In a modest room within her in-laws’ home in Nahet Amer, a village in Maragha, Sohag, 27-year-old Afaf struggles to calm her three-month-old baby who cries incessantly from hunger. Afaf, suffering from chronic diabetes, cannot breastfeed her child naturally. Her family’s financial circumstances do not allow them to afford additional formula after exhausting the last subsidized canister of Egylac 1 provided by the Ministry of Health.
“We rely on herbs like anise and caraway to temporarily satisfy my baby’s hunger until we can afford another can,” Afaf explains. Her husband, earning EGP 2,500 a month as a shopkeeper, barely covers the family’s expenses, including transportation and utility bills, leaving little to spare for formula.
Afaf is among thousands of mothers who depend on monthly subsidized formula from the Ministry of Health. With rising formula prices and shortages exacerbated by import crises and foreign currency constraints, obtaining formula outside the government’s supply system has become nearly impossible for low-income families.
Despite this, the Egyptian government announced new restrictions in early December 2024 to narrow formula subsidies to only eight specific cases, excluding millions of mothers who had previously qualified. Subsidized formula, priced at EGP 5 per canister (with six cans available per month per child), is now only available to mothers in severe medical circumstances such as terminal illness, ICU stays, or giving birth to twins (formula is provided for only one child).
The decision also removed eligibility for mothers with low milk production or health issues outside the strict conditions. Critics argue the policy overlooks conditions like hormonal disorders, poorly controlled diabetes, or postpartum depression, potentially affecting both mothers and infants’ health.
The Ministry of Health has begun digitizing the formula distribution system to prevent fraud, track inventory, and ensure accountability. According to the Prime Minister’s office, 251 assessment committees and 1,131 distribution points have been digitized across 21 governorates, with plans to extend digitization to six governorates under the Universal Health Insurance system.
Minister of Health Khaled Abdel Ghaffar defended the decision as an effort to promote breastfeeding and reduce costs. According to the minister, the government provides 18.6 million subsidized formula cans annually but found that only 10% of beneficiaries truly qualified, necessitating the removal of 90% from the system.
However, critics highlight the insufficiency of current subsidies. Egypt’s 2024/2025 budget allocates EGP 5 billion for medicines and formula, compared to EGP 1.08 billion the previous fiscal year. While the increase is notable, it remains inadequate given Egypt’s 1.4 million annual births, 20% of whom require formula.
MP Irene Saeed criticized the decision, arguing it deprives infants of their right to proper nutrition. She emphasized overlooked conditions that inhibit breastfeeding, such as thyroid issues, hormonal imbalances, or previous breast surgeries. In a parliamentary query, she questioned whether the Ministry of Health could meet demand for subsidized formula and noted disruptions at health units, where staff reportedly refused to evaluate mothers or distribute formula to previously approved recipients.
Saeed called for an urgent discussion in Parliament’s Health Committee to reassess the decision, ensuring children and families retain access to essential nutritional support amidst worsening economic conditions.
Don’t miss: Egypt’s Economic Divide: A Threat to Social Stability
Threatened Children
Mothers from several governorates described the government’s decision as a “death sentence by starvation for children,” particularly as the economic conditions most families in Egypt face do not allow them to purchase infant formula. In Tahwai village, Ashmoun district, Menoufia Governorate, lives Nourah El-Qobaisi, a mother of a four-month-old infant who relies entirely on infant formula provided by the nearby health unit.
Speaking with us, she said: “My son was born prematurely, and with my insufficient natural milk supply that eventually stopped due to my anemia, formula was the only solution to save his life. I submitted a request to the health unit, and I go there every month to receive the subsidized quota (six cans of Egy 1 formula). However, sometimes it’s not enough, so I’m forced to buy a can from the pharmacy, which used to cost EGP 200 but recently increased to about EGP 300, placing a huge burden on us.”
The thirty-something mother expressed fear and shock over the news of potential cuts to formula subsidies. She said: “If that happens, I won’t be able to provide milk for my son. We barely make ends meet. My husband works as a daily wage laborer, and we are drowning in debt. If subsidies are lifted, it would mean a death sentence for our children.”
