Rwanda

In common with most sub-Saharan countries, access to medicines in Rwanda has been hampered by shortages of health staff, poor quality medical facilities and a lack of coordination between donors. Staff shortages have been exacerbated by internal migrations to work for the many foreign NGOs and donor-funded projects that exist in Rwanda, where pay and conditions are often considerably better than in the state sector.

Since the mid 2000s, Rwanda's government has attempted to deal with these problems by instituting major reforms including the introduction of a country-wide independent community health insurance scheme; and the establishment of a performance-based pay initiative; and better coordination of donors and external aid with government policy. It is too early to say if these reforms have been successful.

There is only a nascent local drug manufacturing industry in Rwanda, and most demand has to be met by imports. It is therefore encouraging that tariffs have been reduced since 2003 to 0%.