Saudi Arabia is ranked fifth of the 17 Middle East and African (MEA) pharmaceuticals and healthcare markets, a drop from the country's previous second place in Q4'09 as a result of a fall in its score for limits of potential returns, a latest industry report said. The report further said Saudi Arabian consumers will spend 4 percent of their GDP on healthcare by 2013 and the government is currently constructing more hospitals and recruiting more healthcare professionals to address issues with access to healthcare services in the country. The Saudi Arabia Pharmaceuticals and Healthcare Report Q1 2010 released by companiesandmarkets.com, said that from 2009 to 2014, the pharmaceutical market is expected to post a compound annual growth rate (CAGR) of 6.44 percent in both US dollar and local currency terms. The Council of Cooperative Health Insurance (CCHI) Secretary General Dr Abdullah Al Sharif has said the council has plans to develop a comprehensive healthcare management system centered on health economics and pharmacoeconomics in conjunction with the Saudi Food and Drug Authority. Since Saudi Arabia has both the largest population and the highest level of pharmaceutical spending in the Gulf Cooperation Council (GCC), there is a strong possibility that the Kingdom could itself become a medical tourism destination to rival Jordan. Chronic diseases such as hypertension, diabetes and obesity are forming an increasingly large portion of the region's epidemiological profile. Domestic drugmakers in the region, such as Gulf Pharmaceuticals Industries (Julphar) in the UAE, are using exports to reach other GCC states. However, international accreditation for manufacturing practice would allow firms like this to target more lucrative global markets. Saudi Arabia is highly reliant on foreign doctors for the provision of healthcare. An estimated 78 percent of the Kingdom's 43,000 doctors are expatriates. Recently, Saudi Arabia recruited 500 doctors from Bangladesh for the 2,000 health centers across the country. In total, 4,000 doctors had been recruited to 150 new family health centers by early 2008. A further 7,000 should be recruited over the next few years in an attempt to bring the doctor:patient ratio down from 1:4,000 to 1:400. Many of these extra doctors are expected to come from abroad - mostly from less wealthy Arab countries such as Syria, Jordan and Egypt. The shortage of nurses in the country has initiated an international recruitment drive to make up the deficit. In 2008, the Kingdom recruited 8,000 nurses, with a quarter of these from the Philippines. The government still holds long-term ambitions to decrease dependence on foreign staff, with places on specialist nursing courses reserved for Saudi women. The country is in dire need of over 4,000 more medical staff. The report encourages Saudi Arabia to provide better training and incentives to provide more native doctors, while only using foreign staff as a temporary measure. “We would recommend the Kingdom raise its medical training standards to rival Jordan - now a popular medical tourism destination for Arab patients owing to both its quality of care and medical expertise,” the report said.