There are 324 integrated health centers, 232 dispensaries, eight general hospitals, and 31 reference hospitals in the public sector. To this, we can add 54 private clinics, some of which belong to members of the presidential family.

However, with Decree 2013-691 of October 21, 2013, President Sassou Nguesso created the General Directorate of Health Services of the Presidency of the Republic. This health structure includes a management secretariat, a social service, an administrative and financial service, an equipment and supplies service, the presidential clinic, and the medical center.

The two health structures, the presidential clinic, and the medical center, are not attached to any of the health districts of the Ministry of Health; they depend directly on the presidential domain headed by Edgar Sassou Nguesso.

Therefore, the Presidential Clinic and the Medical Center are exceptional public health establishments.

As a public health establishment, the clinic and medical center should be accessible to any citizen following medical emergency criteria only. Still, it is at this level that the decree takes a strange turn.

Title 2 is confusing and suggests that the clinic is accessible to Presidency staff, but this is false. The title regulates the responsibilities of the General Directorate of Health Services of the Presidency of the Republic.

«It» (the general directorate of health services of the Presidency of the Republic) is responsible, in particular, for:

• Ensure clinical and paraclinical assessments of the President of the Republic and his family;

• Ensure medical care for the President of the Republic and his family;

• Ensure medical care for staff of the Presidency of the Republic;

• Ensure preventive medicine and occupational medicine activities for staff of the Presidency of the Republic;

In chapter 5, the decree stipulates that the clinic is exclusively dedicated to the medical needs of the President and his family.

Chapter 5: From the Presidential Clinic

Article 9: the Presidential Clinic is directed and run by a doctor with the director rank. it is responsible, in particular, for ensuring the clinical and paraclinical assessments of the President of the Republic and his family;

To ensure the medical care of the President of the Republic and his family;

To ensure, if necessary, the hospitalization of the President of the Republic and his family.

Article 10: The presidential clinic, in addition to the medical secretariat, includes:

• The operating room and intensive care unit;
• In radiology;
• The laboratory ;
• The pharmacy ;
• Specialized consulting firms;
• Hospital rooms.

Therefore, chapter 5 of the decree establishes a personal hospital for the President without defining what the term «and his family» covers. 

While the country is making colossal investments to create new general hospitals, this fully equipped President’s clinic does not appear in the health budget accounts, investments, or expenses. 

According to the PWYP Congo 2020-2022 report on the health system, the Presidency Hospital was built in 2015. Unused, it has deteriorated along with its equipment. It underwent reconstruction in 2021 for four billion two hundred million FCFA, a 20% overrun of the forecast budget of three billion five hundred million FCFA, only six years after its inauguration. 

How can we understand this accelerated deterioration of the Presidential Hospital? 

In 2016, the COGEMO clinic, which was associated with the interests of Claudia Sassou Nguesso, improved by acquiring cutting-edge imaging technology. 

In 2020, the presidential doctor, Alain Prosper Bouya, brother of the Minister of Major Works, founded the VERANO clinic with equipment similar to that planned for the presidential hospital.

Isn’t the monopolization of its equipment for the benefit of third parties the reason for the rapid deterioration of the presidential hospital?

The sixth chapter specifies that the medical center provides medical consultations and outpatient care for the Presidency of the Republic staff, as well as preventive medicine and occupational medicine activities.

The medical center does not have a radiology department, an operating and intensive care unit, or a specialized consultation room.

We are facing a situation of medical apartheid: a state-of-the-art clinic for the President and his family on one side and the minimum service for the staff on the other.

The fact that access to this clinic is reserved for the President and his family contradicts the logic of accessibility for all of public health establishments.

In 2016, 47% of Congo’s 5 million people were under 18, and according to the World Bank, around 44.5% of them lived below the national poverty line.

Rather than investing in a state-of-the-art wing in a public hospital like the CHU or even the military hospital of Brazzaville, the President created a personal health system for himself and his family through this decree.

For the rest of the Congolese staff and citizens, a paid health system is punctuated by reagents, medicines, doctors, tap water