The Health Ministry says it has served around 3 million older people, nearly half of those over 65, while older people interviewed by Zawia3 had never heard of it.
Last June, Suzanne Aziz, 71, went to Sayed Galal Hospital in Bab al-Shaariya, Cairo, to have her back examined. Staff told her about an initiative offering free checkups for older people at the health unit behind the hospital. After three weeks of travelling between the unit and Ahmed Maher Hospital, and repeating scans that no one could find, she left with medicines she bought at her own expense and an appointment to return six months later.
The Ministry of Health and Population says the elderly healthcare initiative had served 2,966,000 people aged 65 and over from its launch to mid-July, according to an Egypt Telegraph report published on 31 July. This is equivalent to around half of Egyptians in this age group, estimated at approximately 5.8 million by Zawia3, based on the World Bank’s figure for the share of the population aged 65 and over (5.3% in 2025) and a domestic population that reached 109.5 million in September 2026, according to the Central Agency for Public Mobilization and Statistics (CAPMAS). Yet seven men and women from Cairo and Qalyubia interviewed by Zawia3, three of them in the initiative’s target age group, described experiences that raise two questions: how does the ministry calculate its figure, and what do those who actually reach the service receive?
The initiative is part of the presidential health initiatives that began with the “100 Million Health” campaign in October 2018 to eliminate hepatitis C. The ministry says the elderly initiative, one of the “100 Million Health” initiatives, was launched in October 2022, targeting people aged 65 and over to improve their health-related quality of life. Earlier ministry statements, however, date the same programme, under the name “Continuous Healthcare for Older People” and targeting the same age group, to 1 October 2021. In March 2022, it announced that 263,207 people had been examined in five months, and in July 2022 it said that 405,299 people had received the service. In March 2023, it then announced that it had served 693,586 people, while the number of service centres had increased from 401 to 832 across 21 governorates.
In early March 2026, ministry spokesperson Dr Hossam Abdel Ghaffar said the number of beneficiaries had reached 2,129,000, according to Banker News, a figure the ministry also published on its own page. Between that announcement and the July announcement, the ministry added around 837,000 beneficiaries in four and a half months, or approximately 186,000 a month, compared with around 40,000 a month between March 2023 and March 2026, according to Zawia3’s calculations using the ministry’s announced figures. None of the ministry’s statements explained whether the figure counts distinct individuals or the number of times services were provided, nor how many people returned for a second checkup.
According to a ministry statement, services include early detection of high blood pressure, diabetes, elevated blood lipids, kidney disease, anaemia and malnutrition; a comprehensive clinical examination; an electrocardiogram; abdominal and liver ultrasound scans; vision screening; oral and dental health assessments; and early detection of age-related mental and cognitive disorders, such as depression and Alzheimer’s disease, through validated questionnaires. Abdel Ghaffar said in a press statement that the initiative is not limited to examinations: every beneficiary receives a regular follow-up card, and cases requiring advanced treatment are referred to specialist hospitals. The follow-up card entitles its holder to two examinations a year, according to the ministry.
In a telephone interview with Extra News, Abdel Ghaffar explained that an older person should go to the nearest participating health unit. Anyone who does not know where it is can call the initiative’s hotline, 15335, or the ministry’s general hotline, 105. Those unable to move or reach primary care units can receive home visits coordinated with health units in their residential area. The same two numbers appeared in Sada El Balad’s coverage on 7 November. Eman Mohamed, the initiative’s coordinator at the Health Ministry, told Extra News that the initiative aims to provide older people with social and health protection and achieve health equity for this group.
Dr Wael Abdel Razeq, head of the ministry’s healthcare and nursing sector, said in a telephone interview on Channel One’s Good Morning Egypt that the ministry has a database of the areas most in need of the initiative’s services, linked to the other presidential initiatives. He said the data support decision-making to reach any area requiring tailored services. The ministry has not published data from this database showing which areas the initiative has covered, a survey measuring older people’s satisfaction with the service, or whether an examination includes treatment or more than one medical specialty.
Three weeks between two hospitals
During its visit to the health unit behind Sayed Galal Hospital, Zawia3 found no older patients other than Suzanne Aziz, a resident of Cairo’s al-Zawiya district, who was in the initiatives registration room. Suzanne says she learned about the initiative last June when she went to the hospital to have her back examined: “They told me there was an initiative offering free checkups for older people in the health unit building behind the hospital.”
She was suffering from severe chest pain at the time, so the employee in the registration room referred her to Ahmed Maher Hospital and gave her the initiative’s card. “She told me they would examine me there and do the scans,” she says. She took a bus from outside Sayed Galal Hospital to Ahmed Maher Hospital, where she was examined and had a chest X-ray. A nurse asked her to return a week later.
When she returned, she was asked to repeat the X-ray because the hospital could not find it. She says she kept going up and down the hospital stairs, at the request of the specialist who had performed the first X-ray, to prove that she had undergone it. She then learned she should also have had an ultrasound examination: “I did everything again from the beginning.” An employee then asked her to photocopy some papers and return another week later.
