Kuwait is facing a looming healthcare crisis. In 2005, the World Health Organisation (WHO) ranked Kuwait eighth among the world’s most obese countries, with 74.2 per cent of its population considered overweight.

There has been a lot of partnering between medical institutions in the Middle East and institutions in the west

Ioan Cleaton-Jones, IFC

The state can expect a 110 per cent increase in demand for hospital beds by 2025, according to US consultants McKinsey & Company, driven by rapid population growth and lifestyle change.

The government is responding to the challenge by investing billions of dollars to build new treatment centres and revamp ageing facilities.

Changing demographics

Kuwait’s population has shown steady growth of 2.5-3 per cent in recent years and is expected to rise from the current level of 3.4 million to 5.4 million over the next two decades.

Not only is the population expanding, but the demographics are changing, a trend that is common across the region. In the Gulf, the 65 and above age group is growing faster than the world average. WHO statistics show that life expectancy in Kuwait has increased by 20 years in the past half century, from 59.4 years in 1960 to 78 in 2008.

Such demographic changes put increased burden on Kuwait’s healthcare system. As people grow older they are more likely to suffer from chronic diseases such as heart disease, cancer and diabetes.

The adoption of Western styles of living, which among other things has increased the availability of fast food in the region over the past 15 years, is compounding the strain on the current healthcare infrastructure.

“As income levels have rapidly risen in the region, people have increased fat and proteins in their diets, American-style junk food has become very popular, and this has led to an increasing number of people becoming overweight and obese,” says Ioan Cleaton-Jones, senior health specialist at the International Finance Corporation (IFC), a member of the World Bank Group in Washington.

This has had a marked effect on the health of the general population. Recent data has shown that 24.6 per cent of the Kuwaitis suffer from hypertension, and in 2007, the proportion of people suffering from diabetes was estimated at 14.4 per cent.

McKinsey & Company in its GCC Healthcare 2025 report estimates that there will be a 419 per cent increase in treatments needed for cardiovascular disease; a 323 per cent increase in treatments for diabetes; and a 275 per cent increase for cancer treatments by 2025.

Despite income levels in the GCC being broadly comparable to developed economies, healthcare spending is much lower. Research by Saudi Arabia’s NCB Capital has shown that as populations expand and life expectancy rises, healthcare expenditure in the region will need to increase by more than 400 per cent to reach $60bn over the next 17 years.

Despite being a relatively high income state, Kuwait currently only spends about 2.2 per cent of its gross domestic product on healthcare. This is much lower than the 15.2 per cent spent by the US, the 10.2 per cent spent by Germany and the 5 per cent spent by India.

Despite the population increasing at a steady rate, general government expenditure on health as a percentage of total government expenditure fell from 6.7 per cent in 2000 to 5.4 per cent in 2007.

But now after years of neglect, it appears Kuwait is now willing to start investing serious money into its healthcare sector. 

This year, the state is expected to tender a series of multi-million and billion dollar social infrastructure projects.

Health investment

The Public Works Ministry has been allocated $10.8bn for infrastructure development until 2013. Top of the ministry’s list of priorities is construction of the 479,360 square-metre Sheikh Jaber al-Ahmed al-Sabah Hospital.

In November 2009, a joint venture of Kuwait Arab Contractors Company and Egypt’s Arab Contractors (Osman Ahmed Osman & Company) was awarded a KD304m ($1.1bn) contract to build the hospital in Surra, a district in Kuwait city. It is one of the largest building projects in Kuwait. The hospital will have 1,050 beds and is scheduled to open in 2013.

Jaber al-Ahmed al-Sabah is one of nine new hospitals planned to be built in Kuwait by 2016, at a cost of more than $4.5bn.

Kuwait Oil Company is currently tendering a contract to build the new Ahmadi Hospital and surrounding residential buildings. The prequalified contractors have until 17 August to submit bids for the project, which will be located in the Ahmadi oil township, some 40 kilometres south of Kuwait City.

