At a dinner debate organized by the Association of Journalists in Health, Population and Development (AJSPD) in partnership with the International Budget Partnership (IBP), experts, decision-makers, and civil society actors explored ways to sustainably finance health in Senegal. "Money alone will not be enough, but without well-directed money, there will be no universal health coverage," he summarized the issue.

A health system under pressure

Despite recent progress, health financing remains fragile and inequitable, with more than 43% of expenditures borne by households and only 25% of needs covered by technical and financial partners. This situation jeopardizes the viability of Universal Health Coverage (UHC), a pillar of Vision Senegal 2050. The challenges are well known: a glaring shortage of human resources (7 doctors per 10,000 inhabitants compared to 15 recommended by the WHO), marked inequalities between urban and rural areas, excessive dependence on external funding, and the coexistence of communicable and chronic diseases. For Assietou Diallo Fall, a health economist at the Ministry of Health and Social Action, "strengthening human capital and empowering territories" is urgent. Without a profound reform of financing, these ambitions risk remaining a dead letter.

Relevance before budgets

Dr. Farba Lamine Sall, a health expert, insisted: "The problem is not primarily money, but the relevance of policies and programs." According to him, "reducing health to a budgetary equation is a mistake: what matters is investing in effective and sustainable programs." He lamented that health, despite being declared a national priority, represents less than 5% of the state budget, a level incompatible with the objective of an inclusive and efficient system. For Dr. Sall, the political change must mark a break: "What we were doing until now, we no longer want. The future is UHC, with the principle of leaving no one behind."

It proposes three pillars: strengthening healthcare provision by mobilizing the public and private sectors, financially protecting populations through mandatory health insurance (voluntary provision has shown its limits), and reducing morbidity through prevention and health education. Health sovereignty and trust The debates also emphasized therapeutic sovereignty: developing the local pharmaceutical industry, modernizing technical platforms, and restoring trust in Senegalese hospitals. "As long as our citizens doubt their facilities, they will seek treatment elsewhere," warned Dr. Farba Sall.

Finally, the experts highlighted the key role of information and communication. "Many health problems are linked to a lack of information," acknowledged Dr. Sall, recommending that the Ministry of Health become a central source of information and coordination, collaborating with the media and civil society to amplify prevention messages.