{"id":16945,"date":"2025-08-27T16:25:28","date_gmt":"2025-08-27T14:25:28","guid":{"rendered":"https:\/\/zawia3.com\/?p=16945"},"modified":"2026-10-07T08:45:28","modified_gmt":"2026-10-07T06:45:28","slug":"alveofact","status":"publish","type":"post","link":"https:\/\/zawia3.com\/en\/alveofact\/","title":{"rendered":"Alveofact: Premature Babies Face a Life-Saving Medicine Shortage in Egypt"},"content":{"rendered":"

In neonatal units at public hospitals and some private facilities, mothers face a daily struggle to obtain Alveofact, a pulmonary surfactant used to treat respiratory distress syndrome in premature babies whose lungs are not fully developed. Finding a single vial can take hours because of shortages, although the treatment is essential to reducing respiratory complications.<\/p>\n

Egypt recorded approximately 1.9 million births in 2024, according to reported official statistics<\/a>. A World Health Organization regional resource<\/a> attributes approximately one-fifth of under-five deaths in Egypt to complications of prematurity. That percentage concerns deaths, not all births. The original report used an international range of 5\u201318% to illustrate a possible 95,000\u2013342,000 premature births annually; this calculation is not an official Egyptian estimate.<\/p>\n

\n

Prematurity: what the figures mean<\/h3>\n
\n\n\n\n\n\n\n\n
Measure<\/th>\nFigure<\/th>\nInterpretation<\/th>\n<\/tr>\n<\/thead>\n
Births in Egypt, 2024<\/td>\nApproximately 1.9 million<\/td>\nReported official birth total<\/td>\n<\/tr>\n
Illustrative premature-birth range used by the original report<\/td>\n95,000\u2013342,000<\/td>\nApplying 5\u201318% to 1.9 million; not a national estimate<\/td>\n<\/tr>\n
Share of under-five deaths attributed to prematurity in WHO\u2019s regional table<\/td>\n21% for Egypt<\/td>\nA proportion of deaths, not of all births<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>
The Arabic graphic\u2019s figure of 380,000 deaths or children at risk is not substantiated by its cited WHO source and is not reproduced here.<\/figcaption><\/figure>\n

Alveofact replaces the pulmonary surfactant that helps prevent the tiny air sacs in the lungs from collapsing during breathing. Babies born prematurely may not yet produce enough of it and can develop respiratory failure requiring urgent specialist support.<\/p>\n

At the original report\u2019s publication in August 2025, some pharmacy listings<\/a> offered a vial at about EGP 6,635, while other price lists<\/a> showed EGP 7,400 following a September 2024 update. Older records<\/a> listed approximately EGP 4,400\u20134,700. These differing listings and presentations should not be treated as a single uniform price.<\/p>\n

Comparing EGP 6,635 with the older EGP 4,400\u20134,700 range gives an increase of approximately 41\u201351%; comparing EGP 7,400 gives roughly 57\u201368%. The original article\u2019s 50\u201357% range therefore does not represent every combination of the quoted figures. For families, even the lower listed price is a substantial burden when public hospitals cannot supply the medicine.<\/p>\n

The imported bovine-derived surfactant<\/a> depends on production abroad, making its supply sensitive to exchange rates, customs costs, import policy and distribution. Price differences between public and private providers also raise questions about how it is allocated.<\/p>\n

Neonatologists interviewed for the investigation warned that delays could mean serious complications or death. Interviewees described Alveofact as effectively irreplaceable when other surfactants were unavailable locally. This is a claim about access at the time, rather than proof that no other surfactant treatment exists: the specialist interviewed below names Survanta and Curosurf as well.<\/p>\n

Mahmoud Fouad, director of the Egyptian Centre for the Right to Medicine, identified hospitals where he said newborn deaths had occurred amid the shortage: El Shatby University Hospital, El Demerdash University Hospital, East City Hospital, Mansoura International Hospital, Assiut University Children\u2019s Hospital, Nasser Institute, Mit Ghamr Hospital and Damanhour Teaching Hospital.<\/p>\n

He also cited appeals from a specialist children\u2019s hospital in Abu Hummus, El Ahrar Teaching Hospital, El Galaa Teaching Hospital, the Mersal charity, Suez Canal University Teaching Hospital and El Hayat Hospital in Port Said. These reports are attributed to Fouad; the investigation does not present a verified national mortality count caused by the shortage.<\/p>\n

