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German Legal Expertise in the Middle East since 1981

Healthcare in Egypt

Guiding Principle

The general healthcare situation in Egypt are governed by a number of laws including the Labour Law, the Healthcare Insurance Law, the Law on Healthcare in the Public Sector, the Social Insurance Law and the Law for Young People During their Educational Period. With a population of 80 millions (2009) and an expected increase to 92 millions by 2020,Egyptis a very important market for healthcare in theMiddle EastRegion. Healthcare services areprovided through public and private health sectors.Egypthas some of the oldest medical colleges in the Middle East,Africaand the Arab world. Many Arab and African patients e.g. fromLibya,SudanandSaudi Arabialike to come toEgyptfor medical treatment.

A.  Rules and Regulations Governing the Healthcare inEgypt

I.    Labour Law

The unified Labour Law No.12 of 2003. This law comprises 257 articles and addresses all the legal aspects of the Egyptian labour market. It regulates sickness leave in Art. 54, 216, 219 and 256. Itprovides that an employee, whose sickness is attested by a physician, is entitled to sick leave. During the sick leave the employee shall be compensated according to Art. 78 of the Social Insurance Law, i.e. up to six months of paid sick leave per year at between 75% and 100% of the employee’s normal wage. According to Art. 54 of the Labour Law a worker shall be entitled to benefit from his accumulated annual leave in addition to the sick leave. He shall have the right to request his leave of sickness to be transferred to the annual leave balance. An employer shall not terminate the employee’s service due to sickness unless the employee has utilized the above-mentioned period.according to Art. 127 of the Labour Law.

II.  Healthcare Insurance Law

Medical Insurance is covered by the law No. 75 of 1964, law No. 63 of 1964 and law No. 32 of 1975. About 35 Million Egyptians are covered by public Medical Insurance, financed by 1% of citizen’s salary plus 3% from the employer (4% of basic salary). Medical by insurance coverage may be obtained through 41 public hospitals and many subcontracted private hospitals and clinics. The Medical Insurance budget is 120 million US-dollars per annum covering 530 types of medications supplied almost free of charge. A new Medical Insurance Law is currently in Parliament, which would extend the coverage to 60 million citizens including 15 million living belowproperty level. Additionally 17 million students and 9 million babies are to be covered by the state. One million citizens are covered by 15 private insurance firms operating inEgypt ( e.g. BUPA, AIG, Alliance etc).

III. Other Laws (social laws, regional laws)

The healthcare inEgyptis also governed by other laws such as:

1.   Law on Healtcare in the Public Sector, ET-Law No. 32 of 1975

The law is governing the treatment of insurance for civil servants, local government units, public bodies and public institutions who shall be designated on the stages of a decision of the Minister of Health to reduce the financial burdens on the employer 3% of monthly wages to 1.5%, and reduce the burden on workers from 1% to ½% of basic salary. In return for this reduction some financial contributions are added paid by the insured when he get the Service

2.   Social Insurance Law No. 79/1975

The Social Insurance Law No. 79/1975 is governing 5 types of insurances:

1. Old-age insurance, disability and death

2. Accident insurance

3. Sickness insurance

4. Unemployment insurance

5. Insurance of the welfare of the pensioners

Thus, law No. 79 of 1975 confirms the understanding that work accident insurance and sickness insurance are essential components of the system of social insurance.

This law applies to civilian employees of the administrative system of the state, public bodies and public institutions and economic units affiliated to it and its non-economic units and other economic units in the public sector and the private sector, and subject to theprovisions of the Labour Code, shall also apply theprovisions of work injuries to workers under the age of 18 years, trainees, apprentices and students engaged inprojects operating in summer and charged with public service in return for securing participation of patients as follows:

  • The employer’s share 3% of the total monthly wages.
  • Share of the insured 1% of the total monthly wage.
  • It also includes insurance for pensioners of the disease for about 1% of the monthly pension to the pensioner and 2% of the widow’s pension without the employer’s share.

Art. 47 of the Social Insurance Law describes the healthcare services as following:

  • Medical services performed by the general practitioner
  • Home medical care when required
  • Treatment and hospital stay or sanitarium or a specialized center
  • Surgeries and other treatments as necessary
  • X-ray examination and laboratory research “laboratory” and other necessary medical tests and the like.
  • Dispensing of medicines required in all cases referred to above.
  • Theprovision of rehabilitation services and toprovideprosthesis in accordance with the terms and conditions specified by the decision of the Minister of Health in agreement with the Minister of Social Insurance and under Art. 86 of the General Authority for Health Insurance to the minimum amount specified by the Minister of Health (to ensure a minimum quality of service).

