The healthcare system of the United Arab Emirates (UAE) is best viewed through the prism of its rapidly changing demographic situation. More than 80% of residents are expatriates—in Dubai, for example, they represent 82% of the total population. All expatriates must take out health insurance, while UAE citizens benefit from a free, universal and comprehensive government-funded health service. The UAE is recognised as delivering one of the highest standards of healthcare in the region, so much so that its hospitals and clinics are increasingly popular with international medical tourists, which is significantly boosting its GDP.

The UAE, formerly the Trucial States which ended its protectorate relationship to – and gained full independence from – the United Kingdom (UK) in December 1971, has seen its population expand massively over the past half-century. In 1971, the UAE’s population amounted to a mere 344,513, however, this figure rose sharply to 3.275 million by the turn of the millennium. More recently, it has climbed further, rising to an estimated 9.3 million in 2016, and a total of 10.1 million in 2022. This near 10% increase in just six years has led to even greater demand for healthcare services and triggered a surge in the creation of medical facilities, as well as the recruitment of many doctors, nurses and other health professionals over the last decade. Recruitment of qualified personnel remains an enduring challenge, which is partly attributable to the UAE’s relatively modest national population from which to draw on.

Importantly, most of the alarming infectious diseases, such as malaria, measles and poliomyelitis that plagued the UAE more than half a century ago have been wholly eradicated.

Total expenditure on healthcare amounted to 8.6% of the overall government budget in 2017, however, this share fell to 6.9% in 2020, but it has very likely bounced back with the surge in oil and gas prices over the last couple of years. The UAE is prospering: its total GDP was estimated at $507.1 billion in 2022 and its GDP per capital was an impressive $53,708 for the same year.

Healthcare Statistics

The UAE performs comparatively well when the key health record data for its population is analysed. Infant mortality rates as recorded by the World Health Organisation (WHO) were 5.45 per 1,000 for those under one year of age, while the figure stood at 6.37 for those under five. The infant mortality rate at birth was only 3.49 per 1,000. Furthermore, the maternal mortality ratio was reported to be a mere 6% for every 100.000 live births in 2019, whereas it was 9 in the UK, and 14 in the USA . At the other end of the age spectrum, life expectancy has improved from 73.2 years in 2000 to 76.1 years in 2019 for both sexes.

Healthcare Delivery

Public healthcare services are administered in two tiers: on the one hand by federal regulatory authorities, notably the Ministry of Health & Prevention and the Emirates Health Authority (EJA); while the separate Emirates also have responsibility for certain healthcare services. The Health Authority Abu Dhabi (HAAD) is one such example along with the Dubai Health Authority (DHA).

Over the last decade, following the publication of the UAE’s set of strategic goals in 2014, where world class healthcare was identified as a prime objective, the Ministry of Health has focused on developing a major expansion of health facilities and hospitals, including a state-of-the-art general hospital in Abu Dhabi with over 140 beds. Since 2009, the number of hospitals has increased by 25% with a total of 36 government funded and 79 private hospitals.

In a significant move, recent amendments to health insurance policies have allowed residents to access healthcare offered by non-government providers at a lower cost, thereby reducing the demand for publicly funded hospitals. Moreover, thanks to these insurance reforms, specialisedcentres have attracted additional foreign visitors to the UAE. This has emerged as a distinctive feature of medical tourism in the Gulf region. Indeed, a striking feature of healthcare provision in the UAE is the way it has sought to attract patients from across the Gulf region, and further afield. Dubai Healthcare City is now a serious rival to well established health facilities in the United States (US) and Europe for specialised care. In this context, the UAE has been keen to ensure that its healthcare facilities receive international accreditation, for example through the Joint Commission, one of the largest accreditation organisations globally. Whereas in 2014, the UAE had 39 facilities which were accredited by the Joint Commission, this number had swelled to 214 in 2023—a remarkable expansion. Accreditation is now compulsory for all healthcare facilities in the UAE, including hospitals, primary health centres, laboratories and dental clinics.

The UAE has adopted a National Strategy for Wellbeing 2031 to ensure that the country is considered a world leader in terms of quality of life. The Strategy includes 14 components and 9 strategic objectives, which include improving citizens’ wellbeing by promoting health and active lifestyles, as well as a positive approach to mental health, an area of healthcare that — in this stressful era — is receiving far more appropriate attention.

The Impact of the Covid-19 Pandemic

The UAE recorded a total of 1,067,030 confirmed cases of the Covid-19 virus and the Pandemic accounted for 2,349 deaths. Almost 25 million vaccine doses were administered (24,922,054) with 1,054,525 patients recovering from the virus. The adept response to the Covid-19 outbreak was implemented by the National Emergency Crisis & Disaster Management Authority. In March 2020, when the pandemic started to gain a real grip, the authorities temporarily closed schools and colleges, along with shopping malls and food markets and a curfew was also imposed.

However, the UAE was at the forefront of implementing a vaccine programme. Beginning in December 2020, the UAE began an Emirates-wide vaccination campaigns; initially with the Sinopharm BIBP vaccine, and then adding the Pfizer, Oxford Astra Zeneca and SputnikV vaccines across a wide range of health centres and hospitals in each of the Emirates. These vaccines were provided free of charge.

On the downside, many low skilled migrant workers from Asia and Africa lost their jobs as a result of the pandemic, and they suffered considerable hardships. Overall, however, the International Monetary Fund (IMF) praised the UAE authorities for their effective COVID response, timely policy actions and structural reform implementation. This limited the scope of the pandemic and enabled the country to maintain its impressive economic growth. As the latest IMF report notes: ‘A surge in tourism and domestic activity delivered a boost to growth in 2022, while social and business friendly measures have attracted foreign talent and investment.’

Future Initiatives

The UAE’s healthcare sector generates more than $4.63 billion (USD) annually in revenues and has attracted no less than 75 insurance companies that offer over 12,000 health related insurance policies. A good example of the advanced medical programme now available in the Emirates is illustrated by the launch of a diagnostic technique for breast cancer intervention procedures. Pioneered by the American Hospital in Dubai, this is the first hospital in the Gulf region to provide this cutting-edge procedure. The contrast enhanced breast biopsy service offers patients much better diagnostic precision, far superior to other established methods, such as MRI-guided biopsy. Dr Kinda Douaidari, the Consultant Radiologist and Director of the Breast Clinic at American Hospital Dubai observes that: ‘Contrast-enhanced breast biopsy, a cutting-edge diagnostic technique, enhances precision in beast intervention procedures. … It also elevates diagnostic accuracy and patient care and can replace MRI-guided biopsy with all its inconveniences.’

As well as promoting the wide range of specialised healthcare facilities, the individual Emirates are seeking to attract investment in medical devices and equipment. A study by Fitch Solutions forecast the UAE’s medical device market may be worth $1.52 billion (USD) in annual earningsby 2025. Fitch estimated the compound annual growth rate at 4.45 from 2020 to 2025.

Overall Assessment

Looking ahead, the rapid progress made in artificial intelligence, the digitisation of data and investment in health infrastructure facilities, such as hospitals and clinics, is set to transform the health service sector in the UAE and confirm its status as a centre of excellence. The remarkable progress made by the UAE in terms of attracting medical tourism is truly astonishing to behold. This trend is primed to flourish, but it may be constrained by an inability to recruit sufficient qualified staff to meet the demand of patients worldwide. However, it is fairly reasonable to conclude that, considering the pace of development of the country’s economy, the UAE should have sufficient financial resources to meet this challenge.