Egypt: Score Justification Summary

2026

1.1 Antimicrobial resistance (AMR)

1.1.1 AMR surveillance, detection and reporting

1.1.1a National plan for AMR priority pathogens

Score: 100

There is evidence of an AMR plan in Egypt, and it covers surveillance, detection, and reporting. However, it is important to note that the plan is outdated.

The Egypt National Action Plan for Antimicrobial Resistance (2018-2022) provides clear and extensive evidence of a comprehensive plan for the surveillance, detection, and reporting of priority AMR pathogens. This is a central pillar of the strategy, primarily under Strategic Goal 3: "Strengthen National One-Health Surveillance Efforts to combat resistance that can arise in humans, animals, and the environment." The document details an existing national healthcare-associated infection (HAI) surveillance programme that has been operational since 2011, involving 101 hospitals and monitoring AMR data. It also mentions a fully automated electronic system for this surveillance. Egypt is a member of the WHO's Global Antimicrobial Resistance Surveillance System (GLASS) and has submitted data from 15 sentinel sites (Page 46, Fig. 8). The plan includes activities to strengthen lab capabilities for detection and characterization of AMR across human and animal health sectors (Objective 3.1), including quality assurance through the Central Public Health Laboratory (CPHL) ¹.

According to a news report from the State Information Service on May 13, 2023, the Minister of Health and Population, Dr. Khaled Abdelghaffar, announced the launch of an "Executive Plan to Combat Antimicrobial Resistance". The report confirms that the national AMR program focuses on strengthening AMR surveillance to monitor its spread in the community and healthcare facilities. The Assistant Minister of Health for Preventive Affairs, Dr. Amr Kandil, stated that the plan's objectives include enhancing the capabilities of microbiology laboratories for rapid and efficient diagnosis, as well as strengthening surveillance over the use of antibiotics in hospitals and clinics ². According to a report from Daily News Egypt from March 2025, the Minister of Health reiterated that Egypt launched its National Strategy to Combat Antimicrobial Resistance in 2018 and followed it with the National Antimicrobial Control Plan in May 2023. This recent plan established AMR control programs in hospitals across every governorate, aiming to include 80 hospitals by 2025 ³. However, the 2023 plan is unavailable on the website of the Ministry of Health and Population ⁴.

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

There is evidence of a national laboratory system in Egypt that tests for several priority AMR pathogens, but it does not demonstrate comprehensive, systematic testing for all of the WHO-defined "7+1" priority pathogens across the entire system.

The Egypt National Action Plan for Antimicrobial Resistance (2018-2022) lists the Central Public Health Laboratory (CPHL) as the National Reference Laboratory (NRL) for AMR in the human health sector (Page 45, Strengths #4 & #5). The document provides detailed resistance profiles for: Escherichia coli (Pages 19, 20, 24); Klebsiella pneumoniae (Pages 19, 20); Acinetobacter spp. (Pages 18, 21); "Pseudomonas spp." (Pages 18, 21); Staphylococcus aureus (including MRSA) (Pages 17, 18, 24); and Salmonella spp. (Page 24) ⁵.

The Antimicrobial resistance TrACSS Egypt 2022 country profile, a self-assessment report published by the World Health Organization (WHO), states that the country has reference labs performing AST for "some of the bacteria listed," indicating partial coverage rather than all priority pathogens ⁶.

No further evidence identified on the on the website of the Ministry of Health and Population ⁷.

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is no publicly available evidence to suggest that the Government of Egypt conducts environmental detection or surveillance activities for antimicrobial residues or AMR organisms.

The Antimicrobial resistance TrACSS Egypt 2022 country profile, a self-assessment report published by the World Health Organization (WHO), evaluates the country's AMR activities. In the "Environment" section of the report, Egypt's progress is rated as "in development" for several key indicators. This rating applies to having a national assessment of risks for antimicrobial residues and resistant pathogens in the environment (Indicator 6.1), having legislation to prevent environmental contamination with antimicrobials (Indicator 6.2), and having a regular system for monitoring antimicrobial compounds and resistant bacteria in water quality (Indicator 6.3) ⁸.

The Egyptian National Agricultural Library contains several studies on antibiotic residue in animal meat and dairy products, however the studies only addressed the effect of AMR in food and dairy ⁹. The Central Administration of Laboratories under the Ministry of Health and Population conducts routine tests on food and various water supplies to ensure that they are free from microbes and pollutants and pathogenic microbes, however, no specific mention of AMR is made ¹⁰. Within the Egypt National Action Plan for Antimicrobial Resistance (2018-2022), there is no explicit mention of the Egyptian government conducting environmental detection or surveillance specifically for antimicrobial residues or AMR organisms in soil or waterways ¹¹. A review of the Ministry of Health and Population (MoHP) has not yielded any further evidence ¹².

1.1.2 Antimicrobial control

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 100

Egypt has national legislation and regulations in place requiring prescriptions for antibiotic use for humans.

Within Law No. 127 of 1955 on the Practice of the Pharmacy Profession (published in the Official Gazette on 10 March 1955), Article 32 states that a pharmacist “shall not dispense to the public any medicine prepared in the pharmacy except upon a medical prescription,” and further prohibits dispensing any proprietary pharmaceutical containing substances listed in Schedule (2) except upon a medical prescription, with refills allowed only upon the doctor’s written endorsement (Article 32). Schedule 2 of Law No. 127 of 1955 contains categories of substances and finished products that may only be dispensed upon a medical prescription, and it explicitly includes “antibiotic preparations,” with certain topical exceptions ¹³.

The EDA issued the National Guidelines for Preauthorization of Restricted Antimicrobials in Hospitals (2022), which aim to control the use of specific high-risk antibiotics in hospital settings. According to the Policy Statement (Section 3) of these guidelines, hospitals must create lists of antimicrobials that require preauthorization from a specialist or an antimicrobial stewardship team before being dispensed. This policy applies to certain "Watch" and "Reserve" category antibiotics, such as carbapenems and azithromycin, to prevent their irrational use (Section 7 and Annex I). ¹⁴.

According to the Egyptian National Antimicrobial Formulary published in 2023 by the Central Administration of Pharmaceutical Care under the Egypt Drug Authority, antimicrobials are catalogued with AWaRe categorization and national registration details to guide prescribers and dispensers, indicating regulatory expectations that these agents are used per indication rather than as non‑prescription medicines ¹⁵.

According to a June 2024 news report, the EDA issued a decision tightening dispensing controls for antibiotics, stating that oral antibiotics must not be dispensed without a stamped prescription, and set stricter limits for certain parenteral “Reserve” agents to medical facilities, reflecting stepped-up community‑pharmacy enforcement of prescription-only rules for antimicrobials ¹⁶.

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 50

Egypt has regulations in place requiring prescriptions for antibiotic use for animals. However, there are gaps in enforcement.

According to the Egyptian Drug Authority (EDA) Guidelines on Registration Procedures of Veterinary Pharmaceuticals (2023), veterinary pharmaceuticals (including antibacterial agents) must be registered with EDA, and are handled under the General Administration of Veterinary Pharmaceuticals; registration and market authorization are prerequisites for legal distribution, and dispensing is limited to licensed channels under veterinary regulation, which functionally requires veterinary prescription/authorization for therapeutic use in animals (Section 4: Procedures; General rules) ¹⁷.

As per a May 2025 media report, the EDA is working on regulatory reforms to "restrict the sale of veterinary drugs to licensed veterinary pharmacies…to curb random usage in farms, which can pose serious health and environmental risks". The report states that the chairman of the EDA raised concerns over the unregulated sale of veterinary drugs, "warning that these medicines are often sold in fertilizer stores and small shops without any oversight" ¹⁸.

1.2 Zoonotic disease

1.2.1 National planning for zoonotic diseases/pathogens

1.2.1a Laws/plans on zoonotic disease

Score: 100

Egypt has established comprehensive national legislation, plans, and strategic documents for zoonotic disease prioritization, detection, and reporting.

As detailed on pages 9-10 of the National Strategic Framework for One Health 2023-2027, the Egyptian government issued Prime Minister's Decree No. 101 of 2015 to officially establish the Supreme National Committee to follow up the epidemiological situation of avian influenza, and subsequent efforts expanded this committee's mandate to include other priority zoonotic diseases such as brucellosis, rabies, and Rift Valley fever. According to pages 12-14 of the Strategic Framework, collaborative efforts between the Preventive Sector at the Ministry of Health and Population, the General Organization of Veterinary Services at the Ministry of Agriculture and Land Reclamation, and the Ministry of Environment led to the prioritization of zoonotic diseases based on scientific foundations including incidence and death rates, infection rates, impact on the livestock sector, and capacity for veterinary interventions. The list of priority zoonotic diseases was updated through a One Health Zoonotic Disease Prioritization (OHZDP) workshop conducted in collaboration with WHO and FAO country offices, attended by representatives from multiple ministries, which utilized scientific tools and methods to determine priority health threats. As outlined on pages 39-40 of the Strategic Framework under the technical pillar for Surveillance, Early Warning and Joint Risk Assessment, Egypt's strategy ensures strengthening coordinated surveillance, early warning, and joint risk assessment at the national level ¹⁹.

The National One Health Operational Plan 2024–2027 further operationalizes these strategies on pages 14-15 through activity C.1.1, which includes conducting One Health prioritization exercises to determine priority health threats, and activity C.2.2, which focuses on developing coordinated surveillance guidelines in animal, human, and environmental health sectors including information-sharing mechanisms ²⁰.

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 100

Egypt has established comprehensive national legislation, strategic plans, and operational frameworks that explicitly include measures for risk identification and reduction of zoonotic disease spillover events from animals to humans.

According to pages 10-11 of the National Strategic Framework for One Health 2023-2027, Law No. 152 of 2021 was enacted to address measures for health epidemics and pandemics, allowing the government to take all necessary precautions and actions to respond to epidemics or pandemics, which encompasses zoonotic disease spillover events. This legislative foundation is complemented by Prime Minister's Decree No. 101 of 2015, which officially established the Supreme National Committee to follow up the epidemiological situation of avian influenza, and this decree was proposed to be amended to include follow-up of other zoonotic diseases in addition to addressing the status of antibiotic-resistant microbes. The National Strategic Framework for One Health 2023-2027 dedicates an entire thematic area to controlling and eliminating zoonotic and vector-borne diseases, with specific emphasis on risk reduction and spillover prevention as detailed on pages 26-27. This theme depends on reducing the possibility of emerging epidemics and pandemics of zoonotic origin and minimizing their effects locally through understanding the relationships and factors that cause their emergence and outbreaks ²¹.

Activity "C. Surveillance, Early Warning and Joint Risk Assessment" of the National One Health Operational Plan 2024-2027 lists specific operational for surveillance, early warning, and joint risk assessment to identify and reduce spillover risks, including conducting One Health prioritization exercises to determine priority health threats, adapting tools for joint risk assessment, conducting joint risk assessments for prioritized threats at governorate level, and regularly reviewing and updating joint risk assessments to adapt to changing conditions and emerging pathogens or threats ²².

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 100

Current national strategy documents in Egypt explicitly account for surveillance and control of multiple zoonotic pathogens of public health concern that cover endemic and emerging zoonoses.

According to the National One Health Operational Plan 2024–2027 (Government of Egypt), surveillance and control functions are organized under “C. Surveillance, Early Warning and Joint Risk Assessment,” which mandates a coordinated multisectoral surveillance system across epidemiology and laboratories, mapping existing human, animal, and environmental surveillance systems, and developing coordinated surveillance guidelines and information-sharing across sectors (Section C.2; p. 14 and action matrix items C.2.1–C.2.2 on p. 14 and detailed results outputs on p. 25). The plan specifies joint risk assessments at national and governorate levels to identify priority health threats across pathogens, with periodic updates as new pathogens emerge (Section C.1; p. 14 and p. 25), establishes joint sentinel surveillance sites for priority zoonoses (Results Framework, Output 9; p. 25), and creates One Health Rapid Response Teams for priority diseases and events (Results Framework, Outputs 11–12; p. 25) ²³.

The National Strategic Framework for One Health 2023–2027 defines governance and coordination mechanisms for multi-pathogen zoonotic surveillance and control (“Governance and Leadership” (pp. 33–34)), sets out a process for prioritizing zoonoses to guide surveillance and intervention targeting (“Zoonotic Diseases” (pp. 12–14)), and describes integrated surveillance and laboratory collaboration with joint outbreak investigation and interoperable reporting pathways across ministries to manage multiple priority zoonoses (“Surveillance, Early warning and Joint Risk Assessment” (pp. 38–39)) ²⁴.

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 100

A formal multi-sectoral coordinating mechanism dedicated to zoonotic disease operates across ministries in Egypt.

According to the National One Health Operational Plan 2024–2027, Egypt established a “four-way link task force” in 2011 to share data between the Ministry of Health and Population and the Ministry of Agriculture and Land Reclamation at all levels on priority zoonoses such as avian influenza and Middle East respiratory syndrome coronavirus; this mechanism evolved into the One Health Technical Advisory Group, which expanded participation to include the Ministry of Environment and universities to cover all priority zoonoses and antimicrobial resistance, and a new One Health governance structure with detailed terms of reference was later endorsed by five ministries and multiple national agencies (Introduction; p. 1, p. 3; Establishing the One Health Governance Structure; p. 6). The operational plan assigns the Ministry of Health and Population, the Ministry of Agriculture and Land Reclamation/General Organization for Veterinary Services, and the Ministry of Environment specific roles in joint risk assessment, coordinated epidemiologic and laboratory surveillance, information sharing, sentinel site development, and One Health Rapid Response Team activation (Outputs 6–12 on joint risk assessment, multisector surveillance, sentinel sites, and rapid response; p. 35-43). ²⁵.

1.2.1e Presence of One Health strategic plan

Score: 100

Egypt has its National One Health Operational Plan (2024-2027), launched in April 2023, which outlines the path for implementing One Health in Egypt, deploying five key themes and fulfilling seven technical pillars in each thematic area. ²⁶ The five main themes are: enhancing One Health capacities that ensure collaborative and coordinated activities to prevent health threats; controlling and eliminating zoonotic and vector-borne diseases; joint assessment, management, and communication of risks affecting food and water safety; curbing the silent pandemic of antimicrobial resistance; and integrating the environment into One Health. The objective of the One Health approach is to enhance Egypt’s capacity for prevention, prediction, identification, and response to health threats, as well as to enhance human, animal, plant, and environmental health. It also aims to promote the well-being of all, achieve the Sustainable Development Goals (SDGs), and combat threats to global health security and ecosystems.

1.2.2 Surveillance systems for zoonotic diseases/pathogens

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 100

In Egypt, there is a legal and administrative mechanism that requires livestock owners and keepers to notify the veterinary authority of suspected animal disease, and this feeds into a centralized veterinary surveillance system managed by the General Organization for Veterinary Services.

According to Law No. 53 of 1966 (Agricultural Law), animal owners and keepers “must notify the nearest veterinary clinic or the competent agricultural supervisor” in the event of signs of disease, deaths, or abortions, and must preserve the animal until laboratory results are delivered (Article 127); the law also empowers the Minister of Agriculture to issue executive decrees specifying infectious and epidemic diseases subject to mandatory testing, treatment, or vaccination, and prohibits trade or movement of infected or suspected animals (Articles 125, 129, 131) ²⁷.

According to the World Organisation for Animal Health self-declarations submitted by Egypt in 2021 and 2024, the General Organization for Veterinary Services is the Veterinary Authority with a national epidemiological surveillance network and early warning system that connects central, governorate, and district levels, and it receives and responds to notifications originating from veterinary directorates and units nationwide (Veterinary services description; structure and notification pathways). This centralized system processes reports from field veterinary units that interact directly with animal owners and keepers at village level, operationalizing owner reporting into national surveillance ²⁸²⁹.

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

There is no publicly available evidence that Egypt has laws or guidelines that safeguard the confidentiality of information gathered through surveillance activities for animals (for owners).

Law No. 53 of 1966 (Agricultural Law), which regulate animal disease surveillance in the country, contains no evidence of data confidentiality measures for owners who are required to submit information ³⁰.

A review of the Legal Portal for Egyptian Legislation maintained by the Information and Decision Support Center (IDSC), the Cabinet’s primary think tank and information provider, yields no results about the existence of any such laws or regulations ³¹.

1.2.2c Wildlife zoonotic disease surveillance

Score: 100

National strategy documents and multilateral publications indicate structured surveillance in poultry and livestock, in Egypt.

As detailed on pages 12-13 of the National Strategic Framework for One Health 2023-2027, surveillance and control of priority zoonotic diseases including avian influenza, rabies, brucellosis, and Rift Valley fever demonstrate joint coordination activities carried out through a One Health approach, with formulation of protocols and guidelines for surveillance, control and prevention, strengthening joint surveillance and facilitating exchange of data and information, as well as joint field visits to respond effectively to health emergencies ³².

