[Federal Register Volume 79, Number 116 (Tuesday, June 17, 2014)]
[Notices]
[Pages 34491-34496]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-14063]


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DEPARTMENT OF COMMERCE

International Trade Administration


Healthcare Equipment, Services, and Technologies Trade Mission to 
Egypt, Jordan, and Israel

May 16-21, 2015.
AGENCY: International Trade Administration, Department of Commerce.

ACTION: Notice.

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Mission Description

    The United States Department of Commerce, International Trade 
Administration, is organizing an executive-led healthcare equipment,

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services, and technologies business development mission to Egypt, 
Jordan and Israel, with an optional stop in the West Bank, May 16-21, 
2015. The purpose of the mission is to introduce representatives from 
U.S. firms and healthcare related trade associations to the region and 
to promote exports of U.S. healthcare products and services. Delegates 
will receive market briefings and participate in customized meetings 
with prospective partners. Companies may also participate in a stop in 
the West Bank city of Ramallah at an additional cost.
    Targeted sectors include:

Products and services for maternal and child health needs
Medical equipment and supplies, including diagnostic, monitoring, and 
imaging equipment
Hospital and outpatient clinic design
Hospital management
E-health: healthcare management systems/software/network design
Laboratory and scientific equipment
Products for specialty areas such as oncology, cardiology, wound care, 
and plastic surgery
Products and services for implementing quality standards and 
accreditation
Robotics
Mobile clinics.

Commercial Setting

    Governments across the Middle East and North Africa are 
increasingly aware that continual expansion and upgrading of healthcare 
systems are needed to meet the growing demand of the fast-growing 
population. The healthcare equipment, services, and technologies sector 
is one of the fastest growing sectors in Egypt and Jordan, where 
healthcare expenditure and demand are driven by demographic factors 
such as population growth and increased life expectancy, as well as 
higher literacy, an increasing prevalence of lifestyle-related 
diseases, increased aspirations for better quality healthcare services, 
greater availability of health insurance, and rising income levels. 
Israel offers a particularly technologically advanced setting for U.S. 
companies, with opportunities in both the public and private sectors.
    The region's healthcare spending in 2013 was as follows: Egypt $9.5 
billion, Jordan $1 billion and Israel $20 billion. The current state of 
healthcare infrastructure in the region is not adequate to satisfy 
existing demand. The healthcare equipment, services, and technologies 
expansion in the region is expected to grow at an annual rate of 5-8% 
in 2014. The region's objectives to upgrade healthcare will require 
purchases of medical equipment/services and renovation of existing 
hospitals/clinics. Over the next few years, the private sector will 
play a big role in further realizing the potential in healthcare 
projects throughout North Africa and the Levant. U.S. companies will 
benefit from exploring the market at early stages and introducing their 
advanced technologies.

Country Profiles

Egypt

    With a population of over 85 million and a GDP of USD 219 billion, 
the Egyptian economy is one of the largest in the Arab World, and the 
second largest in the Middle East and North Africa (MENA) region. 
Despite its low per capita spending on healthcare, Egypt is the second-
largest healthcare market in the MENA region after Saudi Arabia. The 
United States is Egypt's largest bilateral trading partner, and Egypt 
is the fourth largest export market for U.S. products and services in 
the MENA region.
Healthcare Equipment, Services, and Technologies
    The healthcare sector in Egypt offers significant opportunities for 
U.S. exporters of medical equipment and devices, as well as for U.S. 
service providers in the long term, cutting across the entire spectrum 
of medical-related activities and requirements. Sales in medical 
devices totaled USD 484.7 million in 2013, a five percent increase from 
the previous year. It is estimated that the market for medical devices 
will be USD 970 million by 2016, and this is almost wholly made up from 
imports, as Egypt produces very little medical equipment.
    The Egyptian Government's Healthcare Reform Program and the 
country's burgeoning population are generating demand for high-tech 
medical equipment and healthcare items. The Ministry of Health operates 
1,300 hospitals or 60 percent of hospital beds. Universities, the Army, 
and the private sector constitute the remaining 40 percent. The 
government is expanding preventive medicine efforts; and in 2014 is 
developing 26 new hospitals, requiring purchases of medical devices. In 
addition, in 2013 consumer healthcare grew by 12 percent to USD 24.2 
billion.
    In line with the reform efforts to upgrade the overall healthcare 
system, it is expected that there will be future opportunities for U.S. 
firms that can offer the following services:
     Construction, management, and rehabilitation of hospitals 
and rural healthcare facilities;
     Emergency care (ambulatory) services;
     Training programs for nurses and physicians;
     Establishment of quality control of biological and 
laboratory centers;
     Development of quality standards for hospitals, 
laboratories, and healthcare institutions;
     Providing plans for regulator and accreditation bodies; 
and
     Training programs to include FDA-drug classification for 
government officials.
    Best sales prospects medical devices and supplies include the 
following categories:

