MENA’s Emerging Healthcare

Industry

Outline• Global Medical Tourism• Demand for Medical Tourism in MENA

o MENA Capacity for the Health Care Industry

• Lebanon’s Distinguished Healthcareo Infrastructure

• Proposed Plan of Actiono Legal Infrastructureo Medical Service Tourist Sectoro Projected Tourism Revenue

Global Medical Tourism

Quality Cost AnonymityTechnolog

y/Expertise

Availability

2004 2010 2012 2013

4060

80100

Global Revenues

$ B

illi

on

s

Statistics

• 50+ Destination Countries• Over 8 million patients• 2013 Expected Growth 20%

TOP 5 Destinations (~6.5 Million MT )

THAILAND

HUNGARY

INDIA

SINGAPORE

MALAYSIA

Global Medical Tourism Hotspots

Demand for Medical Tourism in MENA

150 JCI Accredited Hospitals and Clinics

Medical Tourism Mena

KSA

12 JCI$1 B 240K MT

$2 Billion IMF Loan

Jordan

10 % Growth

40 JCI$1.6 B 50K MT

44 JCI42K MT20%

Growth$16.8 B HC Costs ~ 2015

100K Medical tourists ~ 2016

Middle East Healthcare Market

Trends

Growing HC Demand

(9%)

Growing & Aging Population w/

Chronic Disease Burden

Health Consumption Drivers: Rising

Income Levels and Increased Insurance

Penetration (mandatory)

Human Capital

Shortages

Shortage in physicians. High dependence on

expatriates

Limited medical education options

Increased Regulation

eClaims, DRG-based licensing

Price Revisions

MENA HealthcareD

isease

D

rive

rs

Unhealthy Dietary Habits

Inter-marriages within families

Smoking

Low Exercise Level

Poor Road Safety

38.00%

17.00%

16.00%

3.00%

3.00%

2.00%

21.00%

Leading Causes of Death

MENA Healthcare

KSA Kuwait Bahrain UAE Oman Qatar

400 488 497

885

264

688608

1579

771

1704

520

1612GCC Per Capita Healthcare Costs (USD)

2000

2009

525252

52%

224% 134

%

54%

93%

97%

• Preventative Care• Disease Management• Population 3.2% CAGR

MENA Region Population (millions)  1950 2007 2050Arabian Peninsula 8 61 125North Africa 44 156 235Western Asia 52 215 332

MENA Medical Tourist Projects

OmanInternational Medical City

$1.0 B project 530-bed hospital Transplant Center Rehabilitation Center Diagnostic Prevention Health Resort

BahrainDilmunia Health Island

$1.6 B project 358-bed hospital 216-bed hospital Specialist clinics Sports medicine 3 five-star hotels, Leisure & Recreation Shopping centers 15,000 pp

community

GCC Outpatient Medical Travel

ME 32%

EU 13%

EU 40%NA 95%

ME 2%ME 58%

ME 8%

MENA Medical Travel Destinations

Lebanon’s Distinguished

Healthcare

“Lebanon will be the regional resource serving the advancement of health and medical tourism to the people of the MENA”

Quality & Affordable Health Care

Availability of Hospital Beds Highly Qualified Medical Staff Physician & Nurse Patient

Ratios High Nurse to Patient Ratios Geographic Location World Class Services &

Culture, Skilled and Multi-lingual Staff

Medical Tourism Lebanon

JCI Accredited & University Affiliated Medical Centers

St. GeorgeBalamand University

Rafik HaririLebanese University

Rizk Hospital

Lebanese American Uni

Hotel DieuSt. Joseph's University

Center Hospital

Kaslik University

University Affiliated Medical Centers (Non-Accredited)

Hospitals, Accreditation & Affiliation

Columbia University

U. George Washington

John Hopkins University

Saint Jude Children Research Hospital

University of Poitiers Neurosciences

Laval University in Quebec

Cardiovascular Sciences

Diabetes and Metabolic Disorders

Stem Cell Biology and Therapeutics

Cancer Neuroscience Immunology

Centers of Excellence

Infrastructure

Capacity … 100 000 Medical Tourists

Today … 10,000 foreign MT

10,000 Nurses12,000 Doctors

117

19

28

Private Short& Medium

Private Long Stay

Public Hospitals

(1570)

