Africa: Facing Human Security Challenges in the 21st Century

Chapter 7 - Challenges to Health Security

233 Chapter 7 Challenges to Health Security Overview The World Health Organization (WHO) says regardless of promises of better healthcare by governments and donor countries, millions of mothers, newborn babies and children continue to die each year in Africa from preventable diseases. The WHO has found that some of the continent’s biggest problems are getting worse and the rates of death during childbirth and among young children are increasing. Although Africa has 11% of the global population it has 60% of the world’s HIV/AIDS cases and 90% of world malaria cases, mainly in children under 5. The African Regional Health Report, the first study to look at health trends among 738 million Africans, said more investment was needed to cut disease and tackle poverty and because of AIDS and armed conflicts, the health situation in many African countries has not improved in recent years and in some cases has worsened. The WHO says a “silent epidemic” in African countries accounts for 19 of the 20 countries with the highest rates of maternal mortality worldwide and the highest death rate worldwide for babies up to a month old. The WHO says in Africa it stands at 43 per 1,000 live births or four times the rate in Europe. Although the report was not all negative and successes, such as Uganda’s AIDS program, Mali’s community health centers, and the greater availability of anti-retroviral drugs used to treat people with HIV/AIDS were highlighted, it does reveal the difficult health challenges facing African countries. Africa’s Health Trajectory The Health of the People published in 2013 is the first report to focus on the health of the people living in the African Region of the World Health Organization. While acknowledging that Africa confronts the world’s most dramatic public health crisis, the report 234 offers hope that over time the region can address the health challenges it faces, given sufficient international support. It provides a comprehensive analysis of key public health issues and progress made on them in the Africa Region. x HIV/AIDS continues to devastate the WHO Africa Region, which has 11% of the world’s population but 60% of the people with HIV/AIDS. Although HIV/AIDS remains the leading cause of death for adults, more and more people are receiving lifesaving treatment. The number of HIV-positive people on antiretroviral medicines increased eight-fold, from 100 000 in December 2003 to 810 000 in December 2005. x More than 90% of the estimated 300–500 million malaria cases that occur worldwide every year are in Africans, mainly in children under five years of age, but most countries are moving towards better treatment policies. Of the 42 malaria-endemic countries in the African Region, 33 have adopted artemisinin-based combination therapy—the most effective antimalarial medicines available today—as first-line treatment. x River blindness has been eliminated as a public health problem, and guinea worm control efforts have resulted in a 97% reduction in cases since 1986. Leprosy is close to elimination— meaning there is less than one case per 10 000 people in the Region. x Most countries are making good progress on preventable childhood illness. Polio is close to eradication, and 37 countries are reaching 60% or more of their children with measles immunization. Overall measles deaths have declined by more than 50% since 1999. In 2005 alone 75 million children received measles vaccines. While drawing the world’s attention to some recent successes, the report offers a candid appraisal of major hurdles, such as the high rate of maternal and newborn mortality overall in the Region. Of the 20 countries with the highest maternal mortality ratios worldwide, 19 are in Africa; and the Region has the highest neonatal death rate in the world. Then there is the strain on African health systems imposed by the high burden of life-threatening communicable diseases coupled with increasing rates of noncommunicable diseases such as hypertension and coronary heart disease. Basic sanitation needs remain unmet for many: only 235 58% of people living in sub-Saharan Africa have access to safe water supplies. Noncommunicable diseases, such as hypertension, heart disease, diabetes and are on the rise; and injuries remain among the top causes of death in the Region. Africa Health Forum 2013: Finance and Capacity for Results Big questions were raised about getting the best results in health and development at...