Rwanda Chip Somodevilla/Getty Images

La nouvelle école de médecine au cœur de l’Afrique

SAN FRANCISCO – Le Rwanda est parvenu à des progrès dans les domaines de la santé et de la réduction de la pauvreté qui comptent parmi les plus spectaculaires au monde. Ce petit pays enclavé d’Afrique (il fait la taille du Massachusetts mais est deux fois plus peuplé) a mis en place un système de soins de santé qui offre un accès quasi universel aux soins cliniques et à l’assurance santé. Le Rwanda a réduit les inégalités, tant du point de vue économique que des soins de santé, et il apporte la preuve que l’équité en matière de santé aide à construire des sociétés fortes.

Le secret de la réussite rwandaise, c’est que les dirigeants du pays construisent « des institutions modernes à partir des valeurs traditionnelles ». Ils ont mis en place un système de juridictions populaires, de tribunaux collaboratifs, les gacaca, qui a placé le besoin de réconciliation nationale sous l’égide des traditions de clémence de la justice communautaire. Ils ont réinsufflé la vie à la coutume civique de l’umuganda, qui réunit toute la population, y compris le président, un jour par mois, pour débroussailler les champs, nettoyer les rues, bâtir un logis aux plus pauvres.

En 2015, le gouvernement rwandais et des partenaires de santé de Boston, ont fondé, avec l’aide de la fondation Bill et Melinda Gates et de la fondation Cummings, l’Université de l’équité en santé mondiale (University of Global Health Equity, UGHE), établissement privé à but non lucratif. L’établissement part du principe que chaque membre de la communauté mérite les mêmes soins et les mêmes facilités d’accès, et s’efforce de répondre aux besoins de soins de santé des plus démunis. Pour reprendre les termes d’Agnes Binagwaho, confondatrice de l’UGHE, ancienne ministre de la Santé et professeure associée à la faculté de médecine d’Harvard : « Pourquoi élèverais-je mes enfants dans un pays où tous les enfants n’ont pas accès aux mêmes soins médicaux que les miens ? »

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