Interview: Hossam Badrawi

How significant a concern is overcrowding in hospitals, and what can be done to overcome it?

HOSSAM BADRAWI: The major challenge lies in the distribution and management of bed occupancy rather than the number of beds itself. The bed occupancy rate in government hospitals is around 45%. However, in the absence of a competent referral system, there are problems in distribution between secondary, tertiary and intensive care beds, especially in Upper Egypt. The situation could be alleviated by improving the referral system, developing an automated system for medical records linked to national ID, and establishing a 24-hour call centre for intensive and critical care beds.

How would you rate the public-private partnership (PPP) programme in the health care sector?

BADRAWI: A successful PPP programme requires a stable government that is able to sustain agreements and protect the rights of the private sector. This state of affairs is currently lacking in Egypt. Having said that, there is plenty of potential for investors interested in PPPs, provided they have the right focus.

What sort of competitive advantages does Egypt have to offer in terms of medical tourism?

BADRAWI: Egypt offers many competitive advantages, including its central geographical location and its doctors’ multilingual capabilities. Egypt also has several tertiary care centres with vast experience in cardiac intervention, oncology surgery, chemotherapy and neurosurgery, as well as physical medicine and rehabilitation. All of these are offered at a competitive cost.

Of course, there is room for improvement. Health care projects in South Sinai and Hurghada could become very attractive to medical tourism, particularly in light of the relationship between Egyptian and European health care providers. This can facilitate the provision of services to patients who would otherwise be covered by their national health insurance. To capitalise on this, there should be a selected network of medical centres connected to a specialised promotion centre, in cooperation with the embassies of those countries where potential clients might be found.

How will the rise of non-communicable disease impact the health care sector in the medium term?

BADRAWI: Genetic and environmental factors, along with pollution, noise and the quality of nutrition have all contributed to creating a disease burden. About 26% of Egyptians suffer from hypertension, 14% suffer from diabetes, the obesity rate has substantially increased, and smoking is prevalent among considerable numbers of men and women. As average life expectancy increases over time, health care costs are also forecast to rise accordingly, in order to support an ageing population: 7% of the population is currently over 60 years old.

Egypt urgently needs public health campaigns to prevent the risks of these diseases, as well as further investments in fields such as pharmaceuticals, clinical trials, and tertiary care centres for cerebral interventions, neurosurgery and cardiovascular surgery.

What is your assessment of the current availability of specialised medical services, such as MRI or oncology, to the general public throughout Egypt?

BADRAWI: MRI services are available in Cairo and all the governorates, albeit with a very uneven geographical distribution. For example, there are at least five centres in the Maadi neighbourhood in the south of Cairo alone, but very few by contrast in places such as Upper Egypt or Al Wady Al Jadid. As a result, the quality of reporting in the governorates needs improvement.

Unfortunately, considerations of cost tend to take precedence over considerations of quality in decision-making. Oncology services are well developed, but they are very expensive for families without insurance coverage, and the integration of services following surgery remains insufficient. Similarly, only a few radiotherapy centres in Cairo are able to afford to carry out gamma knife and positron emission tomography procedures.