Current Market Trends
Procurement and Tenders
Population: 1.9 million
GDP: $1.45 billion
Currency: Dalasi (GMD)
Language: English (Official); Wolof and Mandinka (Local)
The Gambia is a low-income country with limited access to health services. The prevalence of communicable diseases like tuberculosis (TB) and malaria have lessened in recent years, as The Gambia nears nationwide malaria elimination. HIV/AIDS affects less than 2% of the Gambian population. The prevalence of maternal and child mortality cases are on the decline, while diabetes and high blood pressure are on the rise. The Government of The Gambia (GOTG) is also contending with increasing fertility rates, which has added more pressure on the already meager health resources. The health sector is experiencing a shortage of healthcare professionals and facilities throughout the country, and particularly in rural areas.
The Ministry of Health and Social Welfare (MOHSW) is responsible for overall policy formulation, planning, organization, and coordination of the health sector at the national, regional, district, and community levels. It seeks to improve the healthcare services sector under the framework of the National Health Policy (2012-2020), the National Health Strategic Plan (2014-2020), and the National Development Plan (NDP) (2018-2021). In 2016, GOTG spending on healthcare rose to 10.56% of its annual budget, which is still below the 15% Abuja Declaration target. The GOTG is also promoting Public Private Partnerships, including in the health service sector.
The NDP activities and programs to improve access to quality basic health services are:
According to the Health Minister, healthcare constitutes 40% of projects under the NDP. The GOTG seeks more investment in the healthcare sector, on a scale that the Minister of Health describes as a “Marshall Plan” for the health sector. The GOTG’s goal is achieve a complete overhaul of the entire healthcare system by equipping all health facilities with adequate manpower and resources.
The health sector is open to foreign investors and is a subsector among the priority sectors identified in the 2015 Gambia Investment and Export Promotion Agency (GIEPA) Act. Healthcare investors are therefore eligible for Special Investment Certificates which offer investors access to tax holidays. The GIEPA is the government agency responsible for the promotion and facilitation of private sector investments in The Gambia. GIEPA services include helping market entrants identify joint venture partners. Prospective investors should also consult with the Gambia Public Procurement Agency, the Gambia Consumer Competition and Protection Commission, and the Gambia Standards Bureau. These agencies are mandated by government acts to regulate health service providers. The 2015 GIEPA Act places no restrictions on the entry of health-related FDI.
The Gambia’s public health service delivery system has three tiers: Tertiary Health Care (Hospitals); Basic Health Services; and Village Health Services (VHS). The Gambia has three hospitals, 36 health facilities at the secondary level, and 492 health posts at the primary level, of which approximately 23 are private clinics. The share of GDP spent on healthcare facilities has been steadily increasing over the years. In June 2017, a private sector-led effort to construct a $27 million tertiary care health facility in Kololi was launched by President Barrow. The project has already received $16.4 million in financing from the African Development Bank (AfDB) and the Islamic Development Bank (IDB) and is sourcing the balance in financing from private investors and philanthropic contributions. Baylor College of Medical Horizons in the United States is also a partner to this project, which is being built in a designed Tourism Development Area and will seek to promote the country as a medical tourism destination.
The GOTG is open to Public Private Partnerships to revamp the healthcare sector; however, the National Development Plan also seeks to engage development partners and agencies in project financing for the NDP. The NDP and main healthcare sector goals are focused on improving the quality of pharmaceuticals, providing training to medical professionals and technical staff, and importing medical supplies and equipment.
A major percentage of healthcare equipment and supplies are imported from the United States and Asia – particularly China and India. More advanced medical treatment and access to more specialists is available to Gambian patients through neighboring Senegal.
There is a healthy demand for healthcare services in The Gambia. The Health Minister has indicated 40% of the activities proposed in the NDP is dedicated to healthcare. Sector needs include the acquisition of medical equipment and supplies; however, financing remains a major challenge. According to the National Health Strategic Plan, the standard bed capacity for major health centers ranges from 110-150 beds per 150,000 - 200,000 population; and between 20–40 beds per 15,000 population at minor health facilities.
A U.S. firm wishing to establish a branch office in The Gambia must register to do business in-country under the Single Window Business Registration Office where prospective firms can pay their incorporation fees and:
There are good market prospects for prospective health sector investors considering the large market gaps that exist. The GOTG is interested in providing nationwide access to medical equipment, supplies, and personnel in its ambition to make The Gambia a regional center of excellence in healthcare. The tax holidays accessible to healthcare investors through the 2015 GIEPA Act, are active for a period of eight years and cover exemptions for the importation of heavy machines and medical equipment. There are no restrictions on foreign investors converting or repatriating funds out of The Gambia.
A weak regulatory environment and poor access to credit are the main barriers to market entry in the Gambian healthcare sector. Additional factors are periodic exchange rate fluctuations; lack of access to a skilled workforce, expertise, and specialists; poor infrastructure in areas, such as electricity, communication networks, and roads; bureaucratic procedures; high transportation and transactional costs and lack of transparency in the public procurement system.
Procurement & Tenders
Most of the tenders and procurements are advertised in local newspapers and online. The main newspapers are:
Ministry of Health and Social Welfare [www.moh.gov.gm]
The Gambia Public Procurement Agency [www.gppa.gm]
U.S. firms interested in entering the Gambian market are advised to visit the Gambia Import and Export Promotion Agency and the Ministry of Health and Social Welfare.
U.S. firms seeking to engage in healthcare related activities in The Gambia are advised to visit The Gambia Chamber of Commerce and Industry (http://www.gcci.gm) and Ministry of Health and Social Welfare (www.moh.gov.gm) for requirements with regard to healthcare investments.
U.S. Commercial Service Contact Information
Name: Kebba Omar Jagne
Position: Economic/Commercial Specialist
Phone: +220 438 1325
Healthcare spending (including investment)
11.2% (2012 percentage of total government expenditure)
... as percent of GDP
Hospitals, Procedures, Healthcare Professionals UN:
Number of hospitals
... available beds per capita
11 (per 10,000)
0.11 physicians/1,000 population (2015)
2,051,363 (July 2017 est.)
Life expectancy men/women
Total: 65.1 years (2017 est.)
male: 62.8 years
female: 67.5 years
60.2 deaths/1,000 live births (2017 est.)
Percent of population older than 60
7 deaths/1,000 population (2017 est.)
...caused by Lower Respiratory Infections
9.55% of total deaths (2016)
...caused by Ischemic Heart Disease
7.5% of total deaths (2016)
Sources: UN Data; World Health Organization; CIA Factbook
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