Diagnostic imaging equipment;
Oncology and radiology;
Disposables;
Surgical and medical equipment;
ICU monitoring equipment;
Laboratory and scientific equipment; and
Mobile clinics

Jordan

    Jordan is strategically positioned at the crossroads of the Middle 
East-North Africa (MENA) region, centrally located between Europe, 
Asia, and Africa. The U.S.-Jordan Free Trade Agreement (FTA), which 
came into force in 2001, continues to create advantages for U.S. 
exporters, who are able to sell high-quality products at more 
attractive prices, as tariff barriers on the majority of goods traded 
between the United States and Jordan have been eliminated. Due to this 
FTA, bilateral trade has surged ten-fold over the past 13 years. Jordan 
remains a haven of stability for business interests and serves as a 
business hub in the region, including business investment to 
neighboring countries including Iraq.
Healthcare Equipment, Services, and Technologies
    Jordan's healthcare system is regarded as one of the best in the 
area, boasting the latest technologies and highly educated, well 
trained doctors. Many Jordanian physicians have received some form of 
medical training in the United States, giving U.S. products good 
exposure. Jordan has become a regional medical tourism destination by 
offering relatively high-quality care at comparatively inexpensive 
rates. Through 104 hospitals, Jordan's healthcare sector serves its 
population and 250,000 patients from neighboring countries annually. 
Moreover, the World Bank ranked Jordan fifth in the world as a medical 
tourism hub. The medical tourism sector generates over $1 billion in 
revenues annually, which

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is expect to increase to USD 1.5 billion by 2015.
    The healthcare sector accounts for 10% of Jordan's GDP. It is 
growing at an annual expenditure rate of about 7%, the 3rd highest in 
the region. Imports of medical equipment and pharmaceuticals exceeded 
$450 million in the year 2013 and are expected to grow to $615 million 
by the end of 2016.
    As part of the Government initiative to reform the healthcare 
sector, reforms underway include:
     Renovating and adding medical diagnostic devices and 
therapeutic equipment;
     Improving the quality of health care and hospital 
services;
     Establishing a number of new hospitals;
     Expanding and upgrading hospital infrastructure including 
the extension and modernization of pediatric facilities;
     Developing and implementing health information systems and 
medical research;
     Supporting the government hospitals' accreditation 
projects; and
     Improving emergency services.
    The E-health care initiative is another key government program 
aiming to ensure the accountability of the health care system. The e-
health system will operate the storage, retrieval and updating of the 
electronic health records of patients cared for by all the 
participating healthcare facilities in Jordan. The government began a 
pilot project of the system in 2011 and will expand it to the entire 
health care system, starting with public hospitals.
    With planned improvements in the healthcare system, the 
introduction of more modern treatment methods, and the construction and 
renovation of both government and privately owned hospitals, demand for 
medical equipment and services is expected to increase. Proposed 
projects expected to come online within the next five years in the 
private and public sector include: expanding the Laser Dermatology 
Fertility Clinic (IVF Treatment) at Specialty hospital, and 
establishment of the Jerash, Ajloun, and Mafraq hospitals.
    The best prospects in Jordan include:

Consulting in hospital administration;
Quality control and certification standards;
Laboratory and hospital administration software;
Diagnostic imaging equipment like C-T, MRI, and PET scanners;
Laboratory reagents and diagnostics;
Testing equipment;
Cardiology and kidney dialysis equipment; and
Hospital furniture

