Diseases in Africa
Tuberculosis, Malaria & New Challenges

The British ex-Prime Minister Tony Blair once said of diseases in Africa:

“It is wrong that more than one in six African children die before their 5th birthday.

It is wrong that only half of the lucky ones that survive are able to complete their primary education, before they have to go out to work to support their family. And it is wrong that 12 million children in Africa have been made orphans by AIDS.”

Statistics - Impact of African diseases

Let's have a look at a study that was done in 2001. It analyzed the role of diseases in the 55m deaths that occurred that year:

- Over 10m of deaths were children, 99% of whom came from developing countries;

- Over 50% of child deaths were due to respiratory infections, diarrhea, malaria, HIV/AIDS (the last three explain most child deaths in Africa);

- Among the major global diseases are: HIV/AIDS, tuberculosis, malaria and diarrhea (i.e. adults are affected by the same diseases);

- HIV/AIDS and tuberculosis are closely related. Over 70% of HIV positive South Africans are also infected with tuberculosis;

- The disease burden per person in Sub-Saharan Africa increased between 1990 and 2001, mostly because of HIV/AIDS, tuberculosis and malaria;

- Every year there are 9 million new cases of tuberculosis, and 1.6m deaths due to this.

- Malnutrition remains one of the main causes of diseases in Africa.

Diabetes and new healthcare challenges

The rise of the modern diseases

A large number of “modern”, non-communicable diseases are on the rise in Africa: from hypertension to heart diseases and diabetes. This is yet another threat to poor African countries that are already investing a huge amount of resources in the prevention or treatment of the "usual" diseases (HIV, tuberculosis, malaria) that plague the continent.

The challenge becomes not just to find the resources but also to train health care workers and get the right health systems in place. Given that there are still drugs shortages every now and then, it’s another public health disaster that is looming with for instance people who have diabetes and no available insulin in their country.

Diabetes - growing and yet neglected

In urban areas it’s estimated that between 1% to 6% of African populations have diabetes, with hikes to more than 10% in Northern Sudan. That makes about 7m people in Sub-Saharan Africa who have diabetes and the number is set to double in the next 20 years. Obviously Africa cannot afford to try to deal first with the “serious” diseases, then deal with the chronic ones, all the more since chronic diseases tend to amplify the effects of HIV/AIDS, tuberculosis or malaria.

Of course the trouble is with being able to afford to invest in more health care in Africa, when the World Health Organization doesn’t consider access to drugs such as insulin a priority and focuses on the “big diseases”. But there is no diabetes treatment without insulin, and among diseases in Africa it’s part of those taking epidemic proportions.

Child mortality, HIV & diseases in Africa

Child mortality rates have been massively falling around the globe with on average 7% of newborns worldwide who die before their 5th birthday. But the picture is more contrasted with Sub-Saharan Africa showing incomparably higher numbers than the rest of the world.

Child mortality before age of 5 is often above 10% in Sub-Saharan Africa, while it is way below 1% in developed countries. The heart of the problem is that most of these deaths are totally avoidable: poor care during pregnancy or childbirth, treatable diseases due to malnutrition or lack of sanitation. As for the great majority of those that cannot be treated there is usually a vaccine (i.e. they’re preventable diseases)... in general not available or too expensive for local populations. This highlights the deep ties between poverty and diseases in Africa.

Man-made epidemics

This is but one more case of man-made poverty. Diseases in Africa thrive with the lack of education and access to health care. Of course there is the issue of the AIDS epidemic that leaves children infected at birth or orphans “at best”… a great way to wander around without parents and catch more random diseases while trying to survive.

But not all Sub-Saharan countries have sky high AIDS infection rates, and yet pretty high child mortality rates. This confirms that a great deal of these deaths is due to diseases that Africans should be able to prevent.