A Health Ministry source briefly acknowledged the crisis but declined to discuss it. Another referred questions to the Egyptian Drug Authority. Zawia3 contacted three authority officials but obtained no explanation by the original publication date.<\/p>\n

<\/svg><\/div>\n

A treatment for those who can afford it<\/h2>\n

A pharmacist who requested anonymity told Zawia3 that two presentations had official prices of approximately EGP 6,500 and EGP 7,500. He said availability had partly improved by August, but the shortage had peaked two months earlier, when the medicine disappeared and black-market prices reached approximately EGP 12,000.<\/p>\n

\n

\u201cIt is a matter of life or death, quite simply,\u201d the pharmacist said. \u201cHaving the medicine gives the child a chance to survive. Its absence may lead to death.\u201d<\/p>\n<\/blockquote>\n

He said the parallel market, despite operating outside the law, had played an unusual role. Some traders imported the drug to supply babies and, he said, tried to charge prices closer to official rates, insisting their purpose was to save children rather than make large profits.<\/p>\n

In his assessment, those suppliers helped fill a dangerous gap: waiting for action through official channels could have taken time during which babies might have died.<\/p>\n

\"A
A screenshot of a listed medicine price sent to Zawia3 by the pharmacy source.<\/figcaption><\/figure>\n
<\/svg><\/div>\n

Why surfactant matters<\/h2>\n

Dr Samar Reda, a consultant in paediatrics and neonatology, explains that premature babies face several risks at birth, particularly respiratory distress syndrome (RDS).<\/p>\n

She attributes the syndrome to absent or insufficient surfactant. She explains that production begins during pregnancy, around weeks 20\u201324, and becomes more mature around week 34. By reducing surface tension, the substance helps keep air sacs open during exhalation. Babies born before adequate production develops are more vulnerable to breathing difficulties and complications.<\/p>\n

Reda describes Alveofact, Survanta and Curosurf as important treatments that replace the missing substance, improve gas exchange and reduce reliance on mechanical ventilation. She says they can reduce serious complications, including chronic lung disease and intracranial bleeding, and lower mortality related to RDS.<\/p>\n

The specialist described both preventive administration after birth in selected at-risk babies and treatment after clinical and radiological diagnosis. The Egyptian Drug Authority\u2019s communication discussed below, however, cites guidelines recommending surfactant for babies showing clinical signs of RDS, rather than routine prophylactic use.<\/p>\n

Some babies require more than one dose, depending on their condition, she adds. Without necessary treatment, severe oxygen deprivation can affect the brain, heart and kidneys, or progress to respiratory failure and death in the first hours or days.<\/p>\n

<\/svg><\/div>\n

Families searching while their babies struggle to breathe<\/h2>\n

Accounts collected across several governorates describe rising prices and near-absence of the medicine in public hospitals and health-insurance units. Private hospitals and centres offered differing prices often beyond families\u2019 means.<\/p>\n

Eman El Sayed, 32, from Giza, says her son was born in the seventh month of pregnancy in April 2025 and urgently needed treatment for his lungs. \u201cI thought the large public hospital where he was born would provide it. I was surprised to learn it was unavailable and we had to bring it from outside.\u201d<\/p>\n

Her husband searched dozens of pharmacies in Cairo and Giza without success. Some private pharmacies offered a vial for almost EGP 8,000, above the official price she had been quoted. The family faced a painful choice between securing treatment at any cost and risking their baby\u2019s life.<\/p>\n

\n

\u201cI had to borrow from relatives to buy it through an intermediary,\u201d Eman says. \u201cWhen I handed it to the doctor, he told me this medicine should be available free in public hospitals to save children like my son Ahmed. But medicine shortages have become a recurring crisis.\u201d<\/p>\n<\/blockquote>\n

In Alexandria, Madiha Ezzat\u2019s daughter was born at 32 weeks and admitted to El Shatby Hospital\u2019s neonatal unit. After initial examinations, the family was told she immediately needed surfactant.<\/p>\n

\u201cThe nurse said it was unavailable and that, if I knew anyone who could get it outside the hospital, they should,\u201d Madiha recalls. She had just undergone a Caesarean delivery and could barely move while her husband tried to raise money. Calls to friends and acquaintances followed. Prices ranged from EGP 7,000 to 7,500 according to the pharmacy or intermediary. After a day of anxiety, they obtained the vial. \u201cYara is two now, but that experience was harsh and unforgettable.\u201d<\/p>\n

