El Salvador - Country Commercial Guide
Medical Equipment

This is a best prospect industry sector for this country. Includes a market overview and trade data.

Last published date: 2021-11-05

Overview

 

2018

2019

2020

2021 Estimated

Total Local Production

0.00

0.00

0.00

0.00

Total Exports

3.07

4.58

38.4

40.32

Total Imports

58.84

60.97

163.98

172.17

Imports from the US

20.39

14.9

26.05

27.35

Total Market Size

55.77

56.39

125.58

131.85

(total market size = (total local production + imports) - exports)
Units: USD millions
Source: Central Reserve Bank of El Salvador, Statistics based in the HTCs: 3005.90; 3006.10; 3006.20; 3006.3010; 3006.3020; 3006.50; 3006.70; 4014.10; 4014.90; 4015.11; 4015.90; 4818.901; 6307.9020; 9011.10; 9012.10; 9012.90; 9013.20; 9013.80; 9013.90; 9018.11; 9018.12; 9018.13; 9018.19; 9018.20; 9018.3110; 9018.3190; 9018.32; 9018.3910; 9018.3990; 9018.50; 9018.90; 9019.20; 9022.12; 9022.14; 9022.21; 9022.30; 9022.90; 9402.9010; 9402.9020; 9402.9090; 9025.11

Upon entering office in June 2019, the Bukele Administration had three main health priorities: resolve the shortage of medicines (which is estimated at 40% in the public sector), improve the lack of maintenance and bad conditions of hospital infrastructure, and increase accessibility of health services. Since 2020, the government priorities pivoted to focus on the Covid-19 pandemic.

The Ministry of Health has been the leading entity coordinating the government’s response to the pandemic. On March 21st, 2020 a nation-wide quarantine was imposed, lasting until August 21, 21, 2021. In July 2021, the Government approved a decree to limited people gathering in concerts, sport events, and local national festivities.

Due to the pandemic, the Ministry of Health renovated all 30 existing public hospitals and built a new hospital to treat Covid-19 patients, Hospital El Salvador, which is located at the former facilities of El Salvador Fairs and Conventions Center (CIFCO). Hospital El Salvador, an investment of $75 million, consisted of three phases: (1) An area to treat 400 Covid-19 patients, 105 beds of Intensive Care Unit, and 295 beds of Intermediate Care Unit; (2) 664 beds, and (3) a Covid-19 main vaccination center. In addition, the government created an official Covid-19 website to inform the population about the number of cases, deaths, vaccinated people, decrees, and other related topics regarding the pandemic.

The Salvadoran health services in the public sector are provided by the Ministry of Public Health and Social Assistance (MINSAL), the Salvadoran Social Security Institute (ISSS), the Salvadoran Integral Rehabilitation Institute (ISRI), Salvadoran Institute of Teachers Welfare (ISBM), the Institute of Social Prevision of the Army (IPSFA), and the Solidarity Fund for Health (FOSALUD). The private health sector is made up of hospitals, clinics, and non-profit organizations. The Ministry of Health has a total of 31 hospitals, and 372 health units; and the ISSS has 11 hospitals, and 71 health units and community units. There is only one military hospital. The private system is composed of approximately 30 hospitals, and over 116 private clinics concentrated in the country’s three main cities: San Salvador, Santa Ana, and San Miguel.

The Ministry of Health is responsible for health policy in El Salvador. The importation and commercialization of medical devices, medical equipment, pharmaceuticals, nutritional supplements, natural, dental, and hygiene products are regulated under the Medicine Law, which entered into force on April 2012; the law is implemented by the regulatory entity National Medicine Directorate (DNM). The Secretary of Innovation is leading the Digital Agenda 2020-2030 Plan, which calls for the design, creation, and implementation of an Electronic Health Record.

According to the approved 2020 El Salvador National Budget, the health budget totals $1.04 billion USD, from which $990.5 million USD are from government funds, $44 million USD from foreign loans, $3 million USD from donations. The Salvadoran government relied on international cooperation and international loans to control the pandemic. The latest reports on budgeting and fiscal measures taken by the Salvadoran Government due to Covid-19 are published at the Ministry of Treasury website.

The 2019 Multipurpose Household Survey Report (EHPM) done by the General Directorate of Statistics and Census (DYGESTIC) in El Salvador reported that 25.3% of the total population had some type of medical insurance. From the people covered, the insurance is broken out as follows: 91.9% ISSS, 6.0% ISBM, 1.6% IPSFA, and 0.4% private or other.