According to page 14 of the National One Health Operational Plan 2024-2027, specific activities have been established to develop coordinated multisectoral surveillance systems for collection, analysis, and dissemination of data among different sectors, including mapping existing surveillance systems and guidelines, developing coordinated surveillance guidelines in animal, human, and environmental health sectors with information-sharing protocols, and establishing targeted joint sentinel surveillance for priority threats through selection and baseline assessment of joint sentinel surveillance sites ³³.

According to Egypt's "Self-declaration of freedom from High pathogenicity avian influenza (with and without vaccination) in poultry compartments in Egypt" to the World Organisation for Animal Health in 2021, Egypt’s General Organization for Veterinary Services operates a national epidemiological surveillance network and early warning system for poultry, with authorized testing by the National Laboratory for Quality Control of Poultry Production, routine sharing of surveillance results with the General Organization for Veterinary Services, crisis cells activated upon confirmation of outbreaks, and comprehensive surveillance components in the national avian influenza control plan (surveillance components referenced in Annex 6–7; crisis cells and contingency plan Annex 8–9; narrative on surveillance network and early warning system; pp. 19 and Annex 5) ³⁴.

1.2.3 International reporting of animal disease outbreaks

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is publicly available evidence of a mechanism for reporting notifiable diseases to the World Organisation for Animal Health.

According to the World Organisation for Animal Health publication of Egypt’s self-declaration establishing an Equine Disease-Free Zone for equine influenza and equine piroplasmosis, the General Organization for Veterinary Services (GOVS) operates national surveillance and laboratory confirmation systems and submits self-declarations and disease status updates for official recognition under World Organisation for Animal Health procedures. (Section 3) The chairman of GOVS is the head of the veterinary services and the WOAH “OIE” delegate. (Section 3.1) ³⁵

1.2.4 Animal health workforce

1.2.4a Number of veterinarians per 100,000 people

Score: 0

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 0

1.2.5 Private sector and zoonotic disease

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 100

Egypt's national plans on zoonotic disease include mechanisms for working with the private sector in controlling zoonoses.

According to page 12 of the National One Health Operational Plan 2024-2027, the resource mobilization strategy under Activity A.5.2 explicitly includes developing partnerships with the private sector alongside international organizations as part of the resource mobilization approach ³⁶.

In the National Strategic Framework for One Health 2023–2027, one of the themes is "to
implement the One Health approach successfully, through defining the concept, along with the engagement of civil society organizations, community leaders, private sector, and other relevant bodies to help unify efforts and maximize contributions in addressing issues under the One Health" ³⁷.

1.3 Biosecurity

1.3.1 Whole-of-government biosecurity systems

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

There is insufficient evidence that Egypt has in place a record, updated within the past five years of the facilities in which especially dangerous pathogens and toxins are stored or processed, including details on inventories and inventory management systems of those facilities.

According to SciDev, The Ministry of Environment (MoE) has a designated department for medical and electronic waste. This department tracks the incoming waste from all health facilities and ensures the safety of the receipt and delivery process, in addition to monitoring their quantities. According to the department's head, there is a designated person that updates the department's database including the quantity of waste, the time of receipt and the facility it came from. ³⁸ However, there is no record that includes all facilities in which especially dangerous pathogens and toxins are stored or processed. A review of Ministry of Health and Population did not yield further evidence. ³⁹ Furthermore, Egypt is a signatory state to the Biological Weapons Convention. However, there is no evidence that Confidence Building Measures have been submitted yet. ⁴⁰

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 0

No publicly available, cross‑sector Egyptian law or regulation was found that comprehensively and explicitly mandates biosecurity requirements (including facility cybersecurity and incident/failure reporting) for all facilities handling especially dangerous pathogens and toxins.

The Ministry of Health and Population (MoHP) Tuberculosis Laboratories Manual 2015 specifies laboratory biosafety levels and physical containment practices for tuberculosis laboratories: it defines three levels (L1–L3) with increasing controls; requires biosafety cabinets and restricted rooms for L3 laboratories; mandates infection control measures, autoclaving of biological waste before disposal, quality systems, emergency procedures, and detailed operational practices. (pp. 6–10) ⁴³.

No further evidence identified on the MoHP website ⁴⁴.

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

There is insufficient publicly available evidence to determine whether Egypt has an established agency responsible for the enforcement of biosecurity legislation and regulations. It is also unclear whether Egypt has such regulations in place.

According to the Law No. 4 of 1994 on the Environment, hazardous substances and wastes are regulated under Chapter Three “Hazardous Substances and Wastes,” which requires licensing for handling and transport (Article 29), empowers the competent authority to issue detailed rules (Article 30), and requires licensing for disposal facilities (Article 31), bans import without permit (Article 32), and obliges remediation (Article 33); Article 31 and its Executive Regulations are the legal basis under which infectious healthcare waste must be managed in licensed facilities with records and manifests, but these provisions do not set laboratory physical containment standards for especially dangerous pathogens or cybersecurity requirements (Articles 29–33). The law notes that the executive regulations designate the competent authority and authorize follow‑up, sampling, and inspections to ensure registers conform to facts, establishing enforcement by the Egyptian Environmental Affairs Agency and the designated competent administrative authorities over hazardous/infectious medical waste handling and facilities (Articles 29–33; marginal notes indicating inspection powers). ⁴⁵. No other law on biosecurity is listed on the VERTIC database ⁴⁶.

No further evidence identified on the MoHP website ⁴⁷.

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is no publicly available evidence that Egypt has taken action to consolidate national inventories of especially dangerous pathogens and toxins into a minimum number of facilities.

Law Number 4 of 1994 on the Environment regulates hazardous substances and wastes via licensing, handling, and disposal requirements (Articles 29–33), but it does not establish any mechanism to concentrate or consolidate especially dangerous pathogens or toxins into fewer facilities, nor does it reference a national register used for consolidation planning ⁴⁸.

No further evidence identified on the MoHP website ⁵⁰.

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 0

In Egypt, there is no public evidence of in-country capacity to conduct Polymerase Chain Reaction (PCR)–based diagnostic testing for anthrax and/or Ebola.

According to “Crimean‑Congo hemorrhagic fever virus in ticks collected from imported camels in Egypt” (Heliyon, 20 December 2021), laboratories in Egypt detected Crimean‑Congo hemorrhagic fever virus genomes in tick pools using nested reverse transcription Polymerase Chain Reaction and real‑time reverse transcription Polymerase Chain Reaction, confirming molecular capacity for high‑risk zoonotic agents ⁵¹.

However, data pertinent to ebola or anthrax was not identified on the Ministry of Health and Population website ⁵².

1.3.2 Biosecurity training and practices

1.3.2a Biosecurity training using a standardised, required approach

Score: 0

There is no publicly available, nationwide legal instrument that mandates standardized, required biosecurity training via a common curriculum or train‑the‑trainer program for all personnel working with especially dangerous pathogens, toxins, or biological materials with pandemic potential.

The Egyptian National Infection Control Manual published on the Ministry of Health and Population's website in 2020 obliges health facilities to train clinically and laboratory staff in prevention, engineering, environmental control, sterilization, disinfection, and incident management equipment, but it remains a clinical/operational infection control framework and does not establish a uniform, uniform, uniform, cross-sectoral biosecurity curriculum for all laboratories dealing with high-risk agents, toxins, or substances with epidemiological potential ⁵⁴. No other pertinent document linked to biosecurity is listed on the VERTIC database ⁵⁵. The World Health Organization Joint External Evaluation of IHR Core Capacities for Egypt was confirmed to have been conducted in 2018, but the report for the same has not been published on the JEE database ⁵⁶. No data pertinent to biosecurity training was identified on the Ministry of Health and Population website ⁵⁷.

1.3.3 Personnel vetting: regulating access to sensitive locations

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is no publicly available regulation or licensing condition in Egypt that specifies a personnel‑reliability program for individuals with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential that includes mandatory drug testing, criminal background checks, and psychological or mental fitness checks.

According to Law Number 4 of 1994 on the Environment, hazardous substances and wastes are regulated through licensing, inspection, registers, and environmental controls, but the law and its executive regulations do not prescribe personnel reliability requirements such as drug testing, criminal background screening, or psychological fitness evaluations for laboratory or security staff handling high‑risk biological agents (Chapter Three “Hazardous Substances and Wastes,” Articles 29–33) ⁵⁸.

No other pertinent document is listed on the VERTIC database ⁵⁹. The World Health Organization Joint External Evaluation of IHR Core Capacities for Egypt was confirmed to have been conducted in 2018, but the report for the same has not been published on the JEE database ⁶⁰. No regulations mandating such training was identified on the Ministry of Health and Population website ⁶¹.

1.3.4 Transportation security

1.3.4a National transport regulations for Category A and B infectious substances

Score: 100

Egypt has publicly available information on national regulations on the safe and secure transport of infectious substances (specifically including Categories A and B).

According to the Egyptian Civil Aviation Authority regulation “Transport of Dangerous Goods, Issue 7, Revision 0” (2025), Egypt regulates the air transport of dangerous goods, adopting the International Civil Aviation Organization Technical Instructions and International Air Transport Association Dangerous Goods Regulations framework, which includes Division 6.2 infectious substances and the classification to UN 2814/UN 2900 for Category A and UN 3373 for Category B, along with operator and personnel training and acceptance procedures for such shipments. This responsibility is explicitly enumerated in Subpart E (8) of the document, which states that "packages of toxic and infectious substances shall be stowed on an aircraft in accordance with the provisions of the ICAO TECHNICAL INSTRUCTIONS FOR THE SAFE TRANSPORT OF DANGEROUS GOODS BY AIR or the IATA DG Regulations" ⁶².

1.3.5 Cross-border transfer and end-user screening

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

No clear, public evidence was found of a dedicated national export control law or regulation that explicitly governs cross-border transfer licensing and end‑user/end‑use screening for especially dangerous pathogens, toxins, or other biological materials with pandemic potential.

Environment Law No. 4 of 1994 and its executive regime prohibit importing hazardous waste or allowing its entry or transit and require licenses for handling hazardous substances and wastes, but they do not establish an export licensing and end‑user screening system for dangerous biological agents or toxins (Chapter Three “Hazardous Substances and Wastes”) ⁶⁵.

The Egyptian Civil Aviation Authority’s regulations Part 175 “Transport of Dangerous Goods” adopts ICAO/IATA rules for air carriage of dangerous goods, including infectious substances (Category A UN 2814/2900 and Category B UN 3373) and associated operator/shipper training and acceptance checks; however, these are safety/transport rules and do not constitute cross‑border export licensing or end‑user vetting for biological agents ⁶⁶.

1.4 Biosafety

1.4.1 Whole-of-government biosafety systems

1.4.1a Biosafety laws/regulations

Score: 0

Publicly available Egyptian instruments provide biosafety-related requirements in environmental protection, clinical infection control, and laboratory practice, but there is no evidence of a single, comprehensive, cross-sector “national biosafety law”.

According to Law No. 4 of 1994 on the Environment, Chapter Three “Hazardous Substances and Wastes” establishes licensing, handling, transport, and disposal controls for hazardous substances and wastes, and empowers detailed executive regulations; this provides a legal basis for biosafety-adjacent controls (e.g., safe handling, storage, and disposal) but is not a dedicated, unified biosafety statute governing all biological activities, laboratories, and LMOs/GMOs (Articles 29–33) ⁶⁹.

According to the Egyptian Environmental Affairs Agency’s Biosafety Clearing-House institutional page, Egypt established biosafety institutional arrangements under the Cartagena Protocol (national focal point and inter-ministerial mechanisms), indicating an environmental biosafety governance track focused on LMOs/GMOs; however, the page does not present a promulgated, comprehensive national biosafety law text covering all sectors. The source mentions the "historical" establishment of a National Biosafety Committee in 1992, but lists no activities after 1995 or an indication that it forms an important part of the regulatory framework ⁷⁰.

The World Health Organization Joint External Evaluation of IHR Core Capacities for Egypt was confirmed to have been conducted in 2018, but the report for the same has not been published on the JEE database ⁷¹. No evidence of such a body was identified on the Ministry of Health and Population website, the VERTIC database, or the Legal Portal for Egyptian Legislation maintained by the Information and Decision Support Center (IDSC), the Cabinet’s primary think tank and information provider ⁷²⁷³⁷⁴.

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

The World Health Organization Joint External Evaluation of IHR Core Capacities for Egypt was confirmed to have been conducted in 2018, but the report for the same has not been published on the JEE database ⁷⁷. No evidence of such a law was identified on the Ministry of Health and Population website, the VERTIC database, or the Legal Portal for Egyptian Legislation maintained by the Information and Decision Support Center (IDSC), the Cabinet’s primary think tank and information provider ⁷⁸⁷⁹⁸⁰.

1.4.2 Biosafety training and practices

1.4.2a Biosafety training using a standardised, required approach

Score: 0

There is no evidence that Egypt requires biosafety training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential.

According to the Ministry of Health and Population Egyptian National Infection Control Manual published in 2020, the guidelines require facilities to maintain an annual training plan and ensure competency in standard and transmission‑based precautions; however, this is clinical/IPC training and does not constitute a unified national biosafety train‑the‑trainer program for all facilities handling high‑risk biological agents ⁸¹.

No other pertinent document is listed on the VERTIC database ⁸³. The World Health Organization Joint External Evaluation of IHR Core Capacities for Egypt was confirmed to have been conducted in 2018, but the report for the same has not been published on the JEE database ⁸⁴. No regulations mandating such training was identified on the Ministry of Health and Population website ⁸⁵.

1.5 Dual-use research and culture of responsible science

1.5.1 Oversight of dual-use research

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is no publicly available evidence that Egypt has conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, and/or pathogens with pandemic potential and/or other dual-use research.

The Ministry of Health and Population (MoHP) has a Central Administration for Health Research and Development. The administration's webpage states the MoHP maintains regulatory oversight over all research activities (clinical and statistical studies) conducted under the auspices of the MoHP in the field of research or health development ⁸⁶. However, no explicit reference is made regarding dual-use research or such research being conducted by entities not under the auspices of the MoHP.

The MoHP website contains guideline documents on research ethics committees, and the research ethics committee follow up report contains a section where researchers are required to fill out a section detailing suspected unexpected serious adverse reactions, however, this appears to be a self-reporting mechanism rather than an indication of regulatory oversight ⁸⁷⁸⁸. The "Training and Research" section of the MoHP website contains no further pertinent information ⁸⁹.

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is no publicly available evidence that Egypt has a legislation and/or regulation requiring oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research.

The Ministry of Health and Population (MoHP) has a Central Administration for Health Research and Development. The administration's webpage states the MoHP maintains regulatory oversight over all research activities (clinical and statistical studies) conducted under the auspices of the MoHP in the field of research or health development ⁹⁰. However, no explicit reference is made regarding dual-use research or such research being conducted by entities not under the auspices of the MoHP.

The MoHP website contains guideline documents on research ethics committees, and the research ethics committee follow up report contains a section where researchers are required to fill out a section detailing suspected unexpected serious adverse reactions, however, this appears to be a self-reporting mechanism rather than an indication of regulatory oversight ⁹¹⁹². The "Training and Research" section of the MoHP website contains no further pertinent information ⁹³.

The World Health Organization Joint External Evaluation of IHR Core Capacities for Egypt was confirmed to have been conducted in 2018, but the report for the same has not been published on the JEE database ⁹⁴. No evidence of such a law was identified on the Ministry of Health and Population website, the VERTIC database, or the Legal Portal for Egyptian Legislation maintained by the Information and Decision Support Center (IDSC), the Cabinet’s primary think tank and information provider ⁹⁵⁹⁶⁹⁷.

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is no publicly available evidence that Egypt has an agency responsible for overseeing research with especially dangerous pathogens, toxins, and/or pathogens with pandemic potential or dual-use research.

The Ministry of Health and Population (MoHP) has a Central Administration for Health Research and Development. The administration's webpage states the MoHP maintains regulatory oversight over all research activities (clinical and statistical studies) conducted under the auspices of the MoHP in the field of research or health development ⁹⁸. However, no explicit reference is made regarding dual-use research or such research being conducted by entities not under the auspices of the MoHP.

The MoHP website contains guideline documents on research ethics committees, and the research ethics committee follow up report contains a section where researchers are required to fill out a section detailing suspected unexpected serious adverse reactions, however, this appears to be a self-reporting mechanism rather than an indication of regulatory oversight ⁹⁹¹⁰⁰. The "Training and Research" section of the MoHP website contains no further pertinent information ¹⁰¹.