Doaa Abdel Bar says her son was born at Abu Hummus Hospital in Beheira with respiratory distress from the outset. Doctors said he needed Alveofact, but no dose was available. When her husband asked the administration, he was told the drug appeared on authority lists but had not yet reached the hospital.<\/p>\n

Faced with waiting for distribution or searching elsewhere, the family transferred the baby in a private ambulance to Nasser Institute in Cairo for EGP 5,000. Doaa says his condition deteriorated during the journey because of the delay.<\/p>\n

Even at Nasser Institute, the medicine was unavailable. Her husband finally found it at a private pharmacy in Mohandessin for EGP 6,800, above the official price he had been given. Doctors administered it and the baby later recovered.<\/p>\n

\n

\u201cI left with the bitter feeling that premature babies\u2019 lives depend on sheer chance: whether the family finds the medicine in time,\u201d Doaa says.<\/p>\n<\/blockquote>\n

Safaa El Bakri, from Sohag, says her baby was born at 31 weeks with severe respiratory distress. Doctors urged immediate surfactant treatment, but the university hospital had none. Her husband searched pharmacies in Sohag and Assiut until a relative in Cairo obtained it for more than EGP 7,000.<\/p>\n

\u201cHassan survived thanks to the treatment, but the experience showed me that obtaining medicine in Upper Egypt is much harder, as though our children\u2019s lives were a lower priority,\u201d she says.<\/p>\n

Zawia3 contacted ten large pharmacies in Cairo, Giza, Alexandria, Mansoura and Sohag. Most said the drug had been unavailable for months. Three offered to source it through intermediaries or private warehouses, at prices above the cited EGP 6,635 official figure. Actual offers ranged from EGP 7,000 to 8,000 per vial.<\/p>\n

The authority\u2019s safety guidance\u2014and the supply gap<\/h2>\n

The Egyptian Drug Authority\u2019s healthcare-professional communication<\/a> on lung surfactants is dated September 2023. The September 2021 date appearing in its footer is the form\u2019s issue date, which the Arabic report mistakenly treated as the communication\u2019s date.<\/p>\n

The communication requires hospital professionals to complete a surfactant follow-up form for each patient, recording medicines, ventilation settings, radiological findings and blood-gas results before and after administration. It calls for monitoring heart rate and oxygen saturation and documenting attempts at extubation.<\/p>\n

\"The
The Egyptian Drug Authority\u2019s lung-surfactant communication: the notice is dated September 2023, while the template footer bears September 2021.<\/figcaption><\/figure>\n

Citing the European Consensus Guidelines on RDS Management 2022, the authority explains that surfactant improves survival and reduces pneumothorax. It favours early treatment when clinical signs appear and less invasive administration where possible, including LISA. It also discusses the intubation\u2013surfactant\u2013extubation approach, IN-SUR-E.<\/p>\n

The guidance concerns safe use and monitoring, including Alveofact, Survanta and Curosurf. It does not establish how readily hospitals can obtain supplies. That leaves a gap between clinical protocols and the access problems families describe.<\/p>\n

<\/svg><\/div>\n

A dangerous gap in the medicine market<\/h2>\n

Fouad says that, over two weeks, he recorded medicines without accessible alternatives in the Egyptian market, calling the situation a major disaster because they save lives. His list included three essential cardiac medicines and Alveofact for premature babies.<\/p>\n

He estimated a vial\u2019s price at approximately EGP 6,000 and said it was imported from Germany. He alleged that authority sources confirmed stock existed but was released only on direct instructions from its head or deputy, without explaining why.<\/p>\n

\n

\u201cThere may be technical considerations I do not know,\u201d Fouad says. \u201cWhat I do know is that hospitals are making real appeals because babies are dying without this life-saving treatment.\u201d<\/p>\n<\/blockquote>\n

He asks how a country with more than 1.6 million births annually can face this shortage. He notes that babies enter neonatal units for jaundice or underdeveloped lungs and says those with the latter condition may urgently need treatment within their first 24\u201348 hours.<\/p>\n