The public sector is the key primary purchaser of medical equipment and supplies through the Ministry of Health and the Salvadoran Social Security Institute (ISSS). Public institutions differ from private entities as they only buy new equipment. Some private hospitals occasionally acquire used or refurbished equipment. Approximately 80% of El Salvador’s market is new medical equipment and 20% used or refurbished.

New and used medical equipment can be imported into El Salvador and need to be registered at the National Medicine Directorate. Used or refurbished equipment cannot be older than 10 years from the date of manufacture. In addition, U.S. exporters should be advised that the Good Manufacturer Certificate (GMC) is required when exporting new, used, or refurbished equipment into El Salvador.

Other healthcare related products, such as medical devices, pharmaceuticals, nutritional supplements, natural, dental, and hygiene products, need to be registered at the DNM. In addition, ionizing radiation devices or equipment require an import permit from the Radiation Protection Directorate at the Ministry of Health.

To enter the market a U.S. exporter needs to identify a local distributor or representative in the country. Selling to public institutions typically requires participation in a public bidding process announced through the government procurement website COMPRASAL. It is recommended that the U.S. companies work closely with their local partner to develop effective promotional strategies and maintain a continuous presence in the market. Also, it is recommended to have a legal representative (law firm) who can assist in preparing a bid offer. According to the Salvadoran Government Procurement Law (LACAP), the lower bid is usually granted.

Leading Sub-Sectors

  • Respiratory equipment
  • PPE Products
  • Ultrasound scanning apparatus
  • Magnetic Resonance Imaging equipment
  • X-ray equipment
  • Cardiac monitors
  • Beds, lamps
  • Dialysis equipment
  • Disposable products

Opportunities

In 2020, El Salvador imported a total of $164 million in medical equipment and devices, with U.S. products making up roughly 15% of the market share. Due to the pandemic, the importation of personal protective equipment, such as face masks, was dominated by China. However, in the Salvadoran market U.S. products are preferred due to quality, customer service, and availability of spare parts and accessories. The main competitors in this sector are products from China, Germany, Brazil, and Mexico. There is no significant local production in El Salvador.

Post-sale service is crucial in the market as hospitals and clinics require technical support for their equipment. For example, a large German manufacturer is one of the leading suppliers in the health system as they have well established operations in El Salvador and can respond quickly to local needs. U.S. companies are encouraged to work with local distributors that can provide technical support to local clients.

Following are short/mid-term projects under development by the public and private sector:

  1. Public Sector – projects funded by a $170 million loan from the Inter-American Development Bank; it includes two hospitals (a) Hospital Zona Norte (contract awarded), and (b) Hospital Rosales (bid in process).  Covid-19 has affected the implementation of the projects. It is recommended that U.S. companies interested in these opportunities should register at the United Nations Development Business and/or COMPRASAL to receive bid notifications. 
  1. Hospital Rosales: main public hospital in El Salvador. The project contemplates the remodeling of current facilities and the construction of new towers; the offers for the bid for the design and construction of the specialized external consultation building will be submitted on July 30, 2021. A bid for equipment is expected to be announced in 2022, $19 million will be allocated for the purchase of medical equipment.
  1. Private Sector
  1. Hospital de Diagnostico: one of the main private hospitals in the country, is planning the opening of a new surgery center and ER unit in the city of Antiguo Cuscatlan (La Libertad). The center will require x-ray machines, a computerized axial tomography (CAT) scan, and potentially an accelerator.

Resources

  • Ministry of Health
  • Covid-19 Official Page
  • Salvadoran Social Security Institute (ISSS)
  • Salvadoran Integral Rehabilitation Institute (ISRI)
  • Salvadoran Institute of Teachers Welfare (ISBM)
  • Institute of Social Prevision of the Army (IPSFA)
  • Solidarity Fund for the Health (FOSALUD)
  • National Medicine Directorate (DNM)
  • Ministry of Treasury
  • Government Transparency Portal (health budget)
  • Government Procurement COMPRASAL
  • UN Development Business
  • General Directorate of Statistics and Census (DYGESTIC)

Interested parties may contact Commercial Specialist Lidia Sosa at Lidia.Sosa@trade.gov