Early exposure to tropical diseases in Africa

Fighting malaria

Campaigns against malaria date way back and an important landmark was the Abuja Declaration (Nigeria) according to which the African income would be over 35% higher if malaria hadn’t been tormenting the continent for the last 50 years. Several studies confirm that number, and others even reveal that if hookworm were eradicated from Africa, income would raise by as much as 25%. Another pretty good evidence of the vicious cycle between poverty and health.

With over 2bn people infected with either malaria or different kinds of worms, these are by no means rare diseases. And having been infected with a parasite myself a few years back, I can confirm that your working performance is seriously undercut. You would usually need tons of food and rest. But on the other hand … you’d have this power for nearly limitless naps.

Avoid early exposure

But where malaria and hookworm aggravate the situation is that they most affect people who had it at an early age. These diseases not only affect children’s physical development (by making them constantly sick), but also their mental development and opportunities to study in decent conditions.

Add this to the fact that early exposure to diseases generally affects people for life and you have a tasty cocktail for poverty.

Mining and tuberculosis in Africa

Africa and mining

As you may or may not know, Africa is the richest continent in primary resources. This means that unthinkable amounts of all kinds of minerals are being mined out of the earth every day by major corporations. If for several African countries mining activity is one of the biggest employers, in general the sector accounts for only 1% of jobs in Sub-Saharan Africa.

In spite of its relatively small scale, after a certain time there were suspicions that mining activity contributes to the development of tuberculosis. If your memory (or education) is good, you’d remember there were already hundreds of novels about coal mining and tuberculosis in France and in the UK during the industrial era. But anyway new scientific studies were apparently needed. Why not.

And they’re mining way more than just coal over there; pretty much any mineral you can think of.

Mining spreads tuberculosis

The results of the study speak for themselves (or so we would hope they actually could): miners are five to six times more likely to have tuberculosis than the rest of the population. Despite the small proportion of miners in Sub-Saharan Africa, there’s a real risk that tuberculosis quickly spreads to the general population.

What is to be done?

Simply improving work environments and safety regulations, as it’s been done decades ago in Western countries, but that implies a huge collaboration between government agencies in charge of health & labor and private companies. But overall, better health care and public health policies are vital to local populations when fighting tuberculosis and diseases in Africa.

Tuberculosis & Poor public health services

Tuberculosis and HIV

In the 1970s there was a very clear prospect of definitively eradicating tuberculosis from the surface of the globe.

But the apparition of the HIV epidemic changed everything because of the way tuberculosis thrives on HIV-infected people. From then on the disease seemed almost out of control with the apparition of multi-drug resistant forms of tuberculosis.

All forms of drug resistance have the same origin: extremely poor public health services and irresponsible use of drugs. And the association of HIV with tuberculosis creates a particularly deadly cocktail that is now much more difficult to contain than in the past.

Find out more about HIV and sexually transmitted diseases in Africa.

Ineffective public policy: worse than nothing

Actually, flawed control programs have done more to worsen the damage of diseases in Africa than just the absence of any program would have. But the now very fast spread of tuberculosis calls for serious, high quality control programs, while new drugs and vaccines are being prepared and distributed throughout Africa. Just waiting doesn’t really sound like a viable option.

Better prospects in the near future ?

It’s now undeniable that health leads to massive differences in how well a country manages to develop as a society. And diseases in Africa have an unspeakable impact on human lives but also on the economy (through loss of productivity in the workforce). HIV/AIDS, tuberculosis, malnutrition-induced diseases and malaria are among the top diseases that cause this large-scale human disaster.

With the dawn of more peaceful times in the continent (or so everybody hopes) there are great prospects for tackling diseases in Africa. With the stabilization of the situation in the Democratic Republic of Congo, the end of the wars in Sierra Leone and Angola, the civil war in Sudan that finally stopped after decades, time is now to rebuilding health systems in Africa.

Literally rebuilding the facilities and infrastructure that have been vandalized, and rebuilding the public health system as a whole with new local organizations, resources, medical supplies etc. There is still a long road till the waning of widespread diseases in Africa.

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