Abu Dhabi boasts an advanced health care sector with quality provision of services. Indeed, the response to the Covid-19 pandemic from both federal and emirate-level government health authorities received recognition from international health and humanitarian organisations. The sector’s contribution to Abu Dhabi’s GDP has been trending upwards for a number of years, with government initiatives and strategies aimed at attracting higher levels of private investment bearing fruit. The result is that a number of international hospital brands, specialised health care facilities, pharmaceutical manufacturers and research entities are establishing or strengthening their presence in the emirate. In addition, recent changes to the emirate’s mandatory health insurance regulations have been designed to reduce the cost of doing business in Abu Dhabi.
Federal Oversight
In June 2019 the UAE government launched its National Strategy for Wellbeing 2031, through which it aims to improve the quality of life and the general health of the UAE population. The strategy’s intrinsic focus on health and lifestyle sees the Ministry of Health and Prevention key to its implementation. Lifestyle-related diseases are a significant contributor to the country’s health care costs, with cardiovascular diseases accounting for 40% of mortality. World Bank data for 2021 displays a 16.4% prevalence of diabetes for Emiratis in the age range 20-79. In light of those statistics, successful execution of the strategy could have a far-reaching and positive socio-economic impact.
The ministry, founded in 1971, is responsible for oversight and regulation of the UAE health sector, overseeing the UAE’s portfolio of hospitals and health care facilities, while developing a legislative framework suitable for a country intent on increased global prominence across the multiple dimensions of the health and life sciences segments. Attracting higher levels of international investment and deeper integration of advanced technologies throughout health services and infrastructure are central to the achievement of the government’s goals. The health sector is among the best-developed areas of the national economy, boasting advanced infrastructure, which has seen the country labelled as a world leader across a range of approved health care indicators.
The Ministry of Health and Prevention has worked to raise the sector’s resilience and the quality of care delivered. Preparedness has also been a core focus, one that was recently put to the test with the pandemic. Despite the challenging health crisis, the UAE received international recognition for its handling of the pandemic and its relative success in curbing the spread of the virus, which allowed Abu Dhabi to reopen to tourists in January 2021.
Another goal has been to establish the emirate as a destination for medical tourism. The UAE has become a renowned destination for medical tourism, and Abu Dhabi is working to bolster further the health care segment. Meanwhile, the federal Ministry of Finance sets the budget allocation for the national health care sector, which in 2023 was Dh4.8bn ($1.3bn), consistent with the previous year’s allocation. Those figures accounted for 7.6% and 8.1%, respectively, of the corresponding total annual budgets.
Health Plans
Various health sector-related strategies and programmes are under implementation, with Emirates Health Services, established in June 2010 under the umbrella of the College of Medicine and Health Sciences to improve sector service provision and workforce capabilities, launching its Innovation Strategy 2023-26. Meanwhile, the UAE Genomics Council was formed in 2021 to oversee advances in the area of genetic research. The council will oversee implementation of the new 10-year National Genome Strategy that launched in March 2023 that will work to integrate genomics-related advancements in national health care systems and services, while monitoring related projects. The largest of those projects is the Emirati Genome Programme, which aims to obtain comprehensive data on the genetic make-up of the country’s population.
Abu Dhabi Oversight
The Department of Health (DoH) is the emirate government body responsible for regulating public and private health services in Abu Dhabi, and overseeing the operation of health infrastructure. Privatising areas of the health sector to improve care delivery is a core component of Abu Dhabi’s economic development agenda. DoH has the authority to set regulations at the emirate level, while also being responsible for formulating roadmaps and strategies to guide sector expansion in line with federal laws and regulations.
Seven strategic priorities see DoH implementing initiatives with the goals of improving the mental and physical health of the population; establishing the emirate as a global leader in health care provision; developing a financially sustainable health sector; raising the level of Emirati representation in the health care workforce; becoming a regional leader in life sciences research; becoming a global leader in the area of digital health care services and infrastructure; and maintaining robust, agile governance mechanisms for the sector.
