As the populist chapter of Kaïs Saied’s rule nears its end, and his throne begins to wobble under the weight of a desperate and disillusioned population, Tunisia stands at a pivotal crossroads. Though re-elected in the contested October 2024 elections, Saied emerges politically diminished, his domestic legitimacy eroded, and his international isolation deepening. Rather than charting a new course, he clings to symbolic gestures and ideological posturing.

His recent meeting with Trump senior adviser for Africa, Massad Boulos, exemplified this drift. Marketed as a sovereign pivot, it instead revealed a president on the defensive, exploiting the tragedy in Gaza to flatter his base by humiliating the American envoy. The performance, intended to project strength, instead laid bare the regime’s fragility — revealing a president increasingly detached from political reality and blind to the country’s pressing economic crises.

Behind Saied’s rhetoric of “diversification” lies no coherent economic vision. China, despite being touted as an alternative, supports IMF-backed reforms and shows little interest in a high-risk partnership. Russia is crippled by war and sanctions; Iran offers ideology, not investment. These alignments do not serve the Tunisian people, they serve a regime in search of legitimacy, propped up by authoritarian allies willing to turn a blind eye. 

What is presented as sovereign diplomacy is, in reality, an empty last stand, a clumsy performance aimed at the United States, a power Kaïs Saied openly despises and deeply fears, in a desperate attempt to cling to power and deflect attention from his failures under the guise of anti-imperialist bravado.

A new future is possible

Today, Tunisia is ready to turn the page on a troubled chapter marked by economic stagnation, political instability, and diminished freedoms.

The nation finds itself at a crossroads, presented with a historic opportunity to reshape its future and reassert its role as a dynamic and influential player in the global economy. Healthcare, in particular, offers a strategic avenue for growth, positioning Tunisia as a potential regional hub of medical excellence. By drawing inspiration from Singapore’s model, the country could attract world-class investment and expertise, particularly from the United States. However, seizing this opportunity will require Tunisia to carefully navigate the complexities of its forthcoming transition and avoid repeating the missteps of the past.

A Multi-Billion-Dollar Opportunity for U.S. Firms 

Tunisia is uniquely positioned to emerge as a premier medical hub in the Mediterranean region, driven by its advanced private healthcare infrastructure, highly competitive operational costs, and strategic geographic location, conveniently accessible from both Europe and Africa. By attracting European patients who seek not only cost-effective and high-quality medical care but also timely treatment unavailable due to extensive waiting lists in their home countries, Tunisia stands to substantially boost its economy, effectively address the increasing demand for prompt medical services, and significantly enhance its international standing as a trusted healthcare destination.

Healthcare spending in Europe has been increasing steadily, reaching 1,35 trillion euros in 2024. Given that approximately 20%-30% of this expenditure involves elective procedures, Tunisia stands to gain access to a market exceeding €100 billion annually by capturing even a modest 10% share.

In this context, U.S. companies and healthcare providers are poised to seize a multi-billion-dollar opportunity by developing hospitals, clinics, and training centers that serve European and African patients. Furthermore, these investments would strengthen U.S.-Tunisia relations, amplifying American influence in the Mediterranean region and ensuring Tunisia remains aligned with the U.S. rather than drifting eastward into the embrace of Iran or Russia. Yet, troubling signs already loom on the horizon: since June 15, 2024, Iranians have enjoyed visa-free entry into Tunisia, quietly planting seeds of influence whose bitter harvest we may soon reap. This policy is part of a broader strategy by Kais Saied to deepen political, trade, and cultural ties with the Iranian regime, a move that raises serious concerns about the geopolitical and domestic ramifications of aligning Tunisia with such a repressive and destabilizing force. 

Simultaneously, Russia, freshly expelled from Syria, actively searches for fertile ground upon which to anchor a new naval base—its eyes now set firmly upon Tunisia’s strategic shores.

Amid growing geopolitical threats, Tunisia has a brief but critical window to redefine its path. The post-populist transition will be crucial, as any delay risks missed opportunities and increased external vulnerability.

Positioning Tunisia as a premier medical hub could serve as a cornerstone of this transition. By addressing critical regulatory and logistical hurdles in the healthcare sector, Tunisia can attract world-class investment and expertise. Crafting comprehensive bilateral agreements with key European countries would streamline reimbursement processes, facilitate patient mobility, and ensure alignment with EU medical standards. Additionally, adopting successful models such as partnerships between American healthcare giants like Johns Hopkins or Mayo Clinic and medical hubs in the UAE or Singapore could reduce European skepticism toward healthcare services outside the EU.

A crucial two-year transition

With Tunisia nearing the end of a turbulent political cycle, the country will require a two-year transition to lay the groundwork for credible reforms and renewed investor confidence—delivering quick wins while shaping a long-term economic strategy.

While healthcare holds long-term promise, Tunisia’s immediate gains lie in its rich phosphate reserves, military collaboration, tourism and real estate opportunities, energy projects, and active regional diplomacy.

Notably, phosphate, though not currently on the U.S. Geological Survey’s Critical Minerals List, is gaining attention, with industry groups like The Fertilizer Institute pushing for its inclusion. Its crucial role in American agriculture aligns with the “America First” agenda, offering quick wins for the Trump administration while boosting Tunisia’s stability and economy.

Tunisia could attract U.S. investments by mirroring Singapore’s stability, infrastructure, and pro-business policies, but it must first tackle corruption, bureaucracy, and instability. That will be among the objectives of Tunisia’s post-populist two-year transition. Initiatives such as special investment zones offering streamlined regulations and incentives could create immediate economic momentum.

To further reassure American investors, and shield itself from hostile neighbors, Tunisia should also replicate Singapore’s nuanced strategy of protecting investments through robust legal guarantees, economic alignment, and a carefully balanced strategic military presence—one that stops short of a full U.S. military base but still signals security and reliability. Tunisian success stories would act as powerful driver for expanding American influence and economic interests into Libya and across the Region.

Ghazi Ben Ahmed

Founder and President

Ghazi Ben Ahmed

Founder and President

A small river named Duden flows by their place and supplies it with the necessary

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