Sharjah looks to increase health and well-being of residents while raising regional medical reputation

Sharjah has a number of modern health care facilities, and with the emirate preparing for a strong push in the sector, the future looks bright for Sharjah as it pursues its goal of becoming a centre of excellence in the UAE. Meanwhile, an ageing population and more sedentary lifestyles are raising new health challenges that both the private and public sector are helping to address.

Health Vision

Nationally, the UAE health sector is overseen by the Ministry of Health and Prevention. The ministry is in charge of implementing governmental policy and for providing health care to all UAE nationals and residents. It is also tasked with establishing training programmes and managing and supervising health care facilities. At the local level, the system is regulated by the Sharjah Health Authority. Other health-related agencies in the country include the Insurance Authority and the Nursing and Midwifery Council.

The UAE Vision 2021 economic development plan places specific emphasis on establishing a high-ranking health care system, with all public and private hospitals now needing to be accredited by national and international organisations. Progress is being made on this metric, with the percentage of accredited health care facilities in the country rising from 46.8% in 2014 to 55% in 2015. Vision 2021 also targets the growing issues of diabetes, obesity and the high levels of smoking among the population, with attempts to reduce long-term health problems related to these various lifestyle-choice conditions.

In the 2016 Legatum Prosperity Index, which measures the quality of health care services in 149 countries around the world, the UAE rose from 34th to 28th in the quality of its health care. The index studies fundamental health care, infrastructure and preventive medicine, as well as the level of satisfaction with mental and physical health care services. The UAE also broke into the top 10 ranking for patient satisfaction.

At the local level it was reported in November 2016 that Sharjah was labelled the first Healthy City in the Middle East, a title awarded by the World Health Organisation (WHO). The emirate reached this milestone only a few years after the commencement of the Sharjah Healthy City programme in 2012.

“In order to move to the next level, Sharjah was required to achieve 80% of the WHO indicators in 2015 across different domains like health development, community-based engagements, education and literacy, skill development, water, air, sanitation and emergency preparedness,” Abdulla Ali Al Mahyan, chairman of Sharjah Health Authority told OBG. “However, Sharjah exceeded expectations and was named a Healthy City with a score of 88% in 2015. With the combined efforts of all the government stakeholders we aim to better our record each year,” he added.

Market Growth

The UAE health care market is expected to experience strong growth over the next few years, with RNCOS, a global business consultancy firm, predicting that the sector will grow at an average annual rate of 7% between 2015-20. Part of the reason is the expected population growth of the country – which could rise from 9.16m to 10.98m by 2030, according to a 2015 UN report – driven by high birth rates, longer life expectancies and a growing number of expatriates relocating to live and work the country.

Sharjah currently operates 16 public and private hospitals, as well as multiple private clinics that cover various medical specialties. The most recent addition to the hospital landscape is the 325-bed University Hospital Sharjah, which opened in 2011. In addition to having 210 in patient beds, the hospital contains 40 specialty outpatient beds, 34 emergency beds and 11 intensive care unit beds. In 2015 the hospital announced a Dh16.8m ($4.6m) expansion that would create 10 new speciality units, including a refractive surgery centre, an interventional cardiology unit, a haemodialysis unit, a dedicated paediatric emergency room and a specialised unit for long-term patient care, many of which had been completed by early 2017.

In September 2016 another facility, Zulekha Hospital Sharjah, opened a new wing. It added 31 in patient rooms to bring the hospital’s total number of beds to 150, and was completed in three months at a cost of $4m. Zulekha Hospital first opened in 1992 with 30 beds and basic medical facilities offering gynaecology, obstetrics, pediatric services and surgery. In 2016 the hospital also achieved platinum level in the US Green Building Council’s LEED certification for existing buildings, becoming the first hospital in the Middle East to achieve this highest rating for sustainable buildings.

Private Sector

The private sector is playing an increasing role in UAE health care, and this is certainly the case in Sharjah. The Sharjah Investment and Development Authority reported that the emirate’s health care sector was worth roughly Dh7.4bn ($2bn) in 2016, and is expected to rise to Dh8.8bn ($2.4bn) by 2019.

Major regional providers present in the local market include Aster DM Healthcare, a Dubai-based health care company, which in January 2016 announced that it was investing Dh1.3bn ($353.9m) in seven new facilities, including two in Sharjah. Also present in Sharjah is Avivo Group, which operates the Conceive Gynaecology and Fertility Hospital, which provides a full range of reproductive treatments, including pre implantation genetic screening of embryos, laparoscopy, colposcopy and hysteroscopy. Avivo Group also offers specialised health and wellness services, with two of its six PRIMACARE Clinics located in the emirate.

Meanwhile, Prime Healthcare Group operates the Al Qasimiah Medical Centre, which offers family medicine, internal medicine, laser treatments, dentistry and dermatology. In June 2015 the group also established the Prime Specialist Medical Centre - King Faisal in Sharjah, which offers diagnostics and treatments in the areas of cardiology, dietetics, ear-nose-throat, internal medicine, gynaecology, orthodontics and radiology.

