*This is an archive page. The links are no longer being updated. 1991.03.21 : Child Health in Sub-Sahara Africa Contact: Campbell Gardett (202) 245-6343 James Kunder USAID Press Office (202) 647-4200 March 21, 1991 Child health has improved in recent years throughout much of sub-Saharan Africa, but severe problems remain, including malnutrition, malaria and vaccine-preventable disease, according to a report to the President released today. The report concludes that United States assistance has helped enhance child health, and such assistance can be extended and improved. But at the same time, the report says, both AIDS and rapid population growth pose growing threats to health, social and economic conditions in Africa. The report was presented by HHS Secretary Louis W. Sullivan, M.D., and Ronald W. Roskens, Ph.D., administrator of the U.S. Agency for International Development, following their mission to Africa on behalf of President Bush. The President announced the mission in his speech to the United Nations Summit for Children last September. The delegation, including HHS and USAID experts on child health, visited seven African nations from Jan. 4-18. "The United States is committed to a long-term partnership with the nations of Africa to improve child health and child survival," Secretary Sullivan said in releasing the report. "The findings and recommendations in this report will help to target and strengthen our assistance and increase the effectiveness of our cooperative efforts." Administrator Roskens said that "efforts to improve child health go hand in hand with the whole range of other development activities, including the hopeful movement toward democratization and economic reform that is taking place in so many African countries. The nations we visited exhibited a self-help attitude toward overcoming the impediments to improved child health, and we are committed to assist them toward those goals." Recommendations in the report included the following: o U.S. policy should continue to emphasize broad-based economic growth to create an environment in which health programs will be sustainable and effective. o Strong primary health care policies and systems must undergird shorter-term health interventions. U.S. assistance should continue to support targeted child survival activities while promoting policies that advance primary health care systems and which integrate disease prevention activities, including immunization programs and broad health education. o U.S. assistance should be intensified in combating malaria, "the forgotten killer." Of the 110 million cases of malaria reported annually, 90 million occur in Africa, and strains of the disease which are chloroquine-resistant are increasingly prevalent. Malaria is the leading killer of children in many African countries. U.S. assistance can help in applied and basic research and malaria control programs. o Behavior change is the key to breaking the AIDS transmission chain. U.S. programs should support additional interventions to promote behavior change, encourage social marketing of condoms and the control of sexually transmitted diseases, and support research on other means to reduce HIV transmission, including vaccines. o Rapid population growth can overwhelm health care efforts. The U.S. should intensify assistance for improved reproductive health and family planning in Africa and should include efforts to increase the range of choice of contraceptive methods. o Information technology can be more effectively harnessed in the battle to save children's lives. The U.S. should explore additional means to assure that African professionals have access to public health information, technical assistance and training in epidemiology, disease surveillance, computer science and data use. o Stronger institutional linkages can improve the health of Africans and Americans. American academic, philanthropic, health and civic institutions can be of assistance to health programs in Africa, including linkages with American medical research and training institutions. Among the findings of the delegation highlighted in the report were the following: -- Progress has been made in child survival in Africa despite worsening economic conditions, including a 15 percent drop in per capita income in some two-thirds of sub-Saharan nations over the past decade. With improved primary care systems, many countries have increased access to immunization, family planning services and oral rehydration therapy for the treatment of life-threatening diarrheal diseases. -- High fertility and rapid population growth are among the greatest threats to child survival in Africa. With a population of 640 million today, sub-Saharan Africa is expected to increase by 1 billion by the year 2025 -- Infant mortality rates in Africa remain among the highest in the world. Of 30 countries with infant mortality higher than 100 deaths per 1,000 live births, 23 are in sub-Saharan Africa. -- Malnutrition is present in an estimated 30 percent of African children between 12-23 months, an important contributor to childhood mortality. -- HIV infection is rapidly becoming one of the major causes of death for children in sub-Saharan Africa. The prevalence of HIV infection in pregnant women is as high as 20-30 percent in some countries, and about a third pass the infection to their unborn child. During the last decade, according to the World Health Organization, some 500,000 infants in Africa were born with HIV infection. It is expected that by the end of the 1990s there will be an additional 10 million HIV-infected children in Africa. In addition, an estimated 10 million children are expected to become orphans in Africa during this decade because of the death of one or both parents from AIDS. It is estimated that infant and child mortality rates in some African countries will increase by 50 percent due to AIDS. The delegation visited Nigeria, Cote d'Ivoire, Uganda, Malawi, South Africa, Zimbabwe and Senegal, and met with the health minister of Namibia. ###