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The High level task force of health financing includes the World Health Organization and major donors, estimates that it requires at least annually US$ 60 per person for universal health coverage.It represents 1.5% USA health expenditures. But even very low, almost developing countries don't have it. The majority have US$ 40 per person per year. The majority of East Africa Countries (4/5) have to increase public budget by 60% to reach the required health expenditures. One country has to double its public budget for health. It is not realistic considering other public needs including cross cutting sectors like infrastructures (water, electricity, roads, etc. The realistic option is to mobilize small contributions from the private informal sector, pool it and focusing on the sick persons. Building the risk sharing (solidarity) through a large economy of scale, combining with public funds for public goods, is an option to go on. The China cooperation insurances, the Rwanda & Ghana community health insurances and the new USA Patient Protection and Affordable Care Act are in the line. Those schemes are helping many low income people.