 President Kagame has made healthcare one of the priorities for the Vision 2020 development programme, boosting spending on health care to 6.5% of the country's gross domestic product in 2013, compared with 1.9% in 1996.The government has devolved the financing and management of healthcare to local communities, through a system of health insurance providers called "mutuelles de santé".The "mutuelles" were piloted in 1999, and were made available nationwide by the mid-2000s, with the assistance of international development partners.