The World Health Organization Joint External Evaluation of IHR Core Capacities for Egypt was confirmed to have been conducted in 2018, but the report for the same has not been published on the JEE database ¹⁰². No evidence of such an agency was identified on the Ministry of Health and Population website, the VERTIC database, or the Legal Portal for Egyptian Legislation maintained by the Information and Decision Support Center (IDSC), the Cabinet’s primary think tank and information provider ¹⁰³¹⁰⁴¹⁰⁵.

1.5.2 Screening requirements for providers of genetic material

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is no publicly available evidence that Egypt has a legislation and/or regulation requiring the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before it is sold.

According to the Egyptian Environmental Affairs Agency’s Biosafety Clearing-House institutional page, Egypt established biosafety institutional arrangements under the Cartagena Protocol (national focal point and inter-ministerial mechanisms), indicating an environmental biosafety governance track focused on LMOs/GMOs; however, the page does not present a promulgated, comprehensive national biosafety law text covering all sectors. The source mentions the existence of a Biosafety Law for Release of Genetically Modified Products being promulgated in 2011, but there is no evidence of the same on government portals ¹⁰⁶¹⁰⁷.

The World Health Organization Joint External Evaluation of IHR Core Capacities for Egypt was confirmed to have been conducted in 2018, but the report for the same has not been published on the JEE database ¹⁰⁸. No evidence of such a law was identified on the Ministry of Health and Population website, the VERTIC database, or the Legal Portal for Egyptian Legislation maintained by the Information and Decision Support Center (IDSC), the Cabinet’s primary think tank and information provider ¹⁰⁹¹¹⁰¹¹¹.

1.6 Immunization

1.6.1 Vaccination rates

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 100

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 100

Official foot-and-mouth (FMD) vaccination figures for livestock in Egypt are publicly available through the World Organisation for Animal Health (WOAH) database.

The latest available data refers to the second semester of 2023. ¹¹²

1.6.1c Equitablenature of national immunization strategy/plan

Score: 100

Egypt has a national immunization planning framework anchored in a current government strategy, and there is public evidence of equity-focused outreach activities embedded in implementation to reach hard-to-reach and vulnerable groups.

According to the Egypt National Health Strategy 2024–2030, immunization is embedded as part of preventive and primary health care within the national strategy, which identifies the Expanded Programme on Immunization (EPI) among core services delivered through the public system (p. 28) ¹¹³.

The Egypt National Strategy for Vaccine Manufacturing Localization 2024–2030 published by the Government of Egypt explicitly states that the Ministry of Health and Population covers vaccines for the Expanded Programme on Immunization, listing routine vaccines provided free of charge, and outlines mechanisms to secure supply, regulatory facilitation by the Egyptian Drug Authority, and coordination among local manufacturers to ensure availability. While focused on production localization, it evidences a national planning approach that supports equitable provision by maintaining no-cost access and stable supply for EPI (pp. 21, 31 on EPI coverage, vaccine list, and EDA regulatory/oversight support) ¹¹⁴.

According to the document on “Outreach vaccination activities in Egypt” (published by the Eastern Mediterranean Public Health Network in collaboration with the Ministry of Health and Population for 2024-2025), the program’s objective is to strengthen routine immunization coverage and enhance population immunity among vulnerable and hard‑to‑reach populations, explicitly targeting nomadic and mobile groups, displaced persons, families in low‑coverage areas, and high‑risk governorates; the plan details monthly outreach sessions, supervision by EPI officers, and community awareness ¹¹⁵.

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 0

Egypt's national health strategy and associated public health initiatives include measures designed to address public trust and awareness, but there is little evidence that there are specific measures to address vaccine hesitancy and build public trust in vaccines.

Within the Egypt National Health Strategy 2024–2030, a sub-objective of the Ministry of Health and Population (MoHP) is to " Implement open communication practices, share
public health data, and address community concerns actively to promote transparency
and accountability. Building trust and confidence in public health initiatives is crucial", and that progress for this objective will be tracked through "public trust and confidence in public health initiatives as measured through surveys or community engagement metrics." (Page 96). However, no specific measures to address vaccine hesitancy and build public trust in vaccines were identified ¹¹⁶.

According to a report from the Eastern Mediterranean Public Health Network (EMPHNET) titled "Outreach vaccination activities in Egypt" (2024), a project funded by the U.S. Centers for Disease Control and Prevention (CDC) includes direct measures to build community trust. The project, which aims to strengthen routine immunization coverage among vulnerable and hard-to-reach groups, includes "community awareness initiatives" as a core component. The plan also specifies that healthcare teams will engage with "community leaders to encourage participation" ¹¹⁷.

No further evidence identified on the MoHP website ¹¹⁸.

1.6.1e National advisory group for immunization strategy/plan

Score: 100

Egypt has a national immuniation technical advisory group, but information about its activities is limited on government websites.

National Immunization Technical Advisory Groups (NITAGs) are multidisciplinary bodies of national experts that provide evidence-based recommendations to policy-makers and immunization programme managers recognized by the WHO ¹¹⁹. As per the NITAG Resource Center maintained by the Global NITAG Network, Egypt's NITAG operates on a clear legislative and administrative basis, guided by formal terms of reference, with a conflict of interest policy in place, representation from at least five areas of expertise, annual meetings as a minimum, and ensures that the agenda and background papers are circulated at least one week in advance ¹²⁰.

However, no evidence of NITAG activities were identified on the website of the Ministry of Health and Population ¹²¹. However, as per a WHO report from 2024, " In Bahrain, Egypt, Iraq, Jordan, Lebanon, Oman, and Saudi Arabia NITAG has played a vital role in supporting evidence-informed influenza vaccination decision-making as well as in evidence-based studies to introduce new vaccines or add specific target groups" .

1.6.1f Presence of an immunization programme for influenza

Score: 0

Egypt has an influenza immunization programme, but only for certain at-risk groups and not as a nationwide policy.

According to the Ministry of Health and Population published “Preparedness Plan for Pandemic Influenza” (2018-2019), the plan commits to the WHO Pandemic Influenza Preparedness Framework and includes actions to “make effective safe vaccine available” and “administer the vaccine as rapidly as possible to all Egyptians at risk of the pandemic influenza infection,” and it emphasizes increasing seasonal influenza vaccination coverage among high‑risk groups, with roles for health directorates and the national focal point, confirming a government‑led vaccination approach within preparedness and routine seasonal contexts (Preparedness Plan for Pandemic Influenza; p. 27 and preceding vaccine provisions) ¹²².

According to the WHO Eastern Mediterranean Region country page on “Egypt”, national guidance recommends seasonal influenza vaccination for high‑risk groups including health workers in fever and chest hospitals, people working on poultry farms, rapid response teams, veterinarians, and pilgrims going to Saudi Arabia for Hajj, evidencing defined national target populations for annual vaccination aligned to Ministry of Health implementation ¹²³.

No further evidence identified on the Ministry of Health and Population website ¹²⁴.

1.7 Climate change adaptation and vector transmission

1.7.1 Health system resilience

1.7.1a Strategy/plan for resilience of health system

Score: 100

Egypt has a national climate change strategy, and it includes considerations that specifically addresses the evolving threat of infectious diseases and changing weather patterns.

Within the Egypt National Climate Change Strategy 2050 (published jointly by the Ministry of Environment/Egyptian Environmental Affairs Agency, 2022), Goal 2 explicitly aims to “protect citizens from the negative health impacts of climate change” and sets out concrete measures tied to infectious disease threats and changing weather patterns: enhancing preparedness for climate‑related diseases; studying impacts on bacteria, parasites, fungi, and viruses; training health teams on climate‑related health risks; strengthening preventive services “especially those related to vaccination and immunization against infection”; establishing early warning and control programs; implementing epidemiological forecasting and proactive surveillance for climate‑related emergencies; and strengthening monitoring/reporting for traditional, emerging, and unfamiliar infections (Goal 2, Objective 2.a; pp. 19–20). To achieve this, the strategy calls for improving health services, increasing the health sector's preparedness for climate-related diseases, and training healthcare teams to handle risks like heat stroke. The plan also emphasizes the need for an infrastructure that can provide adequate healthcare and proactive surveillance of climate-related emergencies ¹²⁵.

However, the National Strategic Framework for One Health 2023–2027 outlines "a need to consolidate all aspects of climate change into a single document that can serve as a key reference to ensure that the climate change dimension is integrated into the
overall planning of all sectors in the government" ¹²⁶.

Early Detection

2.1 Laboratory systems strength and quality

2.1.1 Lab capacity for detecting priority diseases

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 0

There is no evidence that the national laboratory system has the capacity to conduct diagnostic tests for at least 5 of the 10 WHO-defined core tests.

A review of the official website of the Egyptian Ministry of Health and Population, including its sections on the Central Labs and available services, did not yield a publication that explicitly names the WHO-defined core tests that the national laboratory system is equipped to perform ¹²⁷. The section on "Services provided by the Central Administration of Laboratories" does not provide any relevant evidence ¹²⁸.

2.1.1b Plan to conduct testing during a public health emergency

Score: 0

Egypt has a disease-specific plan and a general One Health operational plan which outline considerations for scaling capacity and goals for testing, but not novel pathogens.

According to the Influenza Pandemic Preparedness Plan (2018) published by the Egyptian Ministry of Health and Population, a comprehensive strategy exists for laboratory services during a public health emergency. The "Laboratory services" pillar of the plan outlines measures for scaling capacity, including supporting the Central Public Health Laboratories and regional laboratories with necessary reagents and supplies, as well as conducting training for laboratory workers on sample collection and transfer (Page 67-70). It contains targeted scaling, such as to "Support Epidemiological surveillance efforts to track the spread and trend and impact of the pandemic, e.g. shift laboratory testing priorities from testing all suspected specimens to testing samples from any newly affected area to monitor disease spread", and specific measures to ensure the laboratory system is utilized effectively ¹²⁹.

Further evidence of a strategic approach is found in the National One Health Operational Plan 2024–2027, a government publication developed in collaboration with the WHO and other partners. This plan aims to activate a strategic framework to "enhance Egypt’s capacity for prevention, prediction, identification, and response to health threats" (p. 3). It explicitly includes the goal of establishing a "Coordinated multisectoral surveillance system (Epi & Lab) for collection, analysis and dissemination of data" and strengthening "early warning systems for rapid detection and response to health threats" (p. 25) ¹³⁰.

No further evidence identified on the Ministry of Health and Population website ¹³¹.

2.1.2 Laboratory quality systems

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 100

Egypt has a national laboratory that serves as a reference facility which is accredited.

The Reference Laboratory for Egyptian University Hospitals under the Supreme Council For University Hospitals is ISO 15189:2022 compliant, with the accreditation having been granted by the Egyptian Accreditation Council (EGAC) ¹³². EGAC is recognized for accrediting medical laboratories to ISO 15189 by the International Laboratory Accreditation Cooperation (ILAC), Arab Accreditation Cooperation (ARAC), and African Accreditation Cooperation (AFRAC) ¹³³.

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 100

Public sources show that Egypt’s national reference laboratories participate in formal external quality assurance and accreditation processes.

The Eastern Mediterranean Region Polio Laboratory Network (World Health Organization, EMRO) webpage states that all network laboratories undergo regular WHO accreditation, including proficiency testing panels, onsite reviews, and performance monitoring. Egypt hosts a national polio reference and a regional polio intratypic differentiation laboratory within this network, making it subject to WHO’s external quality assurance and accreditation cycle ¹³⁴. As per a 2024 published US-government Center for Disease Control report about Egypt, the CPHL (Central Public Health Laboratory), under the Ministry of Health and Population is officially Egypt’s national reference laboratory and is a WHO-designated National Influenza Center, which " routinely provides technical assistance and training to CPHL. This training includes support for sub-national laboratories" ¹³⁵.

The Reference Laboratory for Egyptian University Hospitals under the Supreme Council For University Hospitals is ISO 15189:2022 compliant, with the accreditation having been granted by the Egyptian Accreditation Council (EGAC) ¹³⁶. EGAC is recognized for accrediting medical laboratories to ISO 15189 by the International Laboratory Accreditation Cooperation (ILAC), Arab Accreditation Cooperation (ARAC), and African Accreditation Cooperation (AFRAC) ¹³⁷.

However, no information about the CPHL or its activities is published on the Ministry of Health and Population website ¹³⁸.
.

2.2 Laboratory supply chains

2.2.1 Specimen referral and transport system

2.2.1a Nationwide specimen transport system

Score: 100

Public sources indicate that Egypt has a nationwide specimen transport system, which operates through dedicated national disease surveillance programmes and is underpinned by national accreditation standards that mandate procedures for safe specimen handling and transport.

According to the World Health Organization Regional Office for the Eastern Mediterranean (WHO EMRO) Egypt country profile for polio (updated 2025), a well-functioning nationwide surveillance system for acute flaccid paralysis (AFP) is in place. This system requires the systematic collection and transport of stool specimens from suspected polio cases across all 27 governorates to the WHO-accredited national polio laboratory in Giza. The system’s performance is monitored against international standards, including timeliness of specimen arrival ¹³⁹.

The General Authority for Healthcare Accreditation and Regulation Handbook for Clinical Laboratories Standards – Edition 2021 outlines detailed requirements for pre-examination processes, including defining and monitoring transport conditions in section 4, subsection on "Specimens requesting, collection, handling and transportation". The standards' chapter on supply chain manageement requires all laboratories to ensure that "supplies used in the collection, processing, preservation, testing, storage, distribution and transport of specimens meet predefined acceptance criteria" mentioned within the document ¹⁴⁰.

2.2.2 Laboratory cooperation and coordination

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 0

There is no evidence of a formal government-published document that confirms Egypt can scale up its national laboratory capacity during a public health emergency.

A review of the official website of the Egyptian Ministry of Health and Population did not yield a publicly available national plan, strategy, or specific regulation for the rapid authorization or licensing of external laboratories (e.g., private or university labs) to supplement national capacity during a public health emergency ¹⁴¹.

However, according to the World Health Organization report, "Egypt: a primary health care case study in the context of the COVID-19 pandemic" (2022), Egypt demonstrated the ability to scale its diagnostic capacity in an emergency. At the beginning of the pandemic, testing was confined to a single centralized laboratory. This was subsequently expanded to a network of 57 testing centers across the country. The response also included the establishment of a Higher Virology Committee to develop and revise testing guidelines. However, the same report notes an implementation gap, stating that "despite relatively well-developed laboratory networks, some stakeholders consulted in this study felt that testing remained at a lower level than required" (p. 5) ¹⁴².

2.3 Real-time surveillance and reporting

2.3.1 Indicator and event-based surveillance and reporting systems

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 100

Indicator-based surveillance is legally mandated and operates through a national electronic platform in Egypt.

Law No. 137 of 1958 on Health Precautions for the Prevention of Infectious Diseases forms the legal foundation for the country's indicator-based surveillance system. Article 1 of the law defines which diseases are considered infectious and notifiable by referencing a formal, annexed table, which the Minister of Health is empowered to update. The core of the surveillance mandate is outlined in Article 12, which requires the immediate reporting of any person who is infected or suspected of being infected with one of the listed diseases to the competent health officer. Article 13 further clarifies the legal responsibility for this notification and mandates that the report must contain sufficient information (name, age, location, and work) to allow health authorities to locate the infected individual ¹⁴³.

According to a WHO Regional Office for the Eastern Mediterranean publication quarterly bulletin from April 2024, Egypt has successfully integrated its indicator-based surveillance (IBS) with a national electronic event-based surveillance (EBS) system established in 2018. This integration, which includes linking to WHO’s Epidemic Intelligence from Open Sources (EIOS) platform, "significantly improved the system’s ability to identify, analyse and validate public health threats in real-time." The report further notes that to enhance this real-time capability, the Ministry of Health and Population is working on developing a mobile application to facilitate immediate reporting from multiple sectors (p. 6) ¹⁴⁴.

According to the Ministry of Health and Population published "National Surveillance Guideline of Healthcare Acquired Infections," the government operates the HAI National Electronic Surveillance and Reporting (HAI-NESR) system. This system evolved from a project initiated in 2011 and now utilizes a smartphone application for trained infection control personnel to submit data electronically to the MOHP surveillance database. The guideline states that surveillance reports are "automatically generated" and can be directly accessed by participating hospitals via the HAI-NESR website ¹⁴⁵. This electronic framework was officially confirmed in an announcement by the Ministry of Health and Population in April 2024 regarding the launch of the updated "National Electronic Program for the Surveillance of Healthcare-Associated Infections." A statement from the ministry spokesperson, carried by the State Information Service, explained that the General Administration for Infection Control at the MoHP conducts "real-time monitoring of the data dashboard, and data analysis and performance indicators at the republic level" ¹⁴⁶.

