Healthcare Resource Guide: United Arab Emirates			United Arab Emirates (UAE) statistics :
	Summary Market Entry Current Market Main Competitors Current Demand Registration Qualifications	Reimbursement Barriers Trade Events FAQs CS Contacts Best Prospects Market Size	Country: United Arab Emirates Capital: Abu Dhabi Population: 9,400,145 (2018) GDP: USD $408.2 billion Currency: Arab Emirate Dirham (AED) Language: Arabic

Summary

The creation of a world-class healthcare infrastructure is a top priority for the government of the United Arab Emirates (U.A.E.) and, as a result, the sector has advanced and expanded significantly during the past few years. The World Health Organization determined that a third of adults in the U.A.E. are obese, and one out of five people live with diabetes. As the incidences of lifestyle diseases increase, these populations, supported by relatively high levels of income, will demand greater quality of healthcare. The government’s focus is on developing a healthcare infrastructure to address this demand.

Healthcare in the U.A.E. is regulated at both the federal and emirate levels. Federal-level legislation dates back to the 1970s and 1980s and there are pending legislative reform initiatives to facilitate the development of the healthcare industry. The U.A.E. Government is liberalizing policies to attract foreign investments in order to improve the healthcare standard and boost the healthcare industry.

The U.A.E.’s health expenditure reached a value of AED 62.2 billion (approx. $17 billion) in 2017. This includes healthcare expenditure from all the seven emirates in addition to their contribution to the federal budget. In 2018, according to Business Monitor International (BMI), health expenditures are expected to reach over AED 65.7 billion (approx. $17.9 billion) and it is forecast to rise to AED 83.1 billion ($22.7 billion) by 2022, which translates to a compound annual growth rate (CAGR) of 6%. Overall healthcare spending is expected to account for 5% of the country’s GDP by 2027, from 4.7% in 2017.

In June 2015, the U.A.E. government launched a new health insurance program in Dubai to support nationals not covered under any other government-funded health insurance scheme. This scheme is expected to benefit 130,000 by offering healthcare at 23 private hospitals and more than 500 medical clinics in and around Dubai. The Dubai Health Authority (DHA) announced in June 2016, that all Dubai residents should be covered by health insurance that will be tied to the renewal and issuance of their U.A.E. residence visas.

The U.A.E. government wants to boost the number of medical tourists coming to the U.A.E. by establishing Dubai as a center of healthcare excellence in the region. The country has a robust transportation and logistics infrastructure and is geographically well positioned to be the center of a transportation network that links the economies of India and China to Europe and the United States. These factors also make the country an attractive location for establishing a regional distribution center for medical devices. Since January 1, 2018, the UAE has implemented a 5% value added tax (VAT). However, medical fees, medicine costs, and surgery costs are classified as zero-rated items. This means that preventive healthcare services, medical and dental treatment are spared from the tax. Any healthcare procedure not related to treatment or prevention are subject to VAT.

According to investment experts, some of the biggest U.A.E. opportunities are likely to be found in healthcare projects. For instance, “Unison”, a public-private partnership between GE Healthcare, the U.A.E. Ministry of Health and Prevention (MOHAP) and Abu Dhabi International Medical Services (ADI) aims to bring together the best of healthcare technology, hospital management, and patient care into one group of eleven radiology departments spread across the U.A.E. These types of partnerships are emblematic of the government’s efforts to privatize the public healthcare sector in the country.

Market Entry

As a general rule, a foreign company intending to conduct business in the U.A.E. must do so by one of the following:

Restrictions on foreign ownership limit foreign companies’ participation to a maximum of 49% of the equity in a U.A.E. “onshore” company. However, an entity within one of the U.A.E.’s free zones can be wholly owned by a foreign company. This could change with the recent announcement from the UAE Cabinet that foreign companies will be allowed to have 100% ownership onshore. The full application of this new regulation is expected to come to full effect by the end of the year.

The applicant (exporter/company/manufacturer/distributor) must provide the following supporting documents to the Medical Devices Committee:

1. The application form duly filled, signed and stamped by the responsible person in the company

2. Notarized letter issued by the company on its original letterhead, signed and stamped by the responsible person in the company, authorizing a person or a local establishment to submit the registration files on their behalf to the Drug Department & Distribution Rights

3. Notarized Valid ISO13485 certificate issued by the competent authority in country of origin for each site involved in the manufacturing process

4. Legal and valid business licenses (manufacturing license issued by the competent authority in country of origin and attested true by the U.A.E. Embassy in Washington, DC) for legal manufacturer, final releaser & assembling site, if the site is different from legal manufacturer

5. List of the products manufactured and/or assembled by the site

6. Detailed company profile

Current Market Trends

Healthcare expenditure as percentage of GDP represented an estimated 5.6% in 2017, equal to $17 billion, and will continue at that level in the coming years. In 2018, the government approved a federal budget of AED 51.4 billion up from AED 48.7 billion in 2017. While this does not constitute the total government spending in the UAE which derives the total public spending from the respective Emirates, it is a strong indicator of the commitment of the government to raise the standard of healthcare services. Per capita health expenditure will remain high regionally and globally. Although spending increased, reports indicate that the U.A.E. still needs to increase health expenditure, particularly in the Northern Emirates.

