenges can be overcome if the country is able to develop a well-sustained medical insurance program, along with stronger laws to clamp down on counterfeiters. Cairo must also introduce a shorter and more efficient registration process, he says.
Improved medical technology and equipment is equally important. With spending on medical devices rising but local production still limited, the government is trying to make it easier for foreign manufacturers to offer their products for sale within Egypt’s borders. In 2013 the Central Administration for Pharmaceutical Affairs (CAPA) reformed its regulatory standards, streamlining the approval process for imports.
GE Healthcare is at the forefront of that market. It already has more than 12,000 technologies deployed in hospitals across the country. The chief products are PET/CT scanners for disease detection, monitoring, and treatment planning, as well as mammography and ultrasound machines that can also detect blood-flow patterns, used to confirm findings and pinpoint lesions when screening results are inconclusive.
GE Healthcare works closely with the Ministry of Health on several projects. One is a paperless and filmless image-reporting system called RIS PACS. The system allows radiologists at six key hospitals across Egypt to share x-ray images with a central lab in Cairo for remote assessment and storage, helping to speed up diagnoses.
Other projects include installation of a PET/CT unit for the National Cancer Institute, together with a suite of imaging devices for women, capable of serving 12,000 patients a month. GE Healthcare has also helped to launch a mobile breast cancer-screening program, which aims to increase early detection, diagnosis, and treatment, as well as to promote general awareness of the disease. So far, the program, which has four units deployed across the country, has screened over 150,000 women.
Most recently, GE Healthcare installed the country’s first new-generation cyclotron production facility in the Children’s Cancer Hospital Egypt, the largest pediatric oncology center of its kind in the Middle East and Africa.
Like Pfizer, GE Healthcare advises the government on policy reforms and assists in the development of assessment programs and management services, with a focus on education and training for local skills development. In March it signed a partnership framework agreement to establish a Biomed Center of Excellence. This agreement, which is supported by the World Health Organization (W.H.O.), is expected to improve the country’s medical technology management system and enhance biomedical services.
Egypt spends less than five percent of its GDP on healthcare, well below the global average of nearly 10 percent. Per capita, that amounted to $151 (in U.S. dollars) in 2013, compared to the global average of $1,038, according to the latest figures from the WHO.
With Egypt’s healthcare sector lagging so far behind many other countries, Western multinational companies see ample room for the market to grow, possibly even doubling over the next five years. Already, many are exploring new trade and investment opportunities. In May the U.S. Department of Commerce led a delegation of six U.S. healthcare companies to Egypt, the fourth such delegation in only six months.
“Egypt is working to increase access to quality healthcare for it citizens through the Healthcare Reform Program,” said Ken Hyatt, U.S. Deputy Under Secretary of Commerce. “The companies on this trade mission can offer the latest in innovative healthcare technology and services.”
Last November, the U.S. Chamber of Commerce, the world’s largest business federation, brought nearly 70 companies to Cairo for meetings with public and private sector leaders, including Egyptian President Abdel Fattah el-Sisi. It was the biggest delegation in the organization’s recent history.
American executives appear confident that expanded foreign trade and investment in Egypt’s healthcare sector will benefit Egyptians, hastening the revival through innovation, economic cooperation and commercial engagement, as well as providing additional pressure for quicker policy reforms and more public spending.
The views presented in this article are the author’s own and do not necessarily represent the views of any other organization.
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Egypt’s Healthcare Revival
Molecular abstract blue background vector medical illustration.
September 21, 2015
In the ancient world, it is said, there was no better place to receive medical care than Egypt. Whether you suffered from kidney stones or an eye infection, or had your leg shattered by a racing chariot, a treatment could be found in the “Land of Abundance.” Herodotus, the fourth-century BCE Greek historian, wrote that Egypt “is full of physicians: some treat the eye, some the teeth, some of what belongs to the abdomen, and others internal diseases.”
