Skip to content
POL-72

This is a proposal for discussion, not an enacted law.

Ali Zuweid’s Political Programme · Proposed bill · Health, Social Protection and Family

Public Health and Modern National Health System Law

A proposed federal law repealing and replacing the general framework of Public Health Law No. (89) of 1981, as amended. It connects the right to health with system governance, primary healthcare, surveillance, emergencies, workforce, data and accountability, respecting constitutional responsibilities and retaining separate specialist regulation of health insurance, medicines, patients’ rights and data protection.

Prepared by:

Document number
POL-72
Version
1.0
Last updated
5 October 2026
Scope
Republic of Iraq

Executive summary

Iraq’s general federal public-health framework still rests on Law No. (89) of 1981, as amended. Despite repeated updates, including legislation in 2021 and a 2026 decision raising a penalty, its original structure predates the 2005 Constitution, digital transformation, COVID-19, modern health insurance and new health-security capacity assessments. This file therefore proposes repeal and replacement legislation rather than another partial amendment.

The draft preserves matters belonging in specialist laws: Health Insurance Law No. (22) of 2020 and judicial modifications, patients’ rights and medical liability, mental health, medicines, food and medical devices, and data protection. It instead establishes a national public-health and system framework defining core functions, planning responsibilities, service packages, primary care, referral, workforce, surveillance, emergencies, information, contracting and oversight.

It draws on constitutional Articles (30), (31), (114/Fifth), (115) and (121). Because general health policy is shared, the Law is framed as federal coordination and national minima for functions requiring Iraq-wide links, expressly preventing interpretations removing regional powers or regional-law priority in conflicting shared matters.

It also draws on current reforms: expanding health insurance, HeRAMS monitoring of resources and services, the National Strategy for Women’s, Children’s and Adolescents’ Health 2025–2030, the Antimicrobial Resistance Plan 2026–2030 and the Joint External Evaluation of International Health Regulations capacities published in 2025. The proposed result is implementable legislation, not a hospital-building plan or separate financing programme.

Legislative choice

Testing the legislative need
OptionAssessmentConclusion
Retain the 1981 Law with scattered amendmentsPreserves a pre-constitutional structure and increases fragmented transitional provisions.Not preferred.
Enact parallel legislation without repealing the old lawDuplicates powers, licences, penalties and cross-references.Rejected.
Comprehensive repeal and replacement for public health and the health systemUnifies the general framework while preserving specialist laws and temporarily continuing regulations.Selected option.

Text of the draft Law

In the name of the people

Presidency of the Republic

Pursuant to enactment by the Council of Representatives and ratification by the President under Article (61/First) and Article (73/Third) of the Constitution of the Republic of Iraq of 2005, the following Law is issued:

Public Health and Modern National Health System Law

Statement of reasons

To implement the constitutional provisions guaranteeing the right to healthcare and health insurance and entrusting public authorities with public health; to modernise the legal framework still based on Public Health Law No. (89) of 1981, as amended, and align it with the federal constitutional order and developments in primary healthcare, health insurance, epidemiological surveillance, health emergencies, digital information and antimicrobial resistance; to allocate resources according to need and improve referral, workforce, maintenance and transparency; and to unify administrative and judicial safeguards in health oversight without creating unnecessary parallel bodies, this Law is enacted.

Explanatory memorandum

1. Why is replacement preferable to a ninth or tenth amendment?

The 1981 Law is broad and historically important, but predates the 2005 Constitution and today’s institutional and digital transformation. Partial amendments addressed individual matters without shifting the Law’s logic from a list of powers and oversight provisions to a modern governance system. Replacement allows its scope to be redefined, distinguishes it from health insurance, medicines and patient rights, and establishes an orderly legal transition instead of retaining multiple layers of provisions.

2. Relationship with the Health Insurance Law

Health insurance answers the question: who pays, and how are risks pooled and coverage managed? This Law answers: how are the health system, public health functions, network, referral, surveillance and preparedness organised? Separating these functions is essential. POL-72 establishes a reference services package and delivery pathways, while contributions, entitlements, cost-sharing rates, the Authority and Fund remain within POL-73 and the existing insurance law.

3. Why put primary care at the centre of the Law?

Sending every health problem to a hospital increases costs and waiting times and weakens prevention. The proposal therefore makes primary care the anchor, with organised referral and clear emergency exceptions. It does not impose a rigid mandatory spending share or predetermine the number of centres; it requires service gaps to be measured and mapped publicly and investment linked to need.

