Please visit our new website at www.export.gov!

Healthcare Resource Guide: Angola

 

Angola Statistics



Summary

Market Entry

Current Market Trends

Main Competitors

Current Demand

Registration Process

Barriers

Procurement & Tenders

Trade Events

Local Associations

Government Links

Best Prospects

Statistics Snapshot

CS Contacts

 

Capital: Luanda

Population: 28.8 Million Inhabitants

GDP: $ 3,514 GDP per Capita

Currency: Kwanza AKZ

Language: Portuguese (Official)

Summary

Angola is an upper-middle income country of 28.8 million inhabitants that is 63 percent urban. The population is by gender, 47.3 percent male and 52.7 percent female. According to the 2014 Angolan Census, the Angolan population is very young with 65 percent of the population under 24 years.

Angola’s healthcare system is comprised of public and private services. Per Angolan law, public health services, from primary care to specialized services, are available at no cost. However, the public system suffers from shortages of doctors, medicines, nurses, primary health care workers, as well as inadequate training and a lack of a computerized information management system to efficiently track historical records of patients. As a result, access to healthcare services and to pharmaceuticals for the majority of the population is limited. The best quality health services are found in Luanda and in the other major cities of Benguela, Lobito, Lubango and Huambo.

Most middle and upper middle class Angolans use private healthcare services that generally offer higher quality and fee-based care. Four major private clinics are located in Luanda: Girassol (affiliated with state oil company Sonangol), Sagrada Esperança (affiliated with the state diamond company Endiama), Multiperfil (affiliated with the Presidency), and the Luanda Medical Center. Numerous small private clinics are also available. Professional and upper class Angolans typically travel to Namibia, South Africa, Cuba, Spain and Portugal for more complex medical treatments. However, such international health travel has become more difficult due to increased costs with the local currency devaluation and severe restrictions on foreign exchange.

The lack of sufficient pharmaceuticals and medical supplies in the Angolan market due to government budget challenges and foreign exchange delays is significant and is negatively impacting patient health. As the Angolan budget recovers, most likely linked to the global oil market, there will be a need for restocking medical supplies both by the private and public healthcare sectors.

Market Entry

Angola offers medium-term business opportunities for US companies focused in top prospect sectors. Given its challenging business environment, and consistent attention needed to develop market presence, companies should consider the necessary time and financial commitments required to succeed in Angola. The long-established presence by Portuguese companies in Angola provide opportunities for collaboration, and also pose stiff competition for new market entrants. A strong Angolan business partner knowledgeable about local business procedures and established in the target industry with financial strength and established clients is essential to business success. Companies should perform thorough due diligence on potential business partners and establish contractual arrangements conformant to US and Angolan law.

The US Commercial Service Angola offers services to assist US companies in understanding market opportunities, qualifying potential business partners, and conducting necessary due diligence. Referrals to Angolan business service providers such as law firms are also available.

Current Market Trends

The major health concerns in Angola include malaria, typhoid, tuberculosis, infectious and parasitic diseases, respiratory and diarrheal diseases, cholera, rabies, measles, sickle cell anemia, and chronic non-communicable diseases. Angola has a relatively low HIV prevalence of 2 percent. During the 2015/16 summer, two simultaneous epidemics of malaria and yellow fever erupted in Angola. These crises were effectively combated by a massive vaccination campaign against yellow fever led by the World Health Organization (WHO) and assisted by the U.S. government and other bilateral donors, as well as private contributors and an emergency anti-malarial medications procurement led by the U.S. government, Presidential Malaria Initiative (PMI).

U.S. government foreign assistance in Angola supports the Ministry of Health in overall disease surveillance, HIV, malaria, family planning, as well as commodities procurement, tracking and distribution. The President’s Emergency Plan for AIDS Relief (PEPFAR) provides key technical assistance at the National and Provincial Ministries of Health and to nine health facilities in Luanda in order to improve the quality and coverage of HIV testing and treatment services and support high quality programming for key populations and the military. The President’s Malaria Initiative (PMI) works to reduce malaria-related mortality through education, the provision of bed nets, and the distribution of malaria treatments. In 2016, PMI signed a Memorandum of Understanding with the Ministry of Health setting forth an accountability framework for its programs. With USAID’s technical assistance, the Ministry of Health is developing a monitoring and evaluation plan for the Angolan PNDS (2012 – 2025) and a National Health Accounts (NHA) exercise to better understand the flow of resources for health in Angola.