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

There is publicly available evidence of a mechanism for reporting notifiable diseases to the World Health Organization (WHO) in Egypt.

The WHO Regional Office for the Eastern Mediterranean (EMRO) confirms that as part of its implementation of the IHR (2005), Egypt has completed the "identification of a national official responsible for IHR" ¹⁴⁷. However, no evidence about the official or their activities were identified on the Ministry of Health and Population website ¹⁴⁸.

2.3.2 Interoperable, interconnected, electronic real-time reporting systems

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

Egypt operates an electronic disease surveillance system that functions at both the national and sub-national levels, integrating data from peripheral health facilities up to the central ministry.

According to a presentation by the Ministry of Health and Population at a World Health Organization (WHO) EIOS Global Technical Meeting, titled “Participatory Surveillance In Egypt” (2022), the government operates the National Electronic Disease Surveillance System (NEDSS). In the section “Reporting Sources, Levels and Human resources” it shows that NEDSS reporting covers districts, directorates and governorates. (p. 7) The “Phases of EBS Implementation” section mentions expansion of electronic reporting from pilot / initial areas to all governorates, as well as to district level. ¹⁴⁹.

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 50

The Egyptian government operates an electronic disease surveillance system at both the national and sub-national levels. This system collects ongoing laboratory data and allows for data to be disaggregated by demographic characteristics like age. However, this is not real time.

According to a 2022 academic paper, "Evaluation of the National Electronic Disease Surveillance System for COVID-19 in Egypt, 2020", Egypt has a well-established electronic reporting system. The Egypt National Disease Surveillance (NEDSS), established in 2002, electronically reports on 41 infectious diseases. The system operates at both national and sub-national levels, with reporting sites that include all Egyptian governorates, districts, governmental infectious disease hospitals, and primary health units. The evaluation found that the median duration between a patient's admission and the subsequent report was 2.7 days ¹⁵⁰.

A review of the official website for the Egyptian Ministry of Health and Population confirms the mandate of the "General Administration of Epidemiology and Surveillance". The department's responsibilities include proposing necessary indicators to monitor and evaluate the surveillance system, such as incidence rates, prevalence rates, and morbidity rates. However, while the website affirms the government's role in disease surveillance, it does not provide specific technical details about the electronic system, its real-time capabilities, or its data disaggregation fields ¹⁵¹.

2.3.3 Wastewater surveillance

2.3.3a National wastewater surveillance programme or initiative

Score: 100

There is evidence of ongoing national wastewater and environmental surveillance in Egypt.

According to the WHO, Egypt has a vast and well-functioning polio surveillance system, consisting of surveillance for acute flaccid paralysis (AFP) by health workers across the country, and environmental surveillance of sewage runoff. The WHO states that Egypt consistently meets both of the international standards of polio surveillance, even during outbreak. Environmental surveillance has been in place in Egypt since 2000 and workers are given regular training and refresher sessions. Forty-six collection sites operate across the country’s 27 provinces, with at least one in each province. Sites operate on the basis of monthly collection, but since the start of the 2021 outbreak, any site that collects a VDPV2 positive sample moves to a twice-monthly schedule.¹⁵²

2.4 Surveillance data accessibility and transparency

2.4.1 Coverage and use of electronic health records

2.4.1a Common usage of electronic health records

Score: 50

There is evidence that electronic health records (EHRs) / electronic medical records (EMRs) are being adopted in Egypt, but the use is not yet universal nor evenly mature across all settings.

According to the Egypt Healthcare Authority (EHA), part of the Ministry of Health systems under the Universal Health Insurance System, about 4.5 million electronic health records have been created for citizens in the provinces where the universal health insurance system is applied, and primary health care units and centers in those provinces are “fully digitized” in workflow and archiving. The EHA states that hospitals in those provinces have fully computerized systems for their internal workflows, and electronic referral systems are also implemented ¹⁵³. An academic study (“AI-Driven Electronic Health Records System for Enhancing Patient Data Management and Diagnostic Support in Egypt”, 2025) estimates as of October 2024 only 314 hospitals had implemented some form of EHR system ¹⁵⁴.

2.4.1b Public health system access to individual electronic health records

Score: 0

There is no evidence that Egypt’s national public health system uniformly has access to individual electronic health records (EHRs) across the country.

The Universal Health Insurance Law No. 2 of 2018 (Egypt) mandates universal health coverage for all citizens and residents, establishes regulatory bodies (Universal Health Insurance Authority, Egypt Healthcare Authority, General Authority for Healthcare Accreditation and Regulation), and sets out phased implementation across governorates by 2032. However, the text of the law does not explicitly provide that the national public health system has access to the full electronic health records of all individuals ¹⁵⁵.

No evidence of such access was identified on the Ministry of Health and Population and Egypt Healthcare Authority websites ¹⁵⁶¹⁵⁷.

2.4.1c Existence of data standards for health record data comparability

Score: 0

There is no evidence that Egypt’s national public health system uniformly has access to individual electronic health records (EHRs) across the country.

No evidence of such access was identified on the Ministry of Health and Population and Egypt Healthcare Authority websites ¹⁵⁹¹⁶⁰.

Egypt’s National Health Strategy 2024 2030 explicitly includes the goal to ‘implement national health information standards and interoperability frameworks, utilizing HL7 FHIR or similar standards’ as a key action ¹⁶¹. This demonstrates strategic commitment to data comparability. However, these remain targets rather than fully operational, uniformly applied technical standards, and there is no clear public evidence that these standards are already widely implemented across all health facilities ¹⁶².

2.4.2 Data integration between human, animal and environmental health sectors

2.4.2a Data sharing mechanisms

Score: 100

There is evidence that Egypt has established formal mechanisms for data sharing among human, animal, and environmental health (wildlife) surveillance via its One Health framework.

The National One Health Operational Plan 2024-2027 (2024) describes the establishment of a “four-way link task force” linking the Ministry of Health and Population (MOHP), the Ministry of Agriculture and Land Reclamation (MOALR), the Ministry of Environment, and universities to enable sharing of data on zoonotic and epidemic-prone diseases. This is found in section 3.1: Surveillance and Early Warning (p. 18), where routine data exchange is presented as a task for task-force members ¹⁶³.

The National One Health Strategic Framework 2023-2027 (2023) includes a component under its governance and leadership theme that requires policy-making processes and multisectoral committees to ensure regular data sharing. In particular, section “Governance and Leadership” (section 2.2) obliges the creation of Technical Working Groups that bring together the ministries of human health, animal health, and environment, to coordinate zoonotic disease surveillance, vector-borne disease monitoring (including mosquito surveillance), and wildlife aspects ¹⁶⁴.

Egypt established a ‘4-Way Linking’ Task Force / platform (since ~2011) that brings together the Ministry of Health and Population (MoHP), Ministry of Agriculture and Land Reclamation (MoALR), and Ministry of Environment (MoE) to share data, jointly assess risks, and coordinate zoonoses surveillance ¹⁶⁵. The 4-Way Linking initiative evolved into the One Health Technical Advisory Group (OH-TAG), which regularly convenes stakeholders from human, animal and environmental health sectors to exchange epidemiological / laboratory information, discuss outbreaks, antimicrobial resistance (AMR), and perform joint risk assessments ¹⁶⁶.

2.4.3 Transparency of surveillance data

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 0

There is no evidence that Egypt publishes de-identified health surveillance data on infectious diseases via reports.

According to a presentation by the Ministry of Health and Population at a World Health Organization (WHO) EIOS Global Technical Meeting, titled “Participatory Surveillance In Egypt” (2022), the MoHP has a list of communicable diseases under surveillance (Group A, immediate reporting; Group B, 48-hour reporting) which includes ICD-10 disease codes, disease lists, and reporting times, though not raw line-list data (p. 9). However, there is no evidence of this aggregated data on the websites of the Ministry of Health and Population and Egypt Healthcare Authority ¹⁶⁷¹⁶⁸.

2.4.4 Ethical considerations during surveillance

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

In Egypt, there is legislation that safeguards the confidentiality of identifiable health or other sensitive personal information, including what might arise through health surveillance.

The principal law is Law No. 151 of 2020 on the Personal Data Protection Law (PDPL), which came into effect in October 2020. Under PDPL, “sensitive personal data” explicitly includes health data. Article 12 (Chapter Six) restricts the collection, storing, processing, transferring or disclosing of sensitive personal data except with explicit written consent of the data subject, or via a license issued by the Personal Data Protection Centre ¹⁶⁹. Additionally, Law No. 8 of 2021 on Blood Operations and Plasma Collection for Manufacturing and Exportation of its Derivatives requires confidentiality of donor (and recipient) information. Specifically, Article 16 of Law No. 8/2021 states that “all entities working in the field of blood operations and plasma collection shall be committed to the confidentiality of the donor and receiver data and not to disclose them” ¹⁷⁰.

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 100

Egypt has legislation that safeguards identifiable health information, including provisions that relate to protection from cyber incidents or data breaches.

Law No. 151 of 2020 on Personal Data Protection (PDPL) in Article 4 requires the controller to “adopt all technical and regulatory procedures and apply the necessary standard criteria … ensuring confidentiality … preventing any hack, damage, alteration or manipulation through any illegitimate procedure.” Article 12 treats health data as “sensitive personal data” ¹⁷¹.

2.4.5 International data sharing

2.4.5a Cooperative commitments or agreements within regions

Score: 0

There is no evidence that the Egyptian government has made commitments through international agreements and cooperative actions to share surveillance data during public health emergencies.

As per a May 2024 report by the U.S. Centers for Disease Control and Prevention (CDC), the CDC "supports capacity building in surveillance, laboratory diagnostics, and data management and reporting focused on complying with International Health Regulations. CDC supported trainings for surveillance data analysis and data visualization to provide timely data for policy makers." It further states that "Egypt’s Central Public Health Laboratory (CPHL) virology lab serves as the nation’s reference laboratory. CPHL is a WHO-designated National Influenza Center. WHO Collaborating Center at CDC's Influenza Division routinely provides technical assistance and training to CPHL. This training includes support for sub-national laboratories. CPHL regularly shares influenza data and specimens with WHO Collaborating Centers. This data helps inform biannual global recommendations for influenza vaccine antigen composition" ¹⁷².

In practice, the Egyptian Ministry of Health and Population (MOHP) has demonstrated this commitment through its response to regional health crises. For instance, the MOHP deployed its DHIS2 (District Health Information Software 2) platform to support humanitarian efforts for refugees from Sudan and injured civilians from Gaza. For the response in Gaza, the system was used to register patients, record key health data including diagnoses using ICD-10 codes, and manage referrals across more than 30 hospitals ¹⁷³.

However, there is no evidence of a document that concretises data sharing commitments on the websites of the Ministry of Health and Population and Egypt Healthcare Authority ¹⁷⁴¹⁷⁵.

Moreover, the country's adherence to the International Health Regulations (IHR 2005) serves as a primary legal and operational commitment. As a signatory, Egypt is obligated to notify the World Health Organization (WHO) of public health events that may constitute a public health emergency of international concern. This legally binding framework necessitates the sharing of surveillance data with the WHO but does not specify provisions to share with other countries. ¹⁷⁶

2.5 Case-based investigation

2.5.1 Case investigation and contact tracing

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 50

There is evidence that the national government supports sub-national systems, but only in response to active public health emergencies.

The Ministry of Health and Population’s report on Efforts of the Egyptian State in Facing the COVID-19 Pandemic (2021) describes continued training of health cadres, establishment of rapid response teams, maintenance of laboratory capacity across governorates and a risk-communication unit, and explicitly notes ongoing training schedules for primary care and hospital teams ¹⁷⁷. The World Bank’s “Egypt COVID-19 Emergency Response Project” describe deployment of digital apps (for example Sehet/EGY Health) and local contact-tracing operations during 2020–2021, indicating that the national level provided technical platforms and episodic operational support for tracing activities during the pandemic ¹⁷⁸. However, there is no evidence of a document that establishes a permanent, nationally-budgeted, metrics-standardization programme on the websites of the Ministry of Health and Population and Egypt Healthcare Authority ¹⁷⁹¹⁸⁰.

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

There is insufficient evidence that Egypt provides wraparound services to enable infected people and their contacts to self isolate or quarantine as recommended, particularly economic support and medical attention.

While there is no evidence that Egypt provides services to help patients/suspected cases to self-isolate, the only type of services there is evidence Egypt provides are hospital care and isolation services for hospitalized Covid patients and economic relief for the most disadvantaged ¹⁸¹¹⁸²¹⁸³.

2.5.2 Point of entry management

2.5.2a Strategy for tracing and quarantining international travelers

Score: 100

Egypt's national health strategy contains an objective and a coordination mechanism between the between the public health system and border control authorities for upgrading the country's border quarantine capacities.

Within the Egypt National Health Strategy 2024–2030, a "key action" is to "boost the capabilities of Egyptian border quarantine" by augmenting human resources, upgrading infrastructure, and equipping all entry points to ensure efficient public health screening and disease control. This will be achieved by increasing the number of trained and equipped personnel dedicated to border health screening, upgrading infrastructure and technology at airports, seaports, and land border crossings for more efficient and accurate screening, and reducing the time required for passenger clearance. The Ministry of Health and Population (MoHP) will serve as the key implementing agency, working in close coordination with the Ministry of Civil Aviation and the Ministry of Transport for this objective (p. 78) ¹⁸⁴.

2.6 Epidemiology workforce

2.6.1 Existence of applied epidemiology training program such FETP and FETPV

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

Egypt has an official Field Epidemiology Training Program.

According to the official Egypt Field Epidemiology Training Program website, the program was established in 1993 in collaboration with the U.S. Centers for Disease Control and Prevention (CDC) and was the second of its kind in the Eastern Mediterranean Region. The Egypt FETP is fully institutionalized and integrated within the Department of Epidemiology and Surveillance at the Ministry of Health and Population (MOHP). The program is built on a service-based training model where over 75% of the training involves hands-on fieldwork, a core principle of FETPs globally ¹⁸⁵. Egypt has also adapted its basic and intermediate programs to a blended learning modality, combining online and in-person instruction with support from the Eastern Mediterranean Public Health Network (EMPHNET) ¹⁸⁶.

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 100

Field epidemiology training programs in Egypt are explicitly inclusive of animal health professionals through a deliberately integrated, multisectoral approach, rather than offering a separate program like a Field Epidemiology Training Program for Veterinarians (FETPV).

Egypt's One Health Field Epidemiology Training Programme celebrated the graduation of its first cohort in April 2025. The six-month training initiative was designed to foster collaboration across the human, animal, and environmental health sectors. Key partners in this program include the Ministry of Agriculture, alongside the Ministry of Health and Population and the Ministry of Environment, ensuring that personnel from the animal health sector are core participants ¹⁸⁷. Another FETP focused on vector control was launched in July 2025 with support from the Pandemic Fund. As per a July 2025 WHO article, the inaugural training involved 32 participants described as "mainly agricultural engineers from the human and animal sectors" ¹⁸⁸.

2.6.2 Epidemiology workforce capacity

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 0

There is no public evidence that Egypt has at least 1 trained field epidemiologist per 200,000 people. The population of Egypt as per a 2024 Central Agency for Public Mobilization and Statistics (CAPMAS) report from is 105,914,499 ¹⁸⁹. As per a July 2025 WHO media report, Egypt has 385 trained epidemiologists graduated from the national FETP programme since 1993 ¹⁹⁰. Even if all 385 are still working, the number is roughly 1 in 276,600.

Rapid Response

3.1 Emergency preparedness and response planning

3.1.1 National public health emergency preparedness and response plan

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 100

There is evidence that Egypt has a funded, publicly available, public health emergency plan in place.

Priority IV of the Egypt National Health Strategy 2024–2030, titled "Enhancing Prevention, Preparedness, Detection and Response for Health Security," explicitly addresses planning for multiple communicable diseases with epidemic and pandemic potential, as detailed across pages 148-155 within Section 4.4 of the document. The strategy outlines Key Action 1 under this priority, which focuses on enhancing health system resilience by strengthening emergency preparedness, prevention, detection and response at all levels to prevent, detect, respond to, and recover from public health emergencies and disasters, while maintaining essential health services and aligning with global agendas including the International Health Regulations and pandemic accord. Additionally, Key Action 2 specifically mandates the development of a National Action Plan for Health Security (NAPHS), with indicators including the development and finalization of NAPHS within an agreed timeframe and the percentage of national health priorities and strategies integrated into NAPHS ¹⁹¹.

The "Influenza Pandemic Preparedness Plan" (2018), published by the Ministry of Health and Population, is publicly available and contains a section outlining the activation of government machinery during any health crisis (section on 'Command and control to cope with the emergency health crisis', p. 42). Although specific to influenza, its structure and all-of-government approach detailed within serve as a model for a national emergency response ¹⁹².

