IMPACTS OF THE STATE OF THE ENVIRONMENT
In sub-Saharan Africa, 61 per cent of the population lives in ecologically
vulnerable areas characterized by a high degree of sensitivity and low degree
of resilience (IDS 1991). This is not necessarily by choice, but by force of
circumstance, because other options are either unavailable or have been exhausted.
Perhaps one of the major threats to people of the state of the environment
is malaria-a major killer in the region. Between 300 million and 500 million
cases of malaria-which involve mostly the poor-are recorded in Africa annually.
They cause between 1.5 to 2.7 million deaths, of which more than 90 per cent
are children under 5 years of age (World Bank 2000c, Nchinda 1998). Malaria
slows economic growth in Africa by up to 1.3 per cent each year and, according
to statistical estimates, the gross domestic product (GDP) of sub-Saharan Africa
would be up to 32 per cent greater if malaria had been eliminated 35 years ago
(WHO 2000b).
It is estimated that, by 1999, malaria had cost Africa about US$100 000 million
in lost economic opportunities-or nearly five times more than all development
aid provided to the region in 1999 (IRIN 2001). According to a report by the
World Health Organization (WHO), Harvard University, and the London School of
Hygiene and Tropical Medicine, malaria slows economic growth in Africa by up
to 1.3 per cent each year. This slowdown in economic growth due to malaria is
over and above the more readily observed short-term costs of the disease. With
a GDP of about US$300 000 million, the short-term benefits of malaria control
in sub-Saharan Africa are estimated at between US$3 000 million and US$12 000
million per year (WHO 2000b). According to UNICEF, the average cost for each
nation in Africa to implement malaria control programmes is estimated to be
at least US$300 000 a year. This amounts to about six US cents (US$0.06) per
person for a country of 5 million people.
Some of the causes of malaria are summarized in Box 3.6,
which also indicates the areas on which health programmes could focus in order
to fight the disease.
| Box 3.6 Malaria: factors related to human vulnerability |
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A number of factors,many of them relating to various dimensions
of human vulnerability, appear to be contributing to the resurgence
of malaria:
- the rapid spread of resistance of malaria parasites to chloroquine
and other quinolines; .
- frequent armed conflicts and civil unrest in many countries,
forcing large populations to settle under difficult conditions,
sometimes in areas of high malaria transmission;
- migration of non-immune populations-for reasons of agriculture,
commerce and trade-to areas where malaria transmission is high;
- changing climatic conditions, especially rising temperatures
and rainfall patterns;
- water development projects, such as dams and irrigation schemes,
which create new mosquito breeding sites;
- adverse socio-economic conditions, leading to a much-reduced
health budget and gross inadequacy of funds for drugs;
- high birth rates, leading to a rapid increase in the susceptible
population of those younger than 5 years of age; and .
- changes in the behaviour of the vectors, particularly in biting
habits, from indoor to outdoor biters.
(Nchinda 1998)
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The health crisis situation in Africa has been summarized in Table
3.1, which indicates the high percentage of the population of the region
who are undernourished, and who have HIV/AIDS, malaria and tuberculosis. During
1992, cholera affected almost every country in the region of the South African
Development Community (SADC), claiming hundreds of lives.
| Table 3.1 Health crisis and challenges in Africa |
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* Note: More than 50 per cent of
undernourished and more than 95 per cent of all HIV/AIDS and malaria cases
for North Africa are from the Sudan.
Source: JES-Preparation WSSD 2001
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Climate change, and human activities which transform habitats and create conditions
suitable for parasites and disease organisms to breed, have a significant impact
on the distribution and prevalence of vector-borne diseases (VBDs) in Africa.
Climate change affects vector survival primarily through minimum temperatures,
impacting the latitude and elevation of distribution, as well as the length
of season permissive to transmission of VBDs (IPCC 1998). Meteorological variables,
subject to climate variability and global atmospheric change, can therefore
create conditions conducive to the spread of disease or, in the case of flooding
or drought, clusters of outbreaks.
