At a conference held yesterday in Paris, Tunisian Minister of Health Khalil Ezzaouia called for the establishment of universal healthcare for all Tunisians.
Tunisia’s current hybrid healthcare system – based on the principles of assistance and insurance – is funded through employee contributions and government-subsidized coverage for those who are unemployed.
According to Stefano Lazzari, Tunisia’s World Health Organization (WHO) representative, in a report published by the Economist Intelligence Unit (EIC), “Tunisia has the best health indicators across the board of all the countries in North Africa.” The same report found that, “nearly 90% of Tunisians have access to health insurance that provides a relatively high level of basic services – a higher coverage rate than in Algeria and Morocco.” Additionally, Tunisia’s tuberculosis rate is four times lower than Morocco’s, and its maternal mortality rate is half that of Algeria. In Tunisia, life expectancy hovers around 75 years of age for both women and men.
However, Tunisia’s healthcare system is far from perfect, leaving many inadequately covered – particularly those who live in rural, underdeveloped areas. The EUI report highlighted the unequal distribution of services throughout the country: “In the rich coastal areas, the services are comparable to those in Europe, whereas in the interior of Tunisia the number of specialists and doctors, the quality of equipment, and the coverage of services are all much lower.” Furthermore, some estimates indicate that 50% of health expenditures in Tunisia are out-of-pocket.
During the conference, Ezzaouia explained that, “800,000 families, or 2.5 – 3 million Tunisians [out of a total population of 10.7 million inhabitants] with no healthcare coverage, and who mainly live in the country’s poorer interior regions, already benefit from a ‘healthcare card’ that gives families under the poverty line free access to health care, and reduced-price care for others … But this system is inadequate, and puts a big strain on public hospitals’ budget. On the other hand, private health establishments treat 20% of the population and alone they absorb 60% of the medicine budget.”
It is no coincidence that this conference took place in France, where universal healthcare – “la CMU” (Couverture Maladie Universelle) – has existed since 2000, when it was pushed through by the Lionel Jospin government.
“This measure is very anticipated in Tunisia. There is political consensus concerning the project, but a financial plan has yet to be examined,” said Khalil Ezzaouia.
Emna Mnif, the president of the political group Kolna Tounes, estimated that “the project for a universal healthcare system is a necessary step, but it still does not address demands for the right to healthcare access and the right to decent housing … and even the right to work.”
The Tunisian ministers of social affairs and finance were also present at the conference, along with a number of representatives from Tunisian civil society.
All statistics were found in the Economist Intelligence Unit report, “The Future of Healthcare in Africa”. All quotes from the participants at the “Eradication of Poverty in Tunisia” conference were found in an online article in La Croix.