Ministry of Health (Saudi Arabia)

In 1925, Saudi Arabia's first public health department was established in Makkah.[1] The department was founded with the aim to increase the quality and access to healthcare in the country. In the first few decades of its existence, the Ministry focused on the development of hospitals and other healthcare infrastructure in Saudi Arabia. Additional regulation was also added with healthcare centers enforcing regulations to provide necessary standards for practicing medicine and pharmacology.[1] A public health council was also established to address the growing need for healthcare services, and it was the highest-level supervisory board, overseeing all aspects of the country’s healthcare services.[1]

The various healthcare institutions were merged to become a ministerial body in 1950.[2] Abdullah bin Faisal Al Saud was the first health minister and served in the position for three years with his main role to set up the newly formed ministry.[3] He served in the position for three years. He was replaced by Rashad Pharaon who was personal doctor of King Abdulaziz,[4] and he served in the post between 1954 and 1960.

Following World War II, Saudi Arabia's oil production increased dramatically and many remote areas began to see an influx of workers to work in the oil industry. This meant that developing regions in the Kingdom required more healthcare infrastructure, which was subsequently provided. The initial management of this expansion in the early 1960s fell under the responsibility of Dr. Hassan Bin Yousef Nassief and Dr. Hamid Bin Mohammad Al Harsani, the third and fourth ministers of health. They each served a year in the position, from 1960 to 1962.

Later in the 1960s, the growth turned the country into a regional and global power. Following a number of conflicts in the 1960s and 1970s, Saudi Arabia's importance in the region grew. This continued rise in wealth meant that huge investments were made by the country's leaders, in order to improve the standard of living across the country. Health in the rural areas of the country became more accessible during this period, as communities that were once considered rural, were more integrated into society with the expansion of oil fields. This expansion required health facilities, which saw the first major rural expansion of medical care in the country's history. This was overseen by Dr. Yousef Bin Yaqoub Al Hairi and Shaikh Hassan bin Abdullah Aal Alshaikh, both of whom served as ministers of health in the mid to late 1960s.

Cities such as Riyadh and Jeddah saw their healthcare infrastructure grow substantially. The expansion of the city infrastructure was essential, with urbanization increasing in the country, with large corporations also moving their offices to the country with the growing economy. This early development was overseen by Dr. Jamil bin Ibrahim Al Hujailan and Dr. Abdulaziz bin Abdullah Al Khuwaiter, who served as ministers in the early 1970s. The economic expansion did not only lead to the development of hospitals for citizens but also care for the Kingdom's military. In the 1970s saw the construction of Riyadh Military Hospital and many other major infrastructure projects that led to more accessible healthcare.[5] A number of years later saw the creation of King Khalid University Hospital was also completed. Dr. Hussain bin Abdulrazzaq Al Jazairy played a major role in the Kingdom's improved hospitals during his eight-year tenure between 1975 and 1983.

Towards the end of the 1990s, Dr. Faisal bin Abdulaziz Al Hujailan finished serving as minister of health after twelve years. He to this day is still the longest-serving minister of health in Saudi Arabia's history. Al Hujailan's role as health minister was complex and varied. The health of the military and the people during this period was hugely important, due to the conflict surrounding Iraq's invasion of Kuwait and the surrounding conflicts, including the Battle of Khafji.[6] A large coalition army was formed by the United Nations and many were based in the Kingdom during the Gulf War and tensions in the 1990s. Al Hujailan and ministers who followed him had to not only care for the health of its people but also ground troops and wounded soldiers.

In the early 21st century, two ministers played a major part in the development of new high-tech hospitals and infrastructure in many of the cities in the Kingdom. Of them, Hamad bin Abdullah Al Manie served between 2003 and 2009, with Abdullah bin Abdulaziz Al Rabiah serving for five years until 2014. Following Al Rabiah's departure, a number of well known public officials served as minister of health between 2014 and 2016. In total, five Ministers were appointed during this period, including Adel Fakeih, Dr. Mohammed Al-Hayaza and Khalid Al Falih.[7]

A new minister of health was announced in early 2016 as Dr. Tawfig Al Rabiah.[8] Al Rabiah played an influential role in the Kingdom's healthcare and also in the formation of Saudi Vision 2030. From 2016 onwards, the minister stated that he would be focusing on reforming healthcare across the Kingdom, improving the standards and procedures. Much of this improvement would also be focused on developing better procedures and moving healthcare centers into the digital age.

