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Sub-Saharan Africa

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Growth and Poverty Reduction
  • Real per capita income growth in the region’s low-income countries has been stronger since 2000 than in any period since the 1960s. Real per capita GDP growth is expected to be 4 percent in 2006.
  • Despite this strong growth in some countries, Sub-Saharan Africa (SSA) remains unlikely to achieve the first Millennium Development Goal (MDG) – to reduce poverty by half by 2015.
  • The population share of extreme poverty in SSA fell by 4.7 percentage points in 5 years to 41 percent in 2004, but population growth leaves the same actual poverty numbers—nearly 300 million. SSA has 30 percent of the world’s extreme poor.

Region’s progress toward the poverty MDG target 1990-2004; a 2015 forecast
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Poverty Graph SSA

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  • Stronger growth in SSA’s low-income countries could mark a potential turn-around from long stagnation, but concerns persist over a possible slowdown in growth resulting from disorderly unwinding of global imbalances, protectionism, future behavior of world oil prices, or a possible global avian influenza pandemic.
  • Africa has, on average, the weakest institutions of any region—but some indicators suggest strong improvement in many countries. Investment Climate Surveys show African countries, formerly the slowest group to reform, as second only to Europe and Central Asia in improving their investment climates in 2006.

Fragile States

Prospects for improved growth and poverty reduction do not apply to many fragile states, where extreme poverty is increasingly concentrated.

Well over half the world’s fragile states are in this region.

Gender

  • Progress has been varied in increasing female school enrollment. Countries such as Botswana, Rwanda, and South Africa have met enrollment targets. However, of 22 countries worldwide that are unlikely to reach the enrollment target, 16 are from SSA. The region’s female primary school completion rate, among the lowest in the developing world, is 57 percent—10 percentage points below that of boys’.
  • Teenage childbearing can bring disproportionate health risks to both mother and baby. Female genital mutilation, practiced in several countries, heightens this risk. In 2000-04, the share of adolescent (15-19) mothers was high in countries such as Mozambique (41 percent), Nigeria (25.2 percent), and Kenya (23 percent).
  • Women’s labor force participation is high, but they constitute only about 25 percent of non-agricultural wage employment. And despite quotas for women’s presence in parliaments being introduced in Mozambique, Rwanda and South Africa, the regional average share of seats in national parliaments held by women remains low at 15 percent.

Progress toward the Human Development MDGs

  • The region is off-track on all the human development goals, but countries vary considerably. Fragile states have lower performance and slower improvement than others.

Nutrition

  • The region has an estimated 26 percent prevalence of child malnutrition, and in some countries such as Burkina Faso and Zambia trends are worsening.

Universal Primary Completion

  • Benin, Guinea, Madagascar, Mozambique, Rwanda, and Niger were among the global leaders in expanding completion (by over 10 percent/year in 2000-2005).
  • However, of 38 African countries for which data are available, 33 are off track. Malawi, Mauritania, and Namibia are among the world’s weakest performers.

Child Mortality

  • SSA is not on track to meet this goal. Sharp increases in child mortality have been registered in Botswana, Zimbabwe, Swaziland, and Lesotho.
Eritrea

Eritrea: Rapid progress is possible
Eritrea, with a per capita income of only $190, shows that rapid progress is possible. Under-five mortality was halved from 1990-2005, from 147 to 78 per 1,000 births.

This progress was largely due to the IMCI (integrated management of childhood illness) approach, including the training of over 500 health workers at different levels of the health care system in IMCI case management.

Photo: USAID/Eritrea
Awoman and her child receive IMCI counseling from a trained practitioner
  • One regional ‘win’ has been mass childhood vaccination of children for measles. Since 2000, measles deaths in the region have reduced by 75 percent.

Maternal Health

  • Even in some very poor countries such as Benin, Cameroon, Mali, Mozambique, Zambia, and Zimbabwe, at least 90 percent of births in upper income groups are assisted by trained attendants—many times more than in the poorest quintile.

Combating Disease

  • In Africa, AIDS has reversed decades of improvements in life expectancy and left millions of children orphaned.
  • By end-2006 an estimated 39.5 million people globally were living with HIV, up 2.6 million since 2004, and an estimated three million people died from AIDS.
  • While the spread of AIDS has slowed in some parts, the region remains the center of the epidemic—home to just over 10 percent of the world’s people, nearly 64 percent of all adult HIV and 90 percent of all child HIV infections.
  • About 60 percent of HIV-positive adults in Africa are women.

HIV graph SSA
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  • The spread of HIV has slowed in SSA, but with an estimated 2.8 million new cases in 2006, much more remains to be done. Conclusions include:
    • Reversing the spread of HIV/AIDS is possible. The first signs of declining national HIV prevalence are seen in Kenya, Uganda, and Zimbabwe.
    • Treatment is effective in the developing world; UNAIDS estimates that expanded provision of antiretroviral treatment resulted in a gain of 2 million life-years in low- and middle-income countries in 2005.
    • Although access to treatment has expanded, three-quarters of all people with AIDS in the developing world are untreated.

Malaria

Malaria in Sub-Saharan Africa

Of the 1.2 million malaria deaths a year, 80 percent occur in SSA.
The World Bank expects to commit $500 million of International Development Association (IDA) funds to support the Malaria Booster Program in about 20 countries.

  • Annual global growth in tuberculosis of 0.6 percent is attributed to rapid increases in TB infections in SSA, linked to latent infections in HIV carriers.

Using Resources Wisely

  • SSA is the only region way off track to meet MDG7. Just 17 of 36 countries (for which data are available) are on or almost on track to increase access to improved water supply. Of countries for which data exist, only Senegal is on track for sanitation.
  • SSA’s growth path seems unsustainable. Its natural capital (minerals, fossil fuels, land) are being depleted without investing in other areas such as human capital. In 1990-2005, annual deforestation was 0.6 percent—faster than any other region.

The Role of Quality in MDG Progress

  • While access to education and health is important, quality is also critical. Results from several Southern African countries show that less than half of children are able to read by age 12. And given Africa’s need to employ an estimated 1 million new health workers by 2015, healthcare quality also requires special attention.
Need for Scaling Up and Harmonization of Aid
  • The need to bring actions in line with commitments grows acute. Doubling of aid to Africa by 2010 looks unlikely at the current rate of aid growth.
  • Beyond debt relief and special initiatives, most SSA countries are seeing stagnant or declining aid.
  • Excluding Nigeria (a recipient of exceptional debt relief), real ODA from DAC members to the region actually fell in 2005, and stagnated in 2006.
  • While donors are making an effort to harmonize aid, more needs to be done. Take the example of Rwanda: the government’s ability to achieve policy coherence is being undermined as 86 percent of aid for health (mainly targeted for HIV/AIDS and malaria) is bypassing the Ministry of Health.

 

Aid to SSA
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