In December 2016 it was announced that Abu Dhabi-based NMC Healthcare had reached an agreement with Gulf Medical Projects Company to buy Al Zahra Hospital in Sharjah for Dh2.1bn ($571.7m). The hospital, one of the largest private hospitals in the UAE, has 137 beds and serves approximately 400,000 outpatients and 23,000 inpatient bed days each year. The hospital also has seven operating theatres, recovery rooms, more than 80 individual clinics, a maternity complex and emergency services. NMC Healthcare has seven other outpatient medical centres in Sharjah, and the health care provider said that it has identified Dh23.7m ($6.5m) worth of annual cost synergy benefits that would come from the acquisition.

Healthcare City

Sharjah is busy constructing what will become one of the largest health care zones in the Middle East upon completion. Sharjah Healthcare City (SHCC), decreed in 2012, will cover an area of approximately 2.43m sq metres and will be located near Sharjah International Airport.

The city aims to provide health care services to residents of Sharjah and other northern emirates, in addition to providing globally competitive advanced health care services. Sheikh Sultan bin Mohammed Al Qasimi, the ruler of Sharjah, approved the master plan for SHCC in early 2017. The project is focused on attracting regional and global health care providers to Sharjah, in part by providing competitive regulations and benefits. “It functions as a health care free zone, where 100% business ownership is allowed to foreign entities without any form of local partnership,” Al Mahyan told OBG. “The foreign investors will find SHCC attractive with its zero tax and duty structure, 100% repatriation of capital and profits, and dedicated single window services.”

While the exact number of health care-related facilities that will be part of SHCC has not yet been determined, those involved in the project predict that the area will include large and medium-size hospitals, single and multi-doctor clinics, traditional healing centres, laboratories, biotech research centres, as well as yoga and wellness facilities, spas, counselling centres and rehabilitation centres. There will also be facilities for the storage and trading of medical equipment, housing units and hospitality centres.

Health Insurance

Over the last decade the UAE has increasingly moved towards mandatory health insurance for all citizens and residents, with Dubai and Abu Dhabi already having such regulations. In May 2014 Sharjah announced a medical insurance programme covering families of the emirate’s government employees, with health insurance extended in April 2015 to cover all Sharjah citizens over the age of 55. Those in the sector believe that it will not be long before compulsory health insurance is put in place. Meanwhile, a federal law for mandatory insurance for workers across the UAE was drafted in 2013, and is currently under review with the Ministry of Finance.

Medical Tourism

The UAE remains one of the main centres in the region for attracting medical tourism, and Sharjah is hoping that with the arrival of SHCC it can better compete in this segment with its neighbouring emirates. “Once completed, the city will be the most sought after health tourism centre with various treatment providers, wellness facilities, clinics, sports therapy centres and the emirate’s natural and cultural attractions,” Al Mahyan told OBG.

Others suggest that the emirate will need to become more price competitive if it is really to benefit from medical tourism. “The health care sector in Sharjah is at an advanced stage of development, but if it is to move to the next level in terms of growth, it will need to promote medical tourism by becoming more price-competitive,” Sheikh Majid bin Faisal Al Qassimi, managing director of Al Zahra Hospital, told OBG.

Health Issues

In 2013 the WHO reported that the average life expectancy in the UAE was 77 years, up from 72 in 1990. However, there are growing concerns related to an ageing population and more sedentary lifestyles. The UAE’s population is getting proportionately older, with the percentage of Emiratis over the age of 60 forecast to double by 2032, from around 5.2% today to 11%. This ageing trend will increase demands on the health care system, particularly within geriatric care. In addition, according to the International Diabetes Federation, 19.3% of the UAE population suffered from diabetes in 2015. While this figure is among the lowest rates of nations in the region, it is likely to increase with time, putting additional strain on health care services.

To tackle some of these health issues, the Sharjah Health Authority and University Hospital Sharjah offered free medical examinations for residents in November 2016, looking at blood sugar levels, cholesterol, blood pressure and body mass. Additionally, in May 2016 Al Zahra Hospital sponsored the Sharjah Health Village Event to raise awareness of health issues during Ramadan by providing free blood sugar screenings, blood pressure tests and eye check-ups. In September 2015 the UAE launched an official cancer screening initiative to help raise awareness of cancer and also the importance of regular medical check-ups in order to detect cancerous cells in their early stages.

Advanced Technology

In September 2016 Al Qassimi Hospital introduced a new device for cardiac intervention operations, with the EnSite Precision Cardiac Mapping System costing Dh3m ($817,000). This is the latest development in a push to utilise more advanced medical technology in Sharjah. Meanwhile, Al Zahra Hospital acquired the Siemens SOMATOM Force CT scanner, which can perform a full body scan in six seconds with low levels of radiation and contrast. In addition, the hospital is considering introducing robotic surgery, which is not yet available in the UAE, as well as gamma knife technology for brain surgery.

