One of Africa’s most stable and democratic countries, the Democratic Republic of Sao Tome and Principe is located in the Gulf of Guinea, off the western equatorial coast of Central Africa. The people of this island country are predominantly Christian with a Catholic majority. The population is young, with 61 percent of Sao Tome and Principe’s 213,948 people under the age of 25. About 98 percent of residents of Sao Tome and Principe speak Portuguese, the official and de facto national language. With a population comprising descendants of immigrant Europeans and African slaves, Sao Tome and Principe has Mesticos, Angolares, Forros, Servicias, Tongas, Europeans, and Asians as its major ethnic groups.

Sao Tome and Principe gained independence in 1975. The country has a relatively small economy and is dependent on the export of cocoa beans, which in recent times has substantially declined due to drought and mismanagement. The country is import-dependent, with real GDP growth of 3.9 percent, dropping from 4.2 percent in 2016. Per capita GDP is $2,157. The country has considerable potential for developing tourism and petroleum resources, but these are yet to be explored. Close to 66 percent of the Sao Tomean population live below the poverty line. Despite this fact, 97 percent of the population has access to clean drinking water.

The population of Sao Tome and Principe face many challenges as a result of high poverty rates, including challenges in health. Non-communicable and communicable diseases such as ischemic heart disease, lower respiratory infections, stroke, chronic kidney disease, cirrhosis, COPD, neonatal disorders, asthma, road injuries, tuberculosis, malaria, and diarrheal diseases are the cause of most deaths in Sao Tome and Principe. While some communicable diseases have decreased on average, particularly malaria and diarrheal diseases, they continue to be significant contributors to deaths in the country.

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