The advent of the National Council for Universal Coverage (CNCU) in the Democratic Republic of Congo (DRC), by order of President Félix Tshisekedi, has raised expectations and questions about its ability to ensure effective health coverage for all. Since its creation, the CNCU has mainly focused its efforts on free births, leaving aside other important issues related to universal health coverage.
It is essential to recognize that President Tshisekedi’s vision of achieving comprehensive social security and accessible health care for all is laudable. However, the CNCU in its current form does not appear to be resourced to ensure optimal coverage. In addition, the modalities of its implementation and the management of the various diseases must be studied in depth.
One of the main weaknesses of the CNCU is that it does not guarantee free health care, but simply the postponement of direct payment to avoid impoverishing households in difficulty. However, it is legitimate to ask what will be the counterparts to this postponement. Could CNCU partner hospitals face bankruptcy if governments are slow to act effectively?
Faced with these challenges, it is proposed to create a “Health Fund” which would provide real support for the concrete implementation of universal health coverage in the DRC. This fund could rely on taxable persons and beneficiaries of existing social security funds, such as the CNSS (National Social Security Fund) and the CNSSAP (National Social Security Fund for public officials). These two funds already cover more than 30% of the population and could serve as a solid basis for the establishment of the National Health Fund.
It is important to emphasize that health care is an essential branch of social security and deserves special attention. Social security contributions, unlike taxes, are often perceived more pleasantly by the beneficiary populations, as they guarantee a direct counterpart in the form of health and social services.
It is therefore necessary to provide material and intellectual efforts to merge the technical data of providers and beneficiaries, as well as the financial resources generated by the contributors of existing social security funds. This data fusion would make it possible to establish a solid base for the National Health Fund and initially ensure universal health coverage for active workers, retirees and their dependents.
It is encouraging to note that steps have been taken recently to integrate public sector teachers, the police and the army into the existing social security system.. This shows that progress is possible and that a real political will exists to guarantee universal health coverage.
In conclusion, the creation of the National Council for Universal Coverage in the DRC is a positive initiative that aims to ensure accessible health care for all. However, improvements are needed, in particular by setting up a strong and autonomous National Health Fund. By integrating the resources of existing social security funds, it is possible to guarantee more effective and sustainable universal health coverage for the entire Congolese population