NEW YORK – The high cost of treating certain diseases, most notably HIV/AIDS, when coupled with the indirect costs from lost worker productivity, is having a serious negative impact on African economies. More effort must go toward primary care, especially in rural areas, accompanied by activities to promote health, prevent disease and improve education for all ages.
The African continent is the region of the world most affected by the HIV/AIDS pandemic, which is reversing decades of improvement in life expectancy, educational progress and economic growth. For example, in Lesotho , where life expectancy was 60 years in 1995, it plummeted to 35 years in 2010.
In Sub-Saharan Africa, where life expectancy was 62, it is now 47 because of HIV/AIDS. Because teachers in rural areas of developing countries have better salaries than the local population, they travel more and tend to develop sexual relationships with students and local women, some of whom are already HIV infected.
As a result, HIV/AIDS is killing teachers at a faster rate than replacements can be trained. In Zambia , it has been found that two teachers die for every one that graduates from training school. The pandemic affects not only the supply of teachers but also the quality and management of education at local, regional and national levels.
A World Bank report estimates that HIV/AIDS may reduce GDP growth by 1 percent a year in some Sub-Saharan African countries, due to the continuing loss of skilled and unskilled workers in the prime of life. In South Africa, HIV/AIDS may depress GDP by as much as 17 percent over the next decade. In addition, HIV/AIDS is estimated to have decreased agricultural output by as much as 20 percent in many African countries.
According to experts’ predictions, by 2015 South Africa will have 50 million fewer people than it would have had in a non-HIV/AIDS scenario. Public health officials still have to deal with the stigma of AIDS that persists in most African countries. Progress in raising AIDS awareness has been slow despite education efforts and the work of nongovernmental organizations.
Progress has been hindered, particularly in rural areas, by inadequate health services and infrastructure and by the widespread lack of trained medical personnel. If health care systems are to be effective, resources must be redirected from curative care in urban settings with high-tech equipment to primary and preventive care.
HIV/AIDS is not the only concern. South Africa has the highest tuberculosis death rate per capita worldwide, followed by Zimbabwe and Mozambique. There is concern about the increasing number of cases of “multidrug-resistant” tuberculosis (MDR) and “extensively drug-resistant” (XDR) tuberculosis in several countries.
Many diseases affecting both children and adults could be addressed effectively with minimum resources if they were employed strategically. Diarrhea and respiratory infections, measles, malaria and malnutrition represent the greatest threats to children’s health. Malaria is the leading cause of death among African children under 5 years old.
It is estimated that African women are approximately 175 times more likely to die during childbirth and pregnancy than women in industrialized countries. Health problems are made worse by the lack of health professionals, due in part to the continuing exodus of doctors and nurses to industrialized nations.
Moreover, corruption drains critical resources needed to improve people’s health and education. It has been estimated that corruption costs African economies more than $148 billion a year. By comparison, Sub-Saharan countries received $15 billion in development aid in 2011. The widespread practice of bribing government officials by foreign companies must be curtailed. With this goal in mind, industrialized nations should enforce national and international laws that deal with this issue.
In the last few years, emphasis has been placed on economic aid to Africa. African countries, however, need a different kind of aid. They need to have their specialists trained in their own countries; they need more help in preventing major diseases; they need more education for all age levels; and they need better trade conditions.
African countries do not need more monetary aid that ends up in the pockets of government officials and members of the countries’ elites.
Cesar Chelala, M.D. and Ph.D., is an international public health consultant who has served in health-related missions in 50 countries, many of them in Africa.