Overview

 (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

The Bukele Administration aims to modernize and transform El Salvador’s Integrated National Health System. The government’s priorities are to resolve the shortage of medicines, improve the poor hospital infrastructure and lack of maintenance, and increase the accessibility of health services. In 2020 and 2021, actions to prevent and control Covid-19 were added to the government priorities.

The Ministry of Health has been the leading institution coordinating the pandemic crisis. The government constructed a new hospital to treat Covid-19 patients, Hospital El Salvador, located at the former facilities of El Salvador Fairs and Conventions Center (CIFCO). Hospital El Salvador was an investment of USD 75 million and included 1,064 Intensive Care Unit beds and a vaccination center. In addition, the government improved and renewed some public hospitals (including the acquisition of hospital beds for the entire public health network in 2021), and created an official Covid-19 website (https://covid19.gob.sv/) to inform the population about the number of cases, deaths, vaccinated people, decrees, and other related topics regarding the pandemic. The Ministry of Health Medical Emergency System (SEM) monitors positive Covid-19 cases and provides medicine kits to patients that do not require hospitalization. The government provided Oxford-AstraZeneca, Pfizer-BioNTech, Moderna, Sinovac, and Sinopharm vaccines.

The public health sector services 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 includes hospitals, clinics, and non-profit organizations. The Ministry of Health has 31 hospitals and 372 health units; the ISSS has 11 hospitals, 71 health units, and community units. There is only one military hospital. The private system includes approximately 30 hospitals and over 116 private clinics in the country’s three main cities: San Salvador, Santa Ana, and San Miguel.

The Ministry of Health is responsible for the health policy in El Salvador. The National Medicine Directorate (DNM) is responsible for importing and commercializing medical devices, medical equipment, pharmaceuticals, nutritional supplements, natural, dental, and hygiene under the Medicine Law that entered into force in April 2012. In addition, the government is implementing the Digital Agenda 2020-2030, which sets out the design, creation, and implementation of an Electronic Health Record.

According to the approved 2022 El Salvador National Budget, the health budget totals USD 1,085,959,209, from which USD 965,738,144 are from government funds, USD 120,204,515 from foreign loans, and USD 16,550 from donations. The Salvadoran government has relied on international cooperation and loans to control the pandemic. 

The 2020 Multipurpose Household Survey Report (EHPM), organized by the General Directorate of Statistics and Census (DYGESTIC) in El Salvador, reported that 24.8% of the total population had some type of medical insurance: 91.6% ISSS, 5.9% ISBM, 2.1% IPSFA, and 0.4% private or other. 

The public sector is the 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. Approximately 80% of El Salvador’s market is new medical equipment, and 20% is used or refurbished. 

New and used medical equipment can be imported into El Salvador and must be registered at the National Medicine Directorate. Used or refurbished equipment cannot be older than ten 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, dental, and hygiene products, must 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.

Leading Sub-Sectors

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

Opportunities

In 2021, El Salvador imported USD 163.98 million in medical equipment and devices, with U.S. products making up roughly 19% of the market share. The main competitors in this sector are products from China, Germany, and Japan. However, U.S. products are preferred due to quality, customer awareness, and spare parts and accessories availability. There is no significant local production in El Salvador.

Following are public projects funded by a USD 170 million loan from the Inter-American Development Bank. 

• North Zone Hospital: The design and construction contract was awarded in 2021. A bid for equipment is expected to be announced in the second half of 2022. USD 5 million will be allocated for the purchase of medical equipment. 

• Hospital Rosales: The bid for the design and construction announced in 2021 was canceled by the Ministry of Health in February 2022. The Ministry of Health named the recently created organization, Municipal Works Directorate (DOM), as a co-implementer of the project. The DOM announced a pre-qualification process for the construction of the hospital on June 29, 2022, and received offers by the August 29, 2022, deadline. The total investment is approximately USD 80 million, from which USD 19 million will be allocated to purchase medical equipment. 

Resources

• Ministry of Health
• Covid19 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) 
• Government Procurement COMPRASAL 
• General Directorate of Statistics and Census (DYGESTIC)

Information 

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