According to The Pandemic Fund, Egypt was awarded USD 23 million for a project titled "Egypt's Resilience to Pandemics" (October 2024), which aims to develop a robust prevention, preparedness, and response system. This funding, supplemented by over US$20 million in co-financing, directly supports the core capacities outlined in the national plans, such as enhancing disease surveillance, enabling laboratories to diagnose pathogens with pandemic potential, and developing a skilled One Health workforce ¹⁹³.

3.1.1b National public health emergency response plan published in past 3 years

Score: 100

Egypt's overarching plan was updated in 2023.

The Egypt National Health Strategy 2024–2030 serves as an overarching framework for public health security and explicitly addresses preparedness and response to multiple communicable diseases with epidemic and pandemic potential. Within Priority IV, “Enhancing prevention, preparedness, detection and response for health security,” the Strategy outlines objectives including integrated disease surveillance, laboratory network strengthening, One Health coordination, deployment of rapid response teams, and compliance with International Health Regulations (IHR) ¹⁹⁴.

3.1.1c One health principles by covering multiple threat types

Score: 100

Egypt’s national emergency preparedness plan applies One Health principles across zoonotic spillover, antimicrobial resistance, and biological hazards, including accidental or intentional releases.

Egypt National Health Strategy 2024-2030, the overarching national public health emergency response plan, does comprehensively follow One Health principles by covering multiple threat types, including antimicrobial resistance, zoonotic disease spillover, biological accidents, and deliberate acts. As outlined in Priority IV, Section 4.4 on pages 148-155, Key Action 5 specifically mandates the implementation of the One Health National Strategic Framework 2023-2027 to address the interconnections between human, animal, plant, and environmental health. Within the detailed key actions enumerated on pages 168-171, the strategy systematically addresses zoonotic diseases through Key Action 2, which focuses on reducing the risks of zoonotic diseases, endemic diseases, vector-borne diseases, and neglected tropical diseases, with indicators including decrease in incidence rates of priority zoonotic diseases, improvement in early detection and rapid response capacity for emerging zoonotic and other threats, and increased public awareness about risk factors and prevention measures. Key Action 4 on pages 170-171 mandates reducing the risk of antimicrobial resistance through strengthened antimicrobial stewardship programmes and adherence to responsible prescribing practices, with indicators including decreased antibiotic use in both human and animal health sectors, and reduced prevalence of antibiotic-resistant bacteria in humans, animals, and food-producing environments. Priority IV, Key Action 1 on pages 148-155 addresses emergency preparedness, prevention, detection, and response at all levels to prevent, detect, respond to, and recover from public health emergencies and disasters. The strategy further reinforces the One Health approach through Key Action 3 on development and implementation of robust One Health-based systems for food and water safety risk assessment, reduction in outbreaks of foodborne and waterborne diseases linked to zoonotic pathogens, and increased compliance with national and international food and water safety standards ¹⁹⁵.

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 100

The Egypt National Health Strategy 2024–2030 incorporates health equity and the needs of vulnerable populations as components of its overarching public health framework, another component of which is emergency preparedness.

Under Priority IV's first objective on "Enhance health system resilience," the strategy emphasizes "sustainable, equitable resource allocation" and calls for strengthening emergency preparedness "at all levels" while "maintaining essential health services." The strategy includes a dedicated objective to "Provide comprehensive healthcare and support services to refugees and migrants to ensure they receive timely and appropriate care and have access to essential health services." The strategy extensively addresses mechanisms for identifying and serving vulnerable populations, including implementation of evidence-based social programmes targeting key determinants of health inequities such as "poverty, housing, education, food insecurity" through initiatives like Takaful, Karama, and Haya Karima. Targeted interventions to address specific needs of "vulnerable and marginalized populations, focusing on health disparity reduction" are included within the document (pp. 122-126, Priority II, Objective 5) ¹⁹⁶.

3.1.2 Private sector involvement in response planning

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 100

Egypt's National Health Strategy 2024-2030 contains mechanisms for engaging with the private sector in outbreak emergency preparedness and response.

The strategy establishes a dedicated Public-Private Partnership (PPP) framework for private sector engagement under Priority I, Objective 7, which contains an objective to "Promote private sector engagement in the health sector with the aim of improving healthcare accessibility, quality and efficiency." The partnership development process described includes conducting stakeholder analysis to identify potential partners with expertise in healthcare, technology, and innovation, and developing comprehensive frameworks that outline "roles, responsibilities, and objectives" with a specific focus on "risk allocation, financing mechanisms, and performance monitoring." (P. 55) Priority IV, Objective 1 explicitly include "Private Sector" as key partners in emergency preparedness activities. The strategy calls for strengthening "governance and financing structures for sustainable, equitable resource allocation and enhanced coordination and collaboration across government agencies, healthcare providers, and civil society. Priority VI establishES mechanisms for private sector engagement in emergency preparedness through technology partnerships. The strategy includes private sector involvement in developing "health information exchange (HIE) platform for secure data sharing across healthcare providers and institutions," "AI-powered clinical decision support systems (CDSS) for early disease diagnosis," and collaboration in "predictive analytics and machine learning algorithms to anticipate disease outbreaks." (p. 204) ¹⁹⁷

3.1.3 Non-pharmaceutical interventions planning

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 50

Egypt has a comprehensive plan implement non-pharmaceutical interventions (NPIs) during a pandemic, but the plan exists only for one disease.

Chapter 6 of the "Influenza Pandemic Preparedness Plan" (2018) published by the Ministry of Health and Population titled "Preventive Measures," is dedicated entirely to NPIs (p. 81). The chapter outlines a detailed, multi-layered strategy that includes: Personal Protective Measures, such as promoting hand hygiene and respiratory etiquette; Environmental Measures, involving routine cleaning of surfaces; and Social Distancing Measures, which encompass the isolation of sick individuals, voluntary home quarantine for contacts, and considerations for school closures, event cancellations, and travel-related restrictions (pp. 81-91) ¹⁹⁸. However, no evidence of any other plans identified on the MoHP website ¹⁹⁹.

3.2 Exercising response plans

3.2.1 Activating response plans

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 100

There is evidence that in the past year Egypt has completed a national-level, biological threat-focused exercise in June 2024.

A World Health Organization (WHO) report from September 2024, titled "Egypt's CBRN orientation workshop and functional drill," describes a relevant exercise involving a practical simulation. According to the report, "the World Health Organization (WHO) Regional Office for the Eastern Mediterranean, in partnership with the WHO Country Office in Egypt and the Egyptian Ministry of Health and Population, held a series of hands-on training workshops in Ismailia, Egypt with the goal of equipping health care workers and first responders with the skills and knowledge needed to handle chemical, biological, radiological and nuclear (CBRN) emergencies" ²⁰⁰.

A review of the publications section of the website for the Egyptian Ministry of Health and Population did not yield any press releases, reports, or other documents announcing the activation of the national emergency plan or the completion of a national-level biological threat exercise within the last year ²⁰¹.

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 0

There is no evidence that Egypt in the past year has identified a list of gaps and best practices or developed a plan to improve response capabilities.

As per a WHO-Egypt Flash Appeal 2025 published by the government during the escalation of conflict in the occupied Palestinian territory, Egypt’s Ministry of Health and Population (MoHP), together with the Egyptian Healthcare Authority and the Egyptian Red Crescent, rapidly implemented Egypt’s health emergency response platform to manage the influx of medical evacuees through the Rafah border in February 2025. This included deploying fully equipped ambulances, activating a multi-line hospital referral pathway, and a coordinated response involving regular needs assessments, resource optimization, and real-time reporting. Pillar IV of the "WHO Egypt Response Pillars" is dedicated to "Strengthening disease surveillance and outbreak control measures", with 16.66% of the fund appealed for earmarked for this purpose ²⁰².

A review of the publications section of the website for the Egyptian Ministry of Health and Population did not yield any press releases, reports, or other documents outlining gaps or best practices ²⁰³.

3.2.2 Private sector engagement in exercises

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is no evidence that Egypt has completed a national-level biological threat-focused exercise in the last year.

According to the World Health Organization’s report "Strengthening the public health response to the risks posed by cross-border population movement" (September 1, 2025), Egypt convened a sub-regional tabletop simulation exercise in Cairo from August 18–20, 2025, in partnership with Libya, Sudan, and Tunisia. This exercise directly focused on national and cross-border coordination mechanisms for infectious disease outbreaks, testing Egypt’s capacity to respond to large-scale biological threats, and was conducted jointly with WHO and the relevant ministries ²⁰⁴.

A review of the publications section of the website for the Egyptian Ministry of Health and Population did not yield a national-level biological threat-focused exercise in the last year ²⁰⁵.

3.3 Emergency response operation

3.3.1 Emergency response operation

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

Egypt has a multi-layered system of Emergency Operations Centers (EOCs) in place, operating at both the national and governorate levels to coordinate responses to various crises, including public health emergencies.

Egypt Healthcare Authority (EHA), the state's main arm for regulating and providing healthcare services under the Universal Health Insurance System, operates a dedicated network of EOCs. According to a January 2025 announcement from the EHA, the authority has been inaugurating Central Emergency and Crisis Management Operations Rooms in governorates where the new health insurance system is active, such as Aswan, Port Said, Luxor, Ismailia, and South Sinai ²⁰⁶. A central emergency room at the EHA headquarters in Cairo convenes daily during crises to coordinate with these governorate-level rooms, the Ministry of Health and Population (MOHP), and the Egyptian Ambulance Organization ²⁰⁷. As stated by the EHA, these operations rooms are not just for reactive emergency response but also function as proactive tools for analyzing incoming data to enable early detection of public health threats and implement preventive measures ²⁰⁸²⁰⁹.

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 100

Egypt’s public health emergency response framework includes both a formal requirement for annual drills at the facility level and recent evidence of national-level exercises being conducted.

The Egypt National Health Strategy 2024-2030 lists the "Frequency and scope of multi-agency health emergency simulation exercises conducted annually" as a key indicator of the country's health security preparedness ²¹⁰. According to a 2024 World Health Organization report, a multi-day functional drill focused on Chemical, Biological, Radiological, and Nuclear (CBRN) threats was conducted from June 23 to 27, 2024. This hands-on training and exercise involved medical staff from the Egyptian Healthcare Authority (EHA) and first responders from the Egyptian Ambulance Organization, two of the primary state entities responsible for emergency response ²¹¹. Additional evidence of exercises being conducted is found in the WHO Egypt Health Emergencies Programme Achievements Report, 2024, which documents a tabletop exercise and an emergency preparedness plan exercise held at the Suez Medical Complex ²¹².

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is no publicly available evidence to demonstrate that Egypt's Emergency Operations Center (EOC) has conducted a coordinated emergency response or exercise that was activated within 120 minutes of the identification of a public health emergency or scenario in the past year.

While it is established that Egypt has a functional EOC network and conducts regular emergency drills, the publicly accessible documentation for these events does not specify the activation time. For example, a World Health Organization's report "Enhancing preparedness: Egypt's CBRN orientation workshop and functional drill" describes the multi-day exercise in detail but does not provide information on the precise timeline from scenario identification to EOC activation ²¹³. Similarly, reports from the Egypt Healthcare Authority (EHA) on the activation of its emergency rooms for specific events, such as national holidays, confirm that the EOCs are operational but do not contain the specific performance metric of activation within 120 minutes ²¹⁴. No further evidence identified on the Ministry of Health and Population website ²¹⁵.

3.4 Linking public health and security authorities

3.4.1 Public health and security authorities linked for a biological event

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 100

Egypt conducted a multisectoral exercise within the last year to respond to a potential deliberate biological event.There are no publicly available standard operating procedures (SOPs), guidelines, or memorandums of understanding (MOUs) that specifically address a coordinated, multisectoral response to a potential deliberate biological event or bioterrorism attack in Egypt.

In June 2024, Egypt's health authorities, in partnership with the World Health Organization, conducted a multi-day functional drill focused on Chemical, Biological, Radiological, and Nuclear (CBRN) threats. According to a WHO report titled "Enhancing preparedness: Egypt's CBRN orientation workshop and functional drill" (September 15, 2024), the exercise specifically trained participants in "recognizing potential signs of a CBRN event, including deliberate attack indicators," directly addressing the scenario of a bioterrorism attack. The drill involved participants from key public health and national response bodies, including medical staff from the Egypt Healthcare Authority and first responders from the Egyptian Ambulance Organization ²¹⁶. No further evidence identified on the Ministry of Health and Population website ²¹⁷.

3.5 Risk communication

3.5.1 Risk communication planning

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 100

Egypt has a risk communication plan for public health emergencies detailed within its national strategy documents, and there is public evidence of this plan being operationalized.

A specific and detailed risk communication plan is contained within the "Influenza Pandemic Preparedness Plan" (2018), published by the Ministry of Health and Population. Chapter 5 of this document, titled "Information, Education and Communication (IEC)," serves as the national risk communication plan for a pandemic even]. The plan outlines a comprehensive strategy with clear objectives, including raising public awareness about the disease, promoting preventive behaviors, providing timely and accurate information to counter rumors, and maintaining public trust. It identifies specific target audiences, such as the general public, healthcare workers, travelers, and the media, and details the key messages to be delivered during different phases of a pandemic. The plan also establishes a governance structure for communication, creating a central media committee led by the Minister of Health's advisor for media affairs and designating official spokespersons to ensure the centralized and credible release of information [1].

The National One Health Operational Plan 2024–2027 contains a dedicated section, Technical Pillar E, titled "Effective Risk Communication and Community Engagement," which outlines a comprehensive plan with the stated goal to "Raise and enhance awareness regarding One Health and priority health threats". A key component of the plan is activity E.1.2, which mandates the drafting or updating of specific "risk communication and community engagement (RCCE) strategies for priority threats". Implementation guidelines include a multi-pronged approach to disseminate information, which involves creating "harmonized awareness materials targeted at different audiences," conducting workshops for media representatives to ensure accurate reporting, and engaging directly with at-risk populations such as farmers and breeders through community meetings and awareness campaigns (p. 17) [2].

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 100

Egypt's national risk communication plan outlines how messages will be adapted and delivered to reach diverse populations and sectors with different communication needs.

The strategy is detailed within the National One Health Operational Plan 2024–2027. Technical Pillar E of this plan, "Effective Risk Communication and Community Engagement," mandates a tailored approach to public messaging. Specifically, Activity E.2.1 requires the government to "Review and produce risk communication and harmonized awareness materials targeted at different audiences using adapted communication channels". The plan also identifies specific sectors for engagement, such as in Activity E.2.3, which calls for "awareness campaigns and community meetings for target communities (farmers, breeders, etc.)" to ensure messages reach specific occupational groups who may be at higher risk for certain zoonotic diseases (p. 17) ²¹⁸.

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 100

Egypt has a risk communication plan for public health emergencies detailed within its national strategy documents, and there is public evidence of this plan being operationalized.

A specific and detailed risk communication plan is contained within the "Influenza Pandemic Preparedness Plan" (2018), published by the Ministry of Health and Population. As per the "Command and Control" section of the document, " for coordinating whole-of-government planning and response during a national crisis that has national significance and impact, a National Superior Committee (NSC) is formed during emergency health crisis." One of the listed responsibilities of the NSC is "information management and communication with the media and social mobilization" ²¹⁹.

3.5.2 Public health systems communication

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

There is public evidence from the past year that Egypt's public health system has actively shared messages via online media platforms to inform the public and has a demonstrated strategy for dispelling misinformation. The government's communication approach leverages official websites, social media, and dedicated mobile applications.

In the past year, the Ministry of Health and Population (MOHP) has continued communication efforts that were scaled up during the COVID-19 pandemic. For instance, a joint project between the MOHP, the World Health Organization, and USAID, which concluded in June 2024, explicitly included a component to "expand risk communication and community engagement" ²²⁰. The official spokesperson for the MOHP, Hossam Abdel Ghaffar, has been actively communicating developments regarding the country's healthcare digitalization efforts throughout 2024 and 2025, using public announcements to inform citizens about major initiatives like the issuance of nearly 20 million electronic treatment approvals ²²¹. These efforts are part of a broader push toward digital citizen engagement, which includes the development of a "Universal Health Insurance Citizen-Engagement Application," as detailed in a February 2024 announcement, providing a direct channel for public information ²²². According to a 2022 policy paper titled "Improving Egypt’s Access to Vaccines and Medicines: Communicating during COVID-19", the MOHP established a comprehensive digital media strategy specifically to "monitor false news and rumors". This strategy, implemented during the pandemic and indicative of current capabilities, involved using verified accounts on platforms like Facebook, Twitter, Instagram, and YouTube, as well as a WhatsApp business profile (chatbot), to directly "clarify rumors" and "deny wrong news". The policy paper notes that the ministry used its official Facebook account to "remove/ban fake accounts and remove rumors and false news" ²²³.

