The Palestinian pharmaceutical sector has demonstrated dramatic competence in managing the local manufacture of pharmaceuticals and their global distribution. Special emphasis has been put on the production of essential drugs such as antibiotics, diabetes medication, and antihypertensive and analgesic agents. International exporting of these drugs has been enabled thanks to a dedicated attention to quality assurance, as the different local pharmaceutical companies have been able to demonstrate stringent and consistent compliance with the high standards of Good Manufacturing Practice (GMP). Nevertheless, and despite such successes, there remain some major challenges that Palestinian pharmaceutical companies must overcome. Such challenges may be attributed to the small domestic market and to the political restrains imposed by Israel, which include restrictions on the import of raw materials and on access and movement, particularly to Gaza, which represents 40 percent of the pharmaceutical market. In response, the four major Palestinian pharmaceutical companies have engaged in a synergic collaboration in order to overcome such barriers; they are placing special focus on research and development and producing new therapeutics.
The health sector in Palestine is reflecting successful records in the elimination of contagious infectious diseases such as schistosomiasis, leprosy, diphtheria, plague, poliomyelitis, and rabies, and only few cases corresponding to particular infectious diseases such as AIDS, hepatitis, tuberculosis, diarrhea, and pneumonia may still be present. However, non-communicable diseases such as cardiovascular disease, diabetes, cancer, and hypertension have been more closely associated with mortality rates and are still on the rise. In 2011, cardiovascular diseases, followed by cancer and cerebrovascular disease, have ranked top among the factors leading to death in Palestine.
The Palestinian Government, represented by the ministry of health (MOH), is the key Palestinian player in the management of pharmaceutical bureaucracy from policy-making and legislation to execution and inspection. The Palestinian Pharmacists Association (PPA) is the organizational body of pharmacists that works with the MOH in a number of complementary ways. Founded in 1957 as a joint body with the pharmaceutical association in Amman, and in collaboration with the General Directorate of Pharmacy at the MOH, the PPA issues regulations and manages the subsequent inspection in order to assure the highest quality of practice. Such regulations are mainly concerned with the marketing authorization and registration of the currently registered 7,000 products, but also take care of inspection, import control, licensing, market control, quality control, GMP adherence, medicine advertisement and promotion, clinical trial control, and pharmacovigilance. Even though such activities may be covered in current rules, there are no specified regulations corresponding to the inspection of pharmaceuticals at authorized ports of entry, good distribution practice, good pharmacy practice, the promotion and advertising of pharmaceuticals in accordance with national codes of conduct, and the control of particular products, such as narcotics and psychotropics.
The MOH is the major healthcare service provider in Palestine. The bulk of services are provided through their 458 medical centers that are scattered throughout the West Bank and the Gaza Strip. Alongside the MOH are a number of other healthcare providers that include the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Palestinian nongovernmental organizations (NGOs), Palestinian Military Medical Services (PMMS), and private for-profit organizations. These organizations operate 102 (UNRWA), 206 (NGOs), and 23 (PMMS) healthcare centers and clinics that are distributed among the districts of the West Bank and Gaza Strip in addition to 458 primary healthcare centers run by the MOH and 81 governmental and non-governmental hospitals. There are a total of 6,006 hospital beds available, resulting in 14.5 beds per 10,000 Palestinian inhabitants, of which 25% are located in specialized wards, whereas the rest may be termed general. In total, there are 4,522 licensed pharmacists, 10,049 physicians, 2,667 dentists, 9,418 nurses, and 1,039 midwifery personnel working in Palestine, which confers 10.9 pharmacists, 24.2 physicians, and 22.6 nurses per 10,000 capita.
Palestine presents six pharmaceutical companies, which cover an estimated 50% of the local pharmaceutical market. One of these is located in the Gaza Strip and no longer functioning due to the Israeli-imposed siege that is all but preventing the entry of goods and commodities into the Gaza Strip. All others reside in the West Bank. Pharmacare, Al-Quds Pharmaceuticals, Birzeit Pharmaceutical Company and Beit-Jala Pharmaceutical Company have established a strong presence over the years and have reflected quality products that are not only distributed domestically but also and largely exported to international markets. A new entrant to the market is Sama Pharmaceuticals, located in Nablus, and it is expected to launch its first products in late 2017.