The creation of a national health fund: the key to universal health coverage in the DRC
In an effort to improve access to health care for all citizens of the Democratic Republic of Congo (DRC), President Félix Tshisekedi recently created the National Council for Universal Coverage (CNCU). However, it is essential to recognize that the CNCU, as it is currently constituted, cannot guarantee optimal and effective health coverage for all.
The resources of the CNCU seem limited and insufficient. In addition, the technical issues surrounding its creation, operation and the management of the diseases to be covered must be studied in greater depth. Currently, efforts are mainly focused on free childbirth, although pregnancy itself is not a disease.
Universal health coverage, as desired by President Tshisekedi, represents a laudable desire to achieve global social security, offering health care accessible to all. However, the main weakness of the CNCU lies in the fact that it does not guarantee free health care, but rather the absence of direct payment so as not to further impoverish households in difficulty.
However, it is important to ask the question of deferred consideration. Are the pilot hospitals in danger of going bankrupt, given the rigidity of our governments in terms of action? These questions require an adequate response and concrete measures.
This is why the creation of a “Health Fund” could constitute a major support in the realization of this vision of the Head of State. This fund would be an autonomous institution entirely dedicated to the health branch of social security.
Considering that existing health care providers, taxable persons and their dependents of existing social security funds (CNSS and CNSSAP) represent more than 30% of the population, they could be the initial beneficiaries of this fund. Subsequently, the action of this fund could extend to the rest of the population by deducting part of the taxes, legitimately ceded to the “National Health Fund”, to strengthen its resources.
It should be emphasized that health care is an important branch of social security, the humanitarian significance of which is undeniable. However, unlike the other existing branches of social security in the DRC (pensions, occupational risks, family benefits, etc.), health care does not have an independent and specific fund to guarantee its viability and quality..
In order to gradually realize President Tshisekedi’s vision and to face global challenges, it is essential to merge the technical data on providers and beneficiaries, as well as the financial resources generated by the contributors of the two existing social security funds (CNSS and CNSSAP). This process would establish an initial database for the institution of the national health fund.
Thanks to this approach, it would be possible to begin by offering universal health coverage to active and retired workers covered by the general and special schemes, as well as to their dependents. Subsequently, other groups of the population could be gradually included.
It is also important to point out that the recent inclusion of teachers from the public sector, the police and the army within the CNSSA is a step in the right direction. This demonstrates the need for broader universal health coverage for all DRC citizens.
In conclusion, the creation of a national health fund appears to be the key to ensuring universal health coverage in the Democratic Republic of Congo. This fund would make it possible to consolidate financial resources, guarantee autonomous and specific management of health care, and provide accessible and quality care to all citizens