Expat insurance and health insurance in Guinea-Bissau

The Bissau-Guinean health system is among the least equipped in the region according to the sources consulted. France Diplomatie is categorical: "there is no emergency service in Guinea-Bissau suited to a serious accident", and no air ambulance is based in Bissau, the nearest being in Dakar (around 1h30 by air, or a minimum of 12 hours by road for a land evacuation). The INSS (Instituto Nacional de Segurança Social), created in January 2002, in principle manages sickness, maternity, disability, death, unemployment, workplace accident and old-age cover for affiliated workers, but its accessibility for a foreign resident without local employment could not be confirmed on any official source dedicated to expats. The public hospital reference network rests on Simão Mendes National Hospital in Bissau, the country's largest and oldest facility, but specialised guides for expats describe very limited public provision and near-systematic reliance on the capital's few private clinics for everyday care — clinics not subject to consistent quality control according to the same sources. For any serious condition, surgery, obstetric complication or life-threatening emergency, the consistent recommendation from the guides consulted is evacuation to Dakar, Portugal or another country with full medical facilities.

• Mandatory entry visa, in principle applied for at the Guinea-Bissau embassy in Paris before departure. France Diplomatie notes that an emergency visa can be obtained at Bissau airport if the immigration department has been notified in advance, in case of emergency or if the country of departure has no Bissau-Guinean diplomatic representation; fees may then exceed those of the embassy and be required in cash.
• Yellow fever vaccination mandatory, to be done before departure at an approved centre, according to France Diplomatie.
• Declaration of goods and compliance with exchange controls on arrival; for pets, identification, rabies protection and a health certificate less than a week old are required.
• No health insurance is formally required on entry, but a contract covering medical expenses, surgery, hospitalisation and medical repatriation is considered essential by France Diplomatie, as the embassy covers no medical costs locally.
• CFE recommended in addition to private insurance, with a subsidised category available on application for consular assessment for lower-income households.

Heightened health vigilance: cholera is endemic in Guinea-Bissau (transmitted through contaminated water or food, particularly undercooked seafood), malaria circulates year-round, and outbreaks of dengue, chikungunya and zika are possible. Health authorities officially declared an mpox outbreak in summer 2026; France Diplomatie recommends following protective measures and mentions possible vaccination before departure for the most exposed travellers. Vaccinations recommended depending on the case against hepatitis A and B, typhoid fever, ACWY meningitis (dry season, November to June) and tuberculosis for children under 15. The rabies vaccine can be very hard to obtain quickly on site in case of a bite or scratch. Tap water is not safe to drink: only bottled water with a sealed cap, or water made safe by filtration, boiling or disinfection, is recommended.

No social security agreement currently links France and Guinea-Bissau: this country does not appear on CLEISS's list of bilateral agreements in force, unlike several other West African countries (Senegal, Benin, Mali, Togo, Mauritania, Côte d’Ivoire).

• In the absence of an agreement, no coordination exists between the French and Bissau-Guinean social security schemes: neither totalisation of insurance periods nor cross-border coverage of sickness, maternity, old-age or workplace-accident benefits.
• A French resident therefore cannot rely on any agreement mechanism to assert their rights locally; affiliation with the CFE or international health insurance remains the only way to obtain recognised cover for care received in Guinea-Bissau.

• Before departure: apply for a visa at the Guinea-Bissau embassy in Paris, mandatory yellow fever vaccination, insurance or assistance contract covering hospitalisation, surgery and medical repatriation.
• Consult a doctor and/or an international vaccination centre well in advance, and put together a personal medicine kit (medication in its original packaging, with prescription) given the limited local pharmaceutical supply.
• Registration recommended with the roll of French nationals living abroad (French embassy in Bissau).
• Voluntary CFE affiliation recommended in the absence of a social security agreement between France and Guinea-Bissau; subsidised category available on application through the embassy's social services for lower-income households.