/ 2 September 2003

Half of Africa without access to basic medicines

Half of Africa’s population, mostly the poor and disadvantaged, do not have access to existing essential medicines and many more are denied new medicines for treating common diseases like malaria and HIV, says a report released on Monday.

”Only 50 000 of the 4,5-million people who need anti-retroviral therapy have access to treatment despite significant reductions in cost,” states the annual report for 2002 of the regional director of the World Health Organisation.

Only 6% have access to voluntary counselling and only 1% to services for the prevention of mother-to-child transmission, it says.

”The HIV/Aids epidemic continues to spread relentlessly in the African region.”

About 29-million HIV-positive people, 70% of the global total, are in Africa, and an estimated 3-million died of Aids last year.

The overall adult HIV-prevalence is about 9%, while in different regions it varies from 1% to over 30%. Botswana, Lesotho, Swaziland and Zimbabwe have adult infection rates exceeding 30%.

Due to HIV/Aids, tuberculosis has become a growing problem. The average treatment success rate is 68%, compared to the target of 85%.

”Frequent shortages of anti-TB drugs, inadequate human resource capacity and insufficient diagnostic and treatment facilities are some of the challenges which are frustrating control efforts.”

Effective vaccines are available, but diseases which they could prevent still constitute major public health problems in Africa, the report says.

”For example, measles-related deaths are still extremely high at 445 000 annually; pertussis causes 106 000 to 190 000 deaths annually; yellow fever is still endemic in 34 countries, causing about 30 000 deaths annually; and mortality from neonatal tetanus is about 510 per 1 000 live births.”

Malaria makes 270 000 people in Africa acutely ill every year, kills over 900 000 and causes significant loss in household earnings.

”The annual economic loss from malaria is estimated at $12-billion,” the report reads.

”Due to drug resistance and difficulties with implementation in the African region, tools, methods and technologies once considered effective for the management of communicable diseases are failing rapidly.

”At the same time, the acceptance of new and effective drugs and vaccines by national health systems has been slow due to inadequate investments.”

Non-communicable diseases, mental disorders and substance abuse, including tobacco consumption, are becoming major problems in the region.

Countries do not give such diseases enough attention, and treatment is not universally available or affordable. The lack of long-term commitment, coupled with the progressive increase in non-communicable diseases, contributes to widening health gaps between and within countries, the document states.

”All of this is threatening development in the African region.”

At 940 per 100,000 births, Africa has the highest maternal mortality ratio in the world. The average lifetime risk of maternal death is estimated at one in 14.

”More than 75t of the 600,000 annual deaths from pregnancy and childbirth-related causes can be prevented through timely access to essential obstetric care.”

The prevalence of female genital mutilation varies, ranging from 10 percent in Niger to over 98 percent in Guinea.

”The extent and depth of poverty as well as threatening environmental conditions represent major threats to health development in the African region.”

According to the report, over 450-million poor Africans do not have access to safe water, 490-million do not have adequate sanitation and one out of five children dies from a communicable disease linked to environmental conditions.

Poverty causes food insecurity and the consumption of unsafe food.

”Together, these factors contribute to the complex natural and human-made emergencies occurring on a large scale in the region…

”The regional office aims to support member states to make health central to sustainable development through promoting a strategic, systematic and integrated approach to poverty and other determinants of health.” — Sapa