Sovereign Wealth Funds
A number of significant recent developments in the sector have involved the emirate’s sovereign wealth funds, particularly Mubadala and ADQ, which were formed in 2017 and 2018, respectively, to strategically drive Abu Dhabi’s economic development agenda (see Economy chapter), with a strong focus on raising the quality of health care delivery and increasing the emirate’s global health care footprint.
ADQ, in particular, is instrumental in the emirate’s bid to boost its biopharmaceuticals and life sciences segments, with the fund estimating that the value of the UAE-wide pharmaceutical market will exceed $4.7bn by 2025 – 27% higher than its value of $3.7bn in 2021. Supply chain disruption brought by the pandemic has reinforced the resolve of both federal and emirate-level entities to establish the UAE and Abu Dhabi as regional centres for biopharmaceutical research, innovation and production (see analysis). Indeed, the Abu Dhabi Industrial Strategy 2031 includes a core focus on pharmaceuticals manufacturing, with Abu Dhabi Department of Economic Development (ADDED) and DoH among other entities working to facilitate development.
In October 2022 DoH and ADQ signed a memorandum of understanding (MoU) to form a steering committee with the purpose of monitoring and guiding Abu Dhabi’s health investment initiatives, with a core focus on research and innovation projects in the life sciences. The committee will also facilitate the strengthening of linkages between start-ups and small and medium-sized enterprises (SMEs) in order to bolster contributions made by those areas of the business community to improve health outcomes.
In April 2023 Mubadala and Abu Dhabi-based artificial intelligence (AI) specialist G42 Healthcare merged their health-related assets to form a new company, M42. The new entity will work to identify opportunities to expand its international health care presence through pharmaceuticals, health care and health technology-related partnerships and investments. The same month, M42 acquired UK-based Bridgepoint Group’s $2bn-2.5bn-valued Diaverum dialysis clinic chain to create the largest health care firm in the Middle East. The move expands M42’s international health care footprint while also enabling it to bolster its GCC capacities, particularly in the area of renal care and disease.
Further activity for Mubadala saw the entity co-lead a $315m funding round with Singaporean investment firm CBC Group for China-based pharmaceuticals innovation company Hasten Biopharmaceutical in April 2023. The investment will strengthen Mubadala’s presence in the Chinese health care market – a strategic priority for the group – with the funding to be targeted at research designed to advance care for critically ill Chinese patients.
Service Provision
PureHealth owns all public health care facilities in the UAE. In 2021 ADQ purchased a majority shareholding in the company and then in 2022 merged a number of its existing health care assets into PureHealth, forming the largest health care platform in the Middle East. With ADQ’s backing, PureHealth has made a number of significant acquisitions and investments. Those deals include the purchase of a minority equity holding in Ardent Health Services, the fourth-largest private acute care hospital operator in the US, for Dh1.8bn ($490m) in September 2022. The move will afford PureHealth increased access and observational allowances in the US health care market in its bid to better integrate international best practices throughout the UAE health care infrastructure. In August 2023 PureHealth acquired Circle Health Group, the UK’s largest independent operator of hospitals, for Dh4.4bn ($1.2bn), a deal expected to close in the first quarter of 2024.
The Abu Dhabi Health Services Company (SEHA) is a PureHealth asset, and owns and operates all of Abu Dhabi’s public health care facilities, encompassing over 14,000 staff, 14 hospitals, and more than 70 primary and ambulatory care clinics as of September 2023. SEHA is therefore the largest health care service provider in Abu Dhabi and its current goals see it entering into a more diverse range of international partnerships. It is focused on integrating advanced technologies into its operations, while also boosting its research potential and raising its workforce capabilities. Indeed, in June 2022 SEHA signed an MoU with the UAE’s largest vocational training platform, Jaheziya, to provide collaborative training initiatives, focusing on research, for SEHA staff. Furthermore, in October 2022 SEHA signed an MoU with the Children’s Hospital of Philadelphia in the US, with the two entities agreeing to collaborate on development and educational programmes, co-host events and conferences, and engage in knowledge-sharing activities to improve patient experiences and outcomes.
