Egypt
An Eastern Mediterranean country with low recorded opioid sales.
9 domains reviewed · 9 high-confidence · 2 dated estimates · 9 material gaps
WHO region: Eastern Mediterranean. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 9 of 9
- Hospice: 0 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 13
- Sources behind this dossier
- 12
- Newest source 2024
Lessons from Egypt
- A fixed per-prescription cap on morphine undertreats severe pain by design: one weekly prescription would cover only a minority of patients who need strong opioids. Narcotics rules should be audited for quantity or frequency caps that do not scale with clinical need.90
- Oncology departments in every public university did not produce palliative care outside the capital. Palliative capacity is its own target.91,92
- A regional cancer centre with no palliative curriculum or end-of-life policy left most of its staff untrained. Training has to reach general cancer sites directly.91
- Public fear of tramadol misuse can lead people with cancer to refuse pain relief, so misuse messaging should be paired with patient education on medical use.622
- Caregiver burden and depressive symptoms appear soon after a diagnosis of incurable cancer, which supports screening caregivers from the start of palliative care.623,624
Palliative care
Is morphine available in Egypt?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 0.61 MME per 1,000 people per daySOURCE-CHECKED · 2019 DATA
Opioid analgesic consumption, Egypt, 20193
Method: IQVIA MIDAS pharmaceutical sales data for opioid analgesics, in morphine milligram equivalents per 1,000 inhabitants per day (Ju et al. 2022; abstract read September 2026). A sales-based proxy for availability, not a measure of palliative access. Last checked 2026-09-25.
Cite this figure:
Injectable morphine was reported only occasionally available, against constant availability in Saudi Arabia, Jordan and several Gulf states.3,49
What is consumption since 2019, and does the prescription cap explain part of it?
Help answer it:Search PubMedHow does Egypt regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
- 420 mgSOURCE-CHECKED
Maximum oral morphine in a single prescription, Egypt, 201190
Last checked 2026-09-24.
Sixty mg for ampoules. The law as described in the 2011 study.
Cite this figure:
The narcotics control law caps the morphine that may be written in a single prescription, and the first palliative care unit adapted its internal policy to work within the cap.90
Has the per-prescription cap changed since the 2011 study, and what licence does a hospital pharmacy need to stock narcotics? The only post-2019 amendment located concerns trafficking penalties.
Help answer it:Search PubMedWho can prescribe morphine in Egypt?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
- 26 percentSOURCE-CHECKED
Patients needing strong opioids adequately supplied by one weekly prescription, Egypt, 201190
Last checked 2026-09-24.
None would be adequately supplied with parenteral morphine. One unit, record review.
Cite this figure:
Prescribing is physician-led. The cap means most patients needing strong opioids need repeated prescriptions within a week. A regional cancer centre reported no institutional end-of-life policy at all.90,91
May a general physician outside a cancer centre prescribe oral morphine, and on what terms?
Help answer it:Search PubMedHow does palliative care reach patients in Egypt?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 4 centresSOURCE-CHECKED
Recognised palliative care centres, Egypt, 202491
Last checked 2026-09-24.
One paediatric. The source places them in Cairo.
Cite this figure:
Dedicated palliative care is concentrated in Cairo, while general oncology reaches every public university and ministry centres in the provinces. Oncology reach has not carried palliative care with it.91,92
Do the Assiut or Alexandria cancer centres run a recognised palliative or home care service?
Help answer it:Search PubMedWho pays for palliative care in Egypt?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
The regional expert survey reports palliative care funded through the national health budget.49
Does the universal health insurance benefit package, rolled out by governorate since 2019, name palliative care? Secondary accounts disagree.
Help answer it:Search PubMedHow are palliative care clinicians trained in Egypt?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
- 77 percentSOURCE-CHECKED
Nurses and physicians at a regional cancer centre with no palliative care training, Egypt, 202491
Last checked 2026-09-24.
Reported as more than 77 percent. Qena Governorate.
Cite this figure: - 26 universitiesSOURCE-CHECKED · 2021 DATA
Public universities with an oncology department, Egypt, 202192
Last checked 2026-09-24.
Cite this figure:
No accredited palliative medicine specialty was reported, and palliative care appears only as a reference in the national cancer strategy. At a large regional cancer centre most staff had no palliative training.49,91
Which faculties teach palliative care, and does any credential exist?
Help answer it:Search PubMedHow does Egypt prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
Among 178 cancer patients at two centers, 51% said they would refuse tramadol for pain, most citing fear of addiction; tramadol was the only available WHO step-II analgesic in Egypt. Experts reported that injectable morphine is only occasionally available. Government and non-governmental organizations provide harm reduction and addiction treatment, and primary care physicians need more addiction training.622,49,626
Does Egypt provide methadone or buprenorphine treatment and community naloxone, and how have tramadol controls affected access for people with cancer pain?
Help answer it:Search PubMedHow do children get palliative care in Egypt?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
The National Cancer Institute in Cairo launched Egypt's first outpatient palliative care service for children with cancer in late 2007 and added home care in 2010, while no pediatric palliative care guideline existed. In Port Said, 76.8% of 500 family caregivers of children with cancer showed inappropriate palliative care practice.625,440
How many children in Egypt receive palliative care each year, and are oral morphine formulations for children available outside Cairo?
Help answer it:Search PubMedHospice care in Egypt
How the hospice model works here, who can use it, who pays and who it reaches. Covered 0 of 4.
What does hospice care look like in Egypt?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
Does Egypt have any service that calls itself a hospice (inpatient, home or day hospice), and who runs it? PubMed returned no Egypt-specific hospice studies; available papers cover hospital palliative care and ICU end-of-life care.
