© t. m. whitmore today more causes of sub-saharan africa & (under)development role of disease...

© T. M. Whitmore

Today•More causes of Sub-Saharan Africa &

(under)DevelopmentRole of disease (again)The role of development aidRole of debt & “Structural

Adjustment”Women and developmentStructure of African economies

© T. M. Whitmore

Last Time•Sub-Saharan Africa & Development

The characteristics of the least developed

•Causes of (under)developmentRemnants of colonialism SS African environments and

human usesRole of conflictImportance of population &

demographyAgricultural production

© T. M. Whitmore

The Burden of Disease (again)

•HIV/AIDS (again)•TB (Tuberculosis)•G I tract diseases (diarrheas)•Malaria•Some of the rest

MeaslesAfrican sleeping sicknessYellow FeverSchistosomiasisOnchocerciasis (River blindness)

Reduction in production in a Reduction in production in a household with an AIDS death, household with an AIDS death,

ZimbabweZimbabwe

Source: Stover & Bollinger, 1999

•

•

•

•

•

Crops Reduction in output

Maize

Cotton

Vegetables

Groundnuts

Cattle owned

49%

37%

29%

47%

61%

© T. M. Whitmore

TB: re-emerging killer

•1.6 million new cases of TB in Africa yearly

•600,000 TB deaths occur every year

•TB is the leading cause of death in people with HIV in Africa

•Drug resistance increasing

HIV/AIDS is Fueling the TB Epidemic

HIV/AIDS Prevalence in sub-Saharan AfricaEstimated percent of adults living with HIV/AIDS

TB High Burden Countries

10% +

3-9%

1-3%

TB Incidence

0-99 per 100,000

100-299 per 100,000

> 300 per 100, 000

Source: UNAIDS Report, July 2002; WHO Report, 2002, Global TB Control

© T. M. Whitmore

G. I. Tract Diseases• 1.8 billion cases/yr of infant/kid diarrheas,

intestinal parasites, cholera, various types of dysenteryMost are in SS Africa

• Infants and kids who are just weaning are especially susceptible due to impure water

• Many if not most deaths (perhaps 1 million/ yr in the world) can be averted with adequate treatment (Oral Rehydration Therapy)

• To improve => provide adequate sanitation: in rural Africa only about 20% has access to adequate sanitation

© T. M. Whitmore

Malaria •Also related to water since mosquito

vector needs warm stagnant water•World wide annual toll

More than 1 million deaths 90 % of cases in SS Africa

500 million attacks of acute illness50,000 cases of neurological

damage400,000 episodes of severe anemia

in pregnancy – 400,000 LBW babies•Drugs expensive & resistance

increasing

Malaria transmissionMalaria transmission

The Malaria ChallengeThe Malaria Challenge Death rates reduced in Asia but rising in Africa

1900 1930 1950 1970 1990 2000

0.1

1.0

3.0

2.0

China

N.America & Europe

Africa

World

An

nu

al D

eath

s f

rom

Mala

ria

(

million

s)

(R.Carter,1999)

Central & S.America

Asia

Duration of transmissionDuration of transmission

Resistance to Chloroquine - 1960Resistance to Chloroquine - 1960

Source: FHI

Resistance to Chloroquine - 2000Resistance to Chloroquine - 2000

Source: FHI

© T. M. Whitmore

Many others

•African sleeping sickness — transmitted to humans and livestock by the tsetse fly — endemic in much of SS Africa

•Yellow fever — more epidemic than endemic in most all lowland Africa

•Schistosomiasis (also called bilharzia) — absent only in highland areas

•Onchocerciasis (also called river blindness) — common in savanna zones

Onchocerciasis

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•Aid applied according to development theories & ideologies current at the time – or for geopolitical goalsOften not well enough thought outMuch US aid to Egypt, Israel for

example

•Results often aided the Global N or Trans National Corporations

•NGOs, smaller, may have better record, but still have their own agenda

Aid and underdevelopment

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Debt & underdevelopment•Post-independence (1960s-70s)

Good prices for primary sector exports

Encouraged international investment (debt financed)

• Investments were often poorly thought out

•1980s bust in prices => lower income But debt still needed to be paidBy 1980s debt service (interest +

capital) = 25% of all governmental income

© T. M. Whitmore

Debt and underdevelopment II

•Inefficient and corrupt governments

•“Structural adjustments” (IMF & World Bank) force governments to reduce spending to pay debtsLoss of social security netsLoss of subsidies to agriculture (e.g., for fertilizer)

•Recently some re-organization and call for debt forgiveness etc.