Digital Health
DoH is focused on expanding the role that technology plays throughout the health care sector, playing a leading role in realising the country’s 10-year digital-transformation strategy. Further efforts are designed to build upon the 2019 implementation of the Malaffi health information exchange platform, through which health care data and AI are harnessed to more efficiently collate, store and monitor patient information. This in turn allows for more focused and personalised treatment pathways to be formulated by health care professionals. “Malaffi demonstrates our commitment to establishing a connected health care sector, as a critical enabler of digital transformation. It not only enhances the well-being of residents, but also sets a precedent for health care systems across the region,” Kareem Shahin, acting CEO of Malaffi, told OBG.
Indeed, predictive, personalised health care is one of the central benefits of the Emirati Genome Programme. The implementation of AI and broader advanced technology is core to the achievement of the 10-year strategy’s goals in order to improve decision-making and offer deeper insight regarding patient diagnosis and treatment pathways. Ultimately, DoH aims to provide a patient-centric, value-based health care system. Further enhancing the quality of data contained on the Malaffi platform is expected to be instrumental in creating a comprehensive, centralised digital health care platform, as well as in enabling the development of innovative digital applications that can raise the standard of health care delivery in the emirate.
The Abu Dhabi Life Science Hub in the Metaverse was launched in February 2023, establishing a virtual metaverse presence and headquarters for DoH in the emirate. The overarching aims of the platform include enabling virtual consultations and services between patients and physicians, and deepening interconnectivity and interaction between all industry stakeholders, with entrepreneurs, investors, medical professionals and the authorities encouraged to increase knowledge and idea sharing through the hub’s various facilities and features.
Furthermore, March 2023 brought the announcement that DoH and Israel’s Kahn-Sagol-Maccabi Research and Innovation Centre signed an MoU that will see the two entities collaborate in the areas of technological innovation and health care research, while supporting the integration of science, technology, operational best practices and sustainability in Abu Dhabi’s health care sector.
Boosting Capacities
Strategies and plans currently in operation under the guidance of DoH include the Health Care Capacity Master Plan – launched in 2018 and in the process of being updated as of September 2023 – designed to enable the emirate to respond efficiently to the medical requirements of its population through deepening the culture of forward planning regarding health care capacity and delivery enhancement. The master plan analyses health care preparedness in Abu Dhabi’s three constituent regions – Abu Dhabi City, Al Ain and Al Dhafra – highlighting gaps in infrastructure for interested local and foreign investors.
Abu Dhabi Health Workforce Master Plan focuses specifically on expanding the emirate’s health care workforce, and raising capabilities and capacities. In addition to the drive to train and recruit more UAE nationals, DoH retains a focus on attracting top international talent to the sector. The master plan document contains a comprehensive overview of the workforce, identifying gaps, needs and investment opportunities. Since its 2022 update, the document has been circulated throughout the medical community, as well as with existing and potential investors in order to improve cohesion between DoH’s goals and the actions of health care operators.
In October 2022 DoH announced the launch of its Kawader platform, a digital application that provides job listings in areas such as nursing, emergency medicine and internal medicine. The platform is designed to facilitate progress towards the goals of the Health Workforce Master Plan by making knowledge about opportunities in the space more easily accessible.
