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🇹🇳 Tunisia /Health & Science

Tunisia's health crisis: Doctors and pharmacists denounce failed governance, threaten to suspend direct payment system

From La Presse · () French

Translated from French, summarized and contextualized by DistantNews.

At a glance

News Named sources Context piece
  • Tunisian healthcare providers, including doctors and pharmacists, are protesting significant payment arrears from the National Health Insurance Fund (CNAM).
  • Doctors report 80 million dinars in unpaid dues, while pharmacists face 180 million dinars in arrears, leading some pharmacies to suspend direct payment services.
  • Healthcare unions blame CNAM's poor governance and administrative mismanagement for the crisis, not a lack of funds, and are demanding parliamentary intervention.

Tunisian healthcare professionals are sounding the alarm over a critical crisis within the National Health Insurance Fund (CNAM), citing massive payment arrears and a severe lack of governance. Doctors and pharmacists, who recently testified before the Assembly of People's Representatives' health commission, revealed that CNAM owes approximately 80 million dinars to private doctors and 180 million dinars to pharmacies.

The current suffocation of the system stems exclusively from a deficit in governance, managerial opacity, and poor administrative management of reimbursement flows by the directors of the Fund.

— Syndicates of health professionalsDuring a parliamentary hearing, health professionals explained the root cause of the CNAM crisis.

This financial strain has already led nearly 300 pharmacies to suspend the direct payment system, a move that threatens citizens' constitutional access to essential medications and treatments like hemodialysis. The situation has pushed the social security and medical coverage system to an "alarming" point, according to the health commission's bulletin.

Contrary to official communications from social security bodies, healthcare providers argue that CNAM is not suffering from a structural budget deficit or liquidity shortage. Instead, they attribute the current "suffocation" of the system to a "deficit in governance, managerial opacity, and poor administrative management of reimbursement flows" by CNAM directors. Having exhausted all avenues for dialogue and conciliation, the syndicates are now urging parliament to intervene legally to safeguard public health services and protect insured individuals.

The accumulated arrears of CNAM towards private sector doctors amount to a heavy stock of 80 million dinars.

— Medical syndicatesPresenting financial indicators to parliamentarians regarding the debt owed to doctors.

The syndicates are demanding the immediate implementation of a sectoral agreement to revalue hemodialysis session fees, with the increased amount to be directed towards practitioners' fees to ensure the survival of dialysis centers. They emphasize that the crisis is a direct result of mismanagement, not a lack of financial resources, and are seeking legislative action to resolve the ongoing payment deadlock.

The arrears of the Fund reach 180 million for pharmacists.

— Syndicates of health professionalsDetailing the financial burden on pharmacies during a parliamentary hearing.
DistantNews Editorial

Originally published by La Presse in French. Translated, summarized, and contextualized by our editorial team with added local perspective. Read our editorial standards.

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