This was part of the wider Saudi Vision 2030, with major support from the Saudi government to transform the current healthcare offering in the country. This included a complete reworking of strategy, restructuring the entire healthcare system in the Kingdom. A major part of this restructuring was the decentralization of hospitals and other health services into twenty separate districts across the country. The major aim of this was to create clusters based on the population spread. It would allow hospitals and supporting infrastructure to provide assistance to around thirty-four million Saudi citizens and residents.

The health minister spoke about creating friendly competition between each of the districts, and between different medical services and hospitals. This idea resulted in the creation of the “Ada’a” project launched in 2016. The new system is a nationwide performance indicator, for services and hospitals. The program focuses on more than 40 key performance indicators across seven different hospital domains. It aims to identify weaknesses and shortfalls in the system, while also creating competition between each of the services. The model was loosely based on league tables from other countries, such as the NHS league tables in the United Kingdom. Following the implementation of the new KPI tables, waiting times and other major measurements improved dramatically across the Kingdom.[9]

The Kingdom has attempted to link lifestyle with health through a number of initiatives. This focused on attempting to solve the country's obesity issues. The most recent Minister of Health announced that a new strategy had been developed by the Ministry, known as Diet and Physical Activity Strategy or DPAS for short.[10] He believed that many lifestyle issues in the country were causing bad lifestyle choices. This led to the Ministry advising that there should be a tax increase on unhealthy food and drink in the region. They believed the higher costs of the unhealthy food would stop the poorer citizens from buying it, but also the additional tax could be utilized to improve healthcare offerings.[11] As part of the same strategy, calorie labels were added to a number of food and drink products. Ingredients were also listed, not as an aim to reduce obesity, but also for citizens with health issues, it would become easier to manage their diet.[12]

As part of the ongoing focus on tackling obesity, the health minister announced that the Kingdom would be opening women-only gyms. Local media had reported that women in the Kingdom often struggled to exercise enough during a typical day, which was leading to health issues in some women. A number of sports were offered in each of these gyms, including bodybuilding, running and swimming to maintain higher standards of health.[13][14]

The MOH was awarded Healthy City certificates for the cities of Unayzah and Riyadh Al Khabra as 4th and 5th Healthy Cities in Saudi Arabia. The cities were qualified after a successful evaluation by the World Health Organization (WHO) and external experts in March 2019.[15]

The Saudi city of Madinah has been acknowledged by the World Health Organization (WHO) as among the world’s healthiest cities.[16].The holy city gained the accreditation after a visiting WHO team in January 2021 said that it met all the global standards required to be a healthy city. Madinah is believed to be the first city with a population of more than 2 million to be recognized under the organization’s healthy cities program.

Under the leadership of Tawfig AlRabiah, it was announced that the Kingdom would be creating a national health insurance agency, which would be managed by the Ministry of Health. It was announced that implementation would begin in 2018 and would be regulated centrally, but medical services would be independently provided. The move meant that Saudi Arabia was one of the first countries in the Middle East to offer health insurance to its people.[17]

Saudi Arabia identified in the past decade that health concerns with pilgrims could cause severe problems to the country's infrastructure during the pilgrimage season. International Health Regulations were applied to pilgrims, in line with the World Health Organization following the discovery, which would give better medical protection to more than two million people annually.[18] This protection is provided by 25 hospitals, 155 health centers and a workforce of 30,000 medical professionals in the country.[18] As part of the same strategy, a new contingency and emergency planning was introduced by the Minister, with the creation of the Saudi Disaster Medical Assistance Team (S-DMAT). The newly formed relief team would be used during pilgrimage season, but could also be deployed to neighboring countries in times of crisis.[19]

