2017 has been what could be considered a memorable year in the African continent. For example, Robert Mugabe was ousted from power in Zimbabwe, and Ellen Johnson Sirleaf, first elected female head of state in Africa, led her country to a peaceful presidential election. While these are some considerable political events, and they are more noteworthy ones too that happened in the public health arena. The resurgence of cholera and measles, and high incidence of malaria that continue to kill countless numbers of children on a daily basis in many countries are all awful reminders of the impacts of diseases on human health in the African continent.
As a student, 2017 enabled me to appreciate my coursework in a different way. While reading course materials pertaining to the demography transition in other parts of the world, such as in Latin America, as an example, where precipitous declines in Asia and Latin America, from five children per woman in the 1970s to around 2.5 today, I couldn’t help but reflect on the health and demographic changes occurring on the continent. Although, many authors I read have argued that demographic processes such as falling fertility, decline in infant and maternal mortality rates, and increase in life expectancy positively influence patterns of population growth. While it is true that there has been a general improvement in the aforementioned statistics worldwide, their impact on population growth in Africa, writ large, has been slow. The United Nations estimates that the population of the African continent will double to 2.4 billion by 2050. If this projection holds true, The African continent would be unable to feed its population and the impacts of this overpopulation on the environment would be unimaginable.
It is undeniable that social change occurring in Africa, particularly in Sub-Saharan Africa, are having dramatic effects on human health. But does Africa need to follow a course similar to that of Latin America? Perhaps, no. During my work assignments in many countries, I have noticed that people are becoming very conscientious about the need to limit the number of children they have. People are no longer perceiving having many children as a form of “insurance for old age” or labor force. Couples, both in the urban and rural settings, are aware of the burden that comes with having many children. They are concerned about providing food, schooling, and healthcare to their offsprings. So, why hasn’t fertility declined in Africa as it has been the case in Latin America? Perhaps, the answer lies in the low, and at times zero, investments made by many governments in public health, particularly in family planning and basic and quality healthcare services. While some governments have increased the share of their gross domestic product that is allocated to health, many have reduced it significantly in recent years. In many countries, such as South Sudan, Burundi, Somalia, to name a few, the national healthcare system is supported by the international community through local and international NGOs and other groups.
Africa is not completely off the path to achieving a demographic transition. What it would take is a renewed focus on the part of various governments to invest in their healthcare systems, and by reducing their reliance on foreign aid. It has been said that with a new year comes a new beginning. Hence, could 2018 be the year when governments throughout the African continent pay close attention to demographic processes in their countries, and invest in quality healthcare services and robust national family planning programmes? If governments are not willing to change course in 2018, meaning allocating considerable funding to the healthcare sector, prioritising girls’ education and access to modern form of contraception, then we risk seeing a repeat of 2017, which was characterised by crumbling healthcare systems throughout the continent.
Martin Luther King Jr. said “ Unlike plagues of the dark ages or contemporary diseases we do not understand, the modern plague of overpopulation is soluble by means we have discovered and with resources we possess.” What is lacking is not sufficient knowledge of the solution but universal consciousness of the gravity of the problem and education of the billions who are its victims. As we bid farewell to 2017, we must remember that overpopulation is straining the earth’s resources to the breaking point, and this is so true in the African continent. My hope is that 2018 will be different year, one in which investments in healthcare coupled with strong national family planning programmes will be prioritised by governments and the international community throughout the African continent as a way to fight or alleviate hunger, disease, and poverty leading to migration. After all, we have the tools and knowledge to improve the lives of millions of Africans, but it starts with a cogent analysis of its population size and structure.
Issa studies Demography and Health by distance learning.