In addition, in June 2023 DoH announced plans to create 5000 new health sector job opportunities for Emiratis by the end of 2025. “The UAE is seeing a surge in young Emiratis venturing into medical fields, indicating a bright future for leadership in the sector,” Dr Aly Abdel Razek, executive director of Gulf International Cancer Centre, told OBG. “While the country continues to attract talent from abroad with highly specialised skills, it is encouraging to witness the growth of local talent.” Such developments bode well in light of DoH data included in the updated Health Workforce Master Plan document, suggesting that by 2040 the projected demand for physicians would reach 17,215, and 41,280 for nurses, compared to 2022 demand which was 12,047 for physicians and 30,691 for nurses.
Economic Contribution
According to Statistics Centre – Abu Dhabi (SCAD) in 2021 human health and social work activities’ contribution to GDP amounted to Dh14.4bn ($3.9bn), with quarterly value rising incrementally throughout the year from Dh3.3bn ($900.4m) in the first quarter to Dh3.9bn ($1.1bn) in the fourth quarter of 2021. Moving into 2022, sector GDP continued an upward trajectory, starting at Dh4.1bn ($1.1bn) in the first quarter and finishing the full year with a total of over Dh16.8bn ($4.6bn). Health care’s contribution to GDP remained strong in the first quarter of 2023, albeit taking a dip of 1.6% from Dh4.31bn ($1.2bn) in the fourth quarter of 2022 to Dh4.24bn ($1.2bn). In 2021 human health and social work activities contributed a little over 1.4% to Abu Dhabi’s GDP, while for the period between the first quarter of 2022 and the first quarter of 2023 the sector contributed 1.5% to total GDP.
Demand, Facilities & Staff
According to SCAD, in 2021 there were 159,971 inpatients treated in Abu Dhabi’s health care facilities, marking a significant drop from 186,083 in 2020. Similarly, the number of hospital beds decreased from 9826 in 2020 to 6800 in 2021, a trend that can be explained by the multiple makeshift field hospitals introduced during the pandemic becoming surplus to requirements as the number of Covid-19 cases decreased. The number of hospitals in Abu Dhabi in 2021 was 67. Given that SEHA-owned hospitals account for all public hospitals in the emirate, its 14 facilities amount to just over 21% of the total, with the remaining 79% belonging to the private sector. In 2022 public and private facilities combined were staffed by 29,230 nurses and 11,270 physicians.
Moves towards reinforcing health care capacity in the wake of the pandemic are visible in data offered in 2023 by DoH, which states that there were 8900 inpatient beds in Abu Dhabi that year, close to 31% higher than the 6800 in 2021. According to DoH figures, there were 68 hospitals, 1143 treatment centres, 782 medical, dental, school and first aid clinics, and 1145 inpatient and outpatient pharmacies in the emirate as of the third quarter of 2023.
Open for Investment
DoH is actively seeking private and international investment in Abu Dhabi’s health care sector, with the emirate’s advantageous geographic location and economic stability being touted to entice potential domestic, regional and foreign investors. The department divides its drive to develop the sector into six areas of focus: the provision of health care services to cater to regional needs; the development of medical and nursing education institutions, with DoH targeting regional leadership in this respect; wellness; health care innovation; clinical research; and participation by SMEs in the various areas of care.
The development of the health sector is both a national and emirate-level priority, and investors can expect robust, modern infrastructure, as well as various financial and non-financial incentives to ease their entry into the Abu Dhabi health market. Foreign ownership of up to 100% is allowed in the health sector under the provisions set by the UAE Cabinet and Cabinet Resolution No. 16 of 2020. With respect to foreign direct investment, DoH is keen to attract investment in both inpatient and outpatient facilities such as general, specialised and rehabilitation hospitals; medical centres; one-day surgery centres; and specialised and general clinics.
Opportunities also exist in the manufacture of pharmaceuticals, medical devices, complementary medicines and veterinary medicines, with the emirate looking to localise its medical supply chains – an initiative that was in progress before 2020 and imbued with greater impetus since the pandemic – and position itself as an international centre for biopharmaceuticals and life sciences (see analysis).
