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Progress and Hope

Measures such as increased epidemiological surveillance, improved access to health care and healthy living conditions, education for disease prevention with a special focus on women and girls, children’s vaccination, priority to peri-natal and paediatric health services can help change Africa’s image in the health sector.

Among the many diseases that decimate Africa’s population, many are becoming rarer or even being eradicated in several countries. Thus, the incidence of poliomyelitis is no longer significant, except in Nigeria. Yellow fever also seems well on the way to being wiped out and recently, most of the epidemics declared have been rare and not so widespread. Leprosy, a disease that had taken a terrible toll in Africa, has almost been completely eradicated (less than 1 case/100,000 inhabitants reported per country). Onchocerciasis is also under control. With regard to HIV/AIDS, decades of global prevention and mobilisation efforts have finally succeeded in slowing down the epidemic.

The progress made in combating transmissible diseases and in improving access to health services has resulted in the substantial reduction of infant mortality, which has decreased two-fold since the 1970s. Continued efforts by African countries and the international community are necessary to maintain and further these achievements, in order to enable Africans to have decent living conditions.

However, continued vigilance is needed as the fight against these major communicable diseases is far from over – the resurgence of some diseases, such as tuberculosis, proves as much. Interruptions in vaccination campaigns (poliomyelitis in Nigeria), the emergence of AIDS, and the discontinuation of vector control efforts (trypanosomiasis) are all destabilising factors that can erase the fragile victories of the past few decades.

Increasing the number of health workers and strengthening their capacities are essential factors in controlling disease : according to estimates, West Africa has 0.12 doctors per 1,000 inhabitants on average, as compared to 2.3 in the United Kingdom, for example, or 5.9 in Cuba (a world record). In other words, on average, 1 doctor is available for 8,300 inhabitants in West Africa, as compared to 1 for 435 in the United Kingdom.

In addition, there are wide regional disparities. 70% of West Africa’s doctors are found in Nigeria alone, which houses 45% of the region’s population. Cape Verde enjoys by far the best position (1 doctor per 2,000 persons), whereas the situation in countries such as Niger, Liberia and Sierra Leone is critical (less than 1 doctor per 33,300 inhabitants). Some progress has been made in Cameroon and Senegal, but the situation needs to be improved further.

Access to sanitation and drinking water are also essential factors. In Africa, only 60% of the total population has access to drinking water (85% of the urban population and 45% of the rural population), though a slight improvement has been recorded as compared to 1990, particularly in West Africa.

Diarrhoeic diseases, including cholera, cause almost 800,000 deaths in Africa every year, of which 90% are children under the age of five. 88% of these diseases are caused by mismanaged water quality, inadequate sanitation and deficient hygiene. According to estimates, access to good quality water could lead to a 30% fall in Africa’s morbidity rates.