Medical services include permanent treatment centers and a mobile organization for preventive medicine. Special facilities treat leprosy, sleeping sickness, and mental illness. All services are free except at the clinic attached to the hospital in Lomé, where some patients pay a nominal fee. In 1991, the nation's medical personnel included 319 doctors and 1,187 nurses. In 1990, there were 22 dentists, 65 pharmacists, and 222 midwives. As of 1999, there were an estimated 0.1 physicians and 1.5 hospital beds per 1,000 people. About 61% of the population had access to health care services in 1990–95. As of 1999 total health care expenditure was estimated at 2.6% of GDP. In 2000, 54% of the population had access to safe drinking water and 34% had adequate sanitation.
The Mobile Service for Hygiene and Preventive Medicine performs mass inoculations, carries out pest control campaigns, and provides education in hygiene and basic preventive measures. Its activities have led to significant decreases in mortality caused by smallpox, yellow fever, and sleeping sickness. Yaws, malaria, and leprosy continue to be major medical problems. A common disease reported in 1995 was guinea worm (6,144 cases). Goiter was prevalent in 23.5% of school-age children in 1996. In 1999, there were 313 reported cases of tuberculosis per 100,000 people. Immunization rates for children up to one year old in 1990–94 were: tuberculosis, 73%; diphtheria, pertussis, and tetanus, 71%; polio, 71%; and measles, 58%. As of 1999 rates for DPT and measles were, respectively, 41% and 43%. In 1993, 14% of the population had been vaccinated against yellow fever.
There were 177,000 births in 1994. As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 36.1 and 11.3 per 1,000 people. The fertility rate in 2000 was five children per woman living through her childbearing years. The infant mortality rate was 75 per 1,000 live births in 2000 and the maternal mortality rate was 480 per 100,000 live births in 1998. Average life expectancy in 2000 was 49 years.
At the end of 2001 the number of people living with HIV/AIDS was estimated at 150,000 (including 6% of the adult population) and deaths from AIDS that year were estimated at 12,000. HIV prevalence in 1999 was 5.98 per 100 adults. At least 50% of the women in Togo underwent female genital mutilation in 1994. The government has published a policy opposing the practice.