Ridha Chkoundali criticizes social state over unavailable medicines, high costs, and Cnam's administrative burden

University professor of economics, Ridha Chkoundali, criticized the Tunisian healthcare system on April 23, 2026, highlighting medicine shortages, excessive costs, and the administrative inefficiencies of the Caisse Nationale d'Assurance Maladie Cnam. He argued that healthcare has become a luxury, citing an example of a patient unable to afford treatment. Chkoundali stated that the state is deviating from its social role, which should guarantee access to essential medicines at affordable prices. He illustrated this with a middle-class cardiac patient who faced a three-month medication bill exceeding one thousand dinars, a sum deemed prohibitive for an average household. The patient was unable to pay in installments due to new regulations and could not get a refund for a partial purchase from Cnam, ultimately foregoing treatment. Chkoundali noted that these difficulties now affect the middle class, not just vulnerable groups, and questioned the situation for modest households relying on the third-party payment system, as some pharmacists reportedly refuse to operate within this framework. He also pointed out Cnam's dysfunction, including operating without a general director for several months, and urged the Ministry of Health to investigate disorganization in crowded areas. Beyond healthcare, Chkoundali extended his criticism to the general rise in the cost of living and lax price controls, particularly for agricultural and food products, which further strains household budget