The U.A.E. was a zero-tax country until December 2017. In January 2018, a 5% value added tax (VAT) was implemented. The country has an excellent transportation and logistics infrastructure and is geographically well-positioned to be the center of a transportation network that links vibrant economies like India and China to Europe and the United States.

These factors make it an attractive location for establishing a regional distribution center for medical devices. U.A.E. Healthcare system is regulated at both the federal and Emirate level.

Main Competitors

The U.A.E. market is totally dependent on imports for medical devices; while U.S. suppliers enjoy some advantages, including competitive prices, language, and exchange rate, European suppliers are aggressively gaining market share with their close proximity to the market and perceived better customer support.

Current Demand

The U.A.E. suffers from a shortage of trained medical personnel. There are numerous hospital construction and renovation programs underway as a result of public and private investment. The Dubai Health Authority (DHA) has reported that the UAE needs an additional 8,000 hospital beds by 2025, therefore it is encouraging further private sector investment. Estimates suggest there is now a shortage of almost 2,000 hospital beds across the country, despite an increase of around 30% in the number of beds in recent years. A growing medical tourism sector is generating demand for modern facilities with state-of the-art medical equipment. Medical device production will continue to be low, and only limited to basic items such as various types of syringes, and IV sets will be locally produced.

Registration Process

Current U.A.E. medical device regulations are based upon EU, Australian Therapeutic Goods Administration (TGA) and U.S. (FDA) regulations. Products with EU, Australian, Canadian, and U.S. approval are eligible for a shortened registration process in the U.A.E. Furthermore, once the exporter company/manufacturer or distributor has been approved by the MOHAP committee, a registration number will be given that is valid for five years. The application approval issuance depends on the completion of the required documents by MOHAP.

An application to register a medical device in the U.A.E. must be made by the device manufacturer or its local representative or distributor. The local representative or distributer must be formally authorized by the manufacturer to handle the application process and the manufacturer’s legal obligations and responsibilities with regards to placing the medical device in the U.A.E. market. The authorized representative or distributer must be available to interact between the medical device manufacturer and the MOHAP.

Reimbursement

A mandatory health insurance model funds the national healthcare system in the UAE.

The main sources of funding in Abu Dhabi are:

Barriers

The U.A.E. Commercial Companies Law requires that each company established in the U.A.E. have one or more U.A.E. national partner(s) who hold at least 51% of the company’s capital. This could change with the recent announcement of the UAE Cabinet that foreign companies will be allowed to have 100% ownership. The full application of this new regulation is expected to come to full effect by the end of the year.

Foreign companies may engage in a commercial agency arrangement whereby a foreign company is represented by a U.A.E. agent to distribute, sell, offer, or provide goods or services within the U.A.E. The agent must either be a person holding U.A.E. nationality or a company that is 100% owned by U.A.E. nationals.

The U.A.E. Commercial Companies Law requires that each company established in the U.A.E. have one or more U.A.E. national partner(s) who hold at least 51 percent of the company’s capital. Foreign companies may engage in a commercial agency arrangement whereby a foreign company is represented by a U.A.E. agent to distribute, sell, offer, or provide goods or services within the U.A.E. The agent must either be a person holding U.A.E. nationality or a company that is 100 percent owned by U.A.E. nationals.

Most patients who travel to the U.A.E. for healthcare are from the Middle East and North Africa, Jordan, Thailand and India – all of which are cheaper healthcare destinations than the U.A.E. The U.A.E. maintains an advantage over these competitor nations vis-à-vis middle-to-high income patients. The U.A.E. must attract patients from the wealthy upper tier of Africa, the Middle East and Asia, which is not easy as many of them can afford to go to Europe for treatment. Where the U.A.E. will be able to outperform European providers is in offering culturally-suitable care for Muslim patients and high quality specialized services.