4. Health federalism

Health is not an exclusively federal competence. The proposal therefore avoids wording that would make the federal Ministry the direct manager of every facility in a region. Functions requiring national coordination—such as surveillance, response to cross-border events, data definitions, reference laboratories and certain emergency standards—are framed as coordination standards and shared reference frameworks. Where conflict arises over a shared competence, constitutional rules on the precedence of regional law shall be respected.

5. A health emergency is not a constitutional state of emergency

The proposal expressly distinguishes a temporary administrative health declaration from a constitutional state of emergency. A health emergency declaration allows resources to be mobilised, response plans activated and specific health measures prescribed by law imposed; it does not confer unlimited power, suspend the Constitution or eliminate judicial oversight. This distinction matters in preventing expansion of public health powers after the pandemic experience.

6. Isolation and quarantine with safeguards

Isolation and quarantine may be necessary for certain infectious diseases but restrict liberty. The proposal therefore requires a reasoned decision, necessity and proportionality, the shortest necessary duration, humane conditions and access to judicial appeal. It does not permit a health measure to become punishment or indefinite detention.

7. Digital data are not an end in themselves

The proposal does not mandate a vast central database. It requires interoperability standards and a minimum dataset, leaving the technical architecture centralised or distributed according to security and efficiency. This reduces vendor lock-in risks and preserves compatibility with future data protection and digital government legislation.

8. No arbitrary construction figures

The Law does not set a fixed number of hospitals, beds or ambulances, or a uniform physician ratio for all Iraq, because these decisions change with population, epidemiology and resources. Instead, it requires a national planning methodology, annual maps, actual operational capacity and life-cycle appraisal before investment. This makes the legislation durable rather than a frozen budget plan embedded in law.

9. Judicial oversight

The proposal avoids the model of older provisions that made some closure or committee decisions final or barred legal proceedings. Article (100) of the Constitution prohibits shielding any administrative act or decision from appeal. The Federal Supreme Court’s decision on the Health Insurance Law also demonstrated the importance of this rule. All administrative health decisions are therefore subject to judicial review.

10. Updating functions without creating a new bureaucracy

The proposal does not create a new independent national public health authority. Leadership remains with the Ministry of Health and existing health authorities, with only a coordination council established to address the shared nature of health policy. New functions—the observatory, technology assessment and data quality—can be established as units within the Ministry rather than separate legal entities, unless institutional independence is later shown to be necessary.

Alignment with existing legislation

Laws and subjects requiring coordination with POL-72
AreaStatusTreatment
Public Health Law No. 89 of 1981The existing general framework.Repeal and replacement when the new Law takes effect, with instructions temporarily retained.
Ministry of Health Law No. 10 of 1983, as amendedGoverns the Ministry’s structure and powers.Remains in force; its organisational provisions should subsequently be reviewed to avoid duplicate definitions of councils and departments.
Health Insurance Law No. 22 of 2020Governs coverage, insurance and its institutions.Remains a separate legislative track, integrated with the services package and network.
Patient rights and medical liabilityRequire comprehensive specialist regulation.Does not pre-empt POL-74; limited to public health and administrative safeguards.
Medicines, food and medical devicesRegulated by scattered legislation and decisions.Leaves detailed regulation to POL-75 and legislation in force.
Mental healthRequires a specialist rights-based framework.Leaves details to POL-76 and covers only integration into primary care.
Personal data protectionA sensitive cross-cutting area.Establishes minimum health principles, with priority for the Data Protection Law once enacted.
Environment and wasteSeparate environmental competences.Limits health’s role to impact assessment, surveillance and coordination.

Implementation and transition requirements

Success depends on replacing old regulations gradually, rather than repealing them in a single day. The proposal therefore allows 180 days before entry into force and retains previous instructions for up to two years insofar as they do not conflict. It also requires a public register of effective and replaced regulations—an important tool, since reforming the 1981 Law risks creating a regulatory vacuum in licensing, inspection and laboratories if the underlying law is repealed without replacement regulations.

Regulatory priorities after enactment
PeriodRegulatory or institutional outputPurpose
0–3 monthsImplementation leadership unit + coordination council + inventory of old regulations.Prevent fragmented responsibility.
0–6 monthsSurveillance definitions, reporting rules, health emergency framework and inspection rules.Protect functions that cannot tolerate a vacuum.
6–12 monthsServices package, service-gap map, workforce plan and referral standards.Turn the Law into national operating rules.
12–18 monthsHealth information architecture, minimum dataset and published service maps.Data-informed decision-making.
Up to 24 monthsReplace principal old regulations and publish the legal-status register.Complete the transition.

Financial and implementation impact

This Law is not a construction programme and does not justify an arbitrary total cost. Its direct financial impact arises chiefly from regulatory functions and capabilities that should already exist or can be developed within the Ministry: surveillance, data quality, service mapping, a workforce observatory, emergency stocks, referral standards and health technology assessment. Hospitals, equipment and network expansion remain subsequent budget and investment decisions conditional on needs and life-cycle analysis.

