Regional partnerships and integrated health strategies are playing a critical role in transforming public health systems across North Africa and the Eastern Mediterranean, Tunisia’s Minister of Health, Mustapha Ferjani, said in an interview with Gulf Business ahead of the upcoming ‘One Health, One Future’ regional conference.

In a wide-ranging discussion, Ferjani highlighted the impact of Saudi Arabia’s development funding in Tunisia’s underserved areas, lessons from intra-regional collaboration, and the importance of embedding the ‘One Health’ framework — linking human, animal, and environmental health — into national policies. He also outlined Tunisia’s efforts in operationalising the approach through legislative reform, capacity building, and cross-sectoral coordination.

As Tunisia prepares to host the summit co-organised with the World Bank and the Quadripartite, Ferjani called for deeper regional alignment, data sharing, and coordinated efforts to build resilient health systems and respond to emerging challenges.

The Saudi Fund for Development (SFD) has recently deepened its healthcare engagement in Tunisia, funding key hospital projects in underserved regions. How do you view the broader role of such regional development partnerships in transforming public health infrastructure across North Africa and the Eastern Mediterranean?

Regional partnerships in MENA are strategically vital for the development of different sectors including public health in countries such as Tunisia. Investments from high-income countries, such as Saudi Arabia, are particularly beneficial as they foster shared growth while leveraging a deep understanding of regional contexts and specific challenges in comparison to international investments.

The SFD’s funding of key hospital projects in underserved regions of Tunisia, such as Sbiba (Kasserine Governorate) and El Jem (Mahdia Governorate), with an overall commitment of over $1.23bn in soft loans and grants for various development projects, including significant contributions to healthcare, directly addresses critical needs and disparities in healthcare access.

We see the broader role of such regional development partnerships as transformative for public health infrastructure across the MENA region by bridging critical infrastructure gaps and expanding healthcare capacity, particularly in underserved areas, thereby enhancing service quality through the integration of modern technologies and international best practices. These collaborations promote sustainable development by building resilient healthcare systems with long-term operational frameworks.

Tunisia’s collaboration with the SFD is part of a growing trend of intra-regional investment in health and development. What lessons can be drawn from Tunisia’s experience that could be replicated in other MENA countries, especially those facing similar healthcare access challenges?

Tunisia’s collaboration with the SFD demonstrates how successful intra-regional development partnerships are, especially when built on targeted investment, long-term commitment, comprehensive capacity building, and most importantly local ownership.

Among the key lessons that can be drawn from Tunisia’s experience and that are highly replicable in other MENA countries facing similar public health challenges, is directing investments towards underserved regions to address geographical disparities in health and ensure an expanded equitable healthcare delivery.

Our Tunisian Saudi partnership also highlights the value of a long-term commitment and sustainable funding mechanisms, as such financial support allows for comprehensive planning and greater project longevity.

Strong local ownership and seamless alignment with national health strategies, is another key lesson to be considered by other countries to ensure that external funding complements existing national plans and capacities, accelerating the transformation of public health infrastructure and improving healthcare access for millions.

With the upcoming ‘One Health, One Future’ conference for the North Africa and Eastern Mediterranean region, how do you see the ‘One Health’ framework shaping national health strategies across the region? Are there any current examples in Tunisia where this integrated approach has already been adopted or piloted?

Tunisia Ministry of Health foresees the ‘One Health’ framework playing an increasingly central and transformative role in shaping national health strategies across North Africa and the Eastern Mediterranean.

Our upcoming ‘One Health, One Future’ conference for the region is meant to accelerate the adoption of comprehensive One Health national strategies and foster greater inter-sectoral collaboration, moving away from siloed approaches in public health, veterinary medicine, and environmental protection.

Demonstrating a long-standing commitment to this integrated vision, Tunisia has prioritised efforts towards One Health. As early as 1994, well before the concept was formally established, the National Committee on Anthropozoonosis was created and then an early-warning system for avian influenza was established in 2000, combining border screening, farm testing, and wetland bird monitoring.

Following the ratification of the Paris Agreement in 2016, Tunisia’s ambitious Nationally Determined Contribution to the UNFCCC further integrated environmental protection, climate resilience, and public health. Our commitment to One Health was also evident in the finalisation of the National Action Plan on Antimicrobial Resistance (AMR) in 2018, which led to scaled-up AMR monitoring to include fish, dairy, and meat. By 2019, cross-sectorial collaborations between the Ministries of Health, Commerce and Agriculture lead to Law 25 on the sanitary safety of food products.

