The emirate of Dubai in the United Arab Emirates has over 4.6 million people, with one of the fastest growth rates in the world. Only 4% of the population are local people, most (4.4 million) are expatriates without comprehensive access to government-sponsored healthcare.
In 2016, the UAE government set a goal of reducing cancer mortality by 25%, and it became mandatory for all Dubai residents to have healthcare insurance. While the Dubai Health Authority (DHA) has defined a minimum benefits package for expatriates, the coverage level of their mandatory basic health insurance is often insufficient to fund cancer treatments.
This means that expatriates who are not able to pay the remainder out of pocket are excluded from accessing comprehensive cancer treatment. Around 2.6 million low-income workers often leave the country for treatment or palliative care. In addition, cancer screening hasn’t been prioritised in the country. This, along with a low level of cancer awareness, means that diagnosis and thus treatment tends to come too late.
In 2016 we partnered with the DHA and the international health insurer AXA to co-develop and jointly implement an innovative compulsory funding scheme, known as Basmah, that includes screening and treatment for colorectal, breast and cervical cancers. The initiative provides comprehensive access for all expatriates in Dubai, especially those with low incomes.
As a result of the three-way collaboration, AXA developed a supplementary insurance coverage scheme for expatriates. A small additional amount is charged on the premium employers pay for each employee, which is pooled into a central fund. The central fund is used to provide coverage for cancer treatment once eligible cancer patients reach the annual limit of their insurance plan.
In addition we contributed to the development of national screening guidelines, and trained primary physicians and physicians employed by insurance companies on screening and cancer treatment pathways. We also worked with the DHA to ensure that coverage for screening is mandated in all insurance policies in Dubai.
The top-up funding scheme currently covers breast, colorectal and cervical cancer and was extended to cover comprehensive genomic profiling in 2019. It is expected to be expanded to cover lung cancer and haematological malignancies.
As a result of the partnership between public and private sector stakeholders, all expatriates across the income spectrum are now able to access funding for cancer treatments, which is especially helpful for the expatriate population on a lower income.
Furthermore, all Dubai residents will benefit from better screening and diagnosis, regardless of their insurance policy. This initiative considers the growth of the population in the future and is therefore long-lasting.
This approach is now being explored for other countries, especially in the gulf area and we hope to expand the program soon to additional therapeutic areas beyond oncology.