With the appointment of a new Minister of Health Dr. Luis Gomes Sambo, in March 2016, major reform efforts are underway at that Ministry to increase accountability, contain costs, establish a transparent procurement and distribution system for pharmaceuticals and medical suppliers, promote improved quality of pharmaceuticals, and improve services.

Angola’s National Development Plan for 2013-2017 (PND) and National Health Strategic Plan for 2012-2025 (PNDS) outline the government’s priorities. These include: rehabilitating and expanding public healthcare infrastructure and capacity, especially for rural and underserved urban populations; expanding healthcare professional training; and disease prevention. The PNDS projected that about $5.2 billion would be invested in the public system per year for the period 2013 to 2025. However, given budget levels at $2 billion for 2015 and 2016, these targets will be difficult to attain.

The healthcare budget for 2017 is $1.87 billion, 4.3 percent of the Angolan federal budget, a comparable level to 2016. According to the World Health Organization (2014), the annual per capita health expenditures in Angola is $420 per year, 57 percent funded by the public sector. Private health spending is from individuals, employers and private insurance.

Angola’s health indicators rank very low globally. Life expectancy at birth is 61.7 years. Child and maternal mortality rates remain high, with the under-five mortality reaching 157 per 1,000 live births, and maternal mortality rate is at 477 per 100,000 live births (UNICEF 2015). Only 51 percent of child deliveries in Angola take place in health facilities. A high fertility rate of 6.3 births per woman places additional pressure on the health system.

Angola has approximately 0.1 hospital beds per 1,000 people, a total of 3,700 doctors (or about 0.08 doctors per 1,000 inhabitants), 34,300 nurses (0.01 midwives per 1,000 inhabitants), and 6,400 diagnostic and therapeutic technicians (WHO 2013). Cuba has supplied around one-half of the doctors who work throughout Angola’s 18 provinces, but with the reduction in national foreign exchange income, anecdotal evidence indicates that a significant number of these doctors are now leaving Angola. Other expatriate healthcare professionals are mostly from Brazil and Portugal. Angolan universities graduate close to 200 new medical doctors per year. The government plans to expand this rate to 1,000 physicians per year by 2020.

Main Competitors

Pharmaceuticals

Increasing local manufacturing of basic primary pharmaceuticals is a government priority as articulated in Presidential Decree 180/10 which established the country’s National Pharmaceutical Policy. The Ministry of Health reports that pharmaceutical purchases, primarily imports, total over $60 million per year. Leading suppliers of pharmaceutical imports into Angola are China, India, and Portugal. According to the Angolan Pharmaceutical Society, there are over 221 importers and distributors of pharmaceuticals and medical devices. Local production is limited to Nova Angomédica, a joint venture between the Angolan Ministry of Health and private company Suninvest. Nova Angomédica produces anti-anemic, analgesic, antimalarial, anti-inflammatories, anti-tuberculosis, anti-allergic (in pill and syrup forms), as well as saline solution and ointments.

Pharmaceuticals are distributed through pharmacies, public hospitals, and private clinics. The quality of products, prices, and service vary according to location. Small pharmacies in the outskirts of major cities tend to sell unregulated, lower cost pharmaceuticals, often from India and China. Higher quality and fully registered pharmaceuticals are more common in urban centers. Pharmacies in public hospitals generally provide generic pharmaceuticals, while private pharmacies generally carry branded pharmaceuticals.

Counterfeit pharmaceuticals are a concern in Angola. The National Institute for Consumer Protection (INADEC) with the Ministry of Health’s National Direction for Medicines and Equipment (DNME), are responsible for enforcing registration requirements and keeping non-conforming pharmaceuticals and counterfeit products out of the market.

Medical Equipment

Angola relies primarily on imported medical equipment, devices, supplies and consumables to meet local demand. Medical solutions and equipment are distributed to hospitals, clinics, medical centers and practitioners through a small network of local importers and distributors. There is nominal local manufacturing of medical supplies and consumables in Angola.

U.S. medical solutions, equipment, instruments, devices, consumables, supplies and furniture brands are well-known and valued by practitioners in Angola due to their reliability and high quality. Some U.S. manufacturers already selling in Angola through a regional office in neighboring countries or through Angolan importers and distributors include Welch Allyn, Hill-Rom, Accu-Scope, Abbott, Baxter, Johnson & Johnson, Beckman Coultier, Thermo Fisher Scientific, and OPTI Medical Systems.

Current Demand

Opportunities Angola’s public healthcare sector holds potential for U.S. companies given the government’s priority on expanding public healthcare infrastructure and providing efficient primary healthcare delivery. Private healthcare will continue to grow as a portion of the overall health services network in Angola to meet demand for quality healthcare by the middle and upper classes, many of whom currently rely on healthcare treatments outside of Angola.

