Egypt broadened the definition of health spending while public hospital capacity shrank

Egypt's health minister told the government's Egypt Forum that success should be measured by outcomes rather than spending. Mada Masr applied that standard to official CAPMAS data: public-hospital beds fell from 98,291 in 2013 to 84,225 in 2024. Private beds rose from 26,009 to 36,014, but the combined total still declined from 124,300 to 120,239 while the population grew.

The spending measure is equally revealing. Article 18 of the constitution requires public health expenditure of at least 3% of gross national product, rising gradually toward international levels. Mada Masr calculates that the current budget allocates about 1.51% under the conventional measure and that allocations have generally remained below 1.7% since the requirement began in fiscal year 2016/17.

The government now uses a broader definition. It includes expenditure by off-budget economic authorities and companies, police and military hospitals, Al-Azhar hospitals, the universal insurance system and associated programmes. A Finance Ministry source said debt-service allocations for some of those entities can also count as health investment. Broader public-sector accounting is not inherently illegitimate: military or university hospitals do treat patients. The problem is verification. Without published, entity-level figures, outsiders cannot determine whether the expanded total reaches the constitutional floor or whether categories have been changed to make a persistent shortfall disappear.

The government has announced a 50% increase in performance incentives for health workers by 2029/30, 14 new hospitals, 1,000 ambulances and more funding to clear critical waiting lists. Those commitments could improve capacity, but they remain forward promises. The historical record points in the other direction: fewer beds in absolute terms, greater reliance on private provision and public allocations below the old constitutional measure. A credible health-accounting reform would publish both definitions side by side, disclose the off-budget components and connect expenditure to beds, staff, medicine availability and waiting times. Otherwise, the definition improves faster than the service.