DRC – Universal Health Coverage

In the DRC, the vast majority of the population does not benefit from any form of social security. The informal sector is dominant, with irregular and unstable incomes. However, the ability to pay determines access to healthcare, particularly through reliance on family support. Social security coverage in the formal sector is weak, extending only to civil servants and employees of a few companies. Overall, the social protection system has significant gaps in coverage, especially for workers in the informal and rural economy. In 2019, only 14.11% of the population was covered by at least one social protection scheme.

In December 2021, the government adopted five draft decrees intended to initiate the implementation of universal health coverage. The first draft decree concerns the creation of the regulatory authority for monitoring universal health coverage. The second concerns the creation of a public institution called the Health Solidarity Fund. The third draft decree relates to the creation of a public institution called the Public Health Promotion Fund. The fourth draft decree concerns the creation of a public institution called the National Institute of Public Health (INSP). The final draft decree concerns the transformation of a public service called the National Agency for Clinical Engineering and Health Information (ANICIIS) into a public institution called the National Agency for Clinical Engineering and Digital Health (ANICNS).

The combined efforts to grant social status to health products and services also involve streamlining pricing structures and the tariffs for medicines and care. Ensuring fair pricing for health products and services requires consensual reforms, as these products and services are inaccessible to the majority of the Congolese population.

Furthermore, taxes, along with other factors, are among the main determinants of the high cost of health products and services in the DRC, adding approximately 120% to the CIF (Cost, Insurance, and Freight) value. While in other countries bordering the DRC, particularly SADC member states, products are entirely exempt from taxes, other countries apply a single rate lower than that of the DRC.