Between the 8th and 13th centuries, the Eastern Mediterranean Region was a pharmacological powerhouse. In cities like Baghdad, Cairo, and Cordoba, patients sought remedies developed through an extraordinary fusion of knowledge—from ancient Egyptian and Greek traditions to Persian, Arab, Ayurvedic, and Prophetic medicine (al-Tibb al-Nabawi).
By the 9th century, licensed apothecaries were common, overseen by state-appointed inspectors (muhtasibs). Trained in botany, chemistry, and medicine, pharmacists prepared everything from syrups and ointments to antidotes and pills with rigorous care.
In his Comprehensive Book on Medicine (Kitab al-Hawi), ar-Razi systematically catalogued diseases, treatments, and drug interactions. Ibn Sina’s Canon of Medicine lists over 760 simple and compound drugs—detailing their properties, uses, and preparations―while Ibn al-Baitar’s Book of Simple Drugs describes more than 1,400 therapeutic substances drawn from nature.
By some accounts, European physicians of the time wrote prescriptions in Arabic―not for comprehension, but to lend them authority.
Fast forward to today and the story is very different. Despite this illustrious heritage, access to medicines is now one of the most critical health challenges in the Eastern Mediterranean Region.
Half of all essential, low-cost medicines are missing from public health facilities. Millions of people are left to pay out-of-pocket or go without life-saving treatment altogether. First- and second-line therapies for major conditions—from infectious diseases to cardiovascular disorders and cancer—remain widely unavailable. In fragile and conflict-affected settings, even basic medications are out of reach in primary health centres.
The problem is not only one of availability, but of safety. Over 560 substandard or falsified medical products have been reported across the Region in the past 12 years, putting countless lives at risk. In many countries, the lack of well-established systems for regulating medicines and vaccines means that their safety and efficacy are not guaranteed.
Another critical issue is our over-reliance on imported medical products. This dependence drives up costs, risks supply disruptions, and redirects the economic value of health spending to producers outside the Region.
To meet the health needs of their populations, countries in the Eastern Mediterranean must reimagine access to medicines―not as a downstream logistical concern, but as a pillar of health security. This means building end-to-end capabilities in research and development, clinical trials, regulatory approval, local manufacturing, procurement, storage, and distribution.
At WHO, we are working hand-in-hand with governments and stakeholders to help realize this vision. Our support is focused on four key areas: strengthening local production capacity through technical assessments and investment guidance; enhancing national regulatory systems to ensure access to safe, effective, and quality medical products; modernizing supply chains with digital tools and systems to ensure efficient procurement, storage, and delivery; and establishing a regional pooled procurement mechanism to improve bargaining power and equitable access to critical supplies.
Our efforts are already bearing fruit. WHO technical support has helped elevate the national regulatory authorities in Egypt, Jordan, Morocco, Pakistan, Saudi Arabia, and Tunisia. Egypt’s Drug Authority has reached Maturity Level 3 for medicines and vaccines regulation. Saudi Arabia’s Food and Drug Authority has achieved Maturity Level 4—the highest possible classification.
Improving access to quality, affordable medicines will strengthen health systems, accelerate progress toward universal health coverage, and boost economic resilience.
In Jordan, Libya, and Syria, we have supported comprehensive assessments of national medical supply systems, and in Iraq we have conducted in-depth reviews of local pharmaceutical manufacturing to identify investment priorities and market gaps.
These initiatives are helping to promote self-sufficiency and save lives. Improving access to quality, affordable medicines will strengthen health systems, accelerate progress toward universal health coverage, and boost economic resilience.
The opportunity is significant: the Arab pharmaceutical market is projected to reach US$80 billion by 2030. The question is: will the Region seize this opportunity, or continue to depend on expensive and unreliable imports?
Some countries are already showing the way forward. Egypt, the Arab world’s largest pharmaceutical producer, continues to invest in domestic manufacturing. Jordan maintains a strong position in generics and exports to over 60 countries, including the US and EU. Saudi Arabia, under Vision 2030, is advancing plans to localize drug production, and the UAE is investing in biotech and AI-driven drug development.
But truly transformative change will require sustained public and private investment, and cross-sectoral partnerships involving governments, manufacturers, financiers, civil society, and international organizations.
The Gulf countries—already making strides in biotech and pharma—are uniquely positioned to lead. With increased investments in R&D, support for local production, and promotion of regional pooled procurement, they can accelerate access and promote equity across the Region. We know from our regular interactions with Member States that there is strong willingness to work together to expand equitable and timely access to safe and affordable medical products.
Although we may currently lag behind other regions in terms of health access, the deep scientific legacy of the Eastern Mediterranean reminds us of what is possible. With leadership, investment, and solidarity, we can once again become a powerhouse for medical innovation and access—not only in our Region, but for the world.