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is no direct evidence of senior Egyptian leaders, such as the president or government ministers, sharing specific misinformation or disinformation about infectious diseases in the past two years on the Ministry of Health and Population and State Information Services websites ²²⁴²²⁵.

3.6 Access to communications infrastructure

3.6.1 Internet users

3.6.1a Percentage of households with Internet

Score: 75.54

3.6.2 Mobile subscribers

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 50.2

3.6.3 Female access to a mobile phone

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 46.67

3.6.4 Female access to the Internet

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 37.5

3.7 Trade and travel restrictions

3.7.1 Trade restrictions

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 100

There is no public evidence that Egypt has implemented restrictions on the export or import of medical goods due to an infectious disease outbreak in the past year (September 2024 to September 2025). The most recent significant infectious disease event noted was an E. coli outbreak in Aswan in September 2024, but no associated trade restrictions on medical goods were reported ²²⁶. In July 2023, an export ban on oxygen was imposed, but this was not due to any outbreaks ²²⁷. No further evidence identified on the Ministry of Health and Population website ²²⁸.

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is no public evidence to suggest that Egypt has implemented any restrictions on the export or import of non-medical goods, such as food or textiles, as a direct result of an infectious disease outbreak in the past year on the Ministry of Health and Population and State Information Services websites ²²⁹²³⁰

3.7.2 Travel restrictions

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 100

There is no public evidence to show that Egypt has implemented new inbound or outbound travel restrictions, such as border closures or flight bans, due to an infectious disease outbreak in the past year on the Ministry of Health and Population and State Information Services websites ²³¹²³².

3.7.2b Risk-based approach to international travel-related measures

Score: 100

There is evidence that Egypt uses a risk-based approach to international travel-related public health measures. This approach is evident in government actions during past health emergencies and is a component of its national public health strategy.

During the COVID-19 pandemic, the government enacted various travel-related measures that were adjusted based on the evolving situation. According to a June 2025 academic paper, "Navigating the next surge: a perspective on Egypt’s preparedness and prospects for another COVID-19 outbreak," these measures included travel restrictions and the establishment of testing and quarantine protocols for individuals entering the country ²³³.

A review of the publications and departmental structure of the Egyptian Ministry of Health and Population website shows a clear framework for managing health risks related to travel. The ministry has a dedicated "General Administration of Quarantine," which is responsible for implementing preventive measures at points of entry. This department provides health advice for travelers and publishes guidelines for preventing the spread of infectious diseases ²³⁴.

Health System

4.1 Health capacity in clinics, hospitals and community care centers

4.1.1 Available human resources for the broader healthcare system

4.1.1a Doctors per 100,000 people

Score: 9.65

4.1.1b Nurses and midwives per 100,000 people

Score: 24.02

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 100

Within the "Egypt National Health Strategy 2024–2030" document, a dedicated "National Health Care Workforce Strategy" is listed as an upcoming strategy. (p. 64) However, the current national health plan outlines strategic priorities that address workforce insufficiencies and the methods to resolve them. As articulated in Priority I, Objective 2 on pages 89-93, the strategy explicitly mandates that the country "ensure that the healthcare workforce is fit for purpose by strategically deploying health graduates to match national needs and labour market requirements through an integrated health workforce management system encompassing recruitment, retention, accreditation, relicensing, equitable distribution, training, shared competencies, task shifting, performance assessment, incentives, safety, and health information". The strategy identifies specific workforce shortfalls through quantitative analysis presented on pages 42-43, documenting that as of 2022, Egypt has only 9 physicians and 20 nursing and midwifery professionals per 10,000 population, which falls significantly below the WHO minimum threshold of 4.45 doctors, nurses and midwives per 1,000 population (equivalent to 44.5 per 10,000) required to achieve the Sustainable Development Goals, thereby indicating that the current health workforce density is insufficient to make progress towards achieving the SDGs. The document further states on pages 42-43, that although there were 229,033 registered physicians in the Ministry of Health and Population in 2020, the actual number of working physicians in the public health sector was only around 108,000 ²³⁵.

4.1.1d Health system capacity for essential health services

Score: 100

Egypt's public health system possesses a large and expanding capacity to deliver essential health services, but it currently faces significant challenges in infrastructure, workforce availability, and equitable access that prevent it from being considered fully sufficient.

The government has made universal health coverage a central pillar of its National Health Strategy 2024-2030, initiating major investments and structural changes aimed at closing these gaps. The primary vehicle for this transformation is the phased implementation of a new Universal Health Insurance System (UHIS), which aims to improve the quality, efficiency, and accessibility of care for all citizens ²³⁶. According to the World Bank’s Implementation Status & Results Report for the Transforming Egypt's Healthcare System Project, between 2018 and 2025, over 2.18 million people received essential health, nutrition, and population services. 501 primary healthcare centers (PHCs) have passed the Quality Services Index, and 250 PHCs are undergoing elf-assessment for accreditation. (p. 7) Patient satisfaction at PHCs reached 88.85%, and 94% of grievances in target facilities were addressed. Egypt has screened nearly 50 million people for Hepatitis C and provided treatment with a 75% follow-up rate for sustained virological response. (p. 6) The contraceptive prevalence rate improved from 58% to 66.4%, and household visits by community health workers increased significantly. (p. 4) However, the report also notes delays in some areas, such as plasma center certification and full distribution of medical supplies .

A July 2025 WHO Egypt Flash Appeal notes that "Egypt’s health sector is characterized by complexity and fragmentation, as well as low levels of public funding and high out-of-pocket spending. This leaves the health system vulnerable and reduces capacity to accommodate the increased demand created by regional emergencies" . As of 2022, the density of healthcare professionals was 9 physicians and 20 nursing and midwifery professionals per 10,000 people. The Egypt National Health Strategy 2024–2030 notes this is "insufficient to make progress towards achieving the SDGs". A significant challenge is poor retention within the public sector. In 2020, while 229,033 physicians were registered with the Ministry of Health and Population, only about 108,000 were actively working in the public health sector .

4.1.1e Essential health services continuity plan for public health emergencies

Score: 100

Egypt’s National Health Strategy 2024–2030 includes a clear and structured plan to ensure continuity of essential health services during public health emergencies.

Strategic Priority 4: "Enhancing prevention, preparedness, detection and response for health security" lists key actions, implementers, partners, and indicators for this priority. Key elements of the plan include "diversifying the sources of (essential medicines and medical supplies), reducing reliance on a single supplier, and strengthening the supply chain"; "equip(ping) healthcare workforce with training, surge capacity, and ongoing development for emergency preparedness"; and to "strengthen: Health infrastructure and digital technologies for resilience and efficient response coordination" (pp. 148-151) ²³⁷.

4.1.2 Facilities capacity

4.1.2a Hospital beds per 100,000 people

Score: 26.61

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 100

There is some evidence that Egypt has the capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit and/or patient isolation room/unit located within the country.

According to the 2021 “GAHAR Handbook for Hospital Standards” issued by the General Authority for Healthcare Accreditation and Regulation, every acute-care hospital that seeks national accreditation under Egypt’s Universal Health Insurance System must maintain at least one airborne-infection isolation room outfitted with negative pressure, dedicated exhaust and continuous pressure-monitoring alarms (Standard IPC.12, pp. 208-210) ²³⁸.

The World Health Organization’s “WHO-Egypt Flash Appeal 2025” (February 2025) shows how those isolation assets are mobilised in practice: the Ministry of Health and Population activated a three-tier referral system that began with 500 isolation beds in North-Sinai hospitals, expanded to 2,000 beds in Ismailia, Suez and Port Said, and used tertiary centres in Cairo as a final surge tier (pp. 3-4) ²³⁹.

An academic engineering audit, “Designing a New Fast Solution to Control Isolation Rooms in Egyptian Hospitals” (Journal of Building Engineering, August 2022, pp. 3-5), surveyed 20 public hospitals and found that while negative-pressure rooms are present, fewer than 5 percent include medical-gas outlets and none possess sealed anterooms, HEPA-filtered exhaust or other advanced features that define high-level biocontainment wards (e.g., those built for Ebola or Marburg). The study concludes that Egypt’s existing isolation rooms are suitable for airborne pathogens such as TB, measles or COVID-19, but the country lacks purpose-built biocontainment patient-care units that meet the most stringent international engineering standards ²⁴⁰.

The Ministry of Health and Population’s publications portal contains no decree, circular or technical guideline establishing a national high-level isolation unit ²⁴¹.

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 100

There is evidence that Egypt has demonstrated capacity to expand isolation capacity in response to an infectious disease outbreak in the past two years.

According to the World Health Organization’s “WHO-Egypt Flash Appeal 2025” (February 2025, pp. 2-4), the Ministry of Health and Population (MOHP) activated a three-tier hospital-referral pathway within days of the Gaza–Sudan displacement crisis. Tier 1 opened 500 isolation beds in three North-Sinai hospitals; Tier 2 earmarked 2,000 additional isolation beds across Ismailia, Suez and Port Said; Tier 3 allocated further capacity in Cairo and other governorates. The Appeal describes the plan’s trigger criteria (daily admissions >80% of Tier 1) and the logistics for rapid oxygen-supply augmentation ²⁴².

4.2 Supply chain for health system and healthcare workers

4.2.1 Routine health care and laboratory system supply

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 100

There is a national procurement protocol in place that can be utilized by the Ministries of Health and Agriculture for the acquisition of both laboratory and medical supplies for routine needs.

The Unified Procurement Law No. 151 of 2019 and its Executive Regulations (Official Gazette, 15 Jul 2020, arts. 10, 25-32) legally require the Egyptian Authority for Unified Procurement and Medical Technology Management (UPA) to “establish and rotate a national reserve of strategic medical commodities, vaccines and laboratory inputs sufficient for not less than six months of forecast demand.” Article 32 mandates an e-catalogue through which all health-sector entities, including the Ministry of Agriculture’s veterinary laboratories, draw stock during both routine operations and emergencies, ensuring a single, centrally tracked inventory ²⁴³.

The UPA's mandate covers both laboratory and medical supplies. A government report from the State Information Service in December 2024 detailed the UPA's efforts to secure the medical needs of various health authorities. The report specifically mentions the UPA's work in settling dues for the supply of "laboratory supplies" and blood derivatives, in addition to medicines, surgical supplies, and medical equipment like radiology and critical care devices ²⁴⁴.

4.2.2 Stockpiling for emergencies

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 33.33

Egypt has a stockpile of medical supplies for national use during a public health emergency.

According to a media report from March 2025, the spokesperson for the Ministry of Health stated that the ministry had reviewed the "strategic stockpile of medicines and medical supplies in all governorates, to ensure their availability in sufficient quantities to face any potential emergencies" ²⁴⁵. However, no evidence of what this stockpile contains was identified on the Ministry of Health and Population website ²⁴⁶.

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

The government of Egypt has a disease-specific framework for stockpiling supplies for a public health emergency, but publicly available documents provide limited specific evidence about the contents of this stockpile, particularly regarding laboratory supplies like reagents and media.

According to the National Influenza Pandemic Preparedness Plan (2018), a foundational government document, one of the key preparedness actions is to "Assess the need to stockpile strategic reserves of supplies, material and equipment" (p. 55). The plan details lessons learned from the 2009 H1N1 pandemic, which led to the creation of national stockpiles for antiviral medication and the establishment of local manufacturing for Personal Protective Equipment (PPE) (p. 23) ²⁴⁷.

According to a report from April 2025, the Egyptian Drug Authority (EDA) and the Unified Procurement Authority (UPA) are coordinating to "maintain the uninterrupted flow of medicines, especially critical and strategic pharmaceuticals," and ensure the availability of "medicines and medical supplies". However, these statements focus primarily on pharmaceuticals and do not explicitly mention laboratory reagents or other diagnostic consumables as part of the strategic stockpile being monitored ²⁴⁸.

No further evidence identified on the website of the Ministry of Health and Population ²⁴⁹.

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is evidence that Egypt conducts regular reviews of its national stockpile to ensure sufficiency for a public health emergency, although it is not clear if it is done on an annual basis.

According to a September 2025 report from the State Information Service (SIS), a government entity, the Minister of Health and Population chaired a meeting specifically to "review the strategic stockpile of medicines and medical supplies". The official spokesperson for the Ministry stated that the meeting's purpose was to follow up on the availability of supplies in central and branch warehouses. The report notes that the Minister directed the implementation of "periodic follow-up plans for the warehouses" (خطط متابعة دورية للمخازن) and the development of electronic tracking systems to ensure the quality and safety of medicines ²⁵⁰.

4.2.3 Manufacturing and procurement for emergencies

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 100

Egypt meets the criteria, with evidence demonstrating plans and mechanisms for leveraging domestic manufacturing and expediting their entry into the country during a public health emergency.

The Egyptian government has established a clear strategy to leverage and expand its domestic manufacturing capacity for medical supplies to ensure national use during a public health emergency. In June 2025, the Minister of Health announced a 10-year investment plan for the healthcare sector with the explicit goal to "reduce reliance on imported medical equipment by building domestic production capacity" ²⁵¹.

The Egyptian Drug Authority (EDA) has published the "Guidelines on Emergency Use Approval" (2023), which establishes a clear, risk-based procedure for granting time-limited approval to unlicensed medicines and biological products during a public health emergency. As stated in Section 2 of the guideline, its purpose is to provide a regulatory tool for "readiness & preparedness in such cases" by defining steps for an expedited assessment when limited data is available (p. 3) ²⁵².

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 100

The Egyptian government has an explicit plan to leverage private sector domestic manufacturing capacity for laboratory and diagnostic supplies. However, there is no evidence of a plan or mechanism to procure laboratory supplies for national use during a public health emergency, nor of a plan or mechanism to expedite laboratory supplies through points of entry.

According to a February 2025 announcement from the Egypt Healthcare Authority (EHA), a government body, the authority is collaborating with the private sector to achieve self-sufficiency in medical supplies. This includes the planned opening of Egypt’s first factory specializing in "medical and diagnostic supplies", which would help in "significantly improving healthcare delivery and emergency response capabilities" ²⁵³.

However, no further evidence was identified on the Ministry of Health and Population website ²⁵⁴.

4.2.3c Mechanism emergency logistics and supply chain management

Score: 100

"Egypt National Strategy for Vaccine Manufacturing Localization 2024-2030" covers all four criteria.

The strategy establishes a comprehensive system centered around the Egyptian Authority for Unified Procurement (UPA) and the Egyptian Vaccine Manufacturers Alliance (EVMA). The EVMA consists of six major private (or public-private) local manufacturers: VACSERA, Biogeneric Pharma, VBC, Gennvax, Gypto Pharma, and EVA Pharma (Page 37).The UPA is the central body responsible for overseeing purchasing processes, managing long-term contracts, and organizing the vaccine supply chain (Page 34). EVMA acts as the executive arm of the national strategy, coordinating between manufacturers, government entities, and international partners to ensure a resilient supply chain (Page 35) ²⁵⁵.

Vaccine contractors are required to "submit an interim report to the authority every 6 months" and "attend an annual meeting with the authority to discuss the progress" (Page 47). The EVMA is tasked with "closely supervising the implementation of the national strategic plan… on a Quarterly basis" (Page 43) ²⁵⁶.

The strategy highlights VACSERA's "Central Cold Storage Building," which is a fully automated, WHO-GSP compliant facility with a storage capacity of 150 million doses. It features dual cooling systems, 24/7 temperature monitoring, and alarm systems (Pages 58-59). GP's profile mentions "state-of-the-art warehouses with multiple temperature-controlled environments," including 2–8 °C and -20 °C storage (Page 108) ²⁵⁷.

4.3 Medical countermeasures and personnel deployment

4.3.1 System for dispensing MCMs during a public health emergency

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 100

The Emergency Use Approval Guidelines, issued by the Egyptian Drug Authority in 2022 sets out a complete regulatory framework for how unlicensed or restricted medical intervention devices (MCMs) can be made available and dispensed during health crises.

Section 4 (pages 6-20) of the guidelines outlines the procedures for requesting emergency approval for drugs and vaccines, including eligibility criteria and sequential scientific evaluation, with the requirement that the expected benefits outweigh the potential risks. The post-dispensing manual imposes "post-EUA" obligations that include completing clinical trials, providing monthly pharmacovigilance reports, and conducting stability tests to ensure the product's efficacy throughout use (p. 15) ²⁵⁸.

4.3.2 System for receiving foreign health personnel during a public health emergency

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 100

Egypt has provisions and plans in place to facilitate a workforce surge during a public health emergency, though these are integrated within broader national strategies and operational plans rather than existing as a single, standalone document.

