A healthy population is critical to Africa’s efforts to reduce poverty and improve living standards.
Continent-wide, a woman’s risk of dying from maternal causes is 1 in 15. For every 1,000 children born in Africa in 2003, 175 will die before their fifth birthday. Unlike any other part of the world, malnutrition rates are actually increasing in Africa. Some 90 percent of the 600 million malaria cases per year occur in Africa and the incidence of tuberculosis is the highest in the world. Immunization rates for children under one year of age continue to increase but they are still below 80 percent, leaving significant numbers exposed to vaccine preventable illness and death.
Continued high population growth rates in sub-Saharan Africa undermine the best efforts to improve the standards of living and reduce poverty. Fertility rates continue to decline in some countries, particularly those with relatively higher incomes. However, the annual population growth rate is still 2.5 percent per year, the highest in the world. Contraceptive prevalence rates remain under 15 percent in the region, although the majority of women say they desire fewer children. Even with the devastating effects of the HIV/AIDS pandemic, Africa’s population will increase from about 690 million now to about 1 billion in 2020, further straining social infrastructure.
The HIV/AIDS pandemic continues to expand, and Africa remains by far the world’s most affected region in the world with about 26.6 million people living with HIV. Women are more vulnerable to the epidemic – they are at least 1.2 times more likely to be infected than men. There is a great variation in prevalence rates across the continent, but southern Africa is the region most affected by the epidemic; Botswana and Swaziland both have prevalence rates close to 40 percent. However, Kenya, Rwanda, and Uganda have all seen a welcome decline in prevalence. The number of orphans in Africa is expected to increase from 34 million in 2001 to 42 million in 2010, almost half from HIV/AIDS. Average life expectancy will continue to decline over the next decade, falling below 35 years in several high prevalence countries, and a shrinking labor pool will slow the continent’s growth rate by as much as 2 percent a year.
HIV/AIDS is the major health priority for USAID in Africa. HIV/AIDS programs represent 31 percent of all USAID development assistance funding in Africa. USAID focuses on primary prevention and on expanding its coverage of services, including those for orphans and vulnerable children. Pilot care and treatment programs are being introduced in several of the most-affected countries. While most of the efforts are focused within the health sector, other sectors are also engaged to improve education, environment, agriculture, and democracy and governance programs that contribute to the health status of Africans.
To improve health status in Africa, USAID responds by focusing on increasing the availability, effectiveness, and access to quality health care, and on strengthening programs by developing, disseminating and advocating the adoption of state-of-the-art, Africa-appropriate approaches to health improvement. USAID also works to strengthen the capacity of African institutions to plan, manage, implement and evaluate these approaches.
