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

El Salvador is continuing its efforts to modernize and transform its Integrated National Health System. The government’s priorities are to resolve the shortage of medicines, improve the lack of maintenance and poor hospital infrastructure, and increase the accessibility of health services.

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), the 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 Superior Council of Public Health (CSSP) is responsible for authorizing the professionals and establishments that provide private health-related services. For the latest data on the number of private hospitals and medical centers, medical clinics, doctors’ offices, laboratory clinics, dental clinics, etc., please visit https://cssp.gob.sv/.

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. However, on November 2023, the Legislative Assembly approved the Law of the Superintendency of Sanitary Regulation, a new entity that will absorb all DNM responsibilities and will also regulate the exportation, importation, and commercialization of food and beverages, tobacco, veterinary, and agricultural products. The Law of the Superintendency of Sanitary Regulation will enter into force on April 1, 2024.  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 Ministry of Health, as of 2023, public hospitals already use the Electronic Medical Record implemented under the Integrated Health System (SIS- Sistema Integrado de Salud).

According to the approved 2023 El Salvador National Budget, the health budget totals $1,131,126,090 USD, from which $990,227,525 USD are from government funds, $140,863,565 USD from foreign loans, and $35,000 USD from donations.

The 2022 Multipurpose Household Survey Report (EHPM),  developed by the Central Reserve Bank in El Salvador, reported that 25.7% of the total population had some type of medical insurance. From the people covered, the insurance is broken out as follows: 94.1% ISSS, 3.9 % ISBM, 1.7% IPSFA, and 0.3% 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 five 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: www.comprasal.gob.sv. Companies interested in becoming a supplier to the government should register at the Unique Registry of Providers of the State (RUPES). Step-by-step guidelines are available at: https://dinac.gob.sv/registro-proveedores/.

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 2022, El Salvador imported $102.13 million in medical equipment and devices, with U.S. products making up roughly 18% 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. The construction started on June 15, 2023. The bid for equipment is expected to be announced in 2024. It will be a hospital with 105 beds; approximately $5 million will be allocated for the purchase of medical equipment. The project is funded by the Inter-American Development Bank (IDB) under the Integrated Health Program II (PRIDES II).
• 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. A pre-qualification process for the construction of the hospital took place in 2022, and 3 companies pre-qualified. However, in February 2023, after a deserted tender process, the DOM decided to build the new hospital under a “Direct Administration” modality. The project was initially funded by IDB but with the recent decision by the DOM, funding will be coming directly from the Salvadoran Government. It is estimated that $19 million will be allocated for the purchase of medical equipment. The construction started on June 15, 2023, and is expected to last for 18 months.
• Hospital San Bartolo: construction of a new pediatric tower. A bid is expected to be announced in 2024.
• Hospital of the Salvadoran Institute of Teachers Welfare: In May 2023, the Legislative Assembly approved the re-orientation of funds to purchase the land where a new hospital will be built. Details for a bid for the design, construction, and equipment are to be determined.  
• Exchange programs for public sector school hospitals: The Ministry of Health is interested in strengthening exchange programs with hospitals or academia in the U.S. in specializations like surgery, neurosurgery, cardio, cardiovascular surgery, and oncology, among others.

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) 
• Public Municipalities Directorate (DOM)
• Central Reserve Bank (BCR)
• Inter-American Development Bank (IDB)

Information 

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