The UAE’s health sector has to overcome challenges before leading its peers
By Leila Hatoum
In a country where the national population sees continued growth alongside a robust rise in the number of expatriates, it is no wonder that the United Arab Emirates is witnessing a year on year rise in demand on healthcare, a vital sector which the country’s government believes should provide top notch services to its residents.
According to Colliers International, the UAE’s population is expected to reach up to 14.5 million in 2018, up from around 9.5 million persons in 2014, should the country’s economic growth patterns and influx in new comers continue.
And with the aging of the young population—where The World Health Organization (WHO), estimates UAE’s size of aging population to be over 15 percent of the population, by 2020—there will likely be “a sharp rise in healthcare demand, as almost 80 percent of a person’s healthcare requirements typically occur after the age of 40-50 years,” estimates Colliers International.
Perhaps that is why the UAE leadership’s “primary interest… is to provide UAE nationals and expatriates, [with] the highest standard and best quality of health care services that fulfill their well-being,” says the UAE’s Minister of Health, Abdul Rahman Bin Mohammed Al Owais.
In his opening message posted on the Health Ministry’s website, Owais says the “country’s progress and development are defined by the sound mind, body, physical and mental safety and well-being of its citizens and residents.” He adds “health, be it for an individual or a country is its true wealth.”
In that respect, the UAE aims to achieve a world-class healthcare system as per its Vision 2021 National Agenda where the government collaborates with “all health authorities to have all public and private hospitals accredited according to clear national and international quality standards of medical services and staff.”
According to information supplied in the Vision 2021 paper, the percentage of ‘Accredited Health Facilities’ in the country—an indicator which measures the share of public and private hospitals adhering to national or internationally recognized standards—is 48 percent as of 2014; the Ministry of Health aims to raise that to 100 percent by 2021.
And despite a projected fall in UAE’s revenues by as much as 22 percent in 2016 due to lower oil prices, according to the International Monetary Fund, the country’s Prime Minister and Ruler of Dubai, Sheikh Mohammed bin Rashid Al Maktoum insisted last October that the country’s “priorities” in the 2016 national budget “will be geared towards social development, education and health.”
Perhaps this is best manifested in the UAE’s 2016 Federal Budget which allocated 7.9 percent or 3.83 billion dirhams ($1.04 billion) of its 48.5 billion dirhams ($13.2 billion) to the health sector.
This comes in line with the country’s aim to position itself “as of one of the world’s leading and respected health care service providers,” according to Owais.
With all this commitment towards enhancing the health sector, and with the introduction of world class facilities to achieve further progress in terms of providing health services, the country also aims to attract patients from abroad, thus competing for a piece of the regional and international “medical tourism” pie.
In the first half of last year, the emirate of Dubai attracted more than 260,000 medical tourists, according to the World Bank, which placed Dubai and Abu Dhabi in the second and third ranks respectively, right after Jordan, as the most popular medical tourism destinations in the region.
The country is also strongly advertising for its health facilities in multiple languages internally, and has succeeded in attracting international health facilities to pledge to open, and even open medical facilities in the country to cater, not only to residents, but also to traveling patients from across the globe.
The multi billion and very lucrative industry is also creating competitors for the UAE in the region. At the moment, Alpen Capital estimates UAE’s healthcare spending accounts for 26 percent of the total GCC spending, and the GCC healthcare market is projected to grow at a 12.1 percent from an estimated $40.3 billion in 2015 to $71.3 billion in 2020, driven by an increase in the population and rising cost of treatment.
But achieving Vision 2021, and further enhancing its health services cannot happen until the UAE tackles the handicaps its healthcare sector faces, be it shortage in trained staff, specialized medical facilities, and proper legal infrastructure to tackle the rapidly growing industry.
Challenges To Overcome
According to professionals within the sector, WHO, and NGOs, the UAE lacks sufficient healthcare facilities catering to niche specialties, and suffers from a shortage in professionals and trained staff within the sector.
According to Colliers International, the major challenge lies in attracting and keeping quality trained staff in the healthcare business, at a time when competitors from within and abroad tend to “poach physicians” and skilled staff, especially those who gain experience in the UAE and look to immigrate elsewhere later on.
Moreover, the number of national graduates specializing in healthcare remains far lower than what the country needs, and the UAE continues to rely on expatriates in this regard, according to WHO.
The international organization adds that the UAE care delivery system “depends on professionals from overseas with high turnover of expatriates comprising 80 percent of doctors and over 90 percent of nurses, which remains a challenge.”
As it stands, the number of physicians per 1,000 population in the UAE is 2.53 as per the country’s Vision 2021, and the Ministry of Health aims to raise that number to 2.9 per 1000 in 2021. Meanwhile, there are 3.16 nurses for every 1000 persons in the UAE, and the aim is to raise this number to 6 nurses per 1000 population by 2021 according to the same source.
Another challenge to tackle is the distribution of hospitals and prime healthcare facilities in urban areas, which comes at the expense of having similar facilities in rural areas across the country. But perhaps, with the introduction of the compulsory health insurance across the UAE, which started early last month, greater participation of private healthcare providers in rural areas in the UAE may be triggered, according to Colliers International.
Meanwhile, the lack of adequate legal infrastructure, also poses a hiccup for the domain’s progress in the UAE.
This is mainly due to the shortage in medical facilities and skilled staff, which means the health market is not saturated and is open to competition and newcomers. But the lack of regulations governing the sector remains an obstacle in the face of progress. With new entrants to the healthcare sector, there is a need to regulate and organize the framework under which they have to operate, each health service based on its own specialty within the sector. And at the moment, the supply of healthcare facilities, according to Colliers International, struggles to keep pace with the burgeoning population. Approximately 36.4 percent of all hospitals within the UAE are owned and operated by the Ministry of Health, which means the majority are operated by the private sector, which the government currently encourages to cover for the shortfalls.
“Although a number of laws, health policies and strategies for different health programs exist at Ministry of Health and Health authorities, there is a need for a consolidated health policy and strategy at the Ministry of Health level and health authorities’ levels to assist in harmonizing health development at all levels,” says WHO in its UAE-country focus, ‘Cooperation Strategy at A Glance.’
l Non-communicable diseases are responsible for 67 percent of the estimated burden of mortality in 2008 in the UAE, says WHO. This includes cardiovascular diseases, diabetes, cancer, and obesity. According to the UAE’s National Agenda the country seeks “to reduce cancer and lifestyle related diseases such as diabetes and cardiovascular diseases,” via supporting preventive medicine.
l Over 60 percent of the population is overweight, according to WHO.
l The International Diabetes Federation says in its most recent report that there are 803,900 diabetics in the UAE alone, out of 37 million diabetics in the Middle East and North Africa region. According to WHO, 20 percent of the UAE population has been diagnosed with diabetes and a further 18 percent is considered at risk of developing diabetes.
l Cardiovascular diseases account for 38 percent of all mortality in the UAE, says WHO, while a survey by the Emirates Cardiac Society shows that nine out of 10 people are at risk of facing a cardiovascular disease.
l High genetic disorders in the UAE are a result of high prevalence of consanguineous marriages in the UAE, hence infant mortality. The average neonatal mortality rate in 2012 was 5, while the average mortality of babies under five years of age was 8 for the same year, according to WHO.
l Tuberculosis remains present in the country though at negligible rates, 2 cases per 100,000 population while the incidence and prevalence of HIV are very low.
l The alarming increase of tobacco use before the age of 14 years (39 percent in 2005, 82.1 percent in 2010) remains a concern, says WHO. The UAE says it aims to “reduce the prevalence of smoking” by 2021.