Israel

    Israel has a diversified, technologically advanced economy with a 
strong high-tech sector. The country's strong commitment to economic 
development and its talented work force have led to economic growth 
rates that have frequently exceeded 10% annually. Israel's GDP in 2013 
was $266 billion and its per capita GDP was $36,200. The United States 
is Israel's largest single-trading partner. In 2013, bilateral trade 
totaled $36 billion. Exports of U.S. goods to Israel totaled $13.7 
billion. With a favorable dollar exchange rate, U.S. equipment 
suppliers currently enjoy a price advantage over EU-based 
manufacturers.
Healthcare Equipment, Services, and Technologies
    Israel is a lucrative market for advanced healthcare technologies. 
Despite its small size and population of only 8 million, Israel imports 
medical and pharmaceutical products in the amount of $2 billion 
annually. The U.S. share is roughly 15% at $300 million. Germany and 
other EU countries are the major competitors, but U.S. products 
outranked the EU competition in imaging equipment and diagnostics. Easy 
market-entry conditions and receptiveness to buy U.S. technologies and 
services make Israel an ideal destination for U.S. healthcare exports.
    Characterized by a technologically advanced market economy, Israel 
boasts a very high level of healthcare with an extensive infrastructure 
ranging from local community clinics to a world-renowned trauma 
centers. Israel spends 7.5% of its GDP on healthcare and has the 
largest per-capita healthcare market in the Middle East. Israel's 
public healthcare system ensures a universal healthcare coverage to its 
entire population via four health management organizations and a 
network of hospitals, community clinics and specialized doctors. 
Israeli healthcare facilities are modern and are open to adopt new, 
cost effective technologies and procedures. Many Israeli doctors 
receive training in the United States and maintain personal and 
professional relationships with U.S. colleagues at major medical 
centers.
    Market access is fairly clear for U.S. FDA and CE Marked medical 
products. U.S. companies interested in exporting to Israel need to 
appoint a local distributor, agent or other legal representative to 
register their products with the Israel Ministry of Health (MOH). The 
device registration should be accompanied by a 510(k), Pre-Market 
Approval (PMA) or an Investigational Device Exemption (IDE). Best sales 
prospects exist in the advanced medical technologies, instruments and 
disposables in the following categories:

Advanced Diagnostic Procedures
Image-Guided Technologies
Smart Implants
Preventive Medicine
Point of care and wound management technologies

The West Bank (Optional Stop)

    The West Bank has a land area of 5,640 square kilometers (including 
East Jerusalem). Along with Gaza, it is collectively referred to as the 
Palestinian Territories. The population in the Palestinian West Bank 
and Gaza is four million. The population growth rate is 3.9% and around 
50% of the population is 18 years or younger. In 2012, GDP in the West 
Bank & Gaza reached an estimated $10.30 billion, with $7.70 billion in 
the West Bank and $2.60 billion in Gaza, and per capita GDP was $2,239.
    The West Bank experienced a limited revival of economic activity in 
the period 2009-2012. This revival was a result of inflows of donor 
assistance, the PA's implementation of economic reforms, improved 
security, and the relative easing of movement and access restrictions 
within the West Bank by the Israeli Government. The PA under President 
Mahmoud Abbas and previous Prime Minister Salam Fayyad has implemented 
a largely successful campaign of institutional reforms and economic 
development that has contributed to economic growth, and which has been 
supported by more than $3 billion in direct foreign donor assistance to 
the PA's budget since 2007.
    Many American companies have reoriented their marketing efforts to 
acknowledge the Palestinian market as culturally, economically, and 
commercially distinct from the Israeli market. To date, dozens of 
American firms have established a presence and Palestinian consumers 
have demonstrated a strong preference for a wide variety of U.S. goods 
and services.
Healthcare Equipment, Services, and Technologies
    The medical equipment and supplies market in the West Bank and Gaza 
is estimated to be $20 million annually. The market is made up of 
medical capital equipment, medical supplies, lab equipment and lab 
disposable supplies. There is no domestic production of medical 
equipment and supplies, so Palestinians depend 100% on imports. There 
are no import duties on U.S.-

