Prevalence and Trends of Infertility in the Gambia: Public Health Perspectives

Pharmaceutical infertility represents a significant but under recognized public health challenge in many parts of sub-Saharan Africa. Despite being classified by the World Health Organization (WHO) as a disease, infertility and its associated treatments receive limited attention within national health policies and insurance frameworks. The psychological burden of infertility—including emotional distress, anxiety, depression, social stigma, and diminished self-esteem—remains largely overlooked, particularly in low- and middle-income settings. Most national and private health insurance schemes explicitly exclude infertility care, forcing affected couples to bear the financial burden through out-of-pocket payments. This exclusion exacerbates health inequities and restricts access to essential pharmaceutical and assisted reproductive services. Addressing pharmaceutical infertility requires policy reforms that recognize infertility as a priority health condition and integrate its prevention, diagnosis, and treatment into universal health coverage. Strengthening awareness, advocacy, and equitable financing mechanisms is essential to reduce the psychosocial and economic impact of infertility across sub-Saharan Africa.