Before executive referral, a financial Regulatory Impact Assessment must be prepared, covering limited establishment costs for each new function, annual operating costs, existing resources that can be reused, information-system development costs, and costs of updating regulations and training. It must distinguish the Law’s regulatory expenditure from health-sector capital expenditure so that costs unavoidable in any event are not attributed to the legislation.

Method for calculating financial impact
ItemRequired calculation methodControl
Surveillance and laboratoriesWorkforce, equipment and connectivity gaps for each governorate.Avoid counting existing resources twice.
Health informationCost standards, integration, security and training, without assuming procurement of a single central system.Avoid vendor lock-in and unnecessary licences.
WorkforceSpecialty and location gaps and targeted incentives.Make incentives conditional on results.
Emergencies and stocksRisk analysis + minimum days of coverage + stock rotation.Prevent expiry and stockpiling.
Inspection and regulationInspector and visit numbers based on risk, rather than the raw facility count.Risk-based oversight.

Relevant international reference frameworks

The proposal does not transplant any single country’s model. It uses established health-system reform principles: primary healthcare as the foundation of universal health coverage; allocation by need and equity; purchaser–provider separation where appropriate without imposing one model; reliance on surveillance and data; all-hazards emergency management; and proportionality and judicial review of public health measures.

For health security, the proposal draws on the amended International Health Regulations generally effective since 19 September 2025, particularly the need for a national coordination authority, point-of-entry capacities, notification and preparedness. It also aligns with Iraq’s Joint External Evaluation published in 2025 and the updated 2026–2030 antimicrobial resistance plan based on One Health.

Sources and references

  1. Constitution of the Republic of Iraq, 2005 — Iraqi Council of RepresentativesThe constitutional basis for the right to healthcare and health insurance; Article 114/Fifth on formulating general health policy in cooperation with regions and governorates; and Articles 115 and 121 on allocation of competences.
  2. Ministry of Justice — Public Health Law No. (89) of 1981, as amendedThe official translated text published by the Iraqi Gazette Directorate; confirms that the 1981 Law remains the existing general framework with successive amendments.
  3. Ministry of Justice — Iraqi Gazette No. 4627Contains Law No. (20) of 2021 amending Public Health Law No. (89) of 1981.
  4. Ministry of Justice — Iraqi Gazette No. 4867, 18 May 2026Contains a decision amending the fine amount in Article 96/First/A of the Public Health Law, providing recent evidence that the old law remains in force with piecemeal adjustments.
  5. Health Insurance Law No. (22) of 2020 — Ministry of JusticeReference for separating health insurance regulation from this framework law.
  6. Federal Supreme Court — Decision 60/Federal/2022Declared several Health Insurance Law provisions unconstitutional, affirmed their relationship to Articles 30 and 31 of the Constitution, and stressed that administrative decisions must remain subject to constitutional and judicial oversight.
  7. WHO — HeRAMS Iraq: Operational status of the health system, November 2024A relatively recent assessment of resource and service availability, based on data from 5106 health service delivery units as of 14 November 2024.
  8. WHO/Ministry of Health — World Health Day 2025 statementDocuments progress in implementing the Health Insurance Law and increased coverage from 300 thousand people in 2023 to 776 thousand in 2024, supporting coordination of framework reform with the existing insurance system.
  9. WHO — Joint External Evaluation of IHR core capacities in Iraq, mission 17–21 September 2023, published 2025Reference for designing emergency preparedness and national public health capacity provisions.
  10. WHO — Amended International Health Regulations, generally effective since 19 September 2025Reference for international coordination, the national authority, points of entry, notification and health emergency preparedness.
  11. WHO/Ministry of Health — National Action Plan on Antimicrobial Resistance 2026–2030Reference for One Health, surveillance and antimicrobial stewardship.
  12. WHO — National Strategy for Women’s, Children’s and Adolescents’ Health 2025–2030Reference for integrating services across the life course, equity and access in underserved areas.
  13. WHO — Primary health careInternational reference for the central role of primary healthcare in universal health coverage and continuity of care.
  14. WHO — Universal health coverageReference for access to quality health services without financial hardship, while retaining insurance mechanisms in the specialist law.
  15. WHO — Evaluation of WHO contribution in Iraq: Executive summary, 2025Relatively recent institutional context for Iraq’s transition from humanitarian response to building sustainable health systems.

A proposed bill within Ali Zuweid’s political programme. Prepared by . Last updated: 5 October 2026.

What are you looking for?

Search content published on the website.