Most of the health services of Gabon are public, but there are some private institutions, of which the best known is the hospital established in 1913 in Lambaréné by Albert Schweitzer. Gabon’s medical infrastructure is considered one of the best in West Africa. By 1985 there were 28 hospitals, 87 medical centers, and 312 infirmaries and dispensaries. As of 2004, there were an estimated 29 physicians per 100,000 people. Approximately 90% of the population had access to health care services. In 2000, 70% of the population had access to safe drinking water and 21% had adequate sanitation. A comprehensive government health program treats such diseases as leprosy, sleeping sickness, malaria, filariasis, intestinal worms, and tuberculosis. Rates for immunization of children under the age of one were 97% for tuberculosis and 65% for polio. Immunization rates for DPT and measles were 37% and 56% respectively. Gabon has a domestic supply of pharmaceuticals from a large, modern factory in Libreville. The total fertility rate has decreased from 5.8 in 1960 to 4.2 children per mother during childbearing years in 2000. Ten percent of all births were low birth weight. The maternal mortality rate was 520 per 100,000 live births as of 1998. In 2005, the infant mortality rate was 55.35 per 1,000 live births and life expectancy was 55.02 years. As of 2002, the overall mortality rate was estimated at 17.6 per 1,000 inhabitants. The HIV/AIDS prevalence was 8.10 per 100 adults in 2003. As of 2004, there were approximately 48,000 people living with HIV/AIDS in the country. There were an estimated 3,000 deaths from AIDS in 2003.
Education is compulsory for children ages 6 to 16 years under the Education Act, but prohibitive costs for items such as books, uniforms, and school supplies prevent many from attending school. The government has used oil revenue for school construction, paying teachers’ salaries, and promoting education, including in rural areas. However, maintenance of school structures, as well as teachers’ salaries, has been declining. In 2002 the gross primary enrollment rate was 132 percent, and in 2000 the net primary enrollment rate was 78 percent. Gross and net enrollment ratios are based on the number of students formally registered in primary school and therefore do not necessarily reflect actual school attendance. As of 2001, 69 percent of children who started primary school were likely to reach grade 5. Problems in the education system include poor management and planning, lack of oversight, a shortage of teaching material, poorly qualified teachers, overcrowded classrooms, and a curriculum that is not always relevant to students' needs.