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Sao Tome and Principe - P4H Network
Current Health Expenditure (CHE) as % Gross Domestic Product (GDP)7.5%CHE/GDP
Out-of-pocket (OOPS) spending as % of Current Health Expenditure (CHE)12%OOP/CHE
Domestic General Government Health Expenditure (GGHE-D) as % General Government Expenditure (GGE)14.9%GGHE-D/GGE
Gross Domestic Product (GDP), in constant (2020) US$ in millions (M), billions (B), or trillions (T)547MGDP (USD)
Population in thousands (K), millions (M) or billions (B)226.3KPopulation

The Republic of Sao Tome and Principe, a Small Island Developing State (SIDS) off the western coast of central Africa, is making significant strides in universal health coverage. The health service coverage index stands at 59%, reflecting improvement over recent years and mirroring other lower-middle-income countries in the region. Gaps in the comprehensiveness of health services remain a challenge.

The government of Sao Tome and Principe is committed to ensuring that every citizen can afford the health care they need without falling into financial hardship. Its population is approximately 218,000. Only 2.8% of households faces catastrophic health care costs, with medicines being the primary driver. Policymakers are prioritizing this issue, focusing on reducing the financial burden of medications in future health policies.

Health financing and procurement strategies for a healthier future

Health financing in Sao Tome and Principe relies primarily on general taxation, largely from indirect taxes on consumption and imports, with direct taxes and non-tax revenue playing a smaller role. The tax-to-GDP ratiois 12.9%, which falls short of the continent of Africa’s average of 15.6%. The country is actively enhancing tax administration and compliance while broadening the tax base, tackling informal employment as a significant hurdle to increasing revenue collection.

The island nature of Sao Tome and Principe, coupled with its small population, limits the scope of interventions in the health sector and complicates access to medicines and supplies. To address these challenges, Sao Tome and Principe has embraced the African SIDS initiative for the Joint Procurement of Medicines, signed at the World Health Assembly in 2024. 

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Lei n.º 09/2018 Base de Saúde

Sao Tome and Principe
DOCUMENT |

National Health Development Plan 2023-2032

Sao Tome and Principe