3.   Law for Young People During their Educational Period, ET-No.99 of 1992

The Law governs the application of health insurance on the students of all levels of education from kindergarten through secondary school excluding university education:Under this law, each student receives in addition to curative and rehabilitative services, preventive services as follows:

  • A full medical examination at the first enrollment of students at the start of each stage of education.
  • Immunization against diseases.
  • Qualitative examination of the student on a regular basis, or to the circumstances of medical emergency.
  • Providing medical recommendations for the educational requirements for theprovision of health needed to maintain the level of environmental health.
  • Disclosure to the student practitioners of different activities to determine their fitness to carry out these activities.
  • Dissemination of health awareness among the students.
  • Supervision of student nutrition, when applicable.

B.  Healthcare in the in Day to Day Life

Egypthas a long history in healthcare services dating back thousands of years to ancientEgypt. With a population of 80 millions (2009) and an expected increase to 92 millions by 2020,Egyptis a very important market for healthcare in the Middle East Region. Healthcare services areprovided through public and private health sectors.Egypthas some of the oldest medical colleges in the Middle East,Africaand the Arab world, with 25 medical collegesproviding about 10,000 graduating doctors after 6 years of study (following high school certificate) plus one year internship. There are 200,000 physicians registered inEgyptsupported by 75,000 nurses graduating from 260 nursing schools. Foreign doctors are allowed to practice inEgyptunder temporary permits. The average life expectancy inEgypthas increased to 68 years for men and 71 years for women, infant deaths is down from186 in 1960 to 33 in 2008. Egypt in an old pharmaceuticalproducer with 220 licensed pharmaceutical companiesproducing 1,600 types of medicaments covering 93% of local requirements and exporting US $ 300 million worth of medicines to 72 Countries – 85% of active materials are imported. The pharmaceutical market size inEgyptwith 70 international pharmaceutical firms competing is put at 1.8 Billion US $ (2009). Registering a new medicine inEgyptthrough MOH is a costly and time consumingprocess. The pricing of medicaments is controlled inEgyptalso by the MOH. There are 35,000 licensed pharmacies (drug stores) operating inEgypt.Egyptis a large serum & vaccineproducer in the regionproducing 50 million dose per annum, with a growth plan to 150 million doses in 3years. In the past 7 years the Egyptianproduction of medical equipment jumped from US $ 2 million to US $ 94 million (2009), with 130 licensed factories (40 of them are exporting) investing US $ 660 million and employing 10,000 workers, such equipment manufacturers also make disposable syringes, dialysis filters, blood bags, and hospital beds.

C.  The Egyptian Ambulance Service

In 2009 the Ambulance Service received of 813 new ambulances out of the ordered 1500 Kravcr (VW) Ambulance and the further delivery of 400 units for the upgrading of the Egyptian ambulance, which is a part of the upgrade for the field of health care inEgypt. Also, to support this field there is a tracking system for each unit for ambulances to follow-up the patient until the moment of arrival at the hospital and send all reports from inside the ambulance to the hospital. Some of these vehicles are fitted with intensive care equipment and life support. There are several emergency and one day hospitals onEgypt’s highways

The Ambulance and First Aid Law No.8 of 1966 is being updated in intervals.

D.  Healthcare in the in Private Sector

Private hospitals and clinics treat the upper strata’s of society inEgypt. There are 517 private hospitals and thousands of private clinics in Egypt

E.   Healthcare Tourism inEgypt

Many Arab and African patients e.g. fromLibya,SudanandSaudi Arabialike to come toEgyptfor medical treatment. There are many spa areas. Their locations have the advantage of being supported by the medical tourism inEgypt, such the areas of ancient historical fame like Helwan, Ain El Sira, Al Ain Sukhna, Hurghada, Fayoum, the Oasis,Aswan, Sinai, and finally the City ofSafagaon theRed Seacoast, which offers all the elements of treatment and is visited by tourist groups. Sulfur springs and mineral ponds are characterized by a unique formula. Furthermore, the availability of silt in the pools of these sulfur springs with its therapeutic healingproperties cure many bone diseases and diseases of the digestive, respiratory and skin diseases. It alsoprovides treatment for patients with rheumatoid arthritis by burial in the hot sand. Research studies also confirmed that the water of theRed Sea, due to its high mineral content and the presence of chemical from coral reef supports the treatment of psoriasis.

F.   Healthcare in the Public Sector

The public health service is supplied through the Ministry of Health and Population Hospitals (1045), University Hospitals (60), Charity Hospitals and Military Hospitals. The MOH’s budget was 1.2 billions US $ in 2008.

January, 2010 Morad Ahmed and Tarek Mohamed Adel,
Meyer-Reumann & Partners – Alexandria Office
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