In the retail area, Angola has been experiencing an upswing in the establishment of comprehensive, well-stocked pharmacies offering prescription and over-the-counter medicines, personal hygiene, self-improvement health products, smoking cessation, first aid supplies, basic outpatient immunization and diagnosis services. Leading pharmacies in Angola include: Mecofarma, Moniz Silva, Novassol, Central, and Mediang. Once the economic recovery sets in, these pharmacies should become promising clients for U.S. suppliers.

Medical equipment including instruments, diagnostic and imaging are also needed in the market.

Cardiology

Almost 10 percent of the population suffers from cardiovascular diseases, with a concentration in the most heavily populated provinces of Luanda, Benguela and Huila. Many of these patients have high blood pressure or physical limitations. Several specialized cardiology centers are equipped for diagnostic capability as outpatients care; however, very few have the infrastructure or equipment for interventions and surgeries. Angola currently offers limited opportunities for sales of cardiology devices and equipment, but this should expand in the future as diagnosis and treatment capacity improves.

Child and maternal care

Angola lacks primary and specialized care for children and women, contributing to high rates of child and maternal mortality. Opportunities exist for medical devices and pharmaceutical products to enhance care for children and women. There is a high fertility rate of 6.3 children per woman, but only 57 percent of births are assisted by healthcare professionals and 51 percent are in healthcare facilities (UNICEF 2015).

Healthcare Infrastructure

With economic recovery, opportunities should open for design, construction, and equipping of public health facilities to expand capacity in Luanda and other provinces where healthcare services are limited. Luanda General Hospital (Hospital Geral de Luanda) opened in 2015 expanding public health care services in Luanda beyond the Josina Machel General Hospital, Américo Boa Vida Hospital and in David Bernardino Pediatric Hospital.

Telemedicine

Several healthcare facilities are utilizing telemedicine to extend health care service to rural areas and lower income urban populations, groups who typically depend on traditional medicine. However, these services are challenged by limited internet access among poorer populations and inconsistent internet connectivity outside of major population areas, as well as by government budget shortfalls. Examples of telemedicine solutions in Angola include: Girassol Clinic’s five-year contract with Portuguese company PT Inovação e Sistemas to provide medical care and remote specialty consultations, as well as training for the health care professionals throughout the country; Pediatric Hospital David Bernardino in Luanda partners with PT Inovacao e Sistemas telemedicine system to access international medical expertise to diagnose and treat children with heart problems; Nossa Senhora da Paz Hospital in Benguela Province accesses expertise and training on infectious diseases using telemedicine with the Vall d´Hebron Institute of Research in Spain; and, the Luanda Medical Center deploys patient monitoring technologies from Israeli company Shahal Medical Services Ltd.

Oncology

The Angolan Institute for Cancer Control (IACC) was created 2014 to enhance oncology care in the public sector, as well as to oversee policy implementation, programs and prevention plans. The IACC offers specialized cancer treatments in clinical oncology, general surgical oncology, radiotherapy and pathological anatomy and is seeking innovative techniques in the diagnosis and treatment of cancer.

Neurosurgery

A neurosurgery and hydrocephaly treatment center established in Luanda by the Lwini Foundation provides treatment for underserved disabled populations especially women and children. The neurosurgery and hydrocephaly treatment center focuses on corrective surgery for children suffering from spinal bifida and hydrocephaly.

Registration Process

The Ministry of Health, under the Health Inspection Office (IGS) is responsible for monitoring the quality of imported pharmaceuticals and medical equipment, and ensuring that medical devices imported into the country meet WHO norms and Angolan regulations. The Ministry’s National Directorate for Pharmaceuticals and Equipment (DNME) is the regulatory body responsible for establishing the criteria for pharmaceuticals and medical equipment entry into Angola. The Angolan Society of Pharmacists (OFA) conducts consumer education on pharmaceutical quality and consumer behavior.

The Ministry of Health DNME has authorized 219 importers and distributors of pharmaceuticals and medical devices. To import into Angola, pharmaceutical products must be registered with the Ministry of Health, submitted for laboratory tests to meet compliance to norms and standards, and be labelled in Portuguese. There are 14 private DNME certified pharmaceutical laboratories in Angola: AstraZeneca, Bayer Health Care, Bial, BluePharma, Dafra Farma, Edol, GSK, Labesfal, Laboratórios Azevedos, Merck Serono, Sandoz, Sanofi, Shalina and Tecnifar. Health authorities are also planning to develop a public pharmaceutical laboratory that will have the capacity to analyze the quality of pharmaceutical products before entering Angola.