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made goods entering the West Bank. However, products are subject to 
both a purchase tax and a value added tax that is currently 14.5%.
    The majority of the Palestinian population relies on medical 
services provided by public hospitals that are run by the Palestinian 
Ministry of Health under a general health insurance program. The total 
number of public and private hospitals in the West Bank and Gaza is 72 
and the total number of beds is 5,000.
    The U.S. share of the market is roughly 15% of the total, but this 
is likely to change due to two factors. First is the falling value of 
the U.S. dollar vs. the Euro. Second is the continued support by USAID 
of healthcare projects in the West Bank since USAID regulations 
stipulate that funds can be spent on American-made equipment only, and 
the Agency continues to be the main donor for this sector.
    The best prospects include:

Medical disposables;
Surgical instruments;
Ophthalmic testing and surgery equipment;
Ultrasounds;
MRI, CT, X-ray;
Orthopedic implants; and
Laboratory equipment and disposables.

Mission Goals

    The goal of this trade mission is to facilitate greater access to 
the Egypt, Jordan, and Israel markets by providing participants with 
first-hand market information, access to government decision makers, 
and one-on-one appointments with business contacts, including potential 
agents, distributors, and partners. For the medium and longer term, the 
goal is to educate participants on the healthcare-related environment 
in the region in order to arm them with the ability to sustain and 
expand their business in the region.

Mission Scenario

    The trade mission will include the following stops: Cairo, Amman 
and Tel-Aviv (with an optional stop in Ramallah, West Bank). In each 
city, participants will meet with business and government contacts.

                            Mission Timetable
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                                  Egypt
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Saturday--May 16.................   Arrive in Cairo, Egypt.
                                    Overnight stay.
Sunday--May 17...................   Breakfast briefing by
                                    industry experts.
                                    Industry Roundtable.
                                    One-on-one business
                                    meetings.
                                    Networking Dinner or
                                    optional excursion.
                                    Overnight stay.
------------------------------------------------------------------------
                              Egypt/Jordan
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Monday--May 18...................   One-on-one business
                                    meetings.
                                    Networking lunch hosted by a
                                    Chamber.
                                    Evening travel to Amman,
                                    Jordan.
                                    Overnight stay.
------------------------------------------------------------------------
                                 Jordan
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Tuesday- May 19..................   Breakfast briefing by
                                    industry experts.
                                    One-on-one business
                                    meetings.
                                    Networking lunch with local
                                    industry representatives.
                                    Early Evening Departure from
                                    Jordan to Tel Aviv.
                                    (overnight stay in Tel
                                    Aviv).
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                                 Israel
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Wednesday--May 20................   Industry Roundtable.
                                    One-on-one business meetings
                                    (AM).
                                    Networking luncheon.
                                    One-on-one business meetings
                                    (PM).
                                    Wheels-up Cocktail.
                                    Non-West Bank participants
                                    return to United States on own
                                    itinerary.
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                       Israel/West Bank (Optional)
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Thursday--May 21.................   Travel to Jerusalem.
                                    Depart Jerusalem to
                                    Ramallah.
                                    One-on-One Meetings in
                                    Ramallah.
                                    Return to Jerusalem then
                                    TelAviv to travel to U.S.
                                    Evening departure or
                                    Overnight stay on own itinerary.
------------------------------------------------------------------------

Participation Requirements

    All parties interested in participating in the Trade Mission to 
Egypt, Jordan, and Israel must complete and submit an application 
package for consideration by the Department of Commerce. All applicants 
will be evaluated on their ability to meet certain conditions and best 
satisfy the selection criteria as outlined below. A minimum of 12 and 
maximum of 15 representatives will be selected to participate in the 
mission from the applicant pool. U.S. companies already doing business 
with Egypt, Jordan, Israel, and the West Bank as well as U.S. companies 
seeking to enter these markets for the first time may apply.

