Page 66 - GHES-3-3

Global Health Economics and
Sustainability
Pharmaceutical system in Iraq

pharmacy was established in Baghdad during the Islamic Hussain & Lafta, 2019; Torpy et al., 2009; World Health
Golden Age of the 9 century AD (Al-Ghazal, 2003; Organization, 2020; World Health Organization, 2021).
th

Hadzović, 1997). In contemporary history, Iraq had the The effective management of these widespread non-
most organized pharmaceutical regulatory affairs system communicable diseases requires timely pharmaceutical
in the region, until the Gulf Wars (Al Hilfi et al., 2013). support to mitigate physiological complications, which
At present, Iraq is a war-ravaged country with a in turn relies on a well-structured healthcare system
population exceeding 42 million and is estimated to (Boehme et al., 2017; Pi-Sunyer, 2006; Torpy et al., 2009).
reach 50 million by 2030 (United Nations Department As rates of non-communicable diseases continue to rise

of Economic and Social Affairs Population Division, dramatically, inaction will only deepen existing healthcare
2022). Iraq witnessed fundamental changes following inadequacies (Hussain & Lafta, 2019; Republic of Iraq
the United States (US)-led invasion in 2003, and many Ministry of Health, 2019a; World Health Organization,
actors, both domestic and international, participated in 2021). This situation is even more alarming considering
the establishment of a new state (Matsunaga, 2019). An the young age of Iraq’s population (with a median age of
open economic policy and increased oil revenue led to just 20.2 years) since, without effective interventions, these
significant growth in the Iraqi economy (International health challenges will only intensify as the population

Monetary Fund, 2023; World Health Organization, 2023). ages (Torpy et al., 2009; United Nations Department of
In 2023, Iraq is considered an upper-middle-income Economic and Social Affairs Population Division, 2022).
country, placed among the top 50 global economies, with Furthermore, the COVID-19 pandemic revealed how an
a total gross domestic product (GDP) of 254.99 billion US increased burden on an already strained healthcare system
dollars. can undermine Iraq’s capacity to effectively respond to
public health emergencies (Al-Jumaili et al., 2021).
Despite economic growth and the introduction
of national health strategies after 2003, Iraq’s health Since its establishment in 1920, the Ministry of Health
indicators remain lower than those of countries with (MoH) has been considered the backbone of Iraq’s
similar geographic and socioeconomic status (World healthcare system. It is represented by a Directorate of

Health Organization, 2020). The healthcare system is Health in each province and prefecture of the country (Al
highly fragmented and continues to face numerous Hasnawi et al., 2009). The MoH owns all public healthcare
challenges across different operational levels(Al Hilfi et al., facilities and governs the entire pharmaceutical sector. It

2013; Cetorelli & Shabila, 2014; Hussain & Lafta, 2019; also provides primary, secondary, and tertiary healthcare
Republic of Iraq Ministry of Health, 2019a; World Health services to the population at subsidized rates (World
Organization & Alwan, 2004; World Health Organization, Health Organization, 2013a). However, demand for these
2021). A particularly concerning issue is the limited services far outweighs its supply, public healthcare facilities
funding allocated to the health sector: in 2019, only 4.5% are strained due to population growth, dilapidated
(about 5 billion US dollars) of the total GDP was dedicated infrastructure still suffering the aftereffects of turmoil, and
to healthcare. Of this, nearly a quarter was used for a lack of investment in the healthcare sector (Republic of
purchasing medicines and settling overdue payments, yet Iraq Ministry of Health, 2019a).
significant gaps in pharmaceutical supply exist (Republic A particularly concerning consequence is that out-of-

of Iraq Ministry of Health, 2019a). pocket expenses account for more than half of Iraq’s total
The current epidemiological landscape of Iraq is healthcare expenditure (World Health Organization, 2023).
aligned with an upper-middle-income country, with This issue is further exacerbated by the lack of a national
the predominant disease burden originating from non- health financing scheme. Health insurance is available
communicable diseases (Hussain & Lafta, 2019; World only through a limited number of private corporate
Health Organization, 2021). Key conditions of concern programs, which primarily serve the socioeconomically
include obesity, diabetes mellitus, hypertension, and wealthy. These factors collectively contribute to inequitable
cancers (World Health Organization, 2021; World healthcare access and adversely affect population health
Health Organization, 2023). The prevalence of these outcomes.
conditions has been increasing since 2003 (World The MoH is guided by the National Health Policy,
Health Organization, 2023). In addition, high rates of with the current version covering the period from 2013
smoking, inadequate physical activity, and elevated air to 2023. This policy outlines key priority areas within the
pollution levels contribute to more fatal conditions, such health sector (Republic of Iraq Ministry of Health, 2015).
as stroke and ischemic heart disease – currently among The overarching goal is to improve universal healthcare
the leading causes of death in Iraq (Boehme et al., 2017; coverage through strengthening health governance,

Volume 3 Issue 3 (2025) 58 https://doi.org/10.36922/GHES025110025