To import medical devices into Angola, the registered importer must present a Certificate of Origin, a Certificate of Free of Sale, and a certificate proving compliance with ISO 9001 quality norms to the Ministry of Health, which is responsible for processing the required import license.

Barriers

In September 2015, Angola concluded its second WTO review that covered a wide range of trade policies and practices that will be the basis of future WTO compliance efforts. Details at:

https://www.wto.org/english/tratop_e/tpr_e/tp421_e.htm

The US Trade Representative’s Annual Foreign Trade Barriers Report for 2015 highlighted Angola’s increased tariff rates, cumbersome customs process, and lack of transparency in government procurement, weak intellectual property right enforcement, and complex investment climate as challenges to trade in the country. Details at:

https://ustr.gov/sites/default/files/2015%20NTE%20Combined.pdf

Testing Requirements: Imports of pharmaceutical products are subject to testing during customs clearance, and after customs clearance are subject to additional oversight by the Ministries of Commerce and Health

Procurement & Tenders

Most imports of pharmaceuticals and medical equipment are managed by the Angolan private sector. Private health institutions purchase directly from overseas suppliers or through their designated local distributors. CECOMA and parastatal Angopharma are the Ministry of Health’s official procurement agencies. The public sector depends on the central government medical procurement center (CECOMA) which centralizes all orders and manages stocks for all public health institutions nationwide. Payment is based on the budget allocated to each healthcare facility. Hospital Josina Machel in Luanda receives the largest budget though even it is inadequate to meet the significant patient demand.

To increase efficiencies and manage costs, beginning in 2016, CECOMA began to use the UN Development Program for procurement of pharmaceuticals, assuming primarily a distribution and logistics role. The Angolan government procurement of pharmaceuticals for treatment of malaria and tuberculosis are funded 50 percent by the Angolan government, with 25 percent from The Global Fund, and 25 percent from the U.S. government; HIV related commodities are funded 60 percent by the Angolan government and 40 percent by The Global Fund.

Severe delays in access to foreign exchange combined with the limited public sector healthcare budget is impeding some Angolan importers and distributors from introducing new product lines and stocking product inventory.

Trade Events

Médica Hospitalar: www.medicahospitalarangola.com

Angola Medical Expo: www.angolamedicalexpo.com

Congressos da Clinica Girassol: www.girassol.co.ao

Clínica Multiperfil: www.multiperfileventos.com/pt

Local Associations

Ordem dos Médicos de Angola: www.ordemdosmedicosdeangola.org

Ordem dos Farmacêuticos de Angola: www.ordemfarmaceuticosangola.org

Associação dos Farmacêuticos de Língua Portuguesa: http://www.afplp.org

Ordem dos Enfermeiros de Angola: www.ordenfa.amawebs.com

Associação das Doenças Cardio-Vasculares deAngola:

www.facebook.com/congressoangolanodecardiologia

Government Links

Ministry of Health – National Health Plan 2012-2025

www.minsa.gov.ao/VerPublicacao.aspx?id=1266

www.saudeangola.gv.ao

National Directorate for Medicne and Equipment (Direcção Nacional dos Medicamentos e Equipamentos – DNME): http://dnme.co.ao

INE: www.ine.gov.ao

CENSO: http://censo.ine.gov.ao

Jornal da Saúde: www.jornaldasaude.org

Best Prospects

  • Medical equipment (diagnostic and imaging)
  • Instruments
  • Consumables
  • Pharmaceuticals
  • Training and management services and technology
  • Hospital and clinic design and construction
  • Distance medicine services and technologies

Statistics Snapshot

Demographics

Population

28.81 million

Life expectancy men/women

53

Infant mortality

157 per 1000 live births

U.S. Commercial Service Contact Information

Clemência Nogueira

Commercial Specialist

U.S. Commercial Service Angola

Clemencia.Nogueira@trade.gov

(+244) 222 641 076 | (+244) 932 572 822


  Notice to Visitors!


  The link you have chosen will take you to a non-U.S. Government website.

  If the page does not appear in 5 seconds, please click this: outside web site

  Export.gov is managed by the International Trade Administration and external links are covered by its website  disclaimer statement.


  Notice to Visitors!


  The link you have chosen will take you to a non-U.S. Government website.

  If the page does not appear in 5 seconds, please click this: outside web site

  BuyUSA.gov is managed by the International Trade Administration and external links are covered by its website disclaimer statement.