She confirmed that mothers in her village face the same struggle, adding: “There are many mothers in the village who are in the same situation. Most of us live in poverty and have no alternatives. I hope the officials consider our children before making such a decision.”
In Adisiyat Al-Qibliya village, Al-Toud district, Luxor Governorate, Fatma, a mother of a newborn, struggles to make ends meet by selling vegetables in the market. Living in harsh conditions, she relies heavily on the subsidized formula provided by the health unit to feed her baby. She said: “Life is very difficult, and the subsidized milk from the health unit helps feed my son. When I heard the ministry might cut formula subsidies, I felt as though life was closing its doors on me.”
Fatma detailed her daily struggles amidst the high cost of living: “A can of formula in the pharmacy costs at least EGP 270, while my income isn’t enough to cover household expenses. My son needs milk daily, and if I am forced to buy it at that price, I won’t be able to afford our living expenses,” emphasizing that infant formula is not a luxury or an extra option but a necessity for some mothers who cannot breastfeed due to health or other circumstances.
She added: “Not every mother can breastfeed her child naturally. Sometimes illness or circumstances force us to resort to formula, and cutting subsidies would be a death sentence for children like my son.”
According to the latest available data, Egypt’s poverty rate stood at 29.7% during the 2019/2020 fiscal year, prior to the central bank’s devaluation of the pound against the dollar four times. With escalating economic crises, the World Bank indicated that poverty rose to 32.5% in 2022. The Central Agency for Public Mobilization and Statistics (CAPMAS) sets the poverty line at EGP 857 per month, equivalent to EGP 10,279 annually, while the extreme poverty line is set at EGP 550 per month and EGP 6,604 annually, reflecting the growing economic pressures on Egyptian families. CAPMAS has not released updated poverty statistics for 2024 yet, but economic experts estimate that the poverty line is expected to exceed EGP 1,400 per month per individual due to inflation and rising living costs compared to the last estimates in 2020, according to data from Capital Financial Consulting.
Similarly, Suad Ibrahim, a mother of three from Itay El-Baroud district, Beheira Governorate, faces significant challenges in providing for her family’s needs. Her husband works as a simple farmer, and his monthly income barely covers basic expenses.
When her youngest child was born underweight, the doctor advised her to use formula to improve his health. As a result, she started receiving subsidized formula from the health unit, but it is insufficient to meet his needs throughout the month, forcing her to buy additional cans from the market.
In her conversation with us, Suad pointed out the sharp rise in formula prices: “The price of a can in the market has become outrageous, and we resort to borrowing money to provide for the child’s needs. If subsidies for formula are cut, we will face a major crisis and won’t be able to cover these costs. We are already living amidst rising prices for everything, and the children are not to blame for this. We ask the government to reconsider any decision that affects subsidies because this concerns the future of our children.”
In Ain Shams district, Cairo, Salma bears the burden of raising her two children alone after her husband’s death. She said: “My youngest daughter is two months old, and I cannot breastfeed her naturally due to health problems. Formula is the only option to feed her.”
She added: “The government subsidy does not cover her needs. We receive three subsidized cans per month, but they are not enough. I am forced to buy additional cans from the market at a very high price. A few days ago, my neighbor, who works at the health unit, told me that my daughter’s formula would no longer be dispensed under the new decision. Where can we go? We are not asking for much, just the minimum care for our children. If the government considers reducing subsidies, it must provide real alternatives for the neediest families.”
By reviewing five pharmacies contacted by phone, in addition to seven online pharmacy and retail websites selling infant formula, and questioning ten mothers from different governorates about formula prices, Zawia3 found significant increases in formula prices recently. For example, the price of a can of “Hero Baby” formula rose from EGP 224 to EGP 454, an increase of 102%; “Pediamil” formula increased from EGP 181 to EGP 349, an increase of 92%; and “Bebelac” formula in its three concentrations rose from EGP 185 to EGP 300, an increase of 62%. Additionally, “Pediasure” formula increased from EGP 262 to EGP 422, an increase of 61%; and “Swisslac” formula rose from EGP 230 to EGP 274, an increase of 19%. Major pharmacy retailers list “Nan Optipro” Stage 1 formula (0-6 months, 800 grams) at EGP 545, while “S-26 Gold” Stage 1 formula (900 grams) is priced at EGP 619.