Strategic Priority 4: "Enhancing prevention, preparedness, detection and response for health security" of "Egypt National Health Strategy 2024–2030" lists to "Equip healthcare workforce with training, surge capacity, and ongoing development for emergency preparedness" as a key action. "Percentage of healthcare workers trained in emergency preparedness and response protocols" and "Number of additional healthcare personnel mobilized during a simulated or real emergency" are key indicators that will be determined to assess progress for this objective (p. 75) ²⁵⁹. A July 2024 statement from the Minister of Health and Population confirms that the strategy involves mapping all personnel to guide workforce enhancement for emergency preparedness ²⁶⁰.

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is no evidence to suggest Egypt has formal mechanisms to receive health personnel from other countries to respond to public emergencies.

According to the "WHO-Egypt Flash Appeal: Responding to escalation of conflict in the occupied Palestinian territory" (February 2025), Egypt has a well-defined system for collaborating with international partners during a cross-border health crisis. This is evidenced by the response to the conflict in Gaza, where Egypt serves as the primary hub for humanitarian operations and medical evacuations. The plan details a coordinated effort between the Ministry of Health and Population (MOHP), the World Health Organization (WHO), and the Egyptian Red Crescent (ERC). A key component is Pillar 2, "Strengthening Egypt's healthcare system to provide the required healthcare for the medical evacuees," which includes coordinating medical evacuations to EU member states, led by the MOHP (p. 6) ²⁶¹.

A formal government framework for leveraging foreign expertise exists through a program described in the "Intervention by Egypt at the 156th WHO Executive Board Meeting" (2025). In this statement, Egypt outlines its "Experts Program," a strategic initiative designed to enhance the skills of its healthcare professionals by inviting global experts ("foreigners") to conduct comprehensive training programs and complex health interventions within Egypt. This program, which is part of Egypt's broader health workforce regulation and development strategy, specifically targets critical specialties like cardiac surgery, intensive care, and public health (Section 6: Regulation) ²⁶².

The "Egypt National Health Strategy 2024–2030" does not contain any pertinent evidence ²⁶³.

4.3.2c Plan to redeploy existing health personnel within the country

Score: 100

Egypt has public plans and established policies for both the geographical and role-based redeployment of existing health personnel, particularly during emergencies.

According to the "Intervention by Egypt at the 156th WHO Executive Board Meeting" (2025), the government has a formal policy for the equitable geographical distribution of its medical workforce. Section 8, "Retention in Rural and Remote Areas," describes a "fair and inclusive distribution policy" to deploy health professionals to areas with the greatest need, especially remote and rural governorates. This policy is guided by detailed needs assessments using modern health information systems to optimize the allocation of staff. To facilitate this redeployment, the government provides a range of financial and non-financial incentives, including additional salaries, housing, professional development opportunities, and priority for promotions and international missions ²⁶⁴.

This strategic redeployment is put into practice during emergencies. For instance, the "WHO-Egypt Flash Appeal: Responding to escalation of conflict in the occupied Palestinian territory" (February 2025) details a clear, multi-tiered referral and response plan that involves concentrating health services and personnel at different geographical levels. The plan establishes a "1st line of referral" in North Sinai hospitals, a "2nd line" in the Suez Canal governorates, and a "3rd line" in Cairo and other governorates, demonstrating a structured geographical redeployment of healthcare capacity to manage a crisis (page 3) ²⁶⁵. Similarly, the "Emergency Plan of Action (EPoA) Egypt: North Sinai attack" from the International Federation of Red Cross and Red Crescent Societies (IFRC) notes the deployment of Emergency Action Teams from the North Sinai branch to assist in Ismailiyah ²⁶⁶.

4.4 Healthcare access

4.4.1 Access to healthcare

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 75

The Egyptian constitution explicitly guarantees the right to medical care, but not universally free of charge.

According to Article 18 of the Constitution of the Arab Republic of Egypt (2014), "Every citizen has the right to health and to comprehensive health care which complies with quality standards". The right is not, however, guaranteed to be entirely free for all citizens. The same Article 18 mandates the state to establish a "comprehensive health insurance system for all Egyptians covering all diseases". It further specifies that the law will regulate citizens' contributions to this system or their exemption from it based on their income levels ²⁶⁷.

4.4.1b Access to skilled birth attendants (% of population)

Score: 95.59

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 45.45

4.4.1d Coverage of essential health services through universal health coverage

Score: 89.58

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 3.91

4.4.1f Rate of mortality amenable to health care

Score: 24.95

4.4.2 Paid medical leave

4.4.2a Guaranteed paid sick leave

Score: 100

Workers in Egypt are guaranteed paid sick leave, and this leave is available for mental as well as physical health problems. According to Article 141 of the Egyptian Labor Law No. 14 of 2025, an employee who proves illness or injury preventing them from working is entitled to sick leave as determined by the competent medical authority, during which they receive wage compensation in accordance with the Social Insurance and Pensions Law No. 148 of 2019. The law uses the broad term “مرضه” (his illness), which is not restricted to physical health, and Article 132 explicitly includes conditions that affect the worker’s ability to work, including psychological health ²⁶⁸.

4.4.3 Healthcare worker access to healthcare

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is no evidence that the Egypt government has issued legislation, a policy, or a public statement committing to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency on the website of the Ministry of Health and Population ²⁶⁹.

4.5 Communications with healthcare workers during a public health emergency

4.5.1 Communication with healthcare workers

4.5.1a Existence of system for communication during a public health emergency

Score: 0

There is no evidence Egypt has a unified system in place for public health officials and healthcare workers to communicate during a public health emergency, although there are fragmented mechanisms.

According to the Office of the President, Egypt launched The Unified National Network for Emergency Services and Public Safety in October 2022. This network was designed to support the state's sustainable development plans and improve the quality of relief and emergency services by ensuring a speedy response to incidents. A key feature is fostering "cooperation and cooperation among all relevant authorities" and providing accurate, timely data. While not exclusively for health, it serves as the backbone for communications and systems for all government authorities, explicitly including the Ministry of Health and Population to implement applications for "ambulance, critical and urgent care and healthcare through integration among those different bodies in the ministry to ensure the quality of the medical service provided to citizens." The system aims to adopt a unified emergency number and build an integrated system for receiving emergency reports ²⁷⁰.

In July 2025, the Ministry of Health announced a comprehensive upgrade of its free, 24/7 unified hotline (105), converting it into a centralized platform for all health services and public complaints. This hotline is explicitly designed to facilitate communication and ensure a swift response to citizens' requests, but also includes a service for healthcare workers to "inquire about assignment decisions and grievance timelines, with this service available daily from 9am to 9pm" ²⁷¹.

The "Achievements Report, 2024" from the WHO Health Emergencies Programme (WHE) in Egypt details the operational communication and coordination structures used in recent crises. During the Gaza crisis response, the WHE established a "coordination platform" with UN partners and NGOs, holding monthly procurement coordination meetings to align with national requests and plans (p. 20). Similarly, for the Sudan crisis, the WHO co-leads the Health Working Group (HWG) to ensure coordinated health service mapping and alignment with national efforts (p. 25) ²⁷².

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 0

There is no evidence Egypt has a unified system in place for public health officials and healthcare workers in the public or private sector to communicate during a public health emergency, although there are fragmented mechanisms.

4.6 Infection control practices

4.6.1 Healthcare-associated infection (HCAI) monitoring

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 100

There is evidence that Egypt's national public health system has a formal program for monitoring and tracking the number of healthcare-associated infections (HAIs) that occur in its healthcare facilities.

According to the Ministry of Health and Population's Central Unit of Infection Prevention and Control, the "National Surveillance Guideline of Healthcare Acquired Infections" (First Edition, 2021) serves as the foundational document for this program. The guideline explicitly states its objective is to "identify benchmarks of hospital-acquired infections in Egypt through establishing national surveillance programs" and to describe the microbiological profile of pathogens causing HAIs. The methodology of the Egyptian HAI surveillance system is defined as active, prospective, targeted, and standardized, based on the U.S. Centers for Disease Control and Prevention–National Healthcare Safety Network (CDC-NHSN) definitions. This system specifically targets high-risk events, including device-associated infections like ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTI), and central line-associated bloodstream infections (CLABSI), as well as procedure-related HAIs like surgical site infections (SSIs) (p. 10). This system is operationalized through the HAIs National Electronic Surveillance & Reporting (HAI-NESR) system. According to the national guideline, the HAI-NESR system was initiated in 2016 and had expanded to include 39 participating hospitals by 2020 (p. 12) ²⁷⁶.

Research published in 2024 and 2025 uses data from Egypt's national HAI surveillance program to analyze carbapenem-resistant Enterobacteriaceae (CRE) infections and evaluate infection control training in ICUs, showing the system is active ²⁷⁷²⁷⁸.

4.6.1b Infection prevention and control programme

Score: 100

There is clear evidence of a national infection prevention and control programme in place in Egypt.

According to the Egyptian Ministry of Health and Population (MOHP), there is a dedicated department for Infection Prevention and Control called the General Directorate of Infection Control that operates under the Sector of Preventive Affairs and Endemic Diseases. This department is responsible for establishing and monitoring a surveillance system for healthcare-associated infections (HAIs) in health facilities, conducting periodic follow-ups, and ensuring that IPC standards are implemented across all levels of care ²⁷⁹. To support this program, the ministry has published the Egyptian National Guide for Infection Control 2020, which outlines the core components of the national IPC program and the standards that healthcare facilities are expected to follow .

4.6.1c National plan to ensure a safe environment in health facilities

Score: 100

There is evidence of a comprehensive national plan to ensure a safe environment in health facilities across Egypt.

The "GAHAR Handbook for Hospital Standards – Edition 2021," issued by the General Authority for Healthcare Accreditation and Regulation (GAHAR) is a mandatory framework for all hospitals seeking to join the Universal Health Insurance program and sets forth strict, non-negotiable requirements for safety. Section 3 of the handbook, "ORGANIZATION-CENTERED STANDARDS," contains a dedicated chapter on Environmental and Facility Safety (FMS), which outlines a detailed plan for creating and maintaining a safe environment (p. 176). The document highlights fire safety through prevention, early detection, and effective response measures (p. 180), and addresses hazardous materials and waste management by ensuring the safe handling, storage, and disposal of chemical, radioactive, and infectious waste (page 183). It also emphasizes safety and security, establishing protocols to protect patients, staff, and visitors from physical harm while securing the facility (p. 185). In addition, the proper maintenance, testing, and safe use of medical equipment is underscored as essential (p. 187), alongside the management of utility systems such as electrical, water, and medical gases to prevent failures and guarantee safety (p. 188). The handbook stresses emergency preparedness, requiring a comprehensive plan to respond effectively to both internal and external disasters (p. 190). ²⁸⁰.

4.7 Capacity to test and approve new medical countermeasures

4.7.1 Regulatory process for clinical trials of unregistered interventions

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 100

There is a mandatory national requirement for ethical review before any clinical trial can begin in Egypt.

The Egyptian Drug Authority (EDA) is the central regulatory body responsible for the overall oversight of clinical trials. According to the "Guideline for Good Regulatory Oversight of Clinical Trials by the Egyptian Drug Authority" (2024), the EDA's General Administration of Clinical Trials reviews and evaluates all trial applications, and that "A trial should be conducted in compliance with the protocol that has been received prior institutional review board (IRB)/independent ethics committee (IEC) approval/favorable opinion" (Section 7.1 (f)), and that "it is a must" to get Supreme Council for Review of Clinical Medical Research final approval before beginning a trial (Section 7.14.1). The Supreme Council for Review of the Ethics of Medical Clinical Research is established by Prime Minister’s Resolution No. 746 of 2024, and this high-level body is responsible for establishing and enforcing national ethical policies for all medical research in Egypt ²⁸¹.

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 100

Egypt has established formal mechanisms for both expediting the approval of clinical trials for unregistered medical countermeasures (MCMs) during a public health emergency and for recognizing clinical trial data from other jurisdictions to accelerate the process.

According to the "Guideline for Good Regulatory Oversight of Clinical Trials by the Egyptian Drug Authority" (2024), the Egyptian Drug Authority (EDA) has a specific "Non-Routine Submission Pathway" designed to speed up approvals in urgent situations. This pathway provides for "exceptional procedures and measures… to support the expedited authorization of a clinical trial" outside of the standard review timeline. A key feature of this expedited process is the allowance for "parallel submission." This means a sponsor can submit their clinical trial application to the EDA at the same time as it is submitted to the local Institutional Review Board (IRB), rather than waiting for IRB approval first. Section 7.3.2.1 of the guideline explicitly lists the conditions under which this non-routine pathway can be used, with the first case being "In case of pandemic spread or public health emergencies 'internationally or domestically.' The guideline supports expedited access through a "rolling submissions" procedure, which allows the EDA to evaluate data from ongoing trials as it becomes available, rather than waiting for the full dataset at the end. The guideline states that for urgent public health needs, "assessment timelines will be reduced to the absolute minimum" (p. 13) ²⁸².

In July 2025, the EDA joined a Memorandum of Understanding (MoU) on "regulatory reliance" with other African medicines regulatory authorities. According to the African Union Development Agency (AUDA-NEPAD), this MoU establishes a "structured framework to accelerate regulatory processes for medicines, vaccines, and medical devices" ²⁸³.

4.7.2 Regulatory process for approving medical countermeasures

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

The Egyptian Drug Authority (EDA) is the government agency responsible for approving new medical countermeasures (MCMs) for humans in Egypt.

During public health emergencies, the EDA has specific procedures to grant Emergency Use Authorization for unlicensed MCMs. The "Guideline on Emergency Use Approval" (2023) outlines the risk-based procedure for assessing and approving these products on a time-limited basis when limited data are available. This process is managed by the Central Administration of Biological and Innovative Products and the Central Administration of Pharmaceutical Products within the EDA ²⁸⁴.

After a product is approved, the EDA continues to monitor its safety and efficacy through its pharmacovigilance programs, as detailed in the "Egyptian Guidelines for Detecting & Reporting of Adverse Reactions for Pharmaceutical products and Medical Devices" (2023). This includes collecting and analyzing reports of adverse drug reactions from healthcare professionals and the public ²⁸⁵.

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 100

Egypt has an expedited process for the approval of medical countermeasures (MCMs) during public health emergencies, which also includes provisions for recognizing approvals from other countries and international bodies.

According to the Egyptian Drug Authority's Guideline on Emergency Use Approval (2023), there is a formal Emergency Use Approval (EUA) pathway for the use of unlicensed medical products in a public health emergency. Section 4.2.4 of the guideline details the specific criteria for granting an EUA, which include: the product must address a serious or life-threatening condition with the potential to cause an epidemic or pandemic; the known and potential benefits must outweigh the known and potential risks; and the product must be manufactured in compliance with current Good Manufacturing Practices (GMP). The applicant is also required to commit to completing the product's development and applying for full marketing authorization. The Guideline on Emergency Use Approval (2023) also facilitates the recognition of decisions from other authorities by stipulating that for imported products, the product must have been granted an EUA in its country of origin or be listed for emergency use by the World Health Organization (WHO) or a Stringent Regulatory Authority (SRA) (Section 4.1(f)) ²⁸⁶.

Commitment to International Norms

5.1 IHR reporting compliance and disaster risk reduction

5.1.1 Official IHR reporting

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Egypt has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.²⁸⁷

5.1.2 Integration of health into disaster risk reduction

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 0

There is insufficient evidence that pandemics are integrated into the national risk reduction strategy and that there is a standalone national disaster risk reduction strategy specifically for pandemics.

According to the National Strategy for Disaster Risk Reduction 2030, published in April 2017 by the Egyptian Cabinet's Information and Decision Support Center, epidemics are explicitly included within the national framework for managing disasters. On page 5, "Figure (2) Classification of the Most Important Disasters Affecting Egypt" categorizes "Diseases & Epidemics" as a type of man-made disaster that affects the country ²⁸⁸. However, there are no measures for pandemics or epidemics listed within the strategy.

No further evidence of a standalone national disaster risk reduction strategy specifically for pandemics was identified on the website of the Ministry of Health and Population ²⁸⁹.

5.2 Cross-border agreements on public health and animal health emergency response

5.2.1 Cross-border agreements

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 50

Egypt has engaged in multiple cross-border and regional initiatives concerning public health emergencies, including recent memorandums of understanding (MOUs) and collaborative simulation exercises.

According to a news release from the World Health Organization (WHO), in August 2025, Egypt participated in a three-day table-top simulation exercise in Cairo alongside Libya, Sudan, and Tunisia. This exercise, organized by the WHO and the International Organization for Migration (IOM), aimed to test and improve preparedness for cross-border population movements in line with the International Health Regulations (IHR 2005). A key outcome of this meeting was a call from the government representatives of the four nations to establish formal collaboration frameworks and legal agreements between neighboring countries, as well as to standardize public health procedures across borders to enhance coordination ²⁹⁰.

