On 26 June 2026, the “Medicine for All” charitable foundation had its activity halted and its premises sealed, and a committee of the Egyptian Drug Authority issued a decision stopping the receipt or delivery of medicines until further notice, a move that caused widespread resentment among pharmacists and civil society organisations and cast a shadow over thousands of patients unable to afford treatment, who are not covered by the health insurance umbrella or by decisions for treatment at the state’s expense, or who face difficulty obtaining some essential medicines because they are in short supply in pharmacies.
The foundation’s activity dates back to an initiative launched in 2006 with the aim of reducing the waste of medicines and providing treatment to those unable to afford it, before it became, in 2013, a civil foundation officially registered with the Ministry of Social Solidarity, and gradually expanded until it had eight branches serving thousands of beneficiaries daily, through a system for organising the receipt of medicines and redirecting them to patients in need.
Earlier this year, the foundation was surprised by a letter from the Ministry of Social Solidarity asking it to regularise its status with the Egyptian Drug Authority, as the body competent to regulate the circulation of medicines, which prompted the foundation to submit a number of proposals to legalise its activity and place it under the Authority’s supervision, so that the service could continue within a legal framework, before it was taken by surprise by the decision to halt its activity.
According to pharmacist Walid Shawky, chairman of the board of the Medicine for All foundation, the Drug Authority notified civil associations and foundations working in the field of medicine to stop their activity of receiving and distributing medicines, without providing an alternative to guarantee patients’ continued access to treatment. He points out that the Authority stopped these associations’ dealings with medicine distribution companies by closing their accounts on the companies’ electronic system, and that the decision was not limited to stopping the receipt of medicine donations but also barred the associations from dispensing the medicines already in their possession to patients.
He reveals that the latest inspection campaign ended with a committee of the Drug Authority filing a report against the foundation that included accusations of running an unlicensed warehouse, possessing medicines of unknown origin, and medicines listed in the narcotics schedules, explaining that the case is still before the prosecution.
He tells Zawia3: “The foundation asked the Drug Authority to set any regulatory requirements it deems necessary to guarantee the quality of medicines and the mechanisms for their circulation, but it received no response, and when we asked about the fate of the patients after the activity was halted, we got no answer; we were only told: stop working now and we will reach an understanding later.”
He explains that the foundation, which has been working for about 13 years in collecting and redistributing medicines, is subject to oversight by the Ministry of Social Solidarity, and used to serve no fewer than 10,000 patients a month, in return for an administrative fee equal to only 10% of the value of the medicine, in addition to providing medicines for medical convoys, health initiatives and shelters. He affirms that the affected patients mostly suffer from chronic diseases such as diabetes, high blood pressure and heart disease, and many of them have no insurance coverage, or their coverage does not include the medicines they need, or they face shortages of medicines within the government system.
He affirms that the foundation applied an integrated system to verify the safety of medicine before dispensing it, including inspecting packages, checking their validity, and excluding any medicine requiring refrigeration if its storage conditions could not be verified, as well as destroying expired medicines, in addition to following up on the patient’s health to ensure the treatment was effective.
He adds: “To provide treatment for patients, the foundation relied on a mix of financial donations and in-kind donations of medicines; the average value of the medicines it distributed each month was about EGP 4 million, while direct purchases accounted for only about EGP 400,000, with the larger part coming through medicine donations, which makes continuing the activity impossible now that the receipt of those donations has been halted, especially since donations from pharmaceutical companies are limited and confined to slow-moving items or medicines nearing their expiry date.”
He explains that the foundation submitted alternative proposals to the Drug Authority, including creating a system for collecting medicines through boxes inside pharmacies under the direct supervision of the Authority’s inspectors, with full oversight of the collection, sorting and distribution operations, but these proposals were rejected.
Following the halt, the foundation tried to rescue the patients benefiting from its services by buying medicines from its limited financial resources to make up for the ban on in-kind donations, but it ran into the Drug Authority’s suspension of its dealings with medicine distribution companies through the electronic system. At the same time, the Authority required the foundation to apply for a licence to establish a cooperative society pharmacy, the procedures for which the foundation has already begun, at an initial cost of no less than EGP 150,000, but its chairman affirms that this is no solution to the problem of surplus medicines that citizens want to donate.
