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Abstract Introduction Morocco is evolving at a rapid pace, akin to the Bouraq (the Moroccan high speed train)! It is heading towards a future that is certainly more promising. Social, economic, industrial, sporting, and cultural dynamics are fueling this race towards a better Morocco! This is the current sentiment among Moroccans and foreign observers witnessing Morocco's industrial and economic development. Several mega projects are underway, notably since the announcement that Morocco will co-host the 2030 Football World Cup in partnership with Spain and Portugal, and the King of Morocco's speech at the celebration of the Green March on November 6, 2023. This development momentum corroborates the work begun several years ago, as Morocco has embraced the global economy through free trade zones (in several regions of Morocco), industrial progress, and the development of the automotive and aeronautical sectors. The social project aims for optimum medical care for all Moroccans through the generalization of Compulsory Health Insurance (AMO) to all social strata in Morocco. But what about occupational health and safety (OSH) to accompany this progress? Do we have the necessary tools to ensure Moroccan workers can flourish and participate in this development? What are the OHS challenges for improving national indicators in this area? Does the Moroccan OHS management system (policy, strategy, etc.) have a clear vision for achieving OHS promotion objectives? All these questions, and many others, will shed light on the current state of affairs, the challenges ahead, and the recommendations that will enable us to pool the efforts of all public authorities and stakeholders to achieve the desired level of OHS. Problematics The plenary conference aims to highlight various aspects of OHS in Morocco, starting with the royal vision. It seeks inspiration from the highest level of the kingdom through speeches and orientations guiding Morocco's socio-economic aspect. The kingdom's constitution emphasizes the right of trade unions and professional representations to defend and promote the socio-economic interests of the categories they represent. It guarantees the right to security for every person and respects physical or moral integrity, which must not be compromised under any circumstances. The study of various reports and opinions issued by the kingdom's advisory bodies also serves as a foundation for our conference. Our presentation will focus on the analysis of the national profile drawn up in 2017, which includes a number of indicators but, in our opinion, does not reflect the reality of OHS in Morocco. Having ratified the C187 since 2019, Morocco is now obliged to put in place a national OHS policy. What are its orientations? What are the limits of its implementation? What national programs result from it? We will also study the various OHS bodies in Morocco and their involvement in promoting OHS. We will question the effectiveness of these bodies, the degree of their involvement, and the follow-up to actions carried out previously, particularly the occupational medicine and occupational risk prevention council, safety and health committees, etc. A SWOT analysis of the model proposed in the 2017 national OHS profile also enables us to take a critical look at its content and to see how the various topics have evolved over the last six years. This analysis forms the basis of the discussion that follows. Analytics A detailed study of different OHS systems in countries similar to Morocco, in demographic, economic, and locoregional terms, enables us to compare results across different OHS indicators. This allows Morocco to build on best practices and previous experiences. Eight percent of low-income countries have a national OHS program, and 26% have an OHS policy, compared with high-income countries where 58% have a national policy, and over 50% have an updated national program. It is through this benchmark and the results obtained from our SWOT analysis that we propose various recommendations and a vision of OHS adapted to the current socio-economic context in our country. As mentioned above, health coverage is becoming more widespread, but the rate of OHS coverage is barely keeping pace with this trend. Morocco's national profile estimates occupational health service coverage at 20%, while small and medium-sized enterprises (SMEs) account for over 95% of the economic fabric. We know empirically that it is the large and very large companies that implement effective OHS systems for their employees and annexes, while SMEs face a number of economic challenges, neglecting the basics of OHS coverage for their employees. Starting from the elements of the profile represented as a threat, such as the absence of reliable statistics on occupational accidents and diseases, we note that six years later, there is still no organization dedicated to gathering data relating to OHS statistics and capable of consolidating them to propose effective prevention strategies. Apart from the Supervisory Authority of Insurance and Social Welfare (Autorité de Contrôle des Assurances et de la Prévoyance Sociale – ACAPS), which has published some statistics, the use of which is rather timid. According to the ACAPS, 29% of VSEs claim to be covered by workplace accident insurance. Non-affiliated companies deplore the fact that they do not have sufficient income at the company level or a lack of information on the products in question. Workers' compensation insurance is compulsory for companies with more than 10 employees. Efforts should be made to ensure that all employees are covered for occupational accidents and diseases. In terms of insurance premiums, ACAPS states in its 2022 report on the insurance and reinsurance sector that occupational injury insurance has risen by 7.6% to MAD 2.5 billion. This rise could be due to an increase in the number of declarations or to a rise in the severity of injuries, necessitating an extension of the statistics to include a study of the profiles of occupational injuries. As for the number of work-related accidents reported each year, we have no usable figures apart from one for work-related accidents, which estimates them at 40,000 per year, with around 2,000 deaths reported annually. The cost would be around 20,000 MAD (€2,000) per work-related accident in direct costs! Occupational illnesses are largely ignored and rarely reported in Morocco, partly because of the cumbersome procedures that require a court hearing, and partly because the employees concerned are unfamiliar with the reporting system. As a result, statistics on this subject are virtually non-existent. Recommendations Drawing on the ILO's new strategy for its members, three pillars are needed to nurture OHS in Morocco: 1st pillar: strengthen the OHS system based on effective governance, reliable data collection, and evidence-based research, and skills development in OHS services. 2nd pillar: strengthen coordination between the various partners, improve investment in OHS and integrate OHS into policies at the national and global levels. 3rd pillar: promote the principles and values set out in the guidelines on occupational safety and health management systems, while adapting them to the Moroccan socio-economic context. We will also propose a new SWOT analysis based on the progress made in several OSH fields, as well as the transformations and threats to the economic and social fabric that Morocco faces now and in the future. We also need to seize the opportunity offered by Morocco's social and health dynamics to improve the organization of occupational medicine services on a more equitable geographical basis, according to the distribution of economic or industrial agglomerations, by offering and promoting the possibility of creating multidisciplinary occupational health centers with mutualized membership for companies. This would reduce costs for the company and provide more comprehensive care for workers' health. Also, the development of multi-party participation in all existing bodies such as the Safety and Hygiene Committee at company level, or the Occupational Medicine and Risk Prevention Council at the national level, is strongly recommended as a guarantee of continuous improvement for occupational health programs deployed across the country. Conclusion Morocco has marked a milestone on the societal level by adopting several measures to improve health coverage and generalize it to all social categories in Morocco. It is time to accompany this change and seize the opportunity to lay the foundations for a transformation in OHS in order to preserve the human capital of Moroccan workers.
Tahri et al. (Mon,) studied this question.