More recently, in 2022, Tunisia launched a new legislative project led by its national One Health committee and established the One Health Laboratory at Tunis Pasteur Institute. Later in December 2023, the Ministry of Health joined efforts again with other Ministries to draft the joint One Health national roadmap, setting clear objectives for improved surveillance and coordinated response.

This commitment extends to capacity building, with Tunisian veterinarians completing FAO’s One Health courses, and practical applications such as our successful rabies elimination campaigns, which achieved over 80 per cent canine vaccination coverage in 2024 through free, mandatory vaccination and nationwide educational campaigns.

Most recently, in 2025, Tunisia partnered with the World Bank to develop a Budgetary Action Plan further anchoring One Health in national planning.

Given the interconnected nature of human, animal, and environmental health in the region — particularly in rural and agricultural communities — what are the key capacity-building priorities to make ‘One Health’ a functional and sustainable model in Tunisia and beyond?

We aim to transform the ‘One Health’ approach into a dynamic driver for research, innovation, and resilience-building.

To achieve this, regional platforms for collaborative research must be strengthened, and innovation encouraged by establishing effective networks that include researchers, physicians, veterinarians, agricultural engineers, environmental scientists, economists, and data experts.

We also seek to enhance data sharing, jointly set regional priorities, and develop impactful collaborative projects.

Furthermore, we call for launching master’s and doctoral programmes in ‘One Health’ within regional universities, through the preparation of joint training modules covering human medicine, veterinary medicine, environmental sciences, and public health.

In conclusion, we aspire to make ‘One Health’ a true lever for action, innovation, and resilience across our region.

How do you envision regional collaboration evolving post-conference? Could we see more institutional alignment, cross-border initiatives, or even regional task forces to advance the ‘One Health’ agenda collectively across the Arab world?

Hosted by the government of Tunisia and co-organised with the World Bank and the Quadripartite (WHO, FAO, UNEP, WOAH), we envision that our ‘One Health, One Future’ conference for the North Africa and Eastern Mediterranean region to provide a strong push towards greater institutional alignment and regional collaboration around the One Health agenda.

With the anticipated ‘Carthage Declaration‘, this landmark event is designed to be a catalyst for deeper, more structured cooperation across the Arab world and aims to mainstream One Health from dialogue to action.

This means fostering formal agreements and common operational frameworks among health, agriculture, and environment ministries and agencies across the countries in the region.

We also foresee increased collaboration in tackling shared challenges, such as conducting joint disease surveillance activities along common borders, coordinated vaccination campaigns against transboundary zoonosis, collaborative research efforts into regional health determinants, as well as effective cross-border data sharing and risk assessments.

Tunisia’s past engagement with Libya on zoonotic disease prioritisation and participation in Africa CDC’s One Health workshops are early examples of this trend, which we expect to intensify with our One Health MENA Conference.

We also hope to see more countries in the region adopting national One Health roadmaps, similar to Tunisia’s recent initiative, that are harmonized with regional priorities and international standards.

Read: Here’s what Dubai’s new public health law covers

The UAE has officially implemented its Basic Health Insurance Plan for private sector employees and domestic workers across the Northern Emirates, marking a pivotal shift in the nation’s approach to healthcare access and affordability.

Read: UAE insurance: Up to 60% healthcare costs covered privately

Effective since January 1, 2025, the initiative is part of a broader nationwide strategy to ensure that all residents, regardless of income or employment type, have access to essential healthcare services. With an annual premium of just Dhs320, the plan is already reshaping how health services are accessed and delivered, especially for low-income workers previously excluded from mandatory coverage.

Affordable healthcare now a reality for thousands

At the heart of the plan is a commitment to affordability. Under the new scheme, beneficiaries pay:

• 20 per cent co-payment for inpatient care, capped at Dhs500 per visit and Dhs1,000 annually
• 25 per cent co-payment for outpatient visits, with a maximum of Dhs100 per visit
• 30 per cent co-payment on medication, capped at Dhs1,500 annually

Follow-up consultations within seven days of the original appointment are exempt from co-payment, a move aimed at encouraging consistent medical follow-through.

The low-cost structure has been designed to lift a long-standing burden from domestic workers and laborers in the private sector, many of whom previously relied on out-of-pocket payments or informal arrangements.

