Brice NDA

15% on the front, health in apnea: the Gabonese budget on life support In the background Gabon has never met its Abuja commitment to allocate 15% of the national budget to health, revealing a gap between political ambitions and reality on the ground In 2025, health only represents 7.8% of the national budget, insufficient to meet essential needs and ensure equitable health coverage Maternal mortality reaches 399 deaths per 100,000 live births, highlighting the paradox between investments and health outcomes Only 21.62 billion FCFA, or 15% of the health budget, is dedicated to prevention, a modest amount in the face of structural and social challenges The majority of public spending is absorbed by administration, leaving hospitals under-equipped and vulnerable populations to bear their own budget Universal health coverage has not reduced out-of-pocket payments, and many women still have to pay upfront for access to care Social determinants such as high female unemployment, food insecurity, and domestic violence increase risks for maternal health and deepen inequalities “To date, the overall resources allocated to health in Gabon have not contributed to improving health outcomes” - Brice Wilfried Obiang Obounou, Financing the health system and maternal mortality in Gabon. These words strike with their sobriety and lucidity. They summarize twenty years of thwarted efforts, growing budgets, and still fragile indicators. Gabon, a pioneer in Central Africa for universal health coverage, has never kept its Abuja commitment. 15% of the national budget was to be dedicated to health, but the country currently caps at 7.8% according to the finance law. Behind this figure lies a heartbreaking contradiction. Life expectancy is increasing, infrastructure is modernizing, yet mothers continue to die in rural maternity wards as well as in urban hospitals. The work of Brice Wilfried Obiang Obounou sheds light on this fracture between ambition and reality, between symbolic and tangible, revealing the human cost of ineffective funding. The forgotten vow of the African continent In Africa, leaders gathered in Abuja in 2001 to commit to dedicating 15% of their national budgets to health. This pact was to transform the face of public health and offer every citizen effective access to care. A few low-income countries like Rwanda, Malawi, or Gambia have exceeded this commitment, showing that wealth was not a condition for investing in life. But in many resource-rich countries, ambitions have collided with divergent priorities and the complexity of administrations. Sector spending often remains insufficient and oriented towards operations rather than populations. The figures reveal a deep contradiction. The richer a country is in natural resources, the less it seems to invest in the lives of its populations. Central Africa between ambitions and realities Central Africa wanted to believe in universal health coverage and its promises. Institutions multiplied, plans and programs accumulated, but implementation faces structural and financial limits. Administrative expenses absorb most of the budgets, and prevention as well as primary care remain insufficient. Gabon was long perceived as a regional model thanks to the creation of the CNAMGS (National Health Insurance and Social Guarantee Fund) in 2008. This system was supposed to provide equitable access to care. In practice, it faces payment delays, exclusion of the private sector, and bureaucratic complexity. Vulnerable populations continue to pay for their care, sometimes at the cost of debts or sacrifices. Gabon and the paradox of unfinished progress The 2025 health budget of Gabon represents 7.8% of the national budget, a figure that reflects a gap between ambitions and means. The majority of funds are absorbed by administration and fixed costs, leaving hospitals and maternity wards under-equipped and vulnerable populations to bear their own budget. Despite visible progress in life expectancy and infant mortality, maternal mortality reaches 399 deaths per 100,000 live births, signaling a crisis that is not resolved by increasing the budget or modernizing infrastructure. Each death tells a story. A woman giving birth alone in a clinic, another who must buy her medications, a third who travels through several villages to reach a hospital. These lost lives reveal the gap between spending and real impact. When health becomes a luxury Universal health coverage has not eliminated direct payments. In private clinics, 60% of women insured by CNAMGS still pay upfront costs. The poorest, often in rural areas, face endless queues and drug shortages. This social and geographical fracture creates a two-tier system. The wealthy access care quickly and efficiently, while others forgo it or experience delays with often fatal consequences. High female unemployment, food insecurity, and domestic violence exacerbate this situation. Women from low-income households hesitate to use health services for fear of costs or delays. These social determinants directly increase maternal mortality and fuel inequalities. Prevention, a still fragile link Prevention accounts for only 21.62 billion FCFA, or 15% of the health budget in 2025. This funding remains insufficient given the structural and social needs weighing on the population. Vaccinations, prenatal care, screenings, and nutritional programs are essential to reduce maternal and infant mortality. Every franc invested in prevention could save several lives and reduce costs related to avoidable complications. The priority given to curative care at the expense of prevention weakens the system and deepens disparities between urban and rural populations. Relearning to invest in life It is no longer just about how much the country spends, but how it spends. The budget must be redirected towards prevention, equitable access to care, and reducing social inequalities. Health must become a pillar of the social contract again and not a variable of budgetary adjustment. The 15% of Abuja was not a statistic but a human commitment. Failing to reach it means accepting that health remains a matter of privilege and that the lives of thousands of mothers continue to be suspended by the slowness of budgets. Gabon can still transform its trajectory, but this requires a clear vision, real commitment, and effective allocation of resources so that the numbers finally translate into saved lives and restored dignity.

