Assessing Law No. 87 of 2024 on private sector management of public healthcare facilities in Egypt: neoliberal roots, potential consequences, and policy recommendations

In March 2024, Egypt enacted Law No. 87, permitting private sector management of public healthcare facilities. The timing of the law reflects the intersection of domestic challenges including fiscal pressure, institutional capacity constraints, and limitations in public health service delivery, and global policy influences, including neoliberal approaches to economic development. This study analyses the law’s underlying drivers and assesses its anticipated implications for equity, access, and health system governance. A critical political economy of health framework guided this qualitative study. We conducted a multi-level policy analysis of Law No. 87 and relevant regulatory texts, supported by a desk review of scholarly and grey literature. To enhance contextual depth and triangulate findings, we convened a multidisciplinary roundtable with 14 experts from government, academia, civil society, and development agencies. Transcripts were thematically analysed. Findings indicate that Law No. 87 reflects a broader policy trajectory of the adoption of neoliberal economic development, which in the health sector, signals a major health policy shift. For the first time, the private sector is provided a legal framework to manage public health facilities. While some experts viewed it as a necessary, efficiency-oriented reform that would improve quality of health services, others flagged concerns over vague regulatory provisions, limited public oversight, and weak implementation capacity. The absence of community participation and explicit equity safeguards raised further concerns about the law’s ability to advance inclusive and accountable health system governance. Law No. 87 signals a major shift in the governance of public healthcare in Egypt. Beyond efficiency goals, its long-term impact will depend on the state’s capacity to regulate, monitor, and steer implementation toward equity objectives. Addressing gaps in accountability, ensuring stakeholder participation, and articulating clear equity safeguards will be essential for aligning the reform with Egypt’s commitments to universal health coverage and protecting the public interest.