Mining revenue and access to health care in Africa: could the revenue drawn from well-managed mining sectors finance exemption from payment for health?

Various reforms undertaken during the 1980s significantly reduced the capacity of states to regulate health systems. Of the many policies implemented since then to increase access to health care, policies of exemption from direct payment are among the most important. These can be very effective in a well-funded and managed context. Beyond political will, are African states unable to afford policies of exemption from payment for health care? Our analysis, based mostly but not exclusively on research carried out in West Africa, leads us to suggest the importance of a well-managed extractive sector in Africa as a potential source to finance policies of exemption from payment for health care. This could come about if all actors concerned, whether from the private sector or the donor community, were required to follow the same rules and requirements of transparency and accountability being asked of the countries concerned.