Africa’s health challenges

by Cesar Chelala

NEW YORK — Persistent poverty in most African countries is seriously effecting the health and quality of life for children and adults. Diarrheal and respiratory infections, measles, malaria and perinatal pose the most serious threats to children’s lives, while HIV/AIDS and malnutrition cast an ominous shadow. Malnutrition underlines most diseases and makes them more serious.

Problems at childbirth are a significant cause of mortality among women of childbearing age. It is estimated that African women are 175 times more likely to die during childbirth and pregnancy than women in industrialized countries. Most women’s deaths and disabilities in these conditions are the result of delays in recognizing complications, difficulty in reaching a medical facility or lack of adequate medical care. Skilled health attendants are vital for recognizing and preventing medical emergencies.

In adult women and men, HIV/AIDS is a not only a growing health burden but also has a significant demographic, social and economic impact in practically all sub-Saharan African countries. While the bubonic plague is estimated to have killed around 30 million people in medieval Europe, projections by the U.S. Census Bureau indicate that, by 2010, sub-Saharan African countries will have 71 million fewer people than they would have had without the impact of AIDS.

Stigma still surrounds AIDS in most African countries, although slowly some progress has been made toward increasing awareness among the population, particularly through education and the involvement of different religious organizations in the fight against the infection.

Because AIDS affects people in the most productive years of their lives, it has a considerable effect on countries’ economic development. According to statistics from UNAIDS, the GDP of the most affected countries may decline by 8 percent by 2010. Because of its economic impact, AIDS is reversing decades of slow improvement in child survival, life expectancy, educational progress and economic growth.

The impact of diseases in general is even greater by several characteristics of the health-care system in most African countries. Particularly in rural areas, health services and infrastructure are inadequate and there is lack of properly trained medical personnel. To compound the problem, there is an exodus of trained personnel toward industrialized countries.

Health problems in Africa cannot be considered in isolation, and are not only the responsibility of Africans themselves. Health problems happen in a context of widespread poverty and corruption, which have a symbiotic relationship between them. The World Health Organization has called poverty in Africa “the single biggest threat to health.” Solving poverty implies also developing equitable health care systems, as well as redirecting resources from curative care in urban hospitals using high tech equipment to primary and preventive care.

Money pocketed by corrupt African leaders drains resources that could be used otherwise for improving people’s health status. The African Union itself has estimated that every year political corruption costs African countries over $148 billion. It would be easy to say that corrupt leaders are the only ones responsible for corruption. As I was able to see during my work in Africa, international financial institutions, corporations and donor governments contribute to a large extent to this phenomenon.

To be effective foreign aid must bypass corrupt governments and find ways to help people more directly, for example through nongovernment organizations with a proven record of transparency and effectiveness. As for the financial institutions and donor governments, if they are serious about their desire to help Africa and its people, they should carefully monitor how their funds are spent and end policies that undermine health.

When we think about Africa, we tend to think about a continent ravaged by wars and famine. Although these exist, there is another side to Africa: It is a continent full of vibrant people desperate to live in peace and in good health. It is because of a basic sense of responsibility and human concern that we should support policies that allow Africans to express that tremendous potential in their lives.