The national office of the Tunisian Union of Private Pharmacy Owners has stated that pharmacists are facing a severe liquidity crisis due to the accumulation of financial charges and delays in payments of sums owed to them by the National Health Insurance Fund (CNAM). The union warns of the repercussions of this situation on the ability of pharmacies to provide medicines and ensure the continuity of their supply.
This stance follows a statement published by the union in response to remarks attributed to the Minister of Social Affairs, reported on Thursday evening, November 5, 2026 by national and international media, regarding the relations between pharmacists and CNAM.
The union insists on respecting contractual payment deadlines
The national office recalled that the relations between pharmacists and the National Health Insurance Fund are governed by a legal and contractual framework based on Law No. 2004-71 relating to the establishment of a health insurance regime, as well as on the sectoral agreement signed on February 14, 2019 and its amending and supplementary addenda.
It noted that these texts define the rights and obligations of the two parties and constitute the legal and institutional framework governing their relations, noting that they provide for a payment deadline of 14 days.
The union denounces what it considers a bid to force financing
Reacting to statements attributed to the Minister of Social Affairs, the union expressed its rejection of what it calls a “attempt to impose on pharmacists the forced financing of the health insurance system.”
The national office reaffirmed its commitment to respecting all signed contracts and conventions, as well as the State institutions, while expressing its confidence in the institutions of the Republic and in the primacy of the law.
It also considered that contractual and institutional relations do not depend on individuals and do not change with those in charge. According to it, their legitimacy and durability rest on the law, the concluded conventions, and the principle of continuity of the State and its institutions.
In this context, the union stressed that honoring contractual commitments constitutes an institutional obligation, not a choice dictated by circumstances.
Promises to pay since September, with no settlement of sums owed
The union indicated that exchanges with the CNAM and the Ministry of Social Affairs have continued uninterrupted since last September, stating that both institutions were fully informed of the different aspects of the situation.
It explained that it had received verbal promises of payment at the beginning and end of September, as well as at the beginning of October. However, according to its account, these commitments did not lead to settling the sums owed.
The union added that it had contacted the two institutions on several occasions and sent, on 19 October 2026, letters to all the ministries concerned to inform them of the evolution of the crisis.
The national office specified that the meetings had taken place in a climate of mutual respect and understanding, estimating that CNAM had had a sufficient period to honor its commitments.
However, the union maintains that the persistence of what it regards as dilatory maneuvers has led pharmacists to take a measure it describes as “painful, but necessary to stop the hemorrhage.”
It noted that pharmacists had waited, up to the date of publication of the statement, for the final promises to be fulfilled, in the hope of seeing the situation regularized.
More than 3 million insured people affected by the third-party payer system
The national office praised the sacrifices that pharmacists claim to have made for more than ten years in order to preserve the third-party payer system and to ensure the continuity of its services for the benefit of more than three million insured persons.
It explained that private pharmacies had borne, during this period, increasing financial charges that weakened their financial balance and plunged several sector establishments into a severe liquidity crisis.
The union warned that the persistence of this situation now threatens the pharmacies’ ability to fulfill their essential mission, namely to provide medicines to citizens and guarantee the continuity of their supply.
It finally emphasized that pharmacists had, according to its terms, borne charges exceeding their financial capacities in order to preserve citizens’ interests and to ensure the sustainability of the health insurance system.