Key Insights The main obstacle is not money, but knowledge: Contrary to popular belief, the number one barrier to real estate investment is not a lack of capital, but a lack of skills to navigate a complex market. Africa, a testing ground for alternative financing: Faced with limited access to bank credit due to the weight of the informal sector, community financing mechanisms such as “tontines” have evolved. Now digitized, they are inspiring a new generation of PropTech solutions. Syndication democratizes access: Models such as real estate syndication, which are highly structured in the United States, now allow groups of investors to join forces to acquire large-scale properties (office buildings, residential projects), making high-impact investment accessible to a wider audience. Passive investment is key: For many investors, the greatest value of these new models is the ability to invest without having to manage day-to-day operations. This marks the emergence of a new class of accessible and diversified real estate assets. How to invest in real estate without breaking the bank (and without losing sleep) Investing in real estate has always been a symbol of solid wealth, a reliable refuge in an uncertain world. Yet for millions of people around the world, this dream seems out of reach. We often think that the main obstacle is financial. “I don't have enough money,” people say. But the reality is more subtle. The real barrier is not capital, it is complexity. Today, as markets become increasingly volatile, a question arises: how can we democratize access to real estate investment? When constraints drive innovation In sub-Saharan Africa, where nearly 70% of jobs are in the informal sector, accessing traditional real estate credit is an uphill battle. Far from being a hindrance, this constraint has forced the emergence of ingenious alternative solutions. The best known is the tontine, a community-based revolving savings system that allows projects to be financed without going through the banking system. Something that used to be an old-school thing now has a 2.0 version. Mobile apps in Senegal and Ivory Coast are making this process digital, creating “real estate tontines” that let groups of young professionals buy land or apartments together. It's crowdfunding, but with a deep cultural foundation and community trust. From Tontine to Syndication: the emergence of a global model This idea of pooling capital to invest as a group is not unique to Africa. In the United States, it is at the heart of a highly structured model: real estate syndication.. The principle is simple: a "Sponsor" (the professional who leads the project) identifies an opportunity (an office building, a residential complex) and raises funds from a group of "Passive Investors." Together, they form a company to acquire and manage the property. "The main attraction of real estate syndication is to grant the possibility of owning a property that you could not otherwise afford." The advantage for the passive investor is immense. They can diversify their portfolio by holding a share of a high-value asset, without ever having to manage tenants or maintenance. They invest in real estate as they would in the stock market, while benefiting from direct knowledge of the project through regular reports. A new frontier for investors From the digitalization of African tontines to the democratization of real estate syndication, a new fundamental trend is emerging. Real estate investment is no longer reserved for institutional investors or wealthy individuals capable of managing complex projects on their own. These collaborative models and technology are enabling a new generation of investors to access high-potential opportunities, diversify their assets, and participate in large-scale projects, no matter where they are in the world. The real estate investment revolution is on the move, and it is more inclusive and accessible than ever before.