I would like to warmly congratulate your Excellency and the Ministry of Health and Population for producing this white paper which puts the move towards universal health coverage high on the agenda and outlines a clear vision for the health sector in Egypt.
The white paper is a strong response to the new Constitution’s focus on health; it defines the principles and directions that will guide the Egyptian health sector in translating the constitutional aspirations of the right to health and access to health services into reality.
I am pleased that WHO, together with other development partners, have been supporting the development of this white paper.
It acknowledges the progress made in Egypt on many fronts; for example, in achieving the Millennium Development Goals for maternal and child health. But it also underlines the many challenges remaining.
Under-five mortality is two and half times higher in the poorest 20% of the population than it is in the richest 20%. There are also signs of increased malnutrition among children. This demonstrates the inequalities in health outcomes.
Adding to this is the large contribution that households are paying for health services. Over 70% of total health expenditure is borne by individuals, resulting in challenges in access to services and financial difficulties.
The paper also lays out the double challenges of tackling persistent communicable diseases, such as hepatitis C, and the increasing burden of noncommunicable diseases, such as diabetes and cancer.
The white paper also points out the main system-wide bottlenecks that have marred Egypt for the past few decades.
It notes that many of these problems are a result of low investment in health. The Constitution though gives hope as it defines the target for government health spending to be at least 3% of GDP – this would double current public health spending.
The White Paper gives guidance on how to best use this increased investment in health. More money is urgently needed for public health programmes to address key public health challenges, such as hepatitis C, maternal and child health and noncommunicable diseases.
In addition, expansion of health insurance coverage to all Egyptians is outlined as a long-term goal through a step-by-step approach. This is why I am excited by the current discussions on the draft health insurance law, which promises increased support for people to access health services without incurring financial catastrophe.
Asking for more money is the easy part but ensuring that the money is well spent is a challenge in the current system. This White Paper clearly underlines the challenge of inefficiencies. It points out that health sector reform is needed to achieve better health outcomes for the money spent.
Many countries, including in this region, are moving towards universal health coverage – ensuring access to quality health services for everyone without individuals having to suffer financial hardship to pay for health services. We in WHO have learned that this will require a long-term vision, a national effort, well beyond the Ministry of Health and Population, and high level political commitment at the level of the President and Prime Minister.
National health plans with medium and long-term objectives and clearly defined targets and goals will facilitate progress towards achievement of universal coverage. Reviewing progress on a regular basis and adjusting policies if needed are crucial to stay on track to improve health outcomes.
Once again, I congratulate the Ministry of Health. The white paper is a milestone and will provide guidance for future health policy development in Egypt. WHO and development partners are keen to support the next steps in the process of improving the health of all Egyptians.
