1. MENA’s Emerging Healthcare Industry

2. Outline
• Global Medical Tourism
• Demand for Medical Tourism in MENA
o MENA Capacity for the Health Care Industry
• Lebanon’s Distinguished Healthcare
o Infrastructure
• Proposed Plan of Action
o Legal Infrastructure
o Medical Service Tourist Sector
o Projected Tourism Revenue

3. Global Medical Tourism

4. Quality Cost Anonymity Technology/Expertise Availability
2004 2010 2012 2013
40
60
80
100
$Billions
Global Revenues
Statistics
• 50+ Destination Countries
• Over 8 million patients
• 2013 Expected Growth 20%
TOP 5 Destinations
(~6.5 Million MT )
THAILAND
HUNGARY
INDIA
SINGAPORE
MALAYSIA

5. Global Medical Tourism Hotspots

6. Demand for Medical
Tourism in MENA
150 JCI Accredited Hospitals and Clinics

7. 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 JCI
42K MT
20% Growth
$16.8 B HC Costs
~ 2015
100K Medical
tourists ~ 2016

8. 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

9. MENA Healthcare
DiseaseDrivers
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

10. MENA Healthcare
400
488 497
885
264
688608
1579
771
1704
520
1612
KSA Kuwait Bahrain UAE Oman Qatar
GCC 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 2050
Arabian Peninsula 8 61 125
North Africa 44 156 235
Western Asia 52 215 332

11. MENA Medical Tourist Projects
Oman
International Medical City
 $1.0 B project
 530-bed hospital
 Transplant Center
 Rehabilitation Center
 Diagnostic
 Prevention
 Health Resort
Bahrain
Dilmunia 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

12. GCC Outpatient Medical Travel

13. ME 32%
EU 13%
EU 40%
NA 95%
ME 2%ME 58%
ME 8%
MENA Medical Travel Destinations

14. Lebanon’s Distinguished
Healthcare

15. “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

16. JCI Accredited & University Affiliated Medical Centers
St. George
Balamand
University
Rafik Hariri
Lebanese University
Rizk Hospital
Lebanese American
Uni
Hotel Dieu
St. 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
Centers of Excellence

17. Infrastructure
Capacity … 100 000 Medical Tourists
Today … 10,000 foreign MT
10,000 Nurses12,000 Doctors
117
19
28
0
Private Short& Medium
Private Long Stay
Public Hospitals
(1570)
(9224 beds)
(3496)

18. Brain Drain… Wasted Talent

19. 19
New
Hospital
Tower
Cancer and
Children’s
Hospital
Academic and
Clinical Center
Current Medical
Center
$500 M Project
600 Bed Hospital
342 physicians
129 (38%) US Board Certified
AUBMC’s Regional Dominance

20. • 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

21. Surgery ('000) USA India Jordan Singapore Thailand
Lebanon
(AUBMC)
Heart Bypass 144 9 10 14 24 15
Angioplasty 57 9 5 8 7 4
Heart 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 20
Dental Implant 2 - 10 0.5 3 3 0.8
Lap Band 30 8 5 12 12 12
Breast 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

22. Infrastructure

23. Patient Flow

24. Lebanon’s Proposed
Plan of Action

25. 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

26. 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 Board
o 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

27. Potential Revenues
$0
$200
$400
$600
$800
$1,000
$1,200
2015 2016 2017 2018 2019 2020
Medical Tourist Revenue
(million USD)
Tourist Revenues
Medical Revenues
Revenue
Medical Expense $8,560
Tourists Per Patient 4
Avg. Length of Travel 5
Expense/Person $300
Total Other Costs $6,000
Year Medical Tourists Healthcare Staff Service Staff Total New Jobs
2015 16,695 83 334 417
2016 26,085 130 522 652
2017 40,693 203 814 1017
2018 51,127 256 1023 1278
2019 62,604 313 1252 1565
2020 75,125 376 1503 1878
Total 6808