Morocco is undergoing ambitious reforms, extending universal healthcare coverage to all its citizens while resolving the shortcomings laid bare during the COVID-19 pandemic. Endorsed by a USD 450 million Program-for-Results loan from the World Bank, the government’s plans have been well received by the country’s healthcare and life sciences stakeholders who shared their viewpoints in recent PharmaBoardroom interviews.
Sweeping Reforms
While Morocco has implemented other significant healthcare reforms in recent years, the changes driven by King Mohamed VI that are currently underway are much broader in scale and scope, according to the Minister of Health & Social Protection, Khalid Aït Taleb.
Morocco’s healthcare vision adopts a comprehensive and holistic approach, addressing social protection and a complete healthcare system overhaul
Khalid Aït Taleb, Minister of Health & Social Protection
“Morocco’s healthcare vision adopts a comprehensive and holistic approach, addressing social protection and a complete healthcare system overhaul,” he says. As opposed to previous incremental healthcare reforms, the current vision, Minister Aït Taleb says “signifies a transformative shift, placing Moroccan citizens at the forefront.”
The pandemic provided further motivation for broader reform. “COVID-19 accelerated the urgency of social protection, aligning with Morocco’s ongoing efforts to streamline and expand these programs, particularly in terms of ensuring universal access to healthcare services,” points out Hassan Boubrik, director general of the National Social Security Fund (CNSS), the organism that is spearheading the national campaign to expand universal health insurance to the entire Moroccan population.
Another aspect the ongoing reforms are looking to underline is Morocco’s sovereignty, particularly in light of shortcomings during the pandemic “[The COVID-19] crisis highlighted the vital importance of self-reliance and autonomy in healthcare during such global emergencies,” Aït Taleb maintains.
Yet for the minister past reforms lacked sufficient investment, causing them to fall short of expectations. “The debate on universal healthcare coverage began in 2005 and continued until 2012, yet a part of our population remained without coverage, prompting a reconsideration of our social protection policies.”
Extending Coverage to All
While Morocco’s implementation of universal coverage has been ongoing, the inclusion of “vulnerable populations” in 2022 has ensured that it reaches all of the country’s citizens.
Morocco has implemented two key mandatory healthcare plans …This initiative aims to provide comprehensive protection to all Moroccans
Hassan Boubrik, National Social Security Fund
“Morocco has implemented two key mandatory healthcare plans (AMO) to enhance social protection. One program caters to non-salaried workers (AMO-TNS), including farmers, traders, and artisans. The other, called “AMO Tadamon,” (solidarity) targets vulnerable populations identified through a Unified Social Registry (RSU),” says Boubrik.
“The government covers insurance premiums for these [vulnerable] individuals, ensuring they receive the same level of healthcare coverage as salaried workers. This initiative aims to provide comprehensive protection to all Moroccans,” he confirms.
Positive Impact on the Market
For Fadela Benjelloun, the executive director at LEMM, the association of multinational pharma companies in Morocco, the ongoing reforms have another positive effect: to incentivise investments in Morocco. “The healthcare ecosystem, with the expansion of AMO, is becoming an important social and economic sector offering significant investment opportunities.”
The healthcare ecosystem is becoming an important social and economic sector offering significant investment opportunities
Fadela Benjelloun, executive director, LEMM
Pierre Labbé, GM at Maphar and CFAO Healthcare Maghreb, asserts that horizons for growth look bright thanks to the reforms. “Morocco is the fifth largest African pharmaceutical market behind Egypt, Algeria, South Africa and Nigeria, but by 2026 Morocco will be the fourth due to all the reforms being put in place by the government. This will bring the total pharmaceutical market turnover up to around USD 2.1 billion by 2026, which makes it a very exciting time to be engaged in the Moroccan pharmaceutical sector.”
Some stakeholders while more cautious, remain positive about Morocco’s potential. “The expansion of the healthcare and pharma market will happen in the medium and long term rather than immediate or short-term,” claims Ahmad Almwakeh, country manager at Merck Morocco. “So, I recommend that any company considering the healthcare market in Morocco should not focus on the struggles that we are having now but on their strategic planning for the upcoming five years.
