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Health Systems &Integration Bill Brieger | 29 Dec 2009 01:33 pm

One Billion and Counting

As 2009 comes to an end, The Guardian lets us know that, “The baby’s name and nationality are not known. The child will grow up innocent of having a place in history. But somewhere, this year, that child became the billionth person in Africa, the continent with the fastest growing population in the world.”

With 45% of Africa’s current population living in urban areas, the billionth child was as likely to be born in Lagos or Nairobi as in a village. This paints an epidemiological picture where, “Deaths from smoking or car crashes will be a factor as much as the more familiar health issues of malnutrition, malaria and Aids. These citizens will also be vulnerable to droughts, floods and desertification caused by climate change.”

And while the population keeps growing, African children born in 2009 face the highest under 5 year old child mortality rates in the world. Afghanistan and Burma were the only non-African countries among those 38 with rates of 100 child deaths per 1000 live births or greater.

The life expectancy of that child is 55 years – 14 years younger than the world average. It could even be ten years less if the child was born in some of the areas highly endemic for HIV.

So what are we offering the cohort of children born in Africa during 2009? Many countries like Nigeria are in the midst of working toward universal coverage of insecticide treated nets, and just reported a successful campaign in Ogun State where 1.6 million of the proposed 63 million national total were just distributed.

africa-population-growth2.jpgWe have noted that the process of making appropriate malaria medications for children and intermittent preventive treatment for pregnant women (to protect the next cohort of African children as well as the mothers) is well below target. One-off Campaigns to get nets out to households are somewhat ‘easier’ than ensuring an integrated and functioning public, private and non-governmental health system that is needed to provide other routine preventive and treatment services.

We wish that when this one billionth child has a birthday in 2010, she or he will be fully protected from malaria with a net and have ongoing access to the services needed to keep malaria at bay.

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