In the third week, she was prescribed medicines, but they were unavailable at the hospital, so she bought them elsewhere at her own expense. She was given a paper recording the examination and scans, and told to return six months later for the second checkup, “because I am only entitled to one examination,” she says, adding that the repeated journeys to obtain the service exhausted her.
Zawia3 contacted Health Ministry spokesperson Dr Hossam Abdel Ghaffar by telephone to ask how the number of beneficiaries is calculated and the benefits evaluated, and how the initiative reaches people who do not know it exists, but he did not respond.
They had never heard of it
Salah Reda, 73, from Cairo’s Zeitoun district, says he had never heard of any free medical services for older people. He badly needed them after a stroke affected his balance, leaving him unable to walk or stand steadily; whenever he took a few steps, he stumbled and stopped. Having worked as a self-employed carpenter, he still has neither a pension nor health insurance. He was forced to borrow money to pay for treatment and medicines, and says that knowing about such an initiative would have spared him all this.
Omaima Ahmed, 56, from Matariya in Cairo, says her family had never heard of the initiative or of free medical services for older people. Her 79-year-old mother has had high blood pressure and diabetes for more than 25 years, alongside age-related symptoms such as dizziness and falling or rising blood pressure in hot weather. For years, she has been seeing an internal medicine specialist at a private clinic. Omaima explains that the family did not visit a health unit or public hospital where they might have learned about the initiative, except when her mother underwent state-funded spinal surgery in 2018 following a severe fracture. That was their only experience: her parents subsequently stopped attending public hospitals for examinations to avoid complicated procedures and long waits, preferring private clinics because they believed they offered better care.
Omaima adds that a mobile medical team is always stationed near their home in Matariya and starts work at eight in the morning, but she has never seen an older person visit it. Nor has she noticed any effort in the densely populated neighbourhood to tell residents that a mobile team provides the initiative’s services or invite them to particular locations to benefit from them.
The system whose gaps the initiative is meant to fill
The remaining accounts do not concern the initiative directly, because those providing them had not reached its eligibility age or had not tried it. They nevertheless describe the public system the initiative is meant to complement. Three years ago, the mother of Marina Hanna (a pseudonym used at her request), now 65 and living in Qalyubia, suddenly developed difficulty moving and mental confusion. Her daughter took her from one private doctor to another in search of a diagnosis. Marina says this cost the family a great deal in scans and tests, while her mother receives no pension and has no health insurance. It was eventually established that she had suffered a stroke. The family then began buying one injection a week for EGP 1,800 (around US$34), in addition to other medicines, tests, CT scans and MRIs. Marina explains that her mother’s condition could not withstand the long waits and crowding at a public hospital. She recalls her father’s experience: “Before my father died after struggling with hepatitis C, we needed approval for state-funded treatment to obtain his medicines. But the exhausting procedures and travelling from one place to another to complete the paperwork left us traumatised by public hospitals.”
Eman Abdel Wahab, 60, from Qalyubia, has had liver cirrhosis for more than 20 years and obtained approval for state-funded treatment to receive her medicines. She says she struggled to obtain them and that her prescriptions were changed several times: “I used to wait a long time. I would go at seven in the morning, and by the time my turn came they would tell me the supply had run out. Sometimes I could not find the medicine at all.” She stopped collecting her monthly pack and turned to a private liver clinic and outside pharmacies. She subsequently stopped visiting the doctor and buying her medicine regularly because of the cost of consultations and the pack, which costs her EGP 180 a week (around US$3.40), while she receives EGP 660 (around US$12.40) a month from the Takaful and Karama programme. She says interrupting her treatment caused persistent bleeding and swelling in her legs.
Fatma Abdel Hay, 65, was working as a seamstress at a company when she was injured in an accident on the Ring Road two years ago. Her abaya caught in a car wheel, pulling her forward and fracturing her pelvis and knees. She was taken to a hospital affiliated with the company, which performed ordinary X-rays but no MRI. When her son asked why, he was told the MRI machine was broken. He was then directed to another hospital, which he thought belonged to the same organisation, only to discover that his mother was not registered under the company’s health insurance: “They told him I had no insurance with them.” Her son paid for the scans and borrowed a large sum to cover her treatment throughout her recovery at home. She says that when she returned to work, she confronted the floor manager, who had asked her for EGP 150 (around US$2.80) to process her insurance paperwork before the accident. After leaving the job, she applied for Takaful and Karama support but was rejected because she was married. She was asked to apply with her husband as a “cohabiting partner”, even though they had been separated for years without a formal divorce. Fatma takes medicines for heart disease, diabetes and bone problems. She recently needed an echocardiogram but could not afford it.
