Gabon's CNAMGS: admired abroad, challenged at the pharmacy counter

The study, titled "Generalizing Social Protection in Africa," suggests that traditional social security models, based on salary contributions, exclude the vast majority of workers in Africa's informal economy. CNAMGS addresses this by dissociating healthcare access from salary contributions, instead funding coverage for economically vulnerable Gabonese citizens through levies on high-revenue activities like mobile telephony and money transfers. While the financing mechanism is praised as ingenious and a potential path for the continent, the study, authored by FINACTU, which also designed CNAMGS, acknowledges that the system faces challenges in service delivery.

For instance, the pharmacists' union Sypharga considered suspending medication delivery to CNAMGS beneficiaries due to unpaid debts, which amounted to approximately 8 billion CFA francs in October 2025. By early 2026, CNAMGS itself tightened regulations on partner structures, demanding dossier regularization to avoid invoice rejections. The article concludes that Gabon serves as a laboratory, pioneering in financing expanded coverage but still needing to prove its long-term sustainability and quality of care for all insured individuals.