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 the majority, with irregular and unstable incomes. However, the ability to pay determines access to care, particularly through recourse to family solidarity. Social security coverage in the formal sector is weak, covering only civil servants and employees of a few companies. Overall, the social protection system has significant coverage gaps, particularly 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 to set in motion the implementation of universal health coverage. The first draft decree concerns the creation of the regulatory authority to control 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 last draft concerns the transformation of a public service called the National Agency for Clinical Engineering of Health Information (ANICIIS) into a public institution called the National Agency for Clinical Engineering and Digital Health (ANICNS).

Combined efforts to grant social status to health products and services also involve the process of rationalizing pricing structures and the rates of medicines and care. Ensuring fair pricing for health products and services requires consensual reforms, as health 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 costs of health products and services in the DRC, with an additional approximately 120% on the CIF (Cost, Insurance, and Freight) value. While in other countries bordering the DRC, particularly SADC member states, products are fully exempt while other countries apply a single rate lower than that of the DRC.