Egypt’s health service delivery system has traditionally been highly fragmented, involving multiple actors such as government entities, parastatal organizations, NGOs, and a growing private-for-profit sector, particularly in urban tertiary care. The public sector operates through parallel systems managed by various ministries, with limited separation between financing and service provision. Parastatal bodies serve different population groups but remain under the oversight of the Ministry of Health and Population (MOHP), which also administers programs such as Treatment on the Expense of the State (PTES) for uninsured citizens. Out of pocket is the dominant form of financing (57% 2023) exposing high proportion of the population to financial hardship (Cata 10: 31%)
To address these challenges and align with the Sustainable Development Goals (SDGs), Egypt adopted a comprehensive health sector reform through the Universal Health Insurance System (UHIS) in 2018. This is to fulfil 2014 Constitutional mandate and the 2015 Sustainable Development Strategy (SDS-2030).
The UHIS aims to achieve Universal Health Coverage (UHC) by ensuring equitable access to quality health services without financial hardship. This reform introduced significant institutional restructuring, establishing three core entities:
• Universal Health Insurance Authority (UHIA) as the payer
• Egypt Healthcare Authority (EHA) as the provider
• General Authority for Healthcare Accreditation and Regulation (GAHAR) for quality assurance and accreditation
Additional support is provided by the Unified Purchasing Authority (UPA) and the Egyptian Drug Authority (EDA). While MOHP retains responsibility for public health and emergency services, the new system promotes regulated public-private partnerships and seeks to create a more efficient, equitable, and sustainable healthcare model.
Implementation is rolled out in six phases over 15 years (until 2032) with implementation of phase 1 now completed (governorates: Port Said, Ismailia, Luxor, Suez, South Sinai, and Aswan).

Key features of the law include mandatory family-based coverage and subsidies for vulnerable groups to foster social solidarity. The UHIS also offers optional coverage for Egyptians living abroad and foreign residents under reciprocal agreements. When fully implemented, this transformative reform is expected to guarantee access to quality health services for all without financial hardship, marking a major milestone toward achieving UHC.