Gabon

The Constitution does not include a right to health but refers to the obligation of the State, based on its capabilities, to guarantee to all, and in particular children, women, disabled people and, elderly people, health protection, social security, a preserved natural environment, rest and leisure (art. 1.8).

Under the Constitution, the law sets the fundamental principles, among others, for health, social security, labour law (art. 47).

The main goal of the Politique Nationale de Santé du Gabon 2024-2034 is to improve the health and well-being of the population (p. 28).

The policy identifies several strategic axes, including strengthening health system governance, progressing towards universal health coverage, promoting health at all life stages, intensifying disease control, enhancing health information systems, preparing for epidemic responses, operationalizing the health district through primary health care and community participation, and developing public policies that consider environmental and social health determinants (p. 28).

In the context section, the Policy highlights the large array of laws and regulations for health in place in the country but also points out significant challenges (pages 9-10). For example, key services and technical units within the Ministry of Health, such as health promotion, planning and partnership, HIV/AIDS control, the Medicines Agency, and statistical services, lack organizational or implementing texts. This absence also affects hospital reform, the reorganization of the private health sector, the revision of health professionals' nomenclature, and traditional medicine. At the regional and departmental levels, the decree reorganizing health regions and departments (Décret n° 142/PR/MSPS du 2 mars 2015) is not implemented. There is no formalized framework for intersectoral collaboration between the Ministry of Health and other ministries or between public, parapublic, and private sectors. This results in a lack of coordinated actions and insufficient control over private sector activities, including construction standards, pricing, and health data (pages 9-10). Gaps are also highlighted regarding the legislative framework for managing national health information systems (page 16) and laboratories (page 18).

To respond to the challenges faced, the policy outlines specific actions relating to laws and regulations under its strategic axes. For instance, strategic axis 1 (strengthen governance) refers to the need to equip the ministry in charge of health with all the structures provided by the texts, to enhance the implementation of various reforms (pharmaceutical sector reform, hospital reform) by adopting implementing texts; to equip the country with a National Public Health Observatory ; and to implement the private sector reform (non-exhaustive list) (pages 28-29). Under strategic axis 5 (strengthen national health information system), the development of an appropriate legal framework to manage the national health information system is also highlighted (page 32).

The main goal of the "Plan National de Développement Sanitaire du Gabon 2024-2028" is to improve the health and well-being of the Gabonese population by reducing mortality and morbidity rates (page 29).

The plan is based on the eight strategic axes identified in the National Health Policy, including strengthening health system governance, progressing towards universal health coverage, promoting health at all life stages, intensifying disease control, enhancing health information systems, preparing for epidemic outbreaks, operationalizing primary health care, and developing public policies that consider environmental and social health determinants (pages 29-38).

The Plan reiterates the analysis conducted in the Policy regarding the existing legislation and the challenges faced (see analysis performed for the National Health Policy section).

As for specific legislative and regulatory priorities, the plan refers to the need to strengthen the institutional and legal framework for laboratories (page 43) and for managing national health information system (page 45, page 124). Several legislative actions are also included in the logical frame including: the development of organizational text for central services of the ministry of health (page 62), the development of implementing texts for the reform of the pharmaceutical sector and laboratories (pages 62,63, 127), the development of implementing texts for hospital reforms (pages 62-63), the establishment of a National Observatory for Public health (page 29), the implementation of the reform to regulate the private sector, regulation of traditional medicine (page 45), promulgation of the health code (pages 62-63), the strengthening of the legal and regulatory framework for blood transfusion (page 72), the development of a decree creating and governing the IELE (page 135), regulations for food safety (pages 140-141) and, the development of a legal framework for community health (page 148).