© T. M. Whitmore

World Bank & IMF•Created after United Nations

Monetary and Financial Conference (1944-45)

•Loans and grants to ~ 184 members, almost the entire UN

•Focused on Global SouthHuman developmentAgriculture and rural developmentEnvironmental protectionInfrastructure & Governance

•Borrowers must launch reforms

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Criticisms of World Bank & IMF•A tool of the Global N imposing policies

that support Its interestsSupports international corporate

interests over local onesNeo-liberal economic principles

(privatization & markets) Required repayment no matter what

(structural adjustment)•Governance based on level of financial

contribution (from Global N)US 16.4%; Japan 7.9%; Germany 4.5%Major policy shift requires 85% yes;

thus, US controls

© T. M. Whitmore

Women and development

•Cycle of Overwork – poverty – and demands of child rearing => Elevated infant mortality Elevated maternal mortality

•Slower fertility decline Close birth spacing =>

•Poor levels of female education

Western Africa1,040

Eastern Africa1,340

North Africa460

Central Africa 1,020

Southern Africa360

*Maternal deaths per 100,000 live births

Maternal Mortality Ratio*

Source: Kenneth Hill, Carla Abou Zahr, & Tessa Wardlaw: Estimates of maternal mortality for 1995. Bulletin of the World Health Organization, vol.79, no.3, 182-193.

Sub-Saharan Africa 1,100

South Asia 430

East Asia/Pac. 140

LA & C 190

DevelopingCountries 440

Ratio of Girl’s to Boy’s Primary Education

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Structure of economy & development

•Narrowly focused economies often have troublesPrimary sector (such as agriculture or mining) economies have most problems

Recall the least developed countries

A risky primary sector economy => little opportunity to create a more diverse economy

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Agricultural pastoral economies

•West Africa: Liberia, Cote d’Ivoire (Ivory Coast)

•East Africa: Tanzania

•Central Africa: Congo, Cameroon, C. African Republic

•Southern Africa: Madagascar, Mozambique, Malawi

© T. M. Whitmore

Agricultural pastoral economies

African Crop Land

Navin Ramankutty, Nicholas J. Olejniczak, and Jonathan A. FoleyCenter for Sustainability and the Global Environmenthttp://www.sage.wisc.edu

© T. M. Whitmore

Problems for ag-pastoral economies

•Commercial/export ag often benefits only a fewusually occupies best lands

•Ag/pastoral sector usually less rapidly growingat risk to environmental fluctuationsat risk to land degradation and loss of

productive potential•Great competition among ag sector primary

product exporters tends to lower prices to producers (e.g., many countries world-wide export coffee)

© T. M. Whitmore

Mostly mineral extraction-based primary/extractive

economies•West Africa:

Nigeria•Central Africa:

Zaire/Democratic Congo Republic, Gabon

•Southern Africa: Zambia, Botswana, Namibia, Angola

© T. M. Whitmore

Mineral extraction-based primary/extractive economies

© T. M. Whitmore

Problems with mineral-export economies

•Price fluctuations often extreme

•Minerals are a “wasting” resource

•Often mines are foreign owned and controlled

•Environmental problems in places

•Corruption seems to accompany mineral wealth

© T. M. Whitmore

Dual - Sector Economies: agricultural/pastoral and

minerals•West Africa:

Mauritania, Senegal, Guinea, Ghana

•Southern Africa: Zimbabwe, Swaziland and Lesotho

•Problems Still primary sector based => low rates of growth and productivity

© T. M. Whitmore

Dual - Sector Economies

© T. M. Whitmore

Diverse economies — not just primary sector

•KenyaYet Kenya’s GNI/capita still very low

•South Africa

© T. M. Whitmore

Diverse economies

© T. M. Whitmore

Themes for SS Africa Development/Underdevelo

pment •Environmental uncertainty•Disease•Population growth•Food production shortfalls•Conflict•Debt •Structure of economy•All work together in geographic

complexity!