I recommend that any company considering the healthcare market in Morocco should not focus on the struggles that we are having now but on their strategic planning for the upcoming five years
Ahmad Almwakeh, country manager, Merck
For Hocine Mahdi, senior director and GM, North, East & West Africa at IQVIA, the Moroccan market is already demonstrating growth. “Morocco has a growth rate of around five percent, a promising figure. In comparison, other North African countries are experiencing slower growth, or macroeconomic challenges. However, Morocco’s solid macroeconomic fundamentals, despite the ongoing recovery from the post-COVID period, position it favourably for the future.”
Strengthening the System
Other transformative projects beyond universal coverage are also contributing to improved healthcare and access in Morocco, says Ms.Benjelloun. She cites, among other initiatives, the rehabilitation of nationwide Primary Care Facilities (ESSP); new or newly equipped University Hospitals, and the creation of territorial health groups aiming to integrate all regional hospital healthcare offerings into a single autonomous establishment.
In addition, she speaks of the adjacent initiative to create and reform government agencies. “This [healthcare] overhaul is being accompanied by the establishment of crucial bodies for its success, such as the High Health Authority, the Agency of Medicines and Health Products, the Blood and Blood Products Agency, and the Mohamed VI Foundation for Science and Health, which will carry out any activity to reinforce and support the national healthcare system.”
Stakeholders see reformed government agencies as a necessary step. “The Medicines Direction, in its current form, is limited in its potential compared to other countries that have developed autonomous agencies capable of swift progress. Therefore, we have chosen to transform this Medicines Direction into a Medicines Agency, which will be a public entity with full autonomy,” Aït Taleb claims.
“One of the objectives in Morocco is to start creating a regulatory framework. This needs reform, financing, flow of patients, and many other things. The different ministries are working together to reach this goal,” agrees ALMWAKEH.
Made in Morocco
Another major component of the reforms is medicine sovereignty, promoting local production under the “Made in Morocco” brand. “In collaboration with the Ministry of Industry and Commerce, we are actively working on promoting the ‘Made in Morocco’ brand and local production,” says Aït Taleb.
[A] huge opportunity for Morocco is the relocation of the whole industrial chain
Mia Lahlou-Filali, CEO, Pharma 5
Reinforcing local manufacturing also stands to build Morocco’s potential beyond its borders. “Morocco has significant potential; we can easily become an African hub, and not only that but also a part of the European hub. Other countries are now looking to reshore their production, which will considerably impact their healthcare costs. Hence, Morocco can benefit from this situation and become a key player in both African and European pharmaceutical distribution,” says the minister.
Mia Lahlou-Filali, CEO of local generics and biosimilars maker, Pharma 5, says the company has made a commitment to the “Made in Morocco” strategy. [A] huge opportunity for Morocco is the relocation of the whole industrial chain. Out of Morocco’s 60 pharmaceutical companies, around 30 have the production capacities in several specialities. In my opinion, Morocco can be a solution for Mediterranean countries wishing to relocate, at a very competitive price.”
“The government’s focus on sovereignty, particularly in local drug production, aims to reduce costs compared to imports,” asserts Mahdi, citing the creation of a biotech production unit in Benslimane as a significant step in this direction. The newly created ecosystem “could attract investors and multinational companies.”
In this sense the Swedish CDMO Recipharm along with the Mohammed VI Fund and the BAB banking consortium have created MARBIO, a ground-breaking vaccine manufacturing joint venture in Morocco to support vaccine independence, something that is not without challenges. “Here in Morocco, we are starting from scratch. Our role is a pioneering one. A strong level of support from the state – which we thankfully have – is vital, and such transformations can only be achieved via robust public-private partnerships,” states Recipharm CEO Marc Funk.
Supporting Reform
In the opinion of Diego Forero, North Africa Cluster lead at Pfizer, pharma companies need to continue supporting these reforms. To that effect the company recently signed two memorandums of understanding (MoUs) with the Moroccan Ministry of Health. “The first MoU focuses on the looming health threat of antimicrobial resistance (AMR). The second MoU is focused on supporting the government to implement the planned healthcare reforms.”
The plan, according to Forero consists of three main pillars. “One is about improving the patient journey, how the patient can be diagnosed and the barriers a patient may face in their journey. The second focuses on how we can assist in strengthening the healthcare system per se, covering everything regarding capabilities, training, and solutions within the healthcare systems. The third and final pillar aims on developing ways in which we can improve access to patients through innovative agreements for negotiating, contracting and tailor-made patients support programs.”
