Foreign nationals from neighbouring countries living in Rwanda have requested to be enrolled on the universal healthcare scheme, Mutuelle de Sante, but the Ministry of Health says the request may only be considered on agreement with Member States of the EAC.While paying a courtesy call to President Paul Kagame last week, the Ugandan community living in Rwanda requested to be enrolled on the nationally subsidised scheme. Currently, there are about 4,000 Ugandan nationals living and working in Rwanda, some of them married to Rwandan nationals and have requested to have equal benefits like their partners.However, according to the Director of Health Financing Unit in the Ministry of Health, Andrew Makaka, there are a number of financially related constraints that range from the very heavy subsidies that government puts on the scheme.Subscribers to Mutuelle are over 90 per cent of the population and they only pay 10 per cent of their medical bills. "For foreigners married to Rwandan nationals, it is simple for them to get access to Mutuelle de Sante; they just have to legalise their stay in Rwanda by applying for residence permits or nationality,” said Makaka.Annually, the health scheme has a budget of $40 million which mainly comes from contributions from beneficiaries, capped by an additional funding of $5.6 million from the government and a ‘smaller percentage’ from development partners.One of the reasons why Mutuelle de Santé funding is currently considered difficult is because the Global Fund recently reduced its HIV funding to Rwanda by 30 per cent, from US$ 128million to US$ 86million, and now Rwanda is required to fill the gap. "This leaves us on a shaky ground since we have to squeeze all our budgets to cover the 30%per cent. This is where we are putting much attention.However, there is good news for foreigners; we are planning a regional conference by Ministers of Health that will particularly look at a way of formulating a regional social protection scheme,” said Makaka.He added that if all goes according to plan, EAC member states could set up a fund that would pay for anyone who acquires treatment outside his or her country but within the bloc.The Global Fund reduced its funding to Rwanda on grounds that many of the world’s largest economies were not fulfilling their financial commitments to the fund. Their politicians cite budget constraints and the need to prioritise domestic programs over fighting diseases that disproportionately kill the world’s poorest.Meanwhile, in her recent publication, the Minister of Health, Dr Agnes Binagwaho, noted that, "while much has been accomplished, much more remains to be done – and the Global Fund needs at least $2 billion to reverse a funding freeze that is in place through 2014. So the world now plays a waiting game to see whether governments will step up and fill the gap.’