HEALTH
Environmental damage-whether it is water or air pollution, or waste and sanitation-has
serious consequences for human health. Generally, most countries in Africa face
high environmental threats to health (WRI and others, 1999), a situation which
poses a profound challenge to the region.
Pollution of water and air, and their impact on human health, is of immediate
concern. Water pollution and contamination impact on people in the region, resulting
in the predominance of water-borne diseases. Air pollution-from industrial and
car exhaust emissions, and the burning of traditional fuels in homes-kills a
large number of people each year. People die from respiratory damage, heart
and lung diseases, and cancer. Urban air pollution causes close to 1 million
premature deaths worldwide every year, primarily due to respiratory diseases
(World Bank 2000e) affecting mostly the poor. About 4 million people die annually
due to overcrowding, and from indoor pollution caused by burning biomass fuels
for cooking and heating (WRI 1998). As many as 25 million poor agricultural
workers in the developing world (11 million in Africa alone) are poisoned by
pesticides every year, and hundreds of thousands die.
In Africa, human vulnerability is exacerbated by poor health caused by unmitigated
or heightened exposure to disease, malnourishment and undernourishment, and
weak public health institutions and interventions. Linked to this is poverty
and the coping capacities of the population at risk to effectively reduce their
vulnerability to infectious diseases, poor or irregular nutrition, and the myriad
of health conditions that are associated with poverty in urban and rural areas.
The survival indices which are a reflection of the general health situation
in Africa are summarized in Table 3.3.
| Table 3.3 Health progress and setbacks in African countries |
| Sub-region |
Life expectancy at birth (years) |
Infant mortality (per 1 000
live births) |
Under-five mortality rate (per
1 000 live births) |
| 1970-75 |
1995-2000 |
1970 |
1999 |
1970 |
1999 |
| |
| Northern Africa (6) |
52 |
66.1 |
123.8 |
38.7 |
190.7 |
51.2 |
 |
| Western Africa (16-1) |
42.7 |
49.7 |
161.3 |
106.3 |
273.3 |
174.2 |
|
| Central Africa (8-1) |
43.7 |
49.1 |
139.6 |
103.6 |
233.3 |
163.2 |
|
| Eastern Africa (8-1) |
44.7 |
50.1 |
133.6 |
94.7 |
212 |
147.9 |
|
| Southern Africa (11) |
47.7 |
46.2 |
127.6 |
91.3 |
205.1 |
142.2 |
|
| IOC (4.1) |
- |
- |
- |
- |
- |
- |
| |
|
|
|
|
|
|
|
| Source: JES-Preparation WSSD 2001 |
Poor health, lack of or inadequate access to health services, low or skewed
investment in health services (concentration in few urban centres) and dysfunctional
health policies all contribute to lower life expectancy and high mortality rates
in African countries, as indicated in the table. Health-related interventions
may also contribute to vulnerability by, for example, contributing to the evolution
of drug-resistant organisms, or by exposing food webs and people, through the
process of bioaccumulation, to toxins such as DDT.
 |
|
Infectious diseases such as HIV/AIDS, tuberculosis and malaria can thrive
in poorly maintained communities, and the limited access to health-care
services means mortality rates are high in many regions.
UNEP
|
The effects of infectious diseases-such as HIV/AIDS, tuberculosis
and malaria-are felt throughout society and, if unchecked, they damage the social
fabric of the community, diminish agricultural and industrial production, undermine
political, social and economic stability, and contribute to regional and global
insecurity (WHO 2000a). The linkages between environmental change, poverty, reduced
quality of health and vulnerability are complex, and their individual impacts
and causal effects are not easy to isolate. However, the lack of scientifically
proven evidence of such causal changes in Africa does not mean that these changes
do not exist; rather, it may reflect the lack of available epidemiological data
as a result of poor or absent surveillance and health information systems (IPCC
1998). There is, consequently, a pressing need for scientific investigation on
the assumptions about environmental change and its impacts on human health and
vulnerability.
The HIV/AIDS epidemic has spread with devastating speed. It is among the leading
causes of death in sub- Saharan Africa (World Bank 2001), where 2.4 million
adults and children are estimated to have died due to HIV/AIDS in 2000 alone
(UNAIDS/WHO 2000). The HIV/AIDS epidemic is not only the most significant public
health problem affecting large parts of sub-Saharan Africa; it is also an unprecedented
threat to the region's development (World Bank 2000c). More than 95 per cent
of the 36 million people in the world living with HIV/AIDS are in developing
countries, and 25.3 million of them are in sub-Saharan Africa (World Bank/UNAIDS
2001, UNAIDS/WHO 2000). In Africa, HIV/AIDS is largely a rural/urban poor issue,
where a matrix of socioeconomic, cultural and gender-related vulnerabilities
indicate that the links between AIDS, food insecurity and poverty are strong
and deadly (FAO undated).
HIV/AIDS is a threat to sustainable agriculture and rural development through
its systemic impact (FAO/UNAIDS 1999). At the household level, HIV/AIDS can
result in labour shortages and declining productivity, reduced income, increased
expenditure on medical treatments and an increase in the dependency ratio due
to the rise in the number of dependents relying on a smaller number of productive
family members. Smallholder agriculture is a vital sector for rural households
and national economies in many African countries. HIV/AIDS is affecting agricultural
production through the decimation of household labour, the disruption of traditional
social mechanisms, and the forced disposal of productive assets to meet the
costs of medical care and funerals. The disease also results in the loss of
traditional farming methods, inter-generational knowledge, and specialized skills,
practices and customs.