Help answer it:Search PubMedWho can get hospice care in Egypt?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
If hospice-type care exists in Egypt, what diagnosis, prognosis and disclosure rules govern admission?
Help answer it:Search PubMedWho pays for hospice care in Egypt?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
Who pays for end-of-life care outside hospitals in Egypt: public budget, insurance, charities or families?
Help answer it:Search PubMedHow many people reach hospice in Egypt?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
How many Egyptians receive hospice or home end-of-life care, and are children, rural Upper Egypt residents or non-cancer patients reached?
Help answer it:Search PubMedWhat fills the gap in Egypt
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
Family caregivers of older cancer patients at two Egyptian pain and oncology services showed notable strain and widespread dissatisfaction with care. Among 500 family caregivers of children with cancer in Port Said, most identified lack of caregiver training and poor communication with the health team as barriers.439,440
Subnational evidence
Sources cited here
- 3Ju C, Wei L, Man KKC, et al.
Global, regional and national trends in opioid analgesic consumption, 2015 to 2019. Lancet Public Health 2022;7:e335-46. DOI 10.1016/S2468-2667(22)00013-5.
- 49Sanchez-Cardenas MA, Pourghazian N, Garralda E, et al.
Palliative care in the Eastern Mediterranean: comparative analysis using specific indicators. BMC Palliative Care 2022;21:168. DOI 10.1186/s12904-022-01047-7. Expert survey of 12 EMR countries, including Iran, Jordan, Egypt, Morocco and Pakistan. Iran and Jordan are among the countries reported to have a national palliative care strategy, a designated Ministry of Health officer for palliative care and palliative care recognised as a subspecialty; recognition years are not given. Full text read.
- 90Alsirafy SA, El-Mesidi SM, El-Sherief WA, Galal KM, Abou-Elela EN, Aklan NA.
Opioid needs of patients with advanced cancer and the morphine dose-limiting law in Egypt. Journal of Palliative Medicine 2011;14(1):51-54. DOI 10.1089/jpm.2010.0220. Abstract read. Record review at the first palliative care unit in Egypt: the narcotics control law caps the morphine in a single prescription, and a single weekly prescription would adequately supply only a minority of patients needing strong opioids.
- 91Osman A, Horvick SG, Dias N.
Health care providers' perspectives on the need for palliative care in Upper Egypt: a descriptive exploratory study including children and adult patients. BMC Palliative Care 2024;23:152. DOI 10.1186/s12904-024-01469-5. Survey of nurses and physicians at an oncology centre in Qena Governorate; four recognised palliative care centres nationally, all in Cairo; no institutional end-of-life policy at the study site.
- 92Khaled HM, Soliman AS.
Medical oncology education in Egypt over the past 50 years: the experience of the National Cancer Institute of Cairo University. Journal of Cancer Education 2021;36(Suppl 1):87-94. DOI 10.1007/s13187-021-02038-7. Oncology training capacity: oncology departments in every public university and ministry oncology centres in the provinces.
- 622Alsirafy SA, Saleh RN, Fawzy R, et al.
The fear of using tramadol for pain control (tramadolophobia) among Egyptian patients with cancer. J Opioid Manag 2015;11(6):474-80. Structured interviews with 178 adult cancer patients at two Egyptian cancer centers on fear of tramadol; two-site scope. Abstract read.
- 626El-Zoghby SM, Madroumi R, Kewley S, et al.
Insights into primary care physicians' detection, intervention and management of patients with substance use disorders in Egypt. J Ethn Subst Abuse 2024;24(4):1142-1160. National cross-sectional survey of 392 Egyptian family physicians and general practitioners on substance use disorder care in primary care. Abstract read.
- 623El-Sherif RAM, Shaban AH, Abbas FA, et al.
Burden, Depression and Quality of Life in Carers of Newly Diagnosed Advanced Cancer Patients in Egypt. J Pain Symptom Manage 2024;67(5):e403-e408. Cross-sectional study of 95 family caregivers of newly diagnosed incurable cancer patients; burden linked with depression and lower quality of life. Abstract read.
- 624Alsirafy SA, Nagy R, Hassan AD, et al.
Caregiver burden among family caregivers of incurable cancer patients in two eastern Mediterranean countries. BMC Palliat Care 2021;20(1):163. Cross-sectional study of 218 family caregivers (165 Egypt, 53 Saudi Arabia) of incurable cancer patients using the Zarit Burden Interview. Abstract read.
- 625Mojen LK, Rassouli M, Eshghi P, et al.
Palliative Care for Children with Cancer in the Middle East: A Comparative Study. Indian J Palliat Care 2017;23(4):379-386. Literature-based comparison of pediatric palliative care in Egypt, Lebanon, Jordan, Turkey and Iran from 2000 to 2016; secondary data only, part of an Iranian doctoral thesis. Full text read.
- 440Mohamed MA, Ibrahim AM, Ibrahim HM, et al.
Perception of pediatric oncology family care providers toward palliative care and its perceived barriers in Egypt. Palliat Support Care 2022;20(1):55-61. Descriptive study of 500 family caregivers of children with cancer at one governmental hospital in Port Said. Abstract read.
- 439Ibrahim AM, Zaghamir DEF, Sultan Sultan HM, et al.
Optimizing geriatric palliative care in Egypt: Comprehensive patient and family perspectives. Palliat Support Care 2024;22(5):1272-1281. Cross-sectional survey of 110 older patients and 110 family caregivers at Damietta Oncology Institute and Zagazig University pain clinics using validated scales for caregiver strain and family satisfaction. Abstract read.