Rabat (AFP)

The crisis linked to the new coronavirus highlights the dysfunctions of public health in the Maghreb countries, but at the same time gives hope for a change, the next day.

In Morocco, videos shot by patients infected with the virus denouncing the conditions of stay in public hospitals have relaunched the nagging controversy on the state of the health sector, poor relation of the state budget.

In neighboring Algeria, "the health crisis has exposed the shortcomings of the health system," said Professor Kamel Bouzid, head of service and president of the Algerian Society of Medical Oncology, quoted by the TSA website.

In Tunisia, a country in the doldrums, the health sector had already been shaken last year by a series of deaths of newborns, with at the time overwhelming testimony on dirt, poor staff management or the lack of equipment.

Faced with Covid-19 disease, the three countries quickly adopted restrictive measures to limit the spread and ensure that they do their utmost in the face of an unprecedented situation.

To date, Algeria remains the most affected Maghreb country, with 58 deaths and 847 cases declared, against 39 deaths and 676 cases in Morocco, and 14 deaths for 455 cases in Tunisia.

"A considerable effort is made to take care of the patients, the accommodation conditions are normal ... We should also see the favorable testimonies", said to AFP the Moroccan Minister of Health, Khalid Aït Taleb.

After the broadcast of the critical videos, King Mohammed VI ordered to improve the rehabilitation of public hospitals and to integrate military medical personnel there, according to the press.

"Even before the appearance of Covid-19, we had a shortage of human resources, this is the main problem," acknowledges the minister.

In the kingdom, the number of screening tests - less than 3,000 since early March - has also fueled doubts and criticism. Mr. Aït Taleb was invited to explain himself to Parliament when the debates resumed in mid-April, according to the press.

- "Serve as a lesson" -

For the time being, faced with the spread of the Covid, numerous voices are raised in the three countries to denounce the cruel lack of means.

"We don't have enough sampling kits and hydroalcoholic solutions," said a resuscitator stationed in a provincial hospital in Morocco. "The working conditions are difficult," points out an emergency doctor from Casablanca.

Morocco has only 1,642 beds in intensive care for 35 million inhabitants.

"Our destiny is in the hands of a health system that we have neglected for years," summarizes in a video shared on social networks a doctor from Marrakech, hoping that the current pandemic can "serve as a lesson".

In Morocco, the health budget currently represents some 5% of the national budget, against 12% recommended by the World Health Organization (WHO). And the health system remains marked by "deep geographic and socioeconomic inequalities", according to the WHO.

The pandemic has also fueled the debate on the flourishing growth of the private sector, where those who can afford it are treated, while the wealthy prefer to go abroad.

"Welcome to our daily misery," points to the open letter from a Moroccan doctor, recalling the recurring protest movements by his colleagues in the public.

Tunisia in particular has seen in recent years the development of a dense fabric of private clinics: establishments which practice "medical tourism" and welcome a rather affluent clientele, sometimes foreign, seeking for example aesthetic treatments.

- "Take advantage of this crisis" -

To fill the gaps in the face of the Covid-19 pandemic, the Moroccan authorities have launched emergency equipment purchases, financed by a special fund of more than 30 billion dirhams (three billion euros). Tunisia is struggling to mobilize funds.

"We will equip in a hurry today, but we may think (...), the next time, before building a TGV line (which is rusting at the moment) at 23 billion dirhams or two three billion operas while the hospital next door lacks Betadine, "hopes Omar El Hyani, city councilor in Rabat.

This elected representative of the Federation of the Democratic Left (FGD) is all the more indignant that his party's proposal to increase the health budget in the 2020 finance bill, before the onset of the current health crisis, s 'was met with an almost general refusal by the other deputies.

The Parliament, on the other hand, voted for a 30% increase in military spending, increasing the defense envelope to the tune of four billion euros.

Against the backdrop of historic rivalry with Rabat, Algeria spends more than double it: 10 billion euros, against four billion for health, the four budget item.

Will the pandemic upset the order of priorities? "We must + take advantage of this crisis to review our health system", claims Professor Bouzid, in Algeria.

The pandemic "has revealed many shortcomings (...) that we will endeavor to correct in the future by building a strong health system," Algerian Prime Minister Abdelaziz Djerad promised this week.

burs-hme / sof / gk

© 2020 AFP