(9224 beds)

(3496)

Brain Drain… Wasted Talent

19

New Hospital Tower

Cancer and Children’s Hospital

Academic and Clinical Center

Current Medical Center

$500 M Project600 Bed Hospital342 physicians129 (38%) US Board Certified

AUBMC’s Regional Dominance

Active Regional Health Related

Activities• Al Manaa General Hospital

(AMGH) • Damascus Cardiovascular

Center (DCVC)• Jordan Ministry of Health• Iraq Ministry of Health• UNRWA• Palestinian Red Crescent

Society (PRCS• Al Quds University • Medical City Teaching Hospital

(MCTH) in Baghdad• World Health Organization

(WHO): Training for 100 Iraqi physicians and nurses in:o Advanced Trauma Life

Support (ATLS)o Cardiac Life Support (CLS)o Pre-Hospital Trauma Life

Support (PHTLS)o Advanced Trauma Care for

Nurses (ATCN)o Pediatric Trauma

• Al Quds University - Palestine

• King Faisal Specialist Hospital & Research Center - KSA

• King Hussein Cancer Center - Jordan

• Medical City Teaching Hospital (MCTH) - Iraq

• Royal College of Surgeons in Ireland (RCSI) - Bahrain

• Dr. Haifa Mahmoud Eye Center/Hospital – Bahrain

• Mouwasat – KSA• Harley Street Medical

Clinics – Abu Dhabi

Surgery ('000) USA

India

Jordan

Singapore

Thailand

Lebanon (AUBMC)

Heart Bypass 144 9 10 14 24 15

Angioplasty 57 9 5 8 7 4Heart Valve Rep.

170 1.5 12 14 22 15

Hip Rep. 50 8 8 11 14 14

Knee Rep. 50 7 7 11 12 13

Spinal Fusion 100 12 10 18 11 20Dental Implant

2 - 10 0.5 3 3 0.8

Lap Band 30 8 5 12 12 12Breast Implants 10 5 3 5.4 4 4

Rhinoplasty 8 4 2.5 2.7 3.5 4

Face Lift 15 7 3 4 7 4.7

Hysterectomy 15 5.5 2.5 4 5 4.5

Price Analysis

Infrastructure

Patient Flow

Lebanon’s Proposed Plan of Action

Public Private Partnerships

Quality Assurance Board

Medical Research

Regional Marketing

Expedited Visas

Tax Incentives

Tax Write-Offs

Reinvestment into Healthcare

Low Import Duties on new equipment

Depreciation on old equipment

Initiatives

Moving Forward

Accreditation of Medical Tourist Stakeholders

International Accreditation of Health-Care Facilities

Informed Patient Choice

Continuity of Care

Non-Waiver of Liability

• Create a National Regulatory & Accreditation Boardo Maintain the Registrar of Medical Practitioners o Administer continuing medical education o Encourage synergies among the various medical centers

(medical, health, lab, wellness…etc.)o Stimulate collaboration between the health sector and the

emerging entrepreneurial ecosystem in Lebanon. o Regulate the ethical conduct of registered medical

practitioners. Privacy and Confidentiality of Patient Information

Professional Standard of Care and Health Services

Training and Certification of MT Agents

Medical Travel and Complication Insurance

Contributions to Compensation Fund

Potential Revenues

2015 2016 2017 2018 2019 2020$0

$200,000,000

$400,000,000

$600,000,000

$800,000,000

$1,000,000,000

$1,200,000,000

Medical Tourist Revenue (million USD)

Tourist Revenues

Medical Revenues

RevenueMedical Expense $8,560 Tourists Per Patient 4Avg. Length of Travel 5Expense/Person $300 Total Other Costs $6,000 

Year Medical Tourists Healthcare Staff Service Staff Total New Jobs

2015 16,695 83 334 4172016 26,085 130 522 6522017 40,693 203 814 10172018 51,127 256 1023 12782019 62,604 313 1252 15652020 75,125 376 1503 1878

Total 6808