Since 2016, the Kingdom has placed additional focus on innovating its digital offering. One major new service was the creation of eHealth Analytics, abbreviated to Seha. The platform allows Saudi citizens to connect with a physician via the Internet and remotely. The main method of connection is through smartphones, allowing video calls to take place remotely rather than in-person. Added to this development was the implementation of electronic prescriptions, meaning patients can see a physician and receive a prescription digitally.[9]

Since the mid-2010s, the Ministry has had an increased focus on artificial intelligence. As a medium to long term aim, trails and developments demonstrated how Saudi Arabia could become a pioneering country in medical AI. With partnerships with the likes of Siemens and Babylon Health, it is believed that AI operations and other advanced forms of AI could be tested in the country within the next decade.[20]

In recent years, Saudi Arabia has created and developed the Saudi Center for Disease Prevention and Control, often abbreviated to CDC. The announcement of a newly formed CDC came in 2013, which became the first centralized facility of its kind in the Kingdom. The main goals of the facility were to research and treat various health issues across the country, while also conducting experiments. It was believed at the time of its creation, the CDC would dramatically boost the country's health sector.[21]

A new commission was formed in 2016 to aid the treatment of Hepatitis C in the country. The aims of the commission are to eradicate the disease from the domestic population in the Kingdom. This also coincided with the creation of a new Saudi-made medicine that would be used to treat the virus.[22] Wider initiatives on the treatment of disease were also implemented, with flu vaccinations becoming a focus. Between 2016 and 2018, vaccinations in the country quadrupled.[23] The vaccinations were made possible with the launch of rural medical care in the country. Mobile primary care became a new initiative under the Minister's guidance, which meant rural citizens in the Kingdom could access health-related services more easily. The care industry in Saudi Arabia recognized that more people required home visits as part of a wider initiative to help the elderly and those less mobile. The Minister increased the number of services that could be implemented during home visits. It was estimated that 250,000 home visits were conducted by the end of 2018.[24]

As part of a move toward healthier citizens of the Kingdom, the Minister announced that there would be an expansion in the number of clinics to treat tobacco addiction. In order to reduce the number of people taking up smoking, the Kingdom also created a number of initiatives to take a stricter view on smoking as a whole. This included a tax increase on the sale of cigarettes.[25] The University of Massachusetts also became involved in the initiatives, signing a partnership with the Kingdom to assist in the research of the treatment of tobacco addiction.[26]

In order to reduce the number of people taking up smoking, the Kingdom created a number of initiatives to take a stricter view on smoking, which saw a 97% increase in anti-smoking clinics from 254 to 504 clinics, in addition to 100 mobile units for universities and education directorates. Meanwhile, focusing on community consciousness, the MOH achieved a 336% increase in the proportion of breast cancer screenings and screened 61,000, while 3.75 million people were given flu vaccination.

Minister of Health Dr. Tawfiq bin Fawzan Al-Rabiah received a global award on behalf of the Kingdom for combatting smoking through social awareness, treatment, and application of regulations.[27] The award was presented as part of the 72nd session of the World Health Assembly, held in Geneva in May 2019. After becoming one of the first nations to ratify the WHO Framework Convention on Tobacco Control in 2005, it plans to reduce tobacco use from 12.7% in 2017, to 5% in 2030.[27]

Healthcare in schools until recently fell under the stewardship of the Ministry of Education. In 2018, the Council of Ministers transferred healthcare in schools to the Health Ministry. Following this, a thorough check was carried out into the processes at schools for children's health and health checks for 339,825 pupils in 5,570 schools was implemented. In 2018, this was transferred across to the Health Ministry. Following this move, a thorough check was carried out into the processes at schools for children's health. It was decided that reform on health checks was required and subsequently implemented that all pupils in chosen grade intervals would have health checks.[28]

As a wider move to improve health infrastructure in the Kingdom, the Minister opened a number of new Cardiac centers, both for operations and research. The new facilities totaled six by the end of 2018, with performance indicators suggesting heart operation success was up to 96%. Due to the Kingdom's growing population, the MOH launched the Newborn Screening Program, which includes hearing tests and heart examinations, covering up to 96% of the Kingdom's babies. Other highly specialized services are offered in parallel with the screening program.[29]