CAIRO: Current levels of healthcare spending are unacceptable and unable to meet the challenges posed by the health sector in Egypt, the Egyptian Initiatives for Personal Rights (EIPR) said in a press statement issued last week. In a report detailing a roundtable discussion on problems associated with healthcare spending in Egypt, EIPR calls for increased government spending on health, wise use of available resources and civil society participation in decision-making and policies connected with the health sector. The report reveals that a large portion of the population are unable to pay for healthcare and that of the LE 4.6 billion spent annually on medicine, 58 percent of this figure is paid for by patients out of their own pockets. "This is a high figure, and extremely worrying, especially given that the absence of organization or genuine monitoring of drug dispensing in private pharmacies, head of EIPR's health program Alaa Ghanem said in the report. Abdel-Fattah El-Gabaly, head of the Al-Ahram Center for Political and Strategic Studies economic unit, is quoted as saying in the report that there is a wide discrepancy between rural and urban healthcare spending. In addition, the poorest of Egypt s population only benefit from around 16 percent of healthcare spending while the high-income bracket benefits from 24 percent. Healthcare spending in the new annual budget is expected to be around LE 15 billion, or 4.7 percent of the total budget. EIPR points out that this is the same percentage as that of the 2005/2006 budget. "This percentage is less than health spending in other countries with similar levels of development and national income to Egypt. It is also less than the levels proposed by the World Health Organization, EIPR said. In the report El-Gabaly examines the debate surrounding public vs. private healthcare spending. Last year, the administrative court halted government plans to place Egypt s health insurance system under the control of a profit-making company. About half of Egypt s population is insured under this system. Wednesday s edition of Al-Masry Al-Youm meanwhile reported that head of the People s Assembly planning and budget committee, Ahmed Ezz, has called for the ending of state-funded healthcare. El-Gabaly said that as a public commodity, the state must have a role in the administration of healthcare, adding that reliance on market forces as part of private healthcare systems have had more negative than positive results. El-Gabaly also said that the fact that 50 percent of the health budget is directed towards health sector workers wages "could give the impression that wage levels of public health sector workers are high. This is not the case in reality, pointing to the high levels of absenteeism in health units, and the fact that many Ministry of Health doctors are forced to work two jobs to make ends meet as evidence of this. During the roundtable discussion, American University in Cairo professor Samer Suleiman raised the issue of the politicization of the state budget, equating it to a "mirror which reflects political power battles in society. Suleiman gave the example of budgets passed in the 1980s and 1990s when there was a "sharp rise in financial allocations to the Interior Ministry - a natural result of the battle between Islamic groups and the state at that time. The question remains, why is the health sector s share so low? Suleiman suggested that allocation of budget funds to a particular sector is dictated by "the wishes of the ruling regime - which is dependent on the extent to which the regime benefits from the sector - and the extent of the sector s ability to lobby and extract funds. Suleiman said that the role of the Doctors Syndicate in lobbying for improved healthcare spending is undermined by "political polarization and attempts to control the syndicate by the regime and the Muslim Brotherhood. "The continued low levels of government spending - barely 5 percent of expenditures - on health reflect a reduction in individuals share of public spending. This is particularly true if inflation rates and the rise in prices for health services and drugs are taken into account, Ghanem says in the press statement. "Health officials continued references to heath sector reform and widening of the scope of health insurance coverage at a time when their actions indicate an unmistakable decline in concern for health is inexplicable, Ghanem continued.