Procurement & Tenders:

Dubai Health Authority Procurement Contacts:

Eman Khalifan Saleh Al Jallaf

Head of Purchasing and Contracts

Email: EKALJallaf@dha.gov.ae

Halima Ahmad Mohd Sultan

Purchasing Officer

Email: HASultan@dha.gov.ae

Tel: +971 4 219 7111

Trade Events

Health related trade events, shows and exhibitions that will take place in the United Arab Emirates during 2018-2019 are:

Building Healthcare

Date: 2nd Oct. – 3rd Oct. 2018

Venue: Dubai World Trade Center, Dubai - U.A.E.

Website: www.buildinghealthcare-exhibition.com

Organized by: Informa Life Science Exhibitions

Vision X

Date: 13th Nov. - 15th Nov. 2018

Venue: Dubai World Trade Center, Dubai – UAE

Website: www.dubaiopticalshow.com/

Organized by: IEG & DWTC

Arab Health

Date: 28th Jan. – 31st Jan. 2019

Venue: Dubai World Trade Center, Dubai - U.A.E.

Website: www.arabhealthonline.com/

Organized by: Kallman Worldwide Inc.

MedLab | Obs-Gyne

Date: 4th Feb. – 7th Feb. 2019

Venue: Dubai World Trade Center, Dubai - U.A.E.

Website: www.medlabme.com/

Organized by: Scherago International & Informa Life Sciences Exhibitions

AEEDC

Date: 5th Feb. -7th Feb. 2019

Venue: Dubai World Trade Center, Dubai – UAE

Website: www.aeedc.com/

Organized by: Index Conferences & Exhibitions

Local Associations

U.A.E. Government Health Care Links:

FAQs

1. Who are the Regulatory Authorities for Pharmaceuticals in the UAE?

a. UAE Ministry of Health and Prevention (MOHAP)

b. Health Authority-Abu Dhabi (HAAD)

c. Dubai Health Authority (DHA)

d. Sharjah Health Authority (SHA)

These authorities monitor the licensing of pharmacists and pharmacies, the registration of pharmaceuticals and advertising guidelines for drugs. The MOHAP formulates nationwide health policies and regulates the healthcare market in the Northern Emirates. The healthcare system of the country's two largest Emirates, Dubai and Abu Dhabi, are governed by DHA and HAAD respectively.

There was no separate entity to regulate the healthcare system in the Northern Emirates before 2009. The healthcare system of these Emirates fell under the authority of the MOHAP. Sharjah Health Authority was formed in May with the goal to transform and enhance the regional healthcare service industry.

2. What is the regulation of the packaging and labeling of medical products in the UAE?

3. What has been planned in UAE’s Healthcare expansion?

U.S. Commercial Service Contact Information

Rosemary Shenouda

Commercial Specialist

Email: rosemary.shenouda@trade.gov

Tel: +971 4 309 4176

George Messiha

Commercial Specialist

Email: george.messiha@trade.gov

Tel: +971 2 414 2524

Best Prospects:

Sub-sectors of medical devices such as hospital beds are scarce in the U.A.E. The U.A.E has the lowest hospital bed density (which is the number of hospital beds per 1,000 residents) in the GCC. Medical personnel in the U.A.E. also suffer from shortage and from training. We estimate the number of hospital beds at 12,903 at the end of 2017, equal to a 1.4 per thousand population. There are numerous hospitals under construction and renovation programs underway as a result of public and private investment. A growing medical tourism sector is generating demand for modern facilities with state-of the-art medical equipment. Domestic medical device production will continue to be low, and only limited to basic items such as various types of syringes, and IV sets will be locally produced.

Healthcare spending	AED 62.2 bn
... as percent of GDP	3.6%
... of which spent on inpatient services (including long-term care)	4.8% (2016)
... of which spent on pharmaceuticals	16.3% (2016)
... of which spent on outpatient services	7.5% 2016

Hospitals, Procedures, Healthcare Professionals UN:

Number of hospitals	134
…Public	39
…Private	95
Number of U.A.E. hospital beds	12,903
...available beds per capita	1.37 per 1000 population
Number of surgical procedures	117.72 per ‘000 population (2016)
...of which [top procedure]	1. Orthopedic Surgery 2. Gynecology 3. General Surgery
Physicians	21,068
Dentists	5,002
Nurses	47,979

Demographics

U.A.E. Population	9,400.145 million
Life expectancy men/women …Males …Females	77.9 years 75 years 80.4 years
Infant mortality …Males …Females	6.6/1000 live births (2016) 7.4/1000 live births 5.8/1000 live births
Percent of population older than 65	1.144%
...projection, 2030	10,977 million
Annual deaths	7.8%
...caused by [highest disease burden]	Cardiovascular and Neuro Psychiatric
...caused by [second highest]	Non-Communicable diseases