Egypt

The recent funding reduction is affecting all areas of UNHCR’s response and has led to major gaps in humanitarian assistance, particularly in a context where refugees have little or no access to social safety nets and work opportunities. The most affected life-saving sectors are healthcare, education and life-saving cash assistance, primarily used by refugees to buy food, pay rent and basic medicine. 

According to the latest  Health Access and Utilization Survey (HAUS) in 2024, that UNHCR performs annually, 24% of refugee women who delivered during the last 2 years never received any ante-natal care services; 29% of refugees who reported having a chronic disorder did not access care or medications during the 3 months preceding the survey and 24% of refugees who spent money on health care during the month prior to the survey had to accrue debt to afford such expenses.  

To ensure sustainable health protection, Egypt is reforming its health insurance system by introducing a national, mandatory Universal Health Insurance System (UHIS). The first phase of implementation is about to be completed, which includes six of Egypt’s 27 governorates (Port Said, Ismailia, Suez, South Sinai, Luxor, and Aswan). The phased roll-out is expected to continue until 2032, after which the entire Egyptian population should be covered and, through it, have access to most of their curative health care needs.

The Universal Health Insurance Law provides an entry point and opportunity for the inclusion of refugees, as it offers a legal framework for their enrolment, while no mechanisms for refugee inclusion have yet been established due to the limited financing. An eventual inclusion of refugees in the UHIS would eliminate the need for a parallel system for health care provision for refugees and guarantee equal access for refugees and nationals to health care. It would provide a target group of about one million refugees with affordable health care services, protecting vulnerable households from out-of-pocket expenditure (OOP) and debt accumulation while addressing legal and institutional barriers. 

The latest vulnerability assessment (2025) conducted jointly by UNHCR, WFP and the National Statistics Office highlights that over half of the refugees in Egypt experience food insecurity, one in three Sudanese lack access to medical care when needed, and half of refugee children are out of school, largely due to lack of documentation and available resources. 

To accommodate the growing number of refugee students, there is a need to strengthen the capacity of schools in Greater Cairo, Alexandria, Damietta, and Aswan through both technical and financial support. Priorities include the construction of new classrooms and the refurbishment of existing facilities. At the same time, administrative barriers to enrolment need to be addressed. Given the challenges refugees faced in obtaining residency permits, requests have been made to accept the residency permit appointment as sufficient documentation for school enrolment. Following the Government of Egypt’s April 2025 decision to extend the validity of asylum-based residence permits from six months to one year—and to expand capacity at immigration offices—UNHCR anticipates a reduction in wait times (from 1,100 + days to under 590 days), which should help ease the enrolment process

UNHCR had to reduce its monthly cash assistance coverage and transfer value in 2025.  This funding reduction will leave around 50,000 highly vulnerable and eligible refugee families (or 164,000 individuals) without the means to pay rent, buy food, or cover essential expenses, accelerating malnutrition, homelessness, and child labour, also exposing women and girls to higher risks of violence and exploitation. The latest vulnerability assessment (2025) conducted jointly by UNHCR, WFP and the National Statistics Office shows that 92% of refugee households resort to “food-consumption” coping, such as families skipping meals, avoiding rent payments, or withdrawing a child from school, which is harmful, survival-oriented behaviour linked to collapsing purchasing power.

Recent funding cuts have impacted vulnerable groups such as persons with disabilities and unaccompanied children most severely. The pressure on informal support networks and host communities will intensify, potentially fueling social tensions and further marginalizing vulnerable refugee households.

In terms of livelihoods, investments should aim to promote the economic inclusion of refugees by supporting self-employment, entrepreneurship, and wage employment, as well as fostering social cohesion activities. Refugees should be provided with information on self-employment opportunities, access to services, and market opportunities. In terms of policy, the main challenge is related to the absence of enabling regulations for refugees and asylum seekers to access formal employment.

Prioritization of enhanced assistance to UNHCR and to the Egyptian Government is key in the near future to bolster Government capacity to effectively absorb the responsibilities from UNHCR, as part of the implementation of the new "Asylum Law for Foreigners No. 164".  

UNHCR Egypt will prioritize innovative financing mechanisms like social impact bonds and blended finance models (partnering with IFC). These financing strategies will help unlock long-term, sustainable resources.  UNHCR will continue its strong engagement with Egyptian authorities for inclusion and will collaborate with local NGOs and community-based organizations. Data gathering, in partnership with the American University Cairo, World Bank, CAPMAS and WFP, with a view to mobilising resources for inclusion of refugees into Government-run Social Protection Mechanisms and the Universal Health Insurance System will be prioritised.  

In Egypt, UNHCR will seek synergies through multi-agency, multi-year projects with transformational impact and strong M&E components in furtherance of the SDGs and the UNSDCF (2023-2027). This includes the Dutch-funded PROSPECTS project and the EU-funded Joint UN Program for Migrants and Refugees. 

Helping build inclusive policies in the areas of the labour market, social protection systems, and the  Universal Health Insurance System will enable skilled refugees to contribute fully to the Egyptian economy and its public systems — thus reducing the costs of refugee hosting in Egypt and allowing them to become net contributors rather than mere recipients. Donors are encouraged to provide international support for these types of policies and initiatives.