Communicable Diseases
There has been a spectacular increase in the world population’s life expectancy since the early 20th century. It began in Europe and by the end of the 19th century this increase spread to all the countries that are today considered developed.
At the end of the 19th century, life expectancy in these countries was approximately 40 years, and rose to 80 years by the early 21st century. The industrial and agricultural revolutions, as well as increased income levels, led to improved nutrition and better access to drinking water and sanitation. In turn, these positive factors brought about a significant decline in mortality, followed by a decrease in the birth rate and the stabilisation of the population. Most other countries in the world followed a similar path during the 20th century.
Admittedly, this was not a linear process, nor was it exempt of local exceptions. While some countries benefited from globalisation by combining economic growth and improvements in health conditions (China, Costa Rica, emerging East Asian countries), others failed to achieve the expected economic results and experienced a slower improvement in health conditions – sometimes even a decline. Economic crises (Argentina, Mexico, and Russia) curbed investments in social services and reduced access to essential medicines for disadvantaged populations.
On the whole, the African continent – particularly Sub-Saharan Africa – remains the last major world region where mortality rates – particularly infant mortality rates – continue to be very high and life expectancy low. This situation calls for a closer examination of the health and environmental conditions in Sub-Saharan Africa. Particular attention must be paid to nutritional and sanitation conditions, the accessible health infrastructure and personnel and to the health policies adopted at the national and regional level. This chapter provides preliminary information for this study as well as an overview of the main diseases affecting the Sub-Saharan and West African population, the progress achieved in combating them and the challenges that remain.
