Por Cesar Chelala
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Image by Paola Bilancieri. |
For years, the world has treated Africa’s health emergencies as episodic tragedies rather than the predictable outcomes of chronic neglect. Pledges of aid are made, high-profile visits are staged, and yet the continent’s most basic health needs remain unmet. What Africa requires is not another round of promises but a sustained, strategic commitment to strengthening systems that have been fragile for generations.
Africa’s health challenges are not confined to a single disease or region. They are the cumulative result of poverty, conflict, climate shocks, and weak infrastructure. Infectious diseases such as HIV/AIDS, malaria, and tuberculosis—especially drug-resistant TB—continue to take a heavy toll. At the same time, noncommunicable diseases like diabetes, heart disease, and cancer are rising sharply, driven by rapid urbanization and limited access to early diagnosis and treatment. The continent also faces recurring outbreaks of mpox, meningitis, cholera, avian influenza, dengue, and chikungunya. These crises rarely command sustained global attention, but they shape the daily reality of millions.
Malnutrition remains one of Africa’s most devastating and least acknowledged emergencies. Nearly 60 percent of deaths among children under five in developing countries are linked to malnutrition and its interaction with infectious diseases. A malnourished child is far more likely to die from illnesses that are easily preventable elsewhere. This is not simply a food-supply issue. It is a cycle in which poverty fuels malnutrition, and malnutrition deepens poverty. Breaking that cycle requires educating families, ensuring food security, and protecting children through immunization, clean water, and sanitation.
Sub-Saharan Africa remains the world’s most perilous region for pregnancy and childbirth. Maternal mortality ratios are hundreds of times higher than in high-income countries. These deaths are overwhelmingly preventable. They occur because complications are recognized too late, transportation is too slow, or women arrive at facilities that lack trained staff, essential equipment, or emergency obstetric services. For every woman who dies, many more suffer injuries or disabilities that can last a lifetime.
No health system can function without trained professionals, and Africa simply does not have enough of them. Doctors, nurses, and midwives are scarce, and those who are trained often remain in urban centers, leaving rural communities with little or no access to care. The situation is worsened by a steady exodus of health workers to higher-paying jobs abroad.
The World Health Organization now lists dozens of African countries as facing “the most pressing workforce vulnerabilities,” a designation meant to discourage aggressive recruitment by wealthy nations. Malawi illustrates the crisis starkly. With a population exceeding 20 million, the country has only about 1,000 to 1,500 physicians. Many continue to leave for the United Kingdom and other high-income destinations, draining already fragile health systems and leaving rural clinics staffed by a single nurse—or no one at all.
HIV/AIDS continues to carry a heavy stigma across much of Africa, undermining prevention and treatment efforts. While education campaigns and the involvement of religious leaders have helped reduce stigma in some areas, progress remains uneven. The epidemic has also devastated the education sector, killing teachers faster than new ones can be trained and hollowing out school systems already stretched thin.
Solving Africa’s health crisis requires more than charity. It requires strategy and political will. Three steps are essential: building more effective and efficient health systems; expanding coverage so care reaches the most vulnerable; and shifting resources from high-tech urban hospitals to community-based primary and preventive care. These are not radical ideas. They are the foundation of every successful health system in the world.
Economic development remains a critical piece of the puzzle. When people’s incomes rise, their nutrition and health improve almost immediately. But growth alone cannot substitute for targeted investment in health systems. The two must advance together.
Foreign aid must be channeled through organizations with proven track records—WHO, UNICEF, UNFPA, and experienced NGOs that understand local realities. Aid should strengthen civil society and community-based organizations, the backbone of any democratic and resilient society. Africa has endured centuries of hardship, yet its people have shown extraordinary resilience. Well-directed assistance, aligned with local priorities and grounded in respect, can help the continent’s health systems recover and allow Africa to flourish. The world has made enough promises. What Africa needs now is follow-through.
Dr. Cesar Chelala is a co-winner of the 1979 Overseas Press Club of America award for the article “Missing or Disappeared in Argentina: The Desperate Search for Thousands of Abducted Victims.”
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