In the context of the introduction of mandatory health insurance in Gabon, the government was concerned about social coverage for its economically disadvantaged citizens. It was not politically or socially acceptable to establish health coverage that would exclude a large segment of the population. This raised the issue of the financing of their benefits. An innovative form of financing was thus found - specifically, an indirect earmarked tax referred to as the "mandatory health insurance fee". This tax is based currently on the turnover of mobile phone operators (10%) and on funds transfers abroad (outside the Economic and Monetary Community of Central Africa, CEMAC) (1.5%).

To date, 478,945 main insured persons and other entitled individuals are covered, representing 68.42% of the target population. The country's highest authorities decided to conduct a new enrolment campaign within this population category in order to cover the maximum number of people. Complementary sources of financing were also to be sought to meet increased costs.