From Individual Successes to Collective Strategy: The Case for a Functional MENA Health Agenda
Ali Elhaj, LLM., Ph. D. CEO, IVI Holding, Healthcare Sector / Chair, MENASA Group NFP
A Region Tested Like No Other
Few health systems in the world have absorbed as many simultaneous shocks as those of the Middle East and North Africa. Rapid technological change, economic volatility, geopolitical emergencies, pandemics, and open war have struck the region in overlapping waves. Yet the region’s response is too often discussed as if MENA had one health system. It does not.
Treating MENA healthcare as a single block is the first strategic error, and the costliest one.
Four Realities, One Region
The region holds at least four distinct operating realities:
- Systems under war and duress, where hospitals function amid daily destruction, displaced staff, and severed supply chains.
- Systems under instability, where political uncertainty erodes planning, financing, and workforce retention.
- Systems under economic hardship, where the problem is not chaos but chronic scarcity of medicines, equipment, and maintenance budgets.
- Systems with abundant resources, where advanced technology, accredited hospitals, and global partnerships deliver care to international standards and compete worldwide.
What unites them deserves recognition. Clinicians in besieged and bankrupt systems keep delivering essential care with almost nothing. Well-resourced systems have built institutions that rival any in the world. These are real successes, earned under very different conditions.
Individual Success, Collective Failure
Individual success, however, is not collective strategy. Support for systems in crisis remains largely ad hoc: donated equipment without maintenance contracts, short missions without continuity, and pledges announced at conferences but never operationalized.
This is not to dismiss those who help; their commitment is genuine. But the scale and shape of that help are fundamentally incompatible with the reality on the ground. A hospital losing power every day does not need another workshop. It needs fuel, spare parts, trained biomedical engineers, and a supply line that survives the next escalation.
The result is a region of islands: centers of excellence beside systems with nowhere to turn, and no serious mechanism connecting the two.
What a Functional Strategy Requires
The region needs an operational strategy, not a ceremonial one. Five elements would set it apart:
- Tier-specific playbooks. Each category of system needs its own targets, metrics, and interventions. Sustaining high performers and rescuing collapsing systems are different jobs.
- Hospital-to-hospital twinning. Resource-rich institutions should be formally paired with struggling ones for remote clinical consultation, joint training, shared protocols, research and procurement support, with named leads and measurable deliverables.
- A regional surge and supply mechanism. Pre-positioned stocks of essential medicines, oxygen, and critical spare parts, with logistics designed to operate through conflict and sanctions.
- Resilience-first infrastructure. Solar-backed power, modular units, and offline-capable digital systems built for disruption, not for ideal conditions.
- Workforce protection and mobility. Structured pathways that let displaced professionals keep practicing within the region rather than leaving it for good.
Every element must carry a budget, an owner, and a reporting line. Anything less is another communiqué.
The Time Is Now
The cost of delays is counted in lives and in health workforces that, once lost, take a generation to rebuild. Ministries, hospital leaders, regional bodies, donors, and the private sector each hold part of the answer. The well-resourced systems are best placed to act first, and they have the most to gain from a stable region.
The question is no longer whether MENA can produce excellent healthcare. It already does. The question is whether the region will decide that every one of its health systems matters and organize accordingly.
If this matters, the time to build that strategy is now, while there is still something left to build on.
