A hospital with a capacity of more than 100 beds is to be built on Anjouan, following the signing of a bilateral agreement with China. The Chinese government will fund the construction of the Cfr2bn (US$5.6m) facility-the latest in a series of pledges by international governments. In 2006, for example, France announced plans to build a hospital on Anjouan, largely in order to stem the flow of medical evacuations from Comoros to Mayotte, the fourth island in the archipelago, which is a French overseas territory. However this plan was subsequently abandoned in favour of renovating an existing medical centre at Mutsamudu, the capital of Anjouan. Similarly, Arab states have expressed interest in the reconstruction of more than 40 health facilities, including three hospitals. However, there have been few signs of progress thus far (December 2010, The domestic economy).

Although construction of the facility will be welcome, if it indeed proceeds, it will not tackle the systemic problems in healthcare. There are 22 beds but just two physicians per 10,000 people, according to the UN Development Programme's 2010 Human Development Report (December 2010, Foreign trade and payments). It remains to be seen, therefore, just who is going to staff any new facility-and how well they will be paid. In 2007 medical staff at the El Maarouf hospital in Moroni-the country's main facility-went on strike in protest at the lack of equipment (including oxygen and water, as well as gloves and film for X-rays) and pay arrears. Issues such as this will need to be tackled if the country's healthcare indicators are to improve.