Expat insurance and health insurance in the Democratic Republic of the Congo

The DRC’s healthcare system is run by the Ministry of Public Health, Hygiene and Social Welfare and follows a three-tier pyramid structure, organised around health zones: a primary level of health centres and posts spread across health areas, a secondary level of regional hospitals, and a tertiary level of national reference hospitals. The Cliniques universitaires de Kinshasa (CUK), founded in 1957 by the former Lovanium University (now the University of Kinshasa), sit at the top of this pyramid as the country’s tertiary facility of last resort: 648 beds, about 2,600 outpatient consultations a month and seven surgical specialties. France Diplomatie nonetheless describes very run-down public hospitals, with obsolete equipment and generally out of medicines, rarely providing quality care. French residents therefore turn to the private sector, starting with the Centre médical de Kinshasa (CMK), a private medical-surgical clinic designated by the French embassy as its “reference medical provider”, and its emergency service, the Centre privé d’urgence (CPU), which operates exclusively on a subscription basis and whose membership is strongly recommended to French residents as it markedly eases administrative steps in the event of medical evacuation. Clinique Ngaliema (founded in 1927), Clinique du Dr Lelo (run by a French practitioner) and Centre médical de Monkole, supported by French cooperation, round out the capital’s private care offering. For lack of complete facilities for serious conditions, medical evacuation abroad remains common for severe cases, entirely at the expense of the insurance taken out.

• Mandatory visa before departure for any tourist stay (under 6 months), requested online or from the DRC embassy in Paris; passport valid for at least 6 months after the date of entry. Beyond 6 months, a residence permit must be obtained locally from the migration authority.
• Mandatory yellow fever vaccination, with the international vaccination record checked on every flight on arrival; any traveller without a valid certificate is turned back.
• Vaccinations recommended before departure: hepatitis A and B, typhoid, meningitis ACWY (particularly in the dry season) and rabies (especially for young children). A travel medicine consultation is strongly advised.
• Health risks documented by France Diplomatie: regular re-emergence of the Ebola virus due to persistent animal reservoirs, cases of mpox, cholera and plague depending on the region, and malaria, identified as the leading cause of death by disease in the country.
• No specifically named legal health insurance requirement for entry or stay, but France Diplomatie regards travel insurance covering medical costs and medical evacuation as essential, since these costs can under no circumstances be covered by the French embassy.

Unlike neighbouring Congo-Brazzaville, which has had a general social security agreement with France in force since 1 June 1988 (even though it excludes the health branch), no social security agreement appears between France and the Democratic Republic of the Congo in the list of bilateral social security agreements in force published by CLEISS.

• No coordination of any kind therefore exists between the two schemes: not for healthcare, maternity, disability, old age-survivors’ benefits, work accidents/occupational diseases, or family benefits.
• No reimbursement of care received in the DRC is possible under French health insurance, neither on a permanent nor a temporary basis (unlike Protocol No. 1, which exists with Congo-Brazzaville).
• An employee seconded to the DRC stays attached to the French scheme only under the general secondment rules of French social security, independent of any bilateral agreement specific to the DRC.

In practice, for a French resident in the DRC, only the Caisse des Français de l’Étranger (CFE) or private international health insurance allow for genuine reimbursement of care received locally, as well as cover for medical evacuation.

1. Before departure, regardless of purpose: take out health and repatriation insurance, as no France-DRC agreement exists to provide a fallback.
2. Get vaccinated against yellow fever (mandatory, checked on every flight) and consider the recommended vaccines (hepatitis A/B, typhoid, meningitis ACWY, rabies) at a travel medicine consultation.
3. Apply for the visa online or with the DRC embassy in Paris, with a passport valid for at least 6 months after entry.
4. On arrival in Kinshasa: consider joining the CPU (Centre privé d'urgence, within the CMK), recommended by the French embassy to ease procedures in the event of an emergency or medical evacuation.
5. In the months following your move: register with the roll of French nationals living abroad at the French embassy in Kinshasa, free and recommended.