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: 2020-09-30

Overview 

 

2017 

2018 

2019  

2020 Estimated 

Total Local Production 

0.0 

0.0 

0.0 

0.0 

Total Exports 

3.2 

3.0 

4.5 

4.7 

Total Imports 

62.9 

57.4 

59.9 

61.7 

Imports from the US 

18.4 

19.7 

14.6 

15.1 

Total Market Size 

59.7 

54.4 

55.4 

57.0 

(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; 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, which was inaugurated into office June 1, 2019, quickly announced its three health priorities: resolve the shortage of medicines (which is estimated at 40% in the public sector), improve status

of maintenance and poor hospital infrastructure conditions and increase accessibility of health services. 

Covid-19 changed the government priorities in 2020.  

Renovation, Improvement, and Expansion of El Salvador’s Public Hospital Services 

The Ministry of Health has been the lead coordinator since the pandemic crisis hit El Salvador. Initial measures taken by the Government of El Salvador included establishment of quarantine for travelers coming from China, South Korea, Italy, Iran and Spain. On March 21st, the Government of El Salvador (GOES) announced a nationwide quarantine that lasted 86 days. Due to the pandemic, the Ministry of Health’s new priorities pivoted to focus on renovation and improvement of all 30 existing public hospitals and the construction of a new hospital to treat Covid-19 patients, Hospital El Salvador. Hospital El Salvador is located at the former site of the El Salvador Fairs and Conventions Center (CIFCO).

The new Hospital El Salvador represents a total investment of USD $75 million and consists of three construction phases: (1) a 400 patient Covid-19 treatment area, a 105 bed Intensive Care Unit (ICU),and a 295 beds Intermediate Care Unit; (2) addition of 664 beds, and (3) construction of a new building that will accommodate 1,200 beds, including a 200 bed ICU. 

Phase 1 was inaugurated by President Bukele on June 21, 2020. It represents a USD $25 million investment.  

As part of its efforts to contain and inform the country about COVID-19, the government created an official COVID-19 website about the number of cases, deaths, reopening of the economy, decrees, and other topics related to the pandemic. 

Overview of Healthcare in El Salvador 

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 the development and coordination of 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 that entered into force on April 2012. The Medicine Law is implemented by the regulatory entity National Medicine Directorate (DNM).  

 According to the approved 2020 El Salvador National Budget, the health budget totals USD $757.85 million

USD, from which USD $729.28 million are government funds, USD $27.9 million foreign loans, and USD $688,475 donations. 

However, due to COVID-19, the Ministry of Treasury provided additional funds to the Ministry of Health (MINSAL) to deal with  the COVID-19 crisis. Modifications to the health budget are published in the Transparency Portal. In addition, the Salvadoran government has relied and continues to rely 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% Salvadoran Social Security Institute (ISSS), 6.0% Salvadoran Institute of Teachers Welfare (ISBM), 1.6% Institute of Social Prevision of the Army (IPSFA), and 0.4% private or other.  

 Importation and registration of Healthcare Equipment and Products 

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 needs 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 with the DNM. 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 retaining a legal representative (law firm) who can assist in preparing bid offers. 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 2019, El Salvador imported a total of USD $59.9 million in medical equipment and devices, with U.S. products making up roughly 24% of the market share. US products are preferred due to quality, customer awareness and availability of spare parts and accessories. The main competitors in this sector are products from China, Germany, and Japan. 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.  

The below are mid-term projects under development by the public and private sector:  

  1. Public Sector – projects funded by a USD $170 million loan from the Inter-American Development Bank. COVID-19 has affected the implementation of the projects.  Announcements of future bids could be delayed due to the emergency. It is recommended that U.S. companies interested in these opportunities register at the United Nations Development Business or COMPRASAL to get the bids notifications.   

 North Zone Hospital: a new hospital in the northern part of San Salvador, which will provide services to the municipalities of Apopa, Nejapa, Aguilares, Tonacatepeque, Guazapa, and El Paisnal. The hospital will have approximately 100 beds and will provide surgery, pediatric, and gynecologic services. USD $5 million will be allocated for the purchase of medical equipment. The bid for the design and construction of the hospital was published in May 2020; offers are expected to be submitted on September 10, 2020. 

Hospital Rosales: the main public hospital in El Salvador. The project contemplates the remodeling of current facilities and the construction of new towers. USD $19 million will be allocated for the purchase of medical equipment.   

  1. Private Sector Hospital de Diagnostico: one of the main private hospitals in the country, is planning the construction of a Surgery Center and ER Unit in the city of Antiguo Cuscatlán (La Libertad). The center will require x-ray machines, a computerized axial tomography (CAT) scanner, and potentially an accelerator. 

U.S Commercial Service Contact Information 

Lidia Sosa, Commercial Specialist, Lidia.Sosa@trade.gov