The Public Works Ministry is also planning to build a further four hospitals at the Al-Sabah medical area in Shuwaikh, which is located just west of Kuwait City.

The Razi Hospital, Physical Medicine Hospital and the Ibn Sina Hospital will each have 500 beds, while the planned maternity hospital will have 600 beds. Construction of these hospitals is expected to be started and completed between 2011-16.

As part of its plans to improve the provision of public health services throughout Kuwait, the Public Works Ministry is also planning to build an 800-bed hospital at Al-Jahraa, and two 600-bed units at Al-Adan and Al-Ameri within the next five years.

Upgrading facilities

Kuwait is not just increasing the capacity of its healthcare facilities by building new hospitals, it is also upgrading and expanding existing medical establishments.

In June, the Health Ministry announced plans to build nine towers to be added to current hospitals over the next four years at a total cost of $160m. The towers will add 2,000 new beds.

Another priority for the government is to improve the quality of healthcare delivery in the new hospitals and existing facilities.

Many Kuwaitis currently travel abroad for medical treatment, partly due to a lack of faith in their country’s health system, but also because many specialist procedures are unavailable locally. In 2009, Kuwait allocated KD130m of its budget to send patients overseas for specialist treatment not available in its hospitals.

In order to raise standards and increase confidence in the healthcare sector, Kuwait has joined other GCC states in bringing in Western expertise.

“There has been a lot of partnering between medical institutions in the Middle East and institutions in the West, so Gulf states can show people that they are setting a good example,” says Cleaton-Jones.

In November 2009, Kuwait signed a memorandum of understanding (MoU) with London’s Great Ormond Street Hospital, a UK children’s hospital specialising in childhood cancer and leukaemia. This came shortly after Kuwait announced it had signed an MoU with Guy’s and St Thomas Charity Hospital in London in a bid to raise healthcare standards.

“The aim … is to sign MoUs with a number of British healthcare institutions to set plans and development projects for hospitals in Kuwait, especially in terms of quality of services,” Kuwait’s health minister Hilal al-Sayer told local media earlier this year.

A further challenge facing Kuwait is finding sufficient, skilled medical staff. Some 63 per cent of physicians and 90 per cent of nurses are expatriates. This over-reliance on foreign workers results in a high turnover of staff, so expertise is continually being lost. This inevitably has an impact on the quality of care offered in the country.

Kuwait is trying to address the lack of home-grown medical professionals by investing in training facilities.

The largest project in the pipeline is the expansion of the national university, which has witnessed an increase in student and staff numbers of more than 40 per cent over the past five years.

The new $3bn Sabah al-Salem integrated campus is being built at Shadadiyah, 20 kilometres west of Kuwait city. The campus will include a $400m medical school and a 600-bed teaching hospital.

One area that many experts feel should be developed throughout the Gulf is primary healthcare. A fully integrated healthcare system enables patients to access healthcare through a single point of contact.

But at the present, single-point access is not very common in the region and patients can choose any one of a number of points of access, ranging from a local doctor to a specialist hospital.

Primary care

A noticeable feature of Kuwait’s healthcare plans is the absence of primary care facilities. Experts believe that this must be addressed.

“Primary healthcare is important. A lot of these countries in the Middle East are trying to play catch up and build all of these big hospitals that they didn’t have before. They are very much in love with big shiny modern equipment … and they often don’t put enough emphasis on primary care,” says Cleaton-Jones.

With its large oil reserves and a production rate of about 2.3 million barrels a day, Kuwait has readily available capital to direct into improving its healthcare infrastructure. The nine hospitals that the government is planning to build over the next six years is evidence that the state is willing to invest to meet its healthcare needs.

But there is more to improving the healthcare sector than just building large hospitals. Increasing the role of the private sector, improving primary healthcare and training facilities are areas that Kuwait will also need to address in the coming years.