In a separate agreement, the Ministry of Health and Population signed a Memorandum of Understanding with the Kingdom of Saudi Arabia in May 2025 to enhance cooperation in several health-related fields. This MOU explicitly includes collaboration on managing health crises and disasters, exchanging expertise, and unifying positions on international health issues, particularly concerning the IHR. The agreement establishes a joint working group to create and oversee an executive plan, ensuring the implementation of its articles, which cover public health programs, epidemic control, and the exchange of information on health legislation ²⁹¹.

In July 2025, the Egyptian Drug Authority (EDA) joined a Memorandum of Understanding on regulatory reliance with the national regulatory authorities of Ghana, Nigeria, Rwanda, Senegal, South Africa, Tanzania, and Zimbabwe. While not exclusively focused on public health emergencies, this agreement creates a framework to accelerate regulatory processes for medical products, including vaccines, by leveraging the assessments of fellow member states ²⁹².

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 50

Egypt has established cross-border agreements and participates in regional networks to address animal health emergencies. These collaborations focus on disease surveillance, coordinated response, and preventing the spread of transboundary animal diseases.

According to a May 2021 report, the governments of Egypt and Sudan signed a series of agreements to enhance cooperation on animal health. This agreement establishes a joint mechanism to combat the cross-border smuggling of animals and includes provisions for Sudan to import Egyptian veterinary vaccines that meet international standards. The two countries also agreed to establish a joint-venture model farm for animal production in Sudan and for Egypt to import Sudanese meat ²⁹³.

Egypt actively participates in the Mediterranean Animal Health Network (REMESA), a regional body that works to harmonize and coordinate the surveillance and control of major transboundary animal diseases and zoonoses. According to a July 2024 report from the Food and Agriculture Organization (FAO), REMESA brings together countries from North Africa, including Egypt, and Southern Europe to improve cooperation and strengthen veterinary capacities. The network focuses on priority diseases such as foot-and-mouth disease (FMD), lumpy skin disease, and highly pathogenic avian influenza ²⁹⁴.

Through the World Organisation for Animal Health (WOAH) Sub-Regional Representation for North Africa, Egypt is associated with regional activities aimed at strengthening animal disease surveillance and control. While the representation primarily covers the five Maghreb countries, Egypt is involved in certain activities connected to the Global Framework for the Progressive Control of Transboundary Animal Diseases (GF-TADs) and REMESA ²⁹⁵.

Egypt has a regional cross-border framework for cooperation during animal health emergencies, but publicly available evidence does not demonstrate Egypt-specific implementation sufficient to establish full operational effectiveness. In November 2012, the World Organisation for Animal Health and the Food and Agriculture Organization of the United Nations published the “Cooperation Framework between the Chief Veterinary Officers of Algeria, Egypt, France, Italy, Libya, Mauritania, Morocco, Portugal, Spain and Tunisia for the creation and the development of the Mediterranean Animal Health Network,” which identifies Libya as a signatory and establishes cooperation on transboundary animal diseases, including zoonoses, through information exchange, coordination of veterinary services, preparedness activities, and a Joint Permanent Committee responsible for regional steering and decision making ^{296, pp. 1–3, 5, 16}.

5.3 International commitments

5.3.1 Participation in international agreements

5.3.1a Biological and Toxin Weapons Convention status

Score: 50

Egypt signed the Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on their Destruction on April 10, 1972, but has not ratified it ²⁹⁷.

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 0

Egypt has not submitted Confidence-Building Measures (CBMs) for the Biological Weapons Convention (BWC) in the past three years ²⁹⁸.

5.3.1c Submission of UNSCR 1540 reports

Score: 100

Egypt has submitted the required reports to the United Nations Security Council (UNSC) Committee established pursuant to resolution 1540.

According to the official National Reports page maintained by the UNSC's 1540 Committee, Egypt has submitted a total of four reports. The dates of these submissions are listed as October 28, 2004; March 17, 2006; February 28, 2008; and April 22, 2016 ²⁹⁹.

This record is corroborated by a recent diplomatic statement. In the Statement by the Permanent Representative of the Arab Republic of Egypt to the United Nations at a 1540 Committee open briefing on October 9, 2024, the ambassador affirmed Egypt's commitment to the resolution's implementation. Paragraph 4 of the statement explicitly declares, "Egypt submitted four national reports detailing these efforts" ³⁰⁰.

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 25

5.3.2 Voluntary memberships

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

Egypt does not meet at least two of the specified criteria, as it is not a member of any of the three groups.

According to the official website for the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (GP), the G7-led initiative consists of 31 active member countries. Egypt is not included in the list of members ³⁰¹.

According to the official list of participants for the Australia Group (AG), Egypt is not one of the 43 members ³⁰².

Egypt has not endorsed the Proliferation Security Initiative (PSI). While the PSI is a voluntary initiative with over 100 endorsing states, a 2021 report from the National Institute for Public Policy identified Egypt as one of the important coastal states that remains outside of the initiative ³⁰³.

5.4 JEE and PVS

5.4.1 Completion and publication of a JEE assessment and gap analysis

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 0

Egypt last conducted its Joint External Evaluation in 2018 ³⁰⁴.

5.4.2 Completion and publication of a PVS assessment and gap analysis

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

There is limited evidence that Egypt has conducted a Performance of Veterinary Services (PVS) self-evaluation within the last five years.

According to the "Self-declaration of the establishment of an Equine Disease-Free Zone (EDFZ) in the New Capital of Egypt (NC)", a document submitted to the World Organisation for Animal Health (WOAH) in November 2024, an internal PVS self-evaluation was conducted by 2021. Page 17 of this declaration specifies that this assessment was carried out by an internal team using the 2019 version of the WOAH-PVS guidelines and was prompted by the recent evolution of the country's veterinary services and its alignment with the national sustainable development strategy for 2030. The same document also notes that this self-evaluation follows earlier official missions led by WOAH, which included an evaluation in 2007, a follow-up mission in 2009, and a PVS Gap Analysis in 2010 ³⁰⁵. However, as this is a self-declaration, this is insufficient for a score of 1.

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

Egypt has not completed and published a Performance of Veterinary Services (PVS) Gap Analysis in the last five years ³⁰⁶.

5.5 Financing

5.5.1 National financing for epidemic preparedness

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 100

There is evidence that Egypt has allocated national funds to improve its capacity to address pandemic and epidemic threats within the past three years through increased health sector budgeting and co-investment in externally funded projects.

According to the Ministry of Finance's report, Spotlight on Children in the 2023/2024 Budget, for the fiscal year 2023/2024, the total allocation for the health sector reached EGP 397 billion, or 4% of the Gross Domestic Product (GDP) ³⁰⁷.

According to a project brief from The Pandemic Fund, last updated in October 2024, Egypt was awarded a grant of US$23 million to develop a robust system for pandemic prevention, preparedness, and response. The brief states that this external grant mobilized an additional US$10.1 million in co-financing and US$9.9 million in co-investment, representing a direct commitment of national resources to supplement the project. This joint funding supports objectives that directly enhance pandemic response capacity, including expanding disease surveillance sites, establishing a biosafety level 3 laboratory, and developing a skilled "One Health" workforce ³⁰⁸.

5.5.2 Financing under JEE and PVS reports and gap analyses

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

There is no evidence that Egypt's JEE or national health strategy allocate or describe specific funding from the national budget to address the identified gaps.

Egypt last conducted its Joint External Evaluation in 2018, but the report is not published on the JEE database ³⁰⁹. The Egypt National Health Strategy 2024-2030 references the development of a National Action Plan for Health Security (NAPHS), but it does not allocate or describe specific funding from the national budget to address identified gaps ³¹⁰.

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

Egypt has not completed and published a Performance of Veterinary Services (PVS) Gap Analysis or PVS assessment in the last five years ³¹¹.

5.5.3 Financing for emergency response

5.5.3a Emergency public financing during a public health emergency

Score: 100

Egypt has established a publicly identified special emergency public financing mechanism through Law No. 139 of 2021, which creates the “صندوق مواجهة الطوارئ الطبية” (Emergency Medical Response Fund) as a dedicated national reserve fund for public health emergencies. According to Articles 2 and 3, the fund is an independent legal entity with financial and administrative autonomy, aimed at financing and sustaining medical services during disasters, health emergencies, crises, and pandemics. Its resources are outlined in Article 10, which includes contributions from the state, levies on certain goods, donations, and other approved sources, while Article 11 specifies that disbursements are made by the fund’s Board of Trustees to cover costs related to medical emergencies, critical interventions, and patient treatment under state-funded care ³¹².

According to a project document from the World Bank, Egypt has an agreement for emergency financing through the "Supporting Egypt’s Universal Health Insurance System Project". The project's datasheet confirms the inclusion of a Contingent Emergency Response Component (CERC), which is a mechanism that allows for the rapid reallocation of project funds to address an emergency or crisis, including a public health emergency ³¹³.

According to The Pandemic Fund, in 2024 Egypt was awarded a grant of US$23 million specifically to boost its resilience to pandemics and strengthen its preparedness systems ³¹⁴.

5.5.4 Accountability for international commitments to address epidemic threats

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence of public commitments from senior Egyptian leaders over the past three years to improve domestic capacity to address health threats.

According to an official statement from the Egyptian Presidency on May 13, 2025, President Abdel Fattah El-Sisi reviewed and issued directives on national health projects. The President directed the government to expedite the second phase of the Universal Health Insurance system, which covers five governorates at an estimated cost of 115 billion EGP for the development and establishment of 65 hospitals and 669 primary care units. He was also briefed on the completion of 20 hospital construction and development projects during fiscal year 2025 at a cost of 11.7 billion EGP ³¹⁵.

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence from the past three years that Egypt has both provided support to other countries and requested financing and technical support from donors to improve its own domestic capacity to address epidemic threats.

According to the World Health Organization (WHO), in a statement on September 24, 2025, Egypt has committed to supporting 14 African countries in their efforts to combat Hepatitis C. The Egyptian Minister of Health and Population pledged to provide technical support, expertise, screening software, and free treatment for one million individuals across these nations as part of a presidential initiative to eliminate the virus ³¹⁶.

According to the Pandemic Fund, Egypt was awarded a grant of US$23 million to develop a robust system for pandemic prevention, preparedness, and response. This funding, part of the Fund's second round of grants, has mobilized an additional $10.1 million in co-financing and $9.9 million in co-investments. The project is a collaborative effort between the Ministry of Health and Population, the Ministry of Agriculture and Land Reclamation, and three Implementing Entities: the Food and Agriculture Organization (FAO), UNICEF, and the World Health Organization (WHO) ³¹⁷.

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 100

Egypt has fully paid its WHO assessed contributions for 2024.

According to the WHO's "Status of collection of assessed contributions" report dated April 7, 2025, Egypt paid its full 2024 assessed contribution of US$399,060 (or Sw.fr. 357,159), with no outstanding balance remaining for that year. The WHO report shows Egypt in the section of member states that collected their 2024 contributions in full, with zero balance outstanding in both US dollars and Swiss francs for 2024 ³¹⁸.

5.6 Commitment to sharing of genetic & biological data & specimens

5.6.1 Commitment to share data and specimens in emergency/non-emergency research

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is limited evidence of a comprehensive publicly available policy specifically addressing genetic data and biological material sharing beyond influenza across all pathogens, although there are fragmented datasets available.

Egypt has actively participated in international genomic surveillance and data sharing for SARS-CoV-2 through the Global Initiative on Sharing Avian Influenza Data (GISAID) platform. As of September 2021, Egypt had shared 977 SARS-CoV-2 genomes on GISAID, with Egyptian researchers conducting multiple genomic studies and submitting sequences with identifiers. By April 2023, a total of 3,935 SARS-CoV-2 sequences isolated from Egypt had been retrieved from the GISAID database, spanning from March 2020 to 2023 ³¹⁹.

The Egyptian Genome Project (EG) was established through a multi-institutional coalition coordinated by the Academy of Scientific Research and Technology (ASRT), a governmental body under the Ministry of Higher Education and Scientific Research. Following a competitive proposal process in 2020 evaluated by Egyptian expatriate genomics experts, ASRT approved a national consortium led by the Egypt Center for Research and Regenerative Medicine (ECRRM) as project headquarters. The consortium includes multiple governmental and non-governmental universities, research centers, and the National Museum of Egyptian Civilization, with ASRT providing oversight, funding, and technical coordination. Variants of clinical interest arising from the project will be submitted to open access databases, such as dbSNP and ClinVar ³²⁰.

No further evidence identified on the Ministry of Health and Population website ³²¹.

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no public evidence from the World Health Organization (WHO) or the Egyptian government indicating that Egypt has failed to share influenza samples in accordance with the Pandemic Influenza Preparedness (PIP) Framework in the past two years.

The Ministry of Health and Population's "National Influenza Pandemic Preparedness Plan" (December 2018) explicitly states Egypt's commitment to the PIP Framework. The plan outlines that Egypt will ensure the timely sharing of influenza viruses with pandemic potential through the Global Influenza Surveillance and Response System (GISRS) ³²².

No further evidence identified on the Ministry of Health and Population website ³²³.

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no public evidence of Egypt refusing to share samples of a pandemic-potential pathogen during an outbreak in the past two years.

Evidence points toward collaboration on specific outbreaks. According to a 2024 study titled "Monitoring the VDPV2 outbreak in Egypt during 2020-2021 through environmental and acute flaccid paralysis surveillance systems," when circulating vaccine-derived poliovirus type 2 (cVDPV2) was detected in sewage samples, the Egyptian Ministry of Health and Population worked in collaboration with the WHO to launch a response ³²⁴.

No further evidence identified on the Ministry of Health and Population website ³²⁵.

Risk Environment

6.1 Political and security risk

6.1.1 Government effectiveness

6.1.1a Policy formation

Score: 50

6.1.1b Quality of bureaucracy

Score: 25

6.1.1c Excessive bureaucracy/red tape

Score: 50

6.1.1d Vested interests/cronyism

Score: 0

6.1.1e Corruption

Score: 30

6.1.1f Accountability of public officials

Score: 50

6.1.1g Human rights risk

Score: 0

6.1.2 Orderly transfers of power

6.1.2a Orderly transfers of power

Score: 25

6.1.3 Risk of social unrest

6.1.3a Risk of social unrest

Score: 25

6.1.4 Illicit activities by non-state actors

6.1.4a Risk of terrorism

Score: 50

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 75

6.1.5 Armed conflict

6.1.5a Presence or risk of armed conflict

Score: 75

6.1.6 Government territorial control

6.1.6a Government territorial control

Score: 100

6.1.7 International tensions

6.1.7a International tensions

Score: 0

6.2 Socio-economic resilience

6.2.1 Literacy

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 84.23

6.2.2 Gender equality

6.2.2a UNDP Gender Inequality Index score

Score: 63.55

6.2.3 Social inclusion

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 98.43

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 0

6.2.4 Public confidence in government

6.2.4a Public confidence in government

Score: 50

6.2.5 Local media and reporting

6.2.5a Robust, open, diverse local media and reporting

Score: 100

6.2.6 Inequality

6.2.6a Gini coefficient

Score: 71.5

6.3 Infrastructure adequacy

6.3.1 Adequacy of road network

6.3.1a Adequacy of road network

Score: 50

6.3.2 Adequacy of airports

6.3.2a Adequacy of airports

Score: 75

6.3.3 Adequacy of power network

6.3.3a Adequacy of power network

Score: 100

6.4 Environmental risks

6.4.1 Urbanisation

6.4.1a Urban population (% of total population)

Score: 63.1

6.4.2 Land use

6.4.2a Change in forest area (percentage points)

Score: 76.17

6.4.3 Natural disaster risk

6.4.3a Natural disaster risk

Score: 25

6.5 Public health vulnerabilities

6.5.1 Access to quality healthcare

6.5.1a Total life expectancy (years)

Score: 77.89

6.5.1b NCD mortality rate

Score: 33.43

6.5.1c Population aged 65+

Score: 72.63

6.5.1d Tobacco use (% of adults)

Score: 7.86

6.5.1e Level of adult obesity (%)

Score: 51.64

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 41.23

6.5.2 Access to potable water and sanitation

6.5.2a Access to potable water

Score: 97

6.5.2b Access to at least basic sanitation facilities

Score: 97

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 0

6.5.3 Public healthcare spending levels per capita

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 22.81

6.5.4 Trust in medical and health advice

6.5.4a Trust medical and health advice from the government

Score: 100

6.5.4b Trust medical and health advice from medical workers

Score: 100

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