Fouad says he sent complaints and inquiries to an adviser to the prime minister without receiving a response by publication. He estimates Egypt needs approximately 4,000 vials a year and says available stock is much lower. He also reported that another product might soon be offered at EGP 10,000 per vial, adding to families\u2019 burden.<\/p>\n

He sees the crisis as part of wider neglect of life-saving medicines, citing shortages affecting patients with heart attacks, blood clots or arrhythmias.<\/p>\n

Fouad criticised the authority\u2019s performance, alleging it collected approximately EGP 200 million monthly in registration fees, while registration of a new drug involved paperwork and a cost around EGP 1 million. Those figures are his claims. He acknowledged that, through April 2025, the authority had addressed earlier shortages and supplied imported medicines, though prices had risen sharply. Renewed appeals from major hospitals, he says, demand an explanation.<\/p>\n

Who holds the drug authority accountable?<\/h2>\n

Fouad calls for an urgent investigation into shortages of life-saving medicines. He says three essential cardiac drugs had reached zero stock and that a senior cardiologist recently told him he had no information about when they would return.<\/p>\n

When the authority was established in 2019, he says, it was meant to track domestic production, patient consumption, surplus and strategic stocks in medical-supply warehouses. Such information should enable crisis management during war, pandemics and other emergencies. In his assessment, that function remains inadequate.<\/p>\n

Cardiac treatment, he stresses, cannot necessarily wait days or weeks: interruption can directly threaten life. He calls for an inquiry into whether inventory-management mistakes or miscalculated patient needs caused the reported zero-stock situation.<\/p>\n

He argues that an accurate map of patients and medicine consumption would allow production requirements to be calculated and dangerous supply gaps prevented.<\/p>\n

Egypt\u2019s wider medicine shortage<\/a> has affected treatments for chronic diseases as the dollar rose. Reports cited by the investigation described approximately 1,000 missing products<\/a>, including treatments for hypertension, diabetes, heart disease, gallbladder and thyroid conditions, kidney disease and stomach disorders, as well as familial Mediterranean fever, cancer, nasal drops, colds and gynaecological conditions.<\/p>\n

The investigation cites media remarks<\/a> by pharmaceutical-industry chamber head Gamal El Leithy estimating shortages at 30\u201340%, including products without available alternatives. The linked report is dated February 2024; its estimate should not be read as a new August 2025 measurement.<\/p>\n

The Egyptian medicine market<\/a> comprises roughly 17,000 preparations produced through approximately 170 factories. The report cites price increases<\/a> for around 400 products: 20\u201330% for chronic-disease drugs and 30\u201350% for non-essential and seasonal medicines.<\/p>\n

It quotes pharmaceutical division head Ali Auf\u2019s estimates of EGP 215 billion in medicine sales in 2024 compared with EGP 154.7 billion in 2023, an increase of about 39%. The linked November 2024 report<\/a> covered sales of EGP 170 billion during the first ten months, so the full-year figure should be understood as an estimate, rather than a final figure established by that link.<\/p>\n

The Arabic investigation also attributed to Auf an expectation of price increases for about 1,000 products in 2025. Its linked August 2024 article<\/a> discusses a different pricing period; it does not independently establish that 2025 forecast.<\/p>\n

For the size of the pharmacy sector, the original article cites published research<\/a> estimating approximately 213,000 pharmacists and 80,000 pharmacies. It also cites comparative research<\/a> giving one pharmacist per 438 residents and one pharmacy per 1,261 residents in Egypt, compared with international ranges of one pharmacist per 1,100\u20131,600 people and one pharmacy per 3,500\u20135,000. These are figures from the cited studies, rather than a verified current census. One pharmacist per 438 people is approximately 23 per 10,000; that ratio describes Egypt in the comparison, not the stated global range.<\/p>\n

For premature babies, the crisis has become more than a shortage in a market buffeted by exchange rates, imports and pricing policy. It poses a question about the practical right to treatment.<\/p>\n

Some babies survive because families have enough money or contacts to secure a dose. Others face potentially fatal delays. A life-saving medicine\u2019s absence exposes a deeper failure of access: a newborn\u2019s first breaths should not depend on the chance that a relative locates a vial.<\/p>\n

Editorial clarification: This translation distinguishes the original report\u2019s illustrative birth calculations from verified mortality data, corrects the date of the authority\u2019s communication, and identifies claims about local availability as attributed testimony. The cited WHO material does not substantiate the Arabic graphic\u2019s figure of 380,000.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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