Sassou Nguesso’s health policy: Evacuating the Oligarchs, Letting the Congolese Die

The health budget averaged 8% of the national budget over the period. It generally remains lower than that of Defense, particularly during the elections’ run-up (2015, 2016, 2021) and during the post-electoral military repression in the Pool region (2016-2018). Concerning the allocation and execution rates of the health budget, they are as follows:

Year	State budget	MSP allocation rate	Execution rate
2015	2715066000000	14%	31%
2016	3608729000000	5%	43%
2017	2729329000000	5%	54%
2018	1303629000000	11%	37%

The 2022 transition schedule for social expenditure awaiting payment by the Ministry of Health and Population (MSP) allows us to extract the first list of 34 companies in the health sector.

We first note the participation of the Génération à Venir Foundation of Edgard Nguesso, who is none other than the President’s nephew.

Then, we find Pami Partners of Judicaelle Mouandinga Okemba, daughter of the head of the secret services Jean-Dominique Okemba, and the UBIPHARM network led by Hyacinthe Ingani, PCT deputy and brother of Minister Ingani, who are also present.

On the ITEM activity for human health and social action, the most recent national file of companies in Congo from the Ministry of the Economy lists 198 entities in quarter 3 of 2023.

This ITEM includes private clinics, analysis laboratories, and entrepreneurs in the digital health sector, such as Habib Cyril Nguesso’s ETS SYNWELL.

As the health accounts we examined highlight, the most significant item of health spending is medical evacuations abroad.

It remains impossible to know what criteria these evacuation benefits abroad are allocated.

The medical emergency given the deficiencies of local technical platforms? Relatives and political clientele? A black market for evacuation places?

For the year 2022, among the pending expenses of the MSP, there are 48 evacuations supported, including that of personalities such as Philippe Mvouo, head of the Superior Council for Press Freedom, the late minister Coussoud Mavoungou and even Eugène VItal, eldest son of Maurice Nguesso.

By compiling the amounts of evacuations from the operation mandate received by nature of the 2019 fiscal year budget, we obtain the estimate of one hundred and forty-three billion, nine hundred and ninety million, four hundred and fifty-seven thousand, eight hundred and twenty-three FCFA (143,990,457,823).

This amount represents almost the entire health budget for the financial year, which constitutes confirmation of the words of the 2016-2018 Health Account report.

The country’s leading hospitals are in a chronic situation of budgetary bankruptcy.

In 2018, according to figures from the leading union in the sector, they have the following salary arrears:

NAME OF THE STRUCTURE	SITUATION
Loandjili Hospital in Pointe-Noire	7 months of unpaid salaries for a payroll of 200,000,000 FCFA per month
Dolisie Hospital	21 months of unpaid salary arrears
Owando July 31 Hospital	10 months of unpaid salaries for a payroll of 3,800,000 FCFA
CHU of Brazzaville	5 months of unpaid salaries with a payroll of 898,989,570 FCFA
CNTS (National Blood Transfusion Center)	8 months of unpaid salary with a payroll of 90,000,000 FCFA

For comparison, Claudia Sassou’s New York apartment worth 6 million euros would cover 20 months of salary from Loandjili Hospital. In 2020, COVID-19 quickly became a new enrichment opportunity with misappropriation of donations and unexecuted over-the-counter deals.

Infectious and parasitic diseases such as malaria constitute the primary source of health expenditure for the Congolese. However, the free malaria care program for women and children is at a standstill. In 2018, Congo lost funding from the Global Fund to Fight HIV/AIDS, TB, and Malaria in the malaria component due to its classification as a lower middle-income country. However, even during the eligibility period, the free program only sporadically reached the targeted populations. For example, free antimalarials for women and children were unavailable in Moyoundzi in the Bouenza region. 

According to the professionals interviewed, the samples end up with street sellers at each delivery and become chargeable. In this locality, there was only one delivery in 2022 and none in 2024. 

In the Sangha region, the situation is even more severe. The free program is almost unknown and has never been effective in health structures.

In 2018, the causes of death in the postnatal period were infections (27.1%), malaria (24.7%), acute respiratory infections «ARI» (23.5%), gastroenteritis (11 %), malnutrition (6%), congenital malformations (1.8%) and HIV (1.3%). 

Regarding child mortality, the leading causes were malaria (54%), ARI (18.2%), diarrhea (16.9%), malnutrition (6.2%), meningitis ( 2%), HIV (0.7%), and other causes (2%). However, as the compilation shows, almost the entire budget for the year 2019, for example, was devoted to medical evacuations of personalities and their families based on unknown criteria. 

Failing to combat malaria, which is the leading cause of death among young children, is more than negligence; it is a crime.