Don’t miss: Fears Grow Over Cancelling In-Kind Subsidies in Egypt
Why Did the Government Take This Decision?
The Executive Director of the Egyptian Center for the Right to Medicine, Mahmoud Fouad, told Zawia3 that the Minister of Health presented a statement to the media explaining the government’s rationale behind these steps. The minister pointed out that the aim is to eliminate corruption in the distribution of infant formula and to encourage breastfeeding in line with World Health Organization guidelines. Fouad added that Egypt spends nearly $1 billion annually on infant formula, but he believes the minister’s statements are easily contestable.
According to Fouad, corruption in formula distribution is not a new issue, as it has persisted for about 20 to 30 years. He explained: “We’re talking about infant formula that ends up in places like cafes and candy factories operating illegally. If there’s corruption in distribution, why hasn’t it been eradicated yet? The government claims it has relied on digitalization and automation, which should prevent such practices. Yet, we continue to see corruption, including fake invoices. So, why hasn’t digitalization solved this problem?”
He continued, “Moreover, the decision to abolish the ‘sugar milk’ test, which mothers underwent to determine their need for infant formula, is baffling. This test ensured that formula went to those who genuinely needed it. For example, if a mother worked long hours as a nurse or in demanding professions, formula was provided. But now, the government has completely removed this right.”
Fouad noted that the government has stated that formula will only be allocated to specific cases, such as mothers with serious illnesses like cancer or liver and kidney failure, or deceased mothers. However, he argued that such cases are rare, whereas most mothers need formula due to work circumstances or insufficient milk supply. He questioned, “Why wasn’t the test retained to accurately identify those eligible?”
Fouad also explained that Egypt records around 1.6 million births annually, though there are no precise figures on the number of children requiring infant formula. According to experts from pediatric associations, the percentage ranges between 15–20%. Thus, the number of eligible beneficiaries is not large. He suggested that if the government aimed to reduce expenditures, it could have restricted formula provision to the early stages of infancy, especially for working mothers who contribute to society. However, he believes the true objective of these measures is to cut healthcare spending as directed by the International Monetary Fund (IMF).
“This direction is evident,” Fouad said, “through increased fees for healthcare services, such as raising consultation fees at hospitals, limiting patients to one prescribed medication, and raising health insurance premiums. Now, it has extended to reducing subsidies for infant formula, under pretexts like combating corruption.”
According to Fouad, the price of one type of imported infant formula increased sharply by 250% within one year, with some prices exceeding EGP 900. He urged the government to be more transparent in its decisions and to adopt practical solutions, such as digitalization and automation, to ensure subsidies reach those who deserve them. “The focus should be on citizens’ welfare, not cutting costs at the expense of their basic rights.”
The Egyptian Constitution, in Article 80, guarantees every child the right to proper nutrition. It stipulates: “A child is defined as anyone under the age of eighteen, and every child has the right to a name, official papers, free mandatory vaccinations, and health, familial, or alternative care, as well as adequate nutrition, safe shelter, religious upbringing, and emotional and cognitive development.”
Don’t miss: After Fuel Price Hikes… Is Egypt Heading Towards Inflation?
The Ongoing Infant Formula Crisis
The Egyptian market is facing a shortage in infant formula supply, estimated between 25–30% during 2024. This is due to the replacement of the foreign company that previously dominated the market, as its current local distributor in Egypt faced financial difficulties. According to officials speaking to international media, this crisis is temporary, and supply is expected to increase in the coming period, with the exclusion of any conspiracy to benefit local producers of infant formula.
Last April, the head of the Pharmaceutical Division at the General Federation of Chambers of Commerce, Ali Auf, told CNN that there was a shortage in the supply of infant formula in the Egyptian market. He attributed the issue to the foreign company supplying the best-selling formula, “Bebelac,” changing its distributor in Egypt due to the financial difficulties of its current agent, creating a supply gap.