Conditions for Participation

    An applicant must submit a completed and signed mission application 
and supplemental application materials, including adequate information 
on the company's products and/or services, primary market objectives, 
and goals for participation. If the Department of Commerce receives an 
incomplete application, the Department may reject the application, 
request additional information, or take the lack of information into 
account when evaluating the applications.
    Each applicant must also certify that the products and services it 
seeks to export through the mission are either produced in the United 
States, or, if not, marketed under the name of a U.S. firm and have at 
least 51 percent U.S. content of the value of the finished product or 
service. In the case of a trade association/organization, the applicant 
must certify that for each company to be represented by the 
association/organization, the products and services the represented 
company seeks to export through the mission are either produced in the 
United States, or, if not, are marketed under the name of a U.S. firm 
and have a least 51 percent U.S. content of the value of the finished 
product or service.
    Selection Criteria for Participation: Selection will be based on 
the following criteria with respect to the applicant's company, or in 
the case of a trade association/organization, the companies the 
association/organization intends to represent on the mission:
     Relevance of the company's business to the mission goals.
     Suitability of the company's products or services for the 
Egyptian, Jordanian, Israeli, and (as applicable)West Bank markets.
     Applicant's potential for business in Egypt, Jordan, 
Israel, (or the West Bank) including likelihood of exports resulting 
from the mission.
     Consistency of the applicant's goals and objectives with 
the stated scope of the mission.
    Diversity of company size and location may also be considered 
during the review process.
    Referrals from political organizations and any documents containing 
references to partisan political activities (including political 
contributions) will be removed from an applicant's submission and not 
considered during the selection process.

Fees and Expenses

    After a firm or trade association/organization has been selected to 
participate in the mission, a payment to the Department of Commerce in 
the form of a participation fee is required. The participation fee for 
the business development mission will be $3,325.00 for a small or 
medium-sized enterprise (SME) \1\ or trade association/organization 
with fewer than 500 employees; and $4,625.00 for large firms. The fee 
for each additional trade association/organization representative or 
firm representative (large firm or SME) is $1,000. The cost for the 
West Bank optional meetings is in addition to the mission participation 
fee above, at $750 per SME and $2,300 per large firm. Ground group 
transportation costs in Egypt, Jordan, and Tel Aviv have been included 
in the cost. Except as otherwise noted, expenses for travel, lodging, 
meals, and incidentals will be the responsibility of each mission 
participant. If necessary, interpreter services have been included for 
government meetings.
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    \1\ An SME is defined as a firm with 500 or fewer employees or 
that otherwise qualifies as a small business under SBA regulations 
(see http://www.sba.gov/services/contracting opportunities/
sizestandardstopics/index.html). Parent companies, affiliates, and 
subsidiaries will be considered when determining business size. The 
dual pricing reflects the Commercial Service's user fee schedule 
that became effective May 1, 2008 (see http://www.export.gov/newsletter/march2008/initiatives.html for additional information).
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    The mission fee does not include personal travel expenses such as 
lodging, most meals, local ground transportation, except as stated in 
the proposed timetable, and air transportation from the U.S. to the 
mission sites and return to the United States. Business visas may be 
required. Government fees and processing expenses to obtain such visas 
are also not included in the mission costs. However, the U.S. 
Department of Commerce will provide instructions to each participant on 
the procedures required to obtain necessary business visas.

VIII. Timeframe for Recruitment and Applications

    Mission recruitment will be conducted in an open and public manner, 
including publication in the Federal Register, posting on the Commerce 
Department trade mission calendar (http://export.gov/trademissions) and 
other Internet Web sites, press releases to general and trade media, 
direct mail, notices by industry trade associations and other 
multiplier groups, and publicity at industry meetings, symposia, 
conferences, and trade shows.
    Recruitment for the mission will begin immediately and conclude no 
later than MARCH 13, 2015. The U.S. Department of Commerce will review 
applications and make selection decisions on a rolling basis. 
Applications received after MARCH 13,

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2015, will be considered only if space and scheduling constraints 
permit.

Contacts:

Geoffrey Bogart, Commercial Counselor/NAL Healthcare mentor, U.S. 
Commercial Service--Jordan, Tel: +962-6-590-6629, 
[email protected].
Muna Farkouh, Senior Commercial Specialist/NAL Healthcare Team Leader, 
U.S. Commercial Service--Jordan, Tel: +962-6-590-6057, 
[email protected].
Patricia Molinaro, International Trade Specialist--Project Officer, 
Northern NJ Export Assistance Center, U.S. Department of Commerce/
International Trade Administration, Tel: 973-645-4682 x 212, 
[email protected].

Elnora Moye,
Trade Program Assistant.
[FR Doc. 2014-14063 Filed 6-16-14; 8:45 am]
BILLING CODE 3510-DR-P