New coverage brings a regulatory shift

The Basic Health Insurance Plan stems from a federal directive issued in 2024, requiring all private sector employers in Sharjah, Ajman, Fujairah, Ras Al Khaimah, and Umm Al Quwain to provide mandatory health insurance for their workers. The scheme, now fully in effect, complements existing laws in Dubai and Abu Dhabi.

Dubai’s health insurance is governed by Law No. 11 of 2013 under the Dubai Health Authority (DHA), while Abu Dhabi follows Law No. 23 of 2005, enforced by the Department of Health (DoH). Both cities already mandate employer-sponsored insurance, including comprehensive benefits.

With the Northern Emirates now on board, the UAE’s healthcare policy framework has moved significantly closer to universal coverage.

MOHRE and digital integration

The Ministry of Human Resources and Emiratisation (MOHRE) leads the implementation of the Basic Health Insurance Plan in collaboration with the Ministry of Health and Prevention and the Federal Authority for Identity, Citizenship, Customs and Port Security.

Insurance under the new scheme is administered via the Worker Health Insurance platform, managed by Dubai Insurance Company PSC, which also handles claims. The plan’s data infrastructure is integrated with Riayati, the national digital health platform, and the National Unified Medical Record (NUMR)—a step that is streamlining patient care and bolstering public health analytics.

“This is not just about coverage; it’s about systemic transformation,” said Anand Singh, Senior Counsel for Transport and Insurance at Al Tamimi & Company. “We’re witnessing a transition toward a data-driven, integrated health system that aligns with global best practices.”

Changing the game for pharmacies

The impact of the plan is already visible in the pharmaceutical sector. Over 44 pharmacies have joined the provider network, and more are expected to follow. These outlets report increased footfall from newly insured patients seeking both prescription medications and over-the-counter drugs.

Pharmacies are being urged to upgrade their IT systems to comply with the plan’s digital requirements, including electronic prescriptions and automated claims submission. The result? Faster approvals, fewer errors, and a more efficient dispensing process.

This digital transformation is expected to reduce administrative delays and help create a seamless patient journey from diagnosis to treatment.

Visa requirements reinforce compliance

To ensure full enforcement, the UAE has made valid health insurance a mandatory requirement for residency visa issuance and renewal. Expatriates without proof of insurance coverage are ineligible for visa services, effectively closing the gap in enforcement that previously allowed some employers to bypass their obligations.

Golden Visa holders must present proof of long-term health insurance, prompting insurers to develop specialised packages that cater to high-net-worth individuals and long-term residents.

Strengths of the Basic Health Insurance plan

The launch of this plan has addressed several long-standing gaps in the UAE’s healthcare ecosystem:

• Greater access to healthcare: Thousands of low-wage workers now have access to essential services
• Financial protection: Medical costs are reduced for workers and employers alike
• Better public health outcomes: With increased access to early diagnosis and preventive care, the system is expected to reduce long-term treatment costs
• Streamlined data: Integration with Riayati and NUMR improves coordination across providers and ensures continuity of care

Employers previously offering private coverage also benefit, as the Dhs320 plan offers a cost-effective alternative to more expensive insurance packages.

Increasing costs

The rollout of mandatory insurance arrives at a time when the UAE’s healthcare industry is facing cost pressures across the board. Health insurance claims reached Dhs16.5 billion in 2024, an all-time high. Analysts warn that unless cost containment measures are introduced, both insurers and patients may face long-term challenges.

For hospitals and clinics, the sudden influx of insured patients has led to increased demand for medical staff, diagnostic services, and infrastructure upgrades. Without sufficient capacity expansion, patients may encounter longer wait times, reduced face time with doctors, and service delays.

Insurance sector reactions

Insurance companies are also recalibrating. High claim volumes are pushing firms to tighten approval processes and reconsider premium pricing models. Some providers are exploring bundling coverage or introducing tiered plans to manage risk.

The broader concern is sustainability. If costs continue to rise without corresponding revenue growth or efficiency improvements, insurers may be forced to raise premiums on other policies or reduce coverage options.

“This is where coordination between the government, healthcare providers, and the insurance industry becomes critical,” said Singh. “You can’t build a strong healthcare system without economic sustainability.”

A blueprint for the region?

Experts believe that the UAE’s model could set a precedent for neighboring Gulf countries looking to reform their healthcare systems.