He stresses that establishing the cooperative pharmacy will allow medicines to be bought from distribution companies, but it will not provide a mechanism for receiving the surplus medicines held by citizens after patients recover or die, quantities that formed an important part of the reuse system after being inspected and checked for validity. He calls for an alternative mechanism that guarantees medicine continues to reach patients, and that large quantities of usable medicines, which could have been put to use instead of being disposed of, are not wasted.
The crisis goes back to unpublished official correspondence issued by the Central Unit for Associations and Civil Work, which is affiliated with the Ministry of Social Solidarity, containing the recommendations of the meeting held between the ministry and the Egyptian Drug Authority on 26 April 2026 on regulating the procedures under which civil associations and foundations may engage in the activity of distributing medicines.
Those recommendations resulted in direct instructions to the social solidarity directorates and civil associations to exclude the activity of medicine, or donating it, from the statutes of civil associations and foundations in future, while obliging existing associations to regularise their status and not to engage in any activity related to collecting or distributing medicines until they obtain the necessary licences from the Egyptian Drug Authority, in addition to taking stock of the entities working in this field in preparation for taking legal measures against them.
Medicines No Longer Provided to Thousands of Patients
The repercussions of halting medicine distribution by civil associations and civil society organisations, and the threat this poses to the continued access to treatment of thousands of patients unable to afford it, especially those with chronic diseases, prompted MP Ahmed Alaa Fayed, a member of the House of Representatives for the Egyptian Social Democratic Party, to sound a warning in the corridors of parliament last May.
In a briefing request he submitted to the Prime Minister and the Minister of Social Solidarity, the MP revealed that the recommendations of the joint meeting between the Ministry of Social Solidarity and the Egyptian Drug Authority, held on 26 April 2026, required associations to obtain licences from the Drug Authority to engage in medicine distribution, while excluding this activity from associations’ statutes in future; however, a number of associations were surprised to find that there was no mechanism enabling them to obtain those licences, while they were being asked to change their activity, which led these associations to stop providing free or low-cost medicines to thousands of citizens every month, especially those with chronic diseases who rely primarily on these entities to obtain their treatment, amid difficult economic and living conditions and the high cost of medicines on the market.
The MP said: “The absence of a suitable transitional period, and the lack of a clear and announced mechanism for regularising status, puts these institutions between two options: either stop providing the service immediately, or carry on under threat of legal accountability. This raises questions about why the Egyptian Drug Authority has not yet made licences available, and whether this is due to organisational, technical or legislative considerations, and why no clear framework has been announced setting out the conditions and controls for engaging in this activity legally in a way that guarantees the safety of medicine and the continuity of the service.”
The MP called on the government to clarify the reasons for not issuing the licences, to disclose the number of associations affected by this decision nationwide and the number of beneficiaries of their services, and to put in place a clear and flexible regulatory framework allowing these institutions to regularise their status without disrupting their community role, while granting a sufficient transitional period for regularisation and ensuring that treatment services for citizens, especially those with chronic diseases, are not interrupted.
In statements to Zawia3, the MP reveals that he contacted the Ministry of Social Solidarity, which gave no clear answer about the reasons for the decision or the mechanisms for dealing with it, and when he contacted the head of the Egyptian Drug Authority, Dr Ali El-Ghamrawy, the latter assured him that any entity that abides by the rules of practising the profession will not be harmed, while expressing the Authority’s concerns about the safety of donated medicines, particularly regarding storage conditions, the source of the medicine and its fitness for use.
He says: “These concerns deserve attention, but they do not justify halting the activity entirely; the real crisis lies in the lack of coordination between the various bodies, and what is needed is to regulate the work and set oversight controls that guarantee the safety of medicine and its continued delivery to patients, not to resort to a complete ban.”
He adds: “The rise in medicine prices and the shortage of some items make it necessary to look for practical solutions that preserve patients’ right to treatment”, pointing out that he has received no reply on whether the government has an alternative plan to fill the gap that may arise in providing treatment to those unable to afford it now that these associations’ activity has been halted.
Meanwhile, MP Naglaa El-Esseily, a member of the House of Representatives’ Committee on Social Solidarity, Family and Persons with Disabilities, affirms that the decision to stop distributing medicines through civil associations was issued within an executive framework between the Ministry of Social Solidarity and the Egyptian Drug Authority and was not presented to the House of Representatives, and therefore the committee did not discuss it. She considers that any decision to halt an existing activity should include a transitional period allowing institutions to complete licensing procedures, instead of halting the activity immediately, so that the service to patients in need is not interrupted.
