Just like many parts of the world, Covid-19 has had a dramatic impact on Egypt's healthcare system. When the pandemic was at its peak in April and May, a shortage of intensive care beds and ventilators was a common problem. Non-governmental organisations often stepped in, donating ventilators where and when they could. The ultimate challenge to health providers throughout this year was putting Covid-19 under control to limit its impact on the public. As of January 2021, in Egypt, the virus had affected over 140,000 people and killed more than 7,800. The first medical treatment protocol for the coronavirus was introduced in March last year. It has been changed and amended since then at least four times. Medications were removed and others added or tailored according to individual cases. Egypt has agreed with The Vaccine Alliance, GAVI, to secure its share of the potential vaccine against the epidemic. Though the vaccine does not guarantee 100 per cent protection against the virus, it is essential as it reduces the severity of its symptoms. The vaccine's effect will last from 3-12 months. The government has already reserved doses of the US Pfizer-BioNTech vaccine as well as the British vaccine developed by Oxford University and the Chinese vaccine to cover from 20-30 per cent of the country's needs. Minister of Health and Population Hala Zayed noted that the vaccines have obtained emergency approval from WHO, accordingly, Egypt was able to receive its share. Priority will be for people who are more likely to contract infections, such as doctors, nurses, healthcare workers, seniors and those suffering from chronic diseases. The previously mentioned categories will receive their first dose shot from the Chinese vaccine within the coming few days. On 5 January, the health minister inspected the medical centers which have been designated for receiving the vaccine. According to a press release issued by the Ministry of Health, Zayed has also checked on the process of electronic registration for citizens on the website https://egcovac.mohp.gov.eg/ launched for the vaccination process. The website will soon be activated to receive people's requests for taking the vaccine. The 2014 Constitution affirmed the universal right to healthcare and that the state shall allocate a percentage of GDP on health not less than three per cent, a value that represents almost twice the current governmental expenditure on the health sector. One thing Covid-19 did was prioritise spending on the health sector; the government increased health spending. According to a press release issued by the Ministry of Finance on the state budget for the current fiscal year 2020-21, Egypt increased public spending on health care to about three per cent of its Gross Domestic Product. The increase will be directed to the gradual implementation of Egypt's comprehensive health insurance system which will be expanded to include those unable to access social security pensions. There will be an increase in the allocations for health insurance, medicines and treatment of the needy at the state's expense. Further finance will go to the Public Authority for Health Care. Health sector incentives for doctors and nursing staff also increased. Health experts say the increase in doctors' renumeration will be the beginning of a better appreciation of the role of doctors and an improvement in their working conditions, reasons why many doctors have for years chosen to work abroad. Doctors were on the front line of the fight against the virus. According to the Doctors Syndicate, due to the shortages of personal protective equipment and a lack of adequate safety measures, thousands of doctors tested positive for Covid-19. The virus' death toll among doctors has reached 200. While the coronavirus may have prompted the government to act quickly to meet the challenge, efforts were already underway to overhaul the system. These include the launch of the Universal Health Insurance (UHI) system in late 2019 with the aim of providing all Egyptians with full health coverage, something that the current health insurance system does not provide for. The UHI is being rolled out over several phases with a target to fully cover the country by 2032. “Health outcomes in Egypt mirror epidemiologic transition; increasing prevalence of non-communicable diseases (NCDs) and persistent high levels of selected communicable diseases (CDs) place a huge financial burden on the health system's limited resources,” says a 2019 paper published on the WHO website titled “The Egyptian health map: a guide for evidence-based decision making”. According to the paper, non-communicable diseases, including cardiovascular diseases, diabetes, cancer and chronic respiratory diseases, were the leading national cause of death in Egypt. Non-communicable diseases are estimated to account for 82 per cent of all deaths in Egypt. Cardiovascular disease mortality rates were the highest among NCDs. The past few years also saw the government launching health campaigns to address certain areas of challenge such as virus C. Detection and treatment of virus C was dubbed one of the great accomplishments in the past few years. Fifteen million out of Egypt's 100 million people were infected with virus C, one of the world's highest prevalence of the virus. Each year there were 165,000 new cases in Egypt. And the virus killed around 40,000 a year in Egypt. The president's initiative helped in curing more than 90 per cent of virus C patients and ended waiting lists. The 100 Million Health initiative of virus C was not only limited to Egypt but included 18 African countries for eliminating the virus which has infected one million Africans. The initiative will expand to include hepatitis B. Ahmed Al-Sabaawi, a member of the initiative and rapporteur of the National Committee for Combating Non-Communicable Diseases, pointed out that the 100 Million Health presidential campaign comprised several initiatives seeking the welfare of Egyptians' health. “The most important of these was the elimination of virus C, putting an end to virus C waiting lists, the early detection of breast cancer for women, the early detection of anaemia, obesity and stunting, and the detection of non-communicable diseases such as blood pressure, diabetes, cardiovascular disease,” Al-Sabaawi said. Among the other major achievements of the 100 Million Health presidential initiative is to diagnose and treat newborns with hearing impairments. The initiative which took place in 2019 was not only for screening Egypt's 2.6 million infants with hearing impairments but also providing free treatment through early detection of hearing problems. Among these initiatives is the health campaign “Tomorrow's generation grows healthier” being implemented to meet Egypt's 2030 vision. The initiative took place under the umbrella of the 100 Million Health campaign which targeted the health of school students to actively contribute to their own well-being and provide positive future opportunities in the community. The initiative provides free healthcare to anyone suffering from conditions associated with malnutrition such as anaemia, obesity or stunted growth as well as raising awareness about how to avoid such problems in the future. Among further presidential health initiatives is “Health of Pregnant Women” which kicked off in January 2020 for early detection and treatment of diseases and preventing mother-to-child transmission of infections during pregnancy. There was also the presidential initiative for examining and treating chronic diseases as well as the early detection of nephropathy. It provided screening for chronic diseases such as diabetes, hypertension and cardiac diseases. The initiative also examined patients with renal impairment due to their chronic diseases. The initiative targeted citizens over the age of 40. More than 1.5 million citizens who turned out to be suffering from chronic diseases and more than 500,000 suffering nephropathies were provided free medical treatment. According to Al-Sabaawi, all these initiatives ended many diseases in Egypt. “As a result of the presidential initiatives, 60 per cent of the citizens have been enrolled in the ministry's health files, thus facilitating the process of undergoing future medical examinations for entire families.” *A version of this article appears in print in the 7 January, 2021 edition of Al-Ahram Weekly.