Recently discovered evidence from mummified human remains and papyrus texts confirms this laudatory report. It shows that Egyptians as early as the third millennium BCE knew how to care for head wounds, set fractured bones, and even perform rudimentary (though successful) brain surgery. That knowledge eventually found its way to Greece and the Western world through physicians in Alexandria.
Since the early modern era, advances in Western medicine have completely transformed how diseases are diagnosed and treated. Based on new chemical, anatomical, and physiological knowledge, and guided by novel clinical and experimental practices, modern medicine has saved millions from early death and improved the quality of life for countless others.
But today even the most essential drugs and technologies are not available everywhere, to everyone. Each year people in underdeveloped countries suffer or perish from illnesses that could be easily treated through access to affordable interventions.
According to the United Nations, about half the medical equipment in developing countries is non-functioning, either because it has broken down or there are simply too few properly trained technicians to operate it. That figure is much higher in Africa, where close 85 percent of hospitals report difficulty in finding qualified medical engineers.
Pharmaceuticals, on the other hand, are in great supply. The problem, though, is that many are counterfeit—concocted to turn a quick profit with few or no active ingredients. Today, the global trade in counterfeit drugs is second only to the illicit arms trade.
In Egypt the social price is enormous. And its impact is only deepening as the country’s demographics change. With more than 88 million people, Egypt is one of the most populous countries in North Africa and the Middle East. The UN estimates that by 2050 the country will be home to 140 million people. More than 40 percent will live in urban and overcrowded areas, and the population overall will be older since the proportion of dependent seniors is growing faster than the working-age cohort.
While medical care in Egypt has gradually improved over the past thirty years, an expanding and aging population, coupled with deficiencies in the public healthcare system, presents enormous challenges. Costs are rising, and so too are non-communicable diseases, including cancer, diabetes, cardiovascular diseases, and chronic respiratory diseases.
It is no surprise, then, that the country’s new government has moved healthcare to the top of its national, social, and economic development agenda. Multinational companies like Pfizer, Merck, and GE Healthcare see this as an opportunity to help make a difference.
Pfizer, the world’s largest pharmaceuticals firm and one of the oldest in America, has a long history in Egypt. It entered the country over half a century ago, in 1961. Since then it has grown to become Egypt’s seventh-largest drug provider, employing more than 600 people between its corporate headquarters on the western bank of the Nile, across from downtown Cairo, and its high-tech manufacturing and packing plant in Almaza.
Pfizer has a dual focus in Egypt. One is its anti-infectives portfolio, which includes antibiotics in multiple forms and antifungals. The other is its cardiovascular portfolio, which encompasses mature products for hypertension and dyslipidemia. These are just the start, for Pfizer is moving quickly into other product areas in high demand, such as biologics, vaccines, and targeted-therapy oncology medicines.
The company is also working to reshape Egypt’s clinical research environment by promoting better investigative methods and compliance procedures. Its latest initiative applies a pioneering concept for R&D directive called INSPIRE, which stands for “Investigator Networks, Site Partnerships and Infrastructure for Research Excellence.” Through INSPIRE, Pfizer has set up strategic partnerships with the Ministry of Health and a number of top Egyptian universities and hospitals. These are intended to focus clinical studies on areas where they can have the biggest impact.
Merck is another multinational pharmaceutical giant operating the country. It arrived in the Egyptian market in 1965, shortly after Pfizer, and since then has introduced important new drugs, such as Rebif (Interferon beta 1a), one of the most effective treatments for certain forms of multiple sclerosis, which helps to decrease the frequency of relapses and delay the occurrence of some of the physical disability associated with the disease.
Both companies have become active training partners in the country, providing ongoing medical education to local physicians, pharmacists, and paramedics, designed to close knowledge gaps and improve clinical competence.
