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A Year After Agadir, Morocco's Health Workers Strike Again Over a Reform They Do Not Trust

13 November 2026 · Algeria Now

On Tuesday 10 November, health workers belonging to the National Health Union, which is affiliated to the Democratic Confederation of Labour (CDT), one of Morocco's main trade union federations, were called out on a national strike. In an open letter to the head of government, Fatima-Zahra El Mansouri, and to the ministers of finance and health, the union accused the new executive of breaking commitments made by its predecessor and announced that it would boycott the next round of talks with the health ministry. On the same day, the new Minister of Health and Social Protection, Youns Bjijou, told the social sectors committee of the House of Representatives that health workers would keep their civil-servant status and that the state would continue to pay their salaries. The union's letter and the minister's answer, barely a day apart, sum up the distrust that now runs through Morocco's public health system.

A reform its workers fear

At the centre of the dispute is the reorganization of public health into regional bodies known as territorial health groups, which are meant to take over the planning, budgets and staff of hospitals and clinics in each region. The union's concern is concrete. Under an agreement reached in 2024, health workers' salaries were to remain on the general state budget and be paid centrally by the Treasury. The union says the draft finance law for 2027 does not guarantee this, and that the government is treating salaries as an operating expense of the new regional bodies rather than as a core public commitment. It also accuses the executive of ignoring Article 23 of the 2025 finance law, which provided for the continued payment of permanent, trainee and contract staff.

The numbers behind the anger

The strain is not a matter of perception. Morocco's own National Health Compact, adopted in December 2025 and published with the World Bank, sets out the gaps plainly. In 2023 the country had 7.9 doctors per 10,000 inhabitants, against a World Health Organization (WHO) benchmark of 44.5 doctors, nurses and midwives per 10,000 for universal health coverage. Nearly half of all doctors work in just two regions, Rabat-Salé-Kénitra and Casablanca-Settat. In 2018 the maternal mortality rate in rural areas was nearly two and a half times that of the cities. Households still pay about 38 per cent of total health spending out of their own pockets, according to the compact's latest estimate.

The flagship expansion of compulsory health insurance has a similar gap between coverage on paper and access in practice. According to the compact, 88 per cent of the population was covered by the scheme in 2024, but only 19.5 per cent of insured self-employed and other non-salaried workers were actually paying contributions and therefore effectively covered.

The government points to a larger budget. The health ministry received 42.3 billion dirhams in 2026, or 8.7 per cent of the state budget, and more than 1,000 primary care centres have been modernized since 2022, according to the compact. The ministry says it has raised the number of newly qualified specialists by 83 per cent between 2020 and 2025 and assigned 1,204 specialists to the regions in 2025. Its target is 45 health professionals per 10,000 inhabitants by 2030. Yet the ministry's own figures show how far buildings run ahead of staff. In September, it opened fifteen new primary care centres in six regions to serve a potential population of 375,677 people, with 50 health professionals to be deployed across all fifteen.

From Agadir to the street

The current dispute unfolds in the shadow of last year's tragedy in Agadir. In August and September 2025, eight women died in the space of about ten days after caesarean sections at the public Hassan II Hospital. The deaths set off protests in the city that, by the end of September, had grown into the nationwide youth movement known as GenZ 212, organized online and built around a simple demand: hospitals and schools before stadiums.

The state's answer combined promises with force. On 1 October 2025, three young men were shot dead by gendarmes in Lqliâa, near Agadir; the authorities said they had tried to storm a gendarmerie post. Human rights organizations accused security forces of excessive and disproportionate force. By the end of October 2025, about 1,400 people had been arrested and more than 2,000 faced prosecution, according to rights groups, including the Moroccan Association for Human Rights (AMDH), which documented the detention of minors. Some sentences were later reduced on appeal, but the message to a generation was unmistakable.

Meanwhile, the showcase projects continue. Morocco is building and renovating stadiums for the 2030 World Cup, which it will co-host with Spain and Portugal, including a planned 115,000-seat stadium near Casablanca. Officials argue that the tournament will bring investment and jobs. For many families in rural provinces, where a midwife may be available only on certain days of the week, the contrast is difficult to accept.

What comes next

The finance bill for 2027 is still before Parliament, and the unions will judge the government by whether the salary guarantee is written into law rather than merely promised in committee. The GenZ 212 movement, which took to the streets a year ago, has not disappeared; its grievances have simply been absorbed into a broader climate of strikes and protest.

A Year After Agadir, Morocco's Health Workers Strike Again Over a Reform They Do Not Trust

A reform its workers fear

The numbers behind the anger

From Agadir to the street

What comes next

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