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This study models the effects of the COVID-19 pandemic on the performance of the private health-care sector in the Middle East and North Africa (MENA) countries. This paper aims to address the economic, societal and sustainability of the health-care sector.

Data were collected from Bloomberg and the sample consists of 534 firm-year observations from 55 firms listed over 2010–2020. The authors apply panel data and control for the country and governance effects.

The authors found heterogeneous results regarding the three sub-sectors. The pandemic has a negative effect on the accounting and market performances of the “Pharmaceutical companies” and an insignificant impact on “Healthcare Management and Facilities Services.” Moreover, the impact of COVID-19 on health-care firms’ performance depends on the country’s economic classification and the degree of regulatory and governance frameworks.

Further studies may consider a larger sample and other regions. It is recommended to address the health-care sector's challenges to invest in new technologies such as “digital twin” and predictive and personalized medicine. It is worth testing model development theory and its effects on speeding up and designing models to ensure the proper functioning and developing mathematics to determine uncertainties in patient data and model predictions.

To the best of the authors’ knowledge, this paper is novel as it is unique in modeling the impact of COVID-19 on the health-care public companies in the MENA region. The findings pinpoint firms’ and countries’ heterogeneous impacts on financial and market performances.

The seepage of companies' capital accommodated by weak country-level institutions is inconducive to building sustainable businesses. Companies' performance on environmental, social and governance (ESG) issues is still a challenging question. This study aims to test the predictability of ESG on the performance of the health-care industry from a global perspective, while accounting for the country disclosure and director liability indices and performing robustness tests.

This study relies on panel data of 912 companies operating in 38 different countries for 2012–2020. This study controls for firm-level variables (leverage, size and loss), macroeconomic variables (COVID, gross domestic product and inflation) and institutional variables.

Findings indicate that countries with different levels of disclosure exhibit different patterns. Distinctly, the environmental pillar has a concave impact on return on assets, and the role of the disclosure index greatly manifests with the environmental pillar.

This study ponders the impact of country disclosure on sustainability practices from a global health-care perspective.

This paper is original, as it addresses the relationship between ESG performance and financial performance while accounting for the impact of institutional factors such as the business disclosure and director liability indices.