In January 2017 the Ministry of Health and Prevention introduced a new smartphone app at three public health facilities in Sharjah and neighbouring northern emirate Ajman, which could soon be rolled out across other health care facilities within the UAE. The app, created by Belgium company Science Tribune, is used by medical personnel to set up a personal prevention plan for patients and works to encourage individuals to take a more active role in maintaining a healthy lifestyle and monitoring their own health risks.

Workforce

With the health care sector projected to grow considerably over the next few years, staffing adequate human resources could prove a significant challenge for the emirate. “Recruiting and retaining top talent is one of the main objectives faced by UAE-based medical institutions,” Al Qassimi told OBG. “To tackle the former you need to invest in marketing and interviewing abroad, whereas the latter can be addressed by sitting with and helping all of your employees through an open-door policy,” he added.

According to the WHO’s “World Health Statistics” report for 2015, the UAE had 31 nursing and midwifery staff for every 10,000 residents, which is among the lowest ratios in the GCC region and below the level in many Western countries. For example, the UK rate was 88 per 10,000 people, while neighbouring Qatar had 118. At the same time, there were 25.3 doctors per 10,000 people. The report also found that the UAE had one of the lowest rates in the world for the number of psychiatric beds per head, with one bed for every 100,000 people. Significant efforts are being placed on training a new generation of medical professionals in the emirate. University Hospital Sharjah is the first teaching hospital in the UAE. In 2006 the University of Sharjah opened its College of Medicine and has also established Colleges of Dental Medicine, Pharmacy and Health Sciences. The University Dental Hospital Sharjah, opened in 2011, was the first of its kind and is still the country’s largest dental hospital. Furthermore, Sharjah Women’s College offers degrees in nursing. “The existing facilities of health care higher education at the University of Sharjah are already contributing to the ever-growing health care manpower requirements for the region,” Al Mahyan told OBG, adding that the institute will also add value to the new SHCC.

Research & Development

The University of Sharjah has been pushing forward the quality of medical education and research on offer in the UAE. In 2011 the university added the Research Institute of Medical and Health Sciences. There are also plans to establish a centre of excellence in diabetes and endocrinology research, and a centre for nano-medicine. In late 2016 The National newspaper reported that over the last two years more than Dh40m ($10.9m) had been allocated to the university’s medical research institute.

According to Taleb Al Tel, the institute’s director, there are now 11 different research groups operating at the facility, studying areas including policymaking, public health, cancer, therapeutics and drug design. This is likely to have a strong impact on the role of Sharjah in the medical research sector in future years.

Despite these recent additions, research and development spending in the UAE as a whole is still behind where it should be. According to the UN, less than one percent (0.7%) of the UAE’s GDP is spent on research, and most of that research is conducted by businesses. Universities in total spend approximately Dh2.6m ($708,000) per year versus Dh11.4m ($3.1m) by businesses. This percentage compares unfavourably with many other countries, as nations like Austria typically spend around 3% of their GDP on research.

Pharmaceuticals

The UAE continues to import most of its drugs and medical equipment, but there is an active push to establish a domestic pharmaceutical sector. According to Amin Hussein Al Amiri, the assistant undersecretary of public health policy and licensing at the Ministry of Health and Prevention, speaking to The National in February 2016, expenditure on pharmaceutical products is expected to rise to Dh14bn ($3.8bn) in 2019, up from Dh10.3bn ($2.8bn) in 2015, with an 8.1% annual growth rate over that period. Al Amiri also predicted that the number of pharmaceutical manufacturing plants in the UAE would increase from 16 current facilities to 34 in those same years.

Other UAE pioneers such as Dubai Healthcare City and Dubai Science Park have attracted international pharmaceutical companies looking to establish a footprint in the UAE market, including AstraZeneca, Baxter, Johnson & Johnson, Merck Serono, Bayer, Bristol-Myers Squibb and Pfizer. Those involved in the planning of SHCC hope that its dedicated industrial zone will prove to be an attractive location for these kinds of companies, with warehousing and cold storage also set to be available in the free zone. Furthermore, according to BMI Research, the medical device market in the UAE is predicted to grow at a rate of 8.2% per year until at least 2021, rising from a value of $967m in 2015 to $1.4bn in 2021. This points to a range of opportunities for those looking to become involved in the market, which could be of great benefit to the Sharjah emirate.

Outlook

The completion of SHCC is likely to raise the profile of the emirate as a medical destination in the region, and whose benefits could filter down to hospitals and clinics located outside the free zone. With high rates of return for private health care providers setting up in the emirate and a continuously increasing population, there are a wide range of opportunities in the emirate’s health care sector. The focus on raising standards of medical facilities in the UAE bodes well for the economy, with residents benefitting most of all.