These accounts are consistent with findings from earlier studies. A qualitative study by researcher Shaimaa Abdel Fattah among people over 60 attending Cairo University Hospital’s outpatient clinics, published in 2017 in the Journal of the Egyptian Public Health Association before the programme began, found that crowding and long waits topped patients’ complaints. These were followed by complaints about what they described as “supposedly free” public services. The study identified shortages in follow-up care and treatment, the absence of a clear complaints mechanism, and limited information to improve older people’s health. Participants proposed improving care providers’ communication skills, ensuring continuity of care, establishing a geriatric clinic with a multidisciplinary team, and strengthening health education and self-care skills. The study estimated that Egypt’s older population would quadruple between 2010 and 2050. In 2024, a report by Harvard University’s Health Systems Innovation Lab on health systems in G20 and other countries noted in its Egypt chapter that many Egyptians turn to the private sector for specialist treatment, particularly in non-urgent cases or when public-sector waiting times are long, and that regional disparities in care persist despite recent reforms.
An initiative outside the system
Dr Ayman Sabaa, a researcher on the right to health, believes the problem with initiatives of this kind is that they were not an integral part of the Health Ministry’s plan. Assessing whether they achieve their announced results requires clear, public indicators: the initiative’s objectives, target numbers, beneficiary satisfaction measurements, and criteria assessing whether its costs are proportionate to its results. He says that, in the case of the elderly initiative, he has not seen numerical targets or a published budget on which to base an assessment of its success.
Sabaa sees these initiatives as supplementary measures to fill gaps in the conventional health system that the government cannot resolve. He cites the early breast cancer detection initiative, which, in his view, responded to the health system’s inability on its own to close the gap in detection and treatment. He says the elderly initiative’s services should be an integral component of care within the system itself. He adds that ensuring such initiatives reach those entitled to them requires programmes targeting specific groups, additional resources, and clear implementation, monitoring and accountability mechanisms.
Sabaa says the design of any programme begins with two questions: does the service meet a real need, and is it provided where people need it? If the answer is yes, informing the public comes next. If the service is new, it must be accompanied by awareness campaigns and integrated into hospitals’ referral systems. If it is already available, the initiative’s value is measured by improvements in quality and access, not by duplicating what exists. If it does not reflect a real need, there is no justification for launching it. In his view, an initiative should not be designed first, with the question of how to tell people about it considered only afterwards. He believes health units are not suitable places to inform older people about the initiative because they do not normally visit them. This contradicts making access conditional on attending a health unit, as the ministry spokesperson described. Sabaa stresses the importance of internal referrals rather than relying solely on public outreach, because outreach is costly and generates demand for services many older people do not need.
Dr Mohamed Magdy Ibrahim, deputy chair of the House of Representatives’ Health Affairs Committee, believes the gap between the initiative and its intended beneficiaries stems from inadequate awareness and campaigning. He says television and social media are important ways to inform older people, particularly as many have limited mobility and little contact with the outside world. He proposes a solution he describes as more difficult to implement: identifying older people and collecting their details, then sending text messages to their phones explaining the initiative, its services and locations, as companies and banks do with their customers.
When Zawia3 asked him about the initiative’s budget, he said the Health Committee discusses the draft health-sector budget every July based on governorates’ needs presented by Health Ministry undersecretaries. Presidential initiatives, however, are not necessarily tied to the budget preparation timetable: they can be financed at any time as needed with direct support from the Finance Ministry, through a surplus or funds allocated to them. He said the committee had recently submitted a parliamentary request for a briefing on treatments for chronic diseases and cancer, discussed shortages of some medicines, and summoned the Egyptian Drug Authority to clarify whether a medicine was in short supply in the market or whether the problem lay in its distribution: “Then we put in place a mechanism to get medicines to those entitled to them.”
Dr Alaa Ghannam, head of the health programme at the Egyptian Initiative for Personal Rights, believes reaching older people requires integrating the initiative into the health system, specifically the health insurance system, which he estimates covers 58% of the population, in addition to around six million people in the new universal health insurance system. Most people in this age group do not follow media coverage, he says, and integration would allow follow-up care at places they already visit. He says older people account for more than 10% of the population, or around ten million, close to CAPMAS figures, which put their number last October at 10.2 million (9.3% of the population). Those figures include people over 60, whereas the initiative targets those aged 65 and over. Ghannam adds that older people struggle to obtain medicines through health insurance, stand for hours in queues, and face medicine shortages. He questions how the Law on the Care of Older Persons’ Rights, No. 19 of 2024, is being implemented in practice. The law requires government bodies to allocate a service counter for older people so they do not have to compete with others for access.
Article 83 of the Constitution obliges the state to guarantee older people’s health, economic, social, cultural and recreational rights, provide an adequate pension ensuring a dignified life, and enable their participation in public life. Ghannam proposes dedicated health units for older people, offering services without long queues unsuited to their age, and teams assigned to deliver medicines to their homes.
As for Suzanne Aziz, her next appointment is six months after her last visit, for her second examination: all the follow-up card provides in a year.
