Mining Royalties Fueling Improved Health Coverage in DRC

Local health spending in Lualaba province has included an ambulance for Dipeta Heath Referral Center

Local health spending in Lualaba province has included an ambulance for Dipeta Heath Referral Center

Mining is a leading industry in the Democratic Republic of the Congo, generating income via royalties and taxes for local administrative units that support governance and resource distribution. Yet for more than a decade, these units—called Entités Territoriales Décentralisées (ETDs, Decentralized Territorial Entities)—weren’t leveraging these funds to meet the stark needs of their local health systems. Rural and remote areas were especially lacking in quality services and equipment.

Starting in 2020, the Abt-led USAID Integrated Health Program (IHP) has partnered with provincial health divisions in its target regions to bridge these gaps. In late 2022 and 2023, the project convened a series of advocacy meetings across 18 ETDs to explain the pressing needs of the local health zones.

At the end of these meetings, the ETDs invited the Chief Medical Officers of the health zones to help draw up annual investment plans, facilitated by USAID IHP. In 2023, ETDs committed  $22.5 million total for health service improvements in Haut-Katanga and Lualaba.

"We're really pleased with this kind of coaching and support, which enables us to coordinate planning more closely with ETDs,” said Dr. Serge Musoya, Bunkeya Zone Chief Medical Officer in Lualaba province. “This also enables us to meet a number of challenges in the health sector and reinforces the synergy of support from technical and financial partners by improving the quality of care in our health zones."

These commitments have translated into tangible advancements, including new and rehabilitated health centers and essential medical equipment and supplies. ETDs have so far invested in 29 health facilities, constructing 24 new facilities, and rehabilitating five. ETDs also purchased medical equipment, medicine, fuel, 19 motorcycles, five ambulances, and two mortuary refrigerators. Additionally, in Tanganyika, USAID IHP helped secure commitments from ETDs to support the construction of a general referral hospital in Nyemba, a central office for the Nyemba health zone, and drug procurement in the province throughout 2024.

In alignment with USAID's objective of empowering Congolese communities, USAID IHP remains committed to ensuring integration of healthcare priorities in 2024 annual investment plans in two further provinces.