She tells Zawia3: “The state has the right to set controls to regulate the activity of associations working in the circulation of medicines, in a way that guarantees patient safety, but this must be accompanied by a clear announcement of the mechanisms for regularising the status of those associations, so that they can regularise their status and continue providing the service in accordance with the law.”
She calls on the Ministry of Social Solidarity and the Drug Authority to fully clarify the executive procedures, including the body competent to issue licences, the requirements for obtaining them and the body that will oversee the activity, so that associations are not left facing a halt decision without knowing how to regularise their status, in addition to announcing a clear mechanism for dealing with these medicines and clarifying whether they will be collected through a government body or through the associations once their status has been regularised, warning that simply banning the activity without offering a practical alternative will lead to the loss of an important resource from which a large number of patients benefited.
She adds: “The government is required to clarify its plan to fill the gap that may arise in providing treatment to groups unable to afford it, especially patients who are not covered by the health insurance system or treatment at the state’s expense, or whose medicines are not available within the government system, as well as the fate of usable medicines that citizens wish to donate after patients recover or die, and which body will take charge of receiving these medicines and putting them to use instead of wasting them.”
She notes her intention to submit a parliamentary question to the government about the decision, asking about the licensing and oversight mechanisms, the plan for dealing with donated medicines, and the measures that will ensure that patients unable to afford treatment continue to receive it without interruption.
According to official data, the total number of citizens registered in the health insurance system is about 69 million, while the number registered in the new “Comprehensive Health Insurance” system exceeds 5.4 million citizens, out of 109 million people, who made up the total number of the population of the Arab Republic of Egypt inside the country in mid-2026.
Over the whole of 2025, about 2.4 million citizens benefited from decisions for treatment at the state’s expense in Egypt, while the number of beneficiaries of these decisions reached about 922,675 citizens during the first quarter of 2026.
A Grace Period to Regularise Legal Status
For his part, Mahmoud Fouad, head of the Right to Medicine Association, does not support the sudden closure of associations that provided treatment services to patients, calling for them to be given a period to regularise their legal status, by contracting with licensed pharmacies or establishing pharmacies that meet the Drug Authority’s requirements, so that services can continue without breaking the law or harming patient safety.
He believes that the responsibility for providing medicines to patients, especially the uninsured, must be carried out in coordination with official bodies, calling on the Drug Authority to set the necessary technical controls and to help associations correct their status instead of simply closing them, while stressing his categorical rejection of the idea of collecting medicines from homes and redistributing them under any circumstances.
However, the crisis does not concern the work of all charitable associations, but rather initiatives that relied on collecting medicines left over with citizens and redistributing them, which violates health and legal requirements; associations that run hospitals or own licensed pharmacies buy their medicine needs directly from distribution companies, in accordance with the procedures followed in all hospitals and major medical institutions, which guarantees the safety of the medicine, the quality of its storage and the traceability of its source, as he explains to Zawia3.
He says: “Receiving surplus medicines from citizens and redistributing them to those in need is a humane idea, but it carries major risks, as there is no way to verify the medicine’s storage conditions or its validity, or whether it has been exposed to heat or humidity or has expired, in addition to the possibility of open packages or packages of unknown origin circulating, which could put patients’ lives at risk.”
He calls on any entity wishing to distribute medicines to patients unable to afford them to work through a licensed pharmacy run by a pharmacist, obtaining medicines directly from pharmaceutical companies or distribution companies with official invoices, not by collecting medicines from homes, and then to sell the medicine to the patient at reduced prices or provide it free of charge, while maintaining safety and quality standards.
According to Decree No. 1 of 2010 on the procedures for licensing public pharmacies and implementing the health requirements set out in Ministerial Decree No. 380 of 2009, a cooperative society pharmacy licence is granted at the request of the chairman of the society’s board of directors or its director; such a pharmacy is subject to the same provisions as public pharmacies except for the distance condition (one hundred metres) stipulated in Article (30), and it is dedicated to serving the society’s members; the application must be submitted electronically via the Egyptian Drug Authority’s licensing automation programme or through the health affairs directorates.