Infrastructure Expansion
Recent years saw significant additions to Abu Dhabi’s health care infrastructure, with the 2019 opening of the 741-bed Sheikh Shakhbout Medical City (SSMC) and the 2020 launch of the Global Medical Solutions International Hospital Abu Dhabi. The latter became the emirate’s first international hospital. SSMC was launched through a joint venture between SEHA and US non-profit Mayo Clinic, whose involvement enabled the facility to significantly broaden Abu Dhabi’s catalogue of medical specialties. In January 2023 the partner entities announced the launch of a new advanced clinical trials unit that will deepen research capacities and output in areas such as neurology, rheumatology, haematology, oncology, cardiology, ophthalmology, gastroenterology and paediatrics.
In March 2023 Cleveland Clinic, which established its presence in Abu Dhabi’s health care ecosystem in 2015 with its 364-bed hospital on Al Maryah Island, launched its cancer clinic in the emirate. The 19,050-sq-metre Fatima bint Mubarak Centre offers personalised care for cancer patients, and will benefit from Cleveland Clinic’s advanced global research network and clinical trials. The facility is a significant development in Abu Dhabi’s bid to bolster the preparedness of its health infrastructure, given that cancer is the third most-common cause of death in the UAE and the primary reason that patients travel overseas for treatment. The facility will enable the emirate to localise treatment for some cancer patients, offering advanced cell therapies delivered by a 150-strong workforce of medical professionals.
Meanwhile, ADNOC, the emirate’s oil major, is set to build a new hospital and residential premises on Das Island, 160 km north of Abu Dhabi City. The cornerstone of the new facility was laid in July 2023.
Insurance
Medical insurance in the emirate is mandatory and enforced by the Abu Dhabi Health Insurance Law, which was officially introduced with Law No. 23 of 2005 and enforced starting in June 2006. Policies are grouped into three categories: Thiqa (trust), basic and enhanced. Thiqa has been in operation since 2007 and provides all Emiratis living in Abu Dhabi with 100% coverage for domestic medical costs and 90% for treatments received abroad. Basic policies are for expatriates with limited income, while enhanced packages are for higher-earning expatriates. Until April 2023, employers had to provide health insurance coverage for both Emirati and expatriate employees, one spouse and 50% of coverage for up to three dependents.
Annual premium under regulations pre-April 2023 began at Dh950 ($259), with the ceiling contingent on the range of coverage required. Mandatory features of policies include primary care, dental, maternity care, emergency services, surgeries, testing, medications and X-ray coverage. Any individual without health insurance will incur monthly fines of up to Dh300 ($81.66), while for expatriates this would result in work permits, residency permits, and tourist and work visas not being renewed.
Under those parameters, the cost of health insurance had been cited as a significant barrier for foreign entrepreneurs, companies and investors, given its sizeable impact on the cost of establishing a commercial presence within the emirate. In April 2023 it was announced that following investigation and analysis by a joint task force established by ADDED and DoH, a new flexible health insurance scheme would be launched to respond to the needs of the market and raise Abu Dhabi’s attractiveness as a place to establish a business. Individuals earning more than Dh5000 ($1360) per month are eligible for the new plan, with the basic package starting at Dh750 ($204) and potential premiums rising to Dh150,000 ($40,800). The upper limit can be raised depending on medical treatment needs of patients.
Outlook
With welcoming regulations and an increasing government focus on boosting sector revenue and capacity, Abu Dhabi’s health care sector presents itself as an attractive destination for investment. Interested entrepreneurs, investors and multinationals are offered opportunities across the health care spectrum, with private financing sought in a diverse range of specialty areas including, but not limited to, logistics, manufacturing, medical technologies, and hospital and health centre development. Challenges remain in bringing the prevalence and annual cost of non-communicable and lifestyle-related diseases down, but the emirate’s forward-looking policies and strategies should gradually remedy those issues, and further boost the health care sector’s contribution to socio-economic development and prosperity within the emirate.
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