People and Society of Sao Tome and Principe

Nationality

Sao Tomean(s)

Ethnic Groups

mestico, angolares (descendants of Angolan slaves), forros (descendants of freed slaves), servicais (contract laborers from Angola, Mozambique, and Cape Verde), tongas (children of servicais born on the islands), Europeans (primarily Portuguese)

Population

229,300

Population in Major Urban Areas

SAO TOME (capital) 64,000

Medical facilities in São Tomé and Príncipe are extremely limited. There is one hospital in the country on the island of São Tomé, Hospital Central Ayres de Menezes, phone number 239 2-221-222. A few clinics also exist, but the service provided is very basic. For all but minor medical needs, it is necessary to travel to Libreville (Gabon), Lisbon (Portugal), or elsewhere. You should carry an ample supply of properly-labeled prescription drugs and other medications with you; an adequate supply of prescription or over-the-counter drugs in local stores or pharmacies is generally not available. Cerebral malaria is endemic in all areas of São Tomé and Príncipe. Travelers should discuss prophylaxis with a physician well before planned travel as some prophylactic medications must be started two weeks before arriving in a malarial zone. Even with prophylaxis you should familiarize yourself with the symptoms of malaria and seek medical treatment immediately if you experience symptoms. Tap water may not be potable and you should drink and cook with bottled water only. Schistosomiasis, also known as bilharzia, is endemic to São Tomé and Príncipe. Schistosomiasisis a parasite that can penetrate intact skin of those swimming or bathing in fresh water from lakes, rivers and streams. It is recommended to avoid contact with untreated fresh water to prevent schistosomiasis infection. Tuberculosis (TB) is an increasingly serious health concern in São Tomé and Príncipe.

Life Expectancy at Birth

Life expectancy at birth in Sao Tome and Principe has shown meaningful improvement over recent decades, reflecting the island nation's gradual advances in healthcare access, disease control, and maternal and child health services. As of the most recent available data, the overall life expectancy at birth stands at approximately 71 to 72 years, placing the country in a mid-range position relative to other sub-Saharan African nations. Women in Sao Tome and Principe tend to outlive men by several years, with female life expectancy reaching roughly 73 to 74 years compared to approximately 69 to 70 years for males. This gender gap is consistent with global patterns and reflects differences in occupational risks, health-seeking behavior, and biological factors. Several factors have contributed to the nation's improving longevity trends. Increased access to basic healthcare services, improvements in sanitation and clean water infrastructure, and targeted public health campaigns addressing malaria — historically one of the leading causes of mortality on the islands — have all played a role. Malaria remains a significant health concern, though sustained control efforts have reduced its death toll considerably over the years. Infant and child mortality, while still higher than in more developed nations, has declined substantially since the 1980s and 1990s. Reductions in under-five mortality have been a key driver of the overall rise in life expectancy, as childhood deaths disproportionately drag down national averages. Challenges remain, however. The country's remote island geography creates logistical difficulties in delivering consistent healthcare, particularly for residents of Príncipe island and rural communities on São Tomé. Limited medical infrastructure, a shortage of trained health professionals, and dependence on international aid and foreign medical partnerships continue to constrain further gains. Compared to global averages — where life expectancy stands at approximately 73 years — Sao Tome and Principe falls slightly below but performs notably better than many of its continental African neighbors, where averages in several countries remain in the mid-to-low 60s. Continued investment in public health systems and international partnerships will be essential for sustaining and building upon the progress achieved in recent decades.

Infant Mortality Rate

Infant mortality in Sao Tome and Principe has declined significantly over recent decades, reflecting improvements in healthcare access, nutrition programs, and maternal health services across the island nation. As of the most recent available data, the infant mortality rate stands at approximately 25 to 30 deaths per 1,000 live births, a notable reduction from rates that exceeded 60 per 1,000 live births in the early 1990s. Despite this progress, the rate remains considerably higher than the global average for upper-middle-income countries, underscoring ongoing challenges in the country's health infrastructure. Sao Tome and Principe is a small island developing state with limited resources, and geographic isolation between its two main islands can complicate timely access to medical care for mothers and newborns in rural or remote areas. The leading causes of infant death in the country include neonatal complications such as birth asphyxia and prematurity, as well as infectious diseases including malaria, diarrheal diseases, and acute respiratory infections. Malnutrition also plays a contributing role, weakening infant immune responses and increasing vulnerability to illness. International organizations including UNICEF and the World Health Organization have partnered with the Santomean government to expand immunization coverage, improve skilled birth attendance, and promote exclusive breastfeeding during the critical first six months of life. These initiatives have contributed meaningfully to the downward trend in infant deaths. Access to clean water and improved sanitation has also been identified as a key factor in reducing infant mortality, and ongoing development programs continue to address gaps in these essential services. The country has made measurable strides toward broader child health goals, though sustaining and accelerating progress will require continued investment in healthcare workers, medical facilities, and community-level health education. Compared to regional neighbors in sub-Saharan Africa, Sao Tome and Principe performs relatively well, though the country acknowledges that further reductions in infant mortality remain a public health priority.

Major Infectious Diseases

high

Literacy Definition

age 15 and over can read and write

• Christian80.0%

Portuguese (official)

• Spanish

Crime Information

Crimes such as burglary, pick-pocketing, and armed home invasions do occur on the islands, particularly around the winter holidays. Pick-pocketing can occur anywhere but is more prevalent in public places, such as in markets, on the streets, or near hotels. Do not display large amounts of cash in public. Store valuables and extra cash in your hotel safe while sightseeing or visiting the beach. When dining in restaurants or visiting markets, carry a minimal amount of cash and avoid wearing flashy or expensive jewelry. If you are the victim of an attempted robbery or carjacking, you are encouraged to comply with the attacker to avoid injury, and to report all incidents to the police and the U.S. Embassy in Libreville. Police response time to reports of crime can be slow. While scams and confidence schemes are not common, travelers should exercise caution. For general information on scams, see the Department of State’s Financial Scams web page. Don’t buy counterfeit and pirated goods, even if they are widely available. Not only are the bootlegs illegal in the United States, if you purchase them you may also be breaking local law.

Criminal Penalties

While you are traveling in São Tomé and Príncipe, you are subject to its laws even if you are a U.S. citizen. Foreign laws and legal systems can be vastly different than our own and criminal penalties will vary from country to country. There are also some things that might be legal in the country you visit, but still illegal in the United States, and you can be prosecuted under U.S. law if you buy pirated goods. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime prosecutable in the United States. If you break local laws in São Tomé and Príncipe, your U.S. passport won’t help you avoid arrest or prosecution. It’s very important to know what’s legal and what’s not wherever you go. Persons violating the laws of São Tomé and Príncipe, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in São Tomé and Príncipe are severe, and convicted offenders can expect long jail sentences and heavy fines. While some countries will automatically notify the nearest U.S. embassy or consulate if a U.S. citizen is detained or arrested in a foreign country, that might not always be the case. To ensure that the United States is aware of your circumstances, request that the police and prison officials notify the nearest U.S. embassy or consulate as soon as you are arrested or detained overseas.