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Global Health Economics and
            Sustainability
                                                                                        Pharmaceutical system in Iraq



            Table 1. (Continued)
            Institution                             Location        Type        Year of Establishment  Degree
            AlNoor University College             Ninevah          Private            2018         BSc
            Alhaba University College             Ninevah          Private            2018         BSc
            University of Al-Ameed                Kerbela          Private            2019         BSc
            Al-Zaharaa University for Women       Kerbela          Private            2019         BSc
            Alturath University College           Baghdad          Private            2020         BSc
            Al-Knooze University College          Basrah           Private            2020         BSc
            Al-Farabi University College          Baghdad          Private            2020         BSc
            Basrah University College of Science and Technology  Basrah  Private      2020         BSc
            University of Mashreq                 Baghdad          Private            2020         BSc
            Almaaqal University                   Basrah           Private            2020         BSc
            Al-Maaref University College          Anbar            Private            2021         BSc
            Al-Qalam University College           Kirkuk           Private            2021         BSc
            Al-Nisoor University college          Baghdad          Private            2021         BSc
            Middle East University College        Baghdad          Private            2021         BSc
            Al-Amal College for Specialized Medical Sciences   Kerbela  Private       2022         BSc
            Gilgamesh Ahliya University           Baghdad          Private            2022         BSc
            American University of Iraq           Baghdad          Private            2022         BSc
            Total                                 60            17 Gov./43 private
            Source: Ministry of Higher Education and Scientific Research on January 31, 2024.
            Notes: All universities and colleges in Iraq (except for the Kurdistan region) offer a 5-year pharmacy program leading to a Bachelor’s degree in
            Pharmaceutical Sciences;  Formerly Baghdad College of Pharmacy;  Formerly Ibn Hayyan University College.
                                                       b
                             a
            Abbreviations: BSc: Bachelor of Science; MSc: Master of Science; PhD: Doctor of Philosophy.
              Consequently, the long-term deterioration of public   advancement under current and historical health
            healthcare services and the unavailability of medicinal   policies since 2003 (Al-Humadi & Liapi, 2019). Although
            products have caused a significant decline in public trust   these modest advances resulted in positive impacts on
            in the public healthcare system (Ibrahim et al., 2021). This   addressing health system vulnerabilities, the sector still
            distrust has been exploited by the private sector for profit   falls short of the norms and standards expected of a
            over the past decades (Al-Jumaili et al., 2013). Thus, people   modern pharmaceutical sector (Al-Jumaili et al., 2013). As
            rely heavily on the private sector for treatment and medicines,   the pharmaceutical sector suffers from systemic challenges
            often at high costs that may exceed their financial capacity,   and external constraints, no single solution can resolve all
            especially given the absence of any patient subsidy program   the issues. Instead, a range of multidimensional initiatives
            for medicines purchased from the private market (Cetorelli   is required to holistically address these concerns (Figure 5).
            & Shabila, 2014; Moore et al., 2014; Republic of Iraq Ministry   Furthermore,  the  modernization  of  the  pharmaceutical
            of Health, 2019a; USAID, 2006). The WHO has reported that   sector will not only contribute to the reform of the
            more than 70% of individual health spending in Iraq is out-  healthcare sector but will also support the growth of the
            of-pocket, far exceeding the recommended threshold of 30%   country’s economy and strengthen its legitimacy (Suhrcke
            necessary to prevent poverty and ensure financial protection
            and health equity (Republic of Iraq Ministry of Health, 2019a;   et al., 2007).
            World Health Organization, 2023). Nonetheless, limited   Based on the current, up-to-date review of the
            public healthcare services remain an important source of   pharmaceutical sector in Iraq, we present the following
            healthcare, particularly for the poor and unemployed, who   recommendations and considerations:
            account for more than 20% of the population (Burnham   (i)  The healthcare system, including the pharmaceutical
            et al., 2011; UNICEF & World Bank, 2020).              sector, urgently needs to be prioritized through increased
                                                                   funding to fill the gaps in medicine availability and quality
            6. Recommendations                                     of care. This will also alleviate the financial burden on
            Despite its importance in healthcare system reform,    individuals, thereby improving health equity, social
            the Iraqi pharmaceutical sector has shown limited      stability, and access, and meaningfully improving universal

            Volume 3 Issue 3 (2025)                         68                  https://doi.org/10.36922/GHES025110025
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