The combination of affordability, mandatory enforcement, and digital integration creates a blueprint that balances access with accountability. However, observers stress that continuous monitoring, stakeholder feedback, and policy refinement will be essential.

The road ahead

The successful implementation of the Basic Health Insurance Plan is just the beginning. Authorities are expected to monitor the plan’s rollout closely in the coming months, with potential expansions in coverage — including maternity benefits — already under discussion.

As Singh put it, “We’ve cleared the first major hurdle, but healthcare is a moving target. The next challenge is scaling up, closing the gaps, and making sure no one falls through the cracks.”

For now, the UAE’s health sector enters a new chapter — one that promises a more inclusive, equitable, and digitally enabled future.

The Air India plane crash on Thursday which left more than 240 people dead, the worst aviation disaster in a decade, will challenge the airline’s ambitious campaign to restore its reputation and revamp its fleet.

After taking the carrier over from the government in 2022, the Tata Group unveiled plans to reverse years of under investment in an ageing and outdated fleet and create a “world class airline”, as CEO Campbell Wilson has repeatedly put it.

Read: Air India Ahmedabad-London flight crash – 241 confirmed fatalities, one survivor

The turnaround has been aimed at tackling its myriad problems under government ownership including persistent flight delays, disgruntled customers, a shortage of spare parts, poorly maintained planes and years of financial losses.

The cause of the crash, the first for a Boeing Dreamliner wide-body airliner, has not yet been determined and India’s aviation minister said a formal investigation had begun. Air India has not commented on what caused the crash.

“Newer aircraft and better maintenance should be the hallmark for Air India to survive. Proper maintenance is what they should be looking into, because Air India has had a chequered past,” said Vibhuti Deora, a former legal expert at India’s Aircraft Accident Investigation Bureau.

That past includes, while under government ownership, a Boeing 737 flight from Dubai in 2010 that overshot the runway at a domestic airport and crashed into a gorge, killing 158 people. In 2020, an aircraft of its low-cost unit Air India Express skidded off a runway in India, killing 21 people.

Indian Prime Minister Narendra Modi told an international gathering of hundreds of airline executives in New Delhi on June 2 that the country’s booming aviation industry stood at a crucial point.

On Thursday, Air India’s website swapped its bright red colour scheme and logo for a more sombre black and grey one, covering it with a banner that carried the crashed flight’s number: “AI-171”.

“For an airline, the most important thing is the brand’s identity with safety. This will be a major setback for the brand in that aspect,” said Dilip Cherian, a communications consultant and co-founder of public relations firm Perfect Relations.

A difficult day

With its maharajah mascot, Air India was once known for lavishly decorated planes and meticulous service championed by its founder, JRD Tata, India’s first commercial pilot.

But after the mid-2000s the carrier’s reputation worsened as its financial troubles mounted. It has flown wide-body planes with business class seats in poor condition and grounded some of its new Boeing 787 Dreamliners for a lack of spare parts.

When Tata regained control, the airline was “just in absolute shambles”, its CEO Wilson told Reuters in a 2024 interview, noting that some of its planes hadn’t had a product refresh since they were delivered in 2010-2011.

Air India has a 30 per cent share of the domestic passenger market and a fleet of 198 planes, of which 27 are 10 to 15 years old and 43 are more than 15 years old, the civil aviation ministry told parliament in March. Air India Express had 101 planes, with 37 per cent more than 15 years old.

The plane that crashed on Thursday was 11 years old, according to Flightradar24.

Rival Indian airlines such as IndiGo operate newer planes.

Air India, which is part-owned by Singapore Airlines, has placed orders for 570 new jets in recent years and is in talks for dozens more.

While it has aggressively expanded its international flight network, it has also faced persistent complaints from passengers, who often take to social media to show soiled seats, broken armrests, non-operational entertainment systems and dirty cabin areas.

It has been ranked the worst airline for flight delays in Britain, where its departures were on average just under 46 minutes behind schedule in 2024, according to analysis of Civil Aviation Authority data by the PA news agency published in May.

It has also been reporting losses since at least fiscal year 2019-20. In 2023-24, it reported a net loss of $520m on sales of $4.6bn.

For now, Air India faces the task of investigating one of India’s worst aviation disasters.

“This is a difficult day for all of us at Air India,” CEO Wilson said in a video message on Thursday.

“Investigations will take time.”