Still, Egypt’s public healthcare system faces huge obstacles. Many state-run hospitals and clinics are in disrepair, government doctors receive low wages, and the national medical insurance program covers only public workers and schoolchildren. Nearly three-quarters of all healthcare expenses are paid privately out-of-pocket. For many Egyptians, that means essential and even life-saving medicines remain out of reach.
“The main challenges,” says Ashraf El-Khouly, Pfizer’s corporate affairs director for Egypt, “is the pricing of pharmaceutical products, taking into consideration the devaluation of the Egyptian pound, as well as intellectual property rights and data exclusivity.”
El-Khouly believes these challenges can be overcome if the country is able to develop a well-sustained medical insurance program, along with stronger laws to clamp down on counterfeiters. Cairo must also introduce a shorter and more efficient registration process, he says.
Improved medical technology and equipment is equally important. With spending on medical devices rising but local production still limited, the government is trying to make it easier for foreign manufacturers to offer their products for sale within Egypt’s borders. In 2013 the Central Administration for Pharmaceutical Affairs (CAPA) reformed its regulatory standards, streamlining the approval process for imports.
GE Healthcare is at the forefront of that market. It already has more than 12,000 technologies deployed in hospitals across the country. The chief products are PET/CT scanners for disease detection, monitoring, and treatment planning, as well as mammography and ultrasound machines that can also detect blood-flow patterns, used to confirm findings and pinpoint lesions when screening results are inconclusive.
GE Healthcare works closely with the Ministry of Health on several projects. One is a paperless and filmless image-reporting system called RIS PACS. The system allows radiologists at six key hospitals across Egypt to share x-ray images with a central lab in Cairo for remote assessment and storage, helping to speed up diagnoses.
Other projects include installation of a PET/CT unit for the National Cancer Institute, together with a suite of imaging devices for women, capable of serving 12,000 patients a month. GE Healthcare has also helped to launch a mobile breast cancer-screening program, which aims to increase early detection, diagnosis, and treatment, as well as to promote general awareness of the disease. So far, the program, which has four units deployed across the country, has screened over 150,000 women.
Most recently, GE Healthcare installed the country’s first new-generation cyclotron production facility in the Children’s Cancer Hospital Egypt, the largest pediatric oncology center of its kind in the Middle East and Africa.
Like Pfizer, GE Healthcare advises the government on policy reforms and assists in the development of assessment programs and management services, with a focus on education and training for local skills development. In March it signed a partnership framework agreement to establish a Biomed Center of Excellence. This agreement, which is supported by the World Health Organization (W.H.O.), is expected to improve the country’s medical technology management system and enhance biomedical services.
Egypt spends less than five percent of its GDP on healthcare, well below the global average of nearly 10 percent. Per capita, that amounted to $151 (in U.S. dollars) in 2013, compared to the global average of $1,038, according to the latest figures from the WHO.
With Egypt’s healthcare sector lagging so far behind many other countries, Western multinational companies see ample room for the market to grow, possibly even doubling over the next five years. Already, many are exploring new trade and investment opportunities. In May the U.S. Department of Commerce led a delegation of six U.S. healthcare companies to Egypt, the fourth such delegation in only six months.
“Egypt is working to increase access to quality healthcare for it citizens through the Healthcare Reform Program,” said Ken Hyatt, U.S. Deputy Under Secretary of Commerce. “The companies on this trade mission can offer the latest in innovative healthcare technology and services.”
Last November, the U.S. Chamber of Commerce, the world’s largest business federation, brought nearly 70 companies to Cairo for meetings with public and private sector leaders, including Egyptian President Abdel Fattah el-Sisi. It was the biggest delegation in the organization’s recent history.
American executives appear confident that expanded foreign trade and investment in Egypt’s healthcare sector will benefit Egyptians, hastening the revival through innovation, economic cooperation and commercial engagement, as well as providing additional pressure for quicker policy reforms and more public spending.
The views presented in this article are the author’s own and do not necessarily represent the views of any other organization.