This change, according to Auf, caused a gap in the supply of infant formula in the Egyptian market. However, the crisis may ease in the coming days as the new distributor has started importing new shipments, while competing companies are working to increase their imports to bridge the current gap. In fact, a private company recently introduced a new shipment of infant formula into the market.
Bebelac is one of the production lines of the global company Danone, which first introduced the product to Egypt in 1960. Danone established its factory in Egypt in 2006, producing (Danone yogurt, Danette, Activia, and Dango) and early life nutrition products (Bebelac and Aptamil).
Auf stated that Egypt has a very high consumption rate of infant formula, with an annual average consumption of 50 million cans. He added that the infant formula market in Egypt is roughly split evenly between the Ministry of Health and private sector companies. The Ministry of Health distributes 25 million cans annually to eligible families at a very low price of 5 EGP per can, even though production costs exceed 150 EGP. Meanwhile, four major companies import another 25 million cans for distribution at free-market prices exceeding 300 EGP per can.
Essam Abdel Hamid, Deputy of the Egyptian Pharmacists Syndicate, attributes the crisis primarily to the unavailability of U.S. dollars for a prolonged period. Speaking to Zawia3, he explained that most infant formula in Egypt is imported, and until recently, four companies handled the imports. However, the government began to pay attention to the issue in recent years amid significant price increases and formula shortages. For example, the price of some products rose from 50 EGP to 200 EGP gradually, influenced by large shifts in the currency exchange market.
He believes that the exit of one of the four companies or the entry of another would not significantly impact the pharmaceutical and formula markets. The Egyptian Company for Trading Medicines has started providing formulas like “Bebelac,” making them available at sales outlets. However, Abdel Hamid noted that the real crisis in formula prices is tied to the rising value of foreign currency.
He added, “Formula prices are set by the importing companies abroad, so the market directly responds to changes in the dollar exchange rate.” He explained that the recent decision by the Ministry of Health is primarily about stricter monitoring of formula distribution by implementing more stringent measures aimed at limiting formula availability to eligible recipients. It is only natural for a crisis to arise because the formula previously distributed through Ministry of Health outlets helped citizens access formula at prices aligned with their economic circumstances. But now, the situation has changed, and they can no longer do so.
When asked about alternatives for the government to provide formula without restricting access for the most vulnerable, the Deputy suggested, “A proposal to establish a local formula factory was submitted to the government ten years ago by the syndicate. The problem was that the factory was expected to sell around 50–60 million cans annually to cover costs, as well as export a portion to European countries. However, the issue is that there are no grazing lands in Egypt capable of producing milk without challenges.”
This is not the first such crisis Egypt has faced. A similar situation occurred seven years ago when the prices of infant formula rose. At that time, the National Service Projects Organization (affiliated with the Egyptian Armed Forces) intervened to import large quantities of formula from abroad, offering it at discounted prices up to 50% lower than the original. The organization also acquired “Lacto Misr,” the only local producer of infant formula, and worked to double its production capacity to meet the Ministry of Health’s demand for this product.
According to an official statement issued by the presidency in April 2022, President Abdel Fattah el-Sisi directed Lacto Misr, which owns the largest infant formula factory in Egypt, to enhance its domestic production capacity to cover local needs and reduce import dependency. In 2023, Egypt experienced another crisis due to formula shortages, as prices rose unprecedentedly amid difficulties faced by distributors, leading to some popular brands disappearing from the market temporarily.
In November, a Ministry of Health statement mentioned that Lacto Misr, specializing in infant formula and nutritional products, would focus on expanding its production of stage-one and stage-two infant formula. This move aims to ensure sufficient availability of infant formula for children. The government is also working to attract foreign investment and cooperate with the private sector to expand the production of children’s nutritional products, according to the statement.
The infant formula crisis remains one of Egypt’s significant health and economic issues, requiring comprehensive and sustainable interventions from the government and private sector. To safeguard children’s health and meet their essential nutritional needs, it is crucial to strengthen local production strategies, develop fair and efficient distribution mechanisms, and continuously support low-income families. Providing affordable, high-quality infant formula must be a health and social priority, necessitating concerted efforts from all concerned parties to ensure market stability and meet the needs of children in Egypt.