Concerns over the Safety of Medicine Storage
Despite the impact of the halt to the collection and distribution of medicines by civil associations and civil society organisations on thousands of patients who cannot afford treatment and are not registered in the health insurance system, pharmacists, among them pharmacist Hanaa Mohamed, founder of the “Providing Medicine” initiative, warn that circulating medicines outside pharmaceutical supervision may pose a risk to patient safety, given the lack of the technical expertise needed to handle pharmaceutical preparations.
The pharmacist explains that many citizens do not realise that some tablets need to be kept in the refrigerator, or that some packages become unfit for use after a certain period of being opened, which could lead to dispensing a medicine that has lost its effectiveness or become unsafe, despite the good intentions behind donating it. She points out that licensed pharmacies are subject to precise requirements covering storage equipment, refrigerators, temperatures and periodic inspection by the competent authorities, controls that may not be available inside some associations that do not have qualified pharmaceutical staff.
She tells Zawia3: “The pharmacist does not merely dispense medicine but also gives guidance on how to store and use it, as many pharmaceutical preparations have precise instructions, such as keeping them away from light or within specific temperatures, details that non-specialists may overlook; that is why my volunteer initiative relies on full pharmaceutical supervision in handling medicines”
Nevertheless, she believes that the continuation of associations’ community role in supporting patients is important, but it must take place within a framework that guarantees technical supervision by specialists, suggesting that associations rely on volunteer pharmacists or specialised staff to inspect medicines and supervise their storage and distribution, striking a balance between charitable work and patient safety.
She adds: “Providing treatment for groups unable to afford it is a humanitarian necessity, but this must not come at the expense of the patient’s safety”, stressing that any system for distributing donated medicines should be subject to specialised professional supervision that guarantees safe storage, the validity of the preparations and awareness of how to use them.
She affirms that there are associations that already rely on volunteer pharmacists and apply professional standards in handling medicines, considering that this model can be built upon instead of entrusting the task to people who lack the necessary scientific background.
Meanwhile, Dr Ali Abdullah, director of the Egyptian Centre for Pharmaceutical Studies and Statistics, believes that the circulation of medicine must be regulated entirely by the laws and controls governing the profession, since patient safety requires that no medicine package be dispensed except through a licensed pharmaceutical system and under a pharmacist’s supervision, amid calls to control the circulation of medicine and prevent its sale outside pharmaceutical institutions, whether through electronic applications or otherwise.
He considers that the problem of patients who cannot afford to buy treatment is first and foremost the state’s responsibility, while the role of civil associations is limited to providing financial support to those in need so that they can buy medicines from licensed pharmacies, rather than the associations themselves taking charge of storing or distributing medicines.
Nevertheless, he affirms that the experience offered by the “Medicine for All” foundation in collecting unused medicines and redistributing them to patients in need is humane and unique, but it remains outside the regulated framework for the circulation of medicine. To solve this problem, he believes it is necessary for charitable associations to cooperate with pharmacies and doctors, so that the associations verify the patient’s eligibility for assistance and then bear the cost of the treatment or part of it, while the medicine is dispensed through a licensed pharmacy.
He tells Zawia3: “The standard must be the same for everyone, so that medicines are not collected in a mosque, a church or a charitable association, because medicine should only be dispensed through licensed pharmaceutical institutions, and many pharmacists already receive medicines donated by citizens after patients recover or die, then sort them and provide them free of charge to cases that cannot afford them.”
He considers that there are other forms of solidarity that can be developed, such as cooperation between charitable associations and doctors to provide free examinations for cases that cannot afford them, with the associations then bearing the cost of the medicines dispensed from pharmacies, or financing treatment directly, or covering the value of medical prescriptions, or supporting patients from zakat and charity funds, so that they continue to receive treatment without violating the controls regulating the circulation of medicine.
Between fears of pharmaceutical preparations circulating outside the oversight system and warnings of treatment being cut off for thousands of patients who cannot afford it, the crisis appears to go beyond a mere dispute over licensing procedures; it raises a broader question about how to reconcile the requirements of drug safety with preserving one of the channels of treatment support on which thousands of patients have relied for years.
With the continued absence of an announced mechanism for regularising associations’ status or of an official alternative for receiving usable medicines and redirecting them, patients remain the link most affected by the decision, while the need remains for a regulatory framework that achieves oversight of the circulation of medicine without disrupting the delivery of treatment to the groups most in need, or wasting quantities of usable medicines that could be put to use under clear professional and legal controls.
