Guinea has been reorganizing its health system since the Bamako Initiative of 1987 formally promoted community-based methods of increasing accessibility of drugs and health care services to the population, in part by implementing user fees.[2] The new strategy dramatically increased accessibility through community-based healthcare, resulting in more efficient and equitable provision of services. A comprehensive strategy was extended to all areas of health care, with subsequent improvement in health indicators and improvement in health care efficiency and cost.[3]