1. Health African Economic Development Renata Serra – March 29 th 2007

2. The African health crisis Quantitative Qualitative Regress through time after painful progress Lack of conditions for reverting the crisis in the short term

3. The worst areas Infant mortality from preventable diseases and malnutrition combined Maternal mortality (risk factor for African women is 500 times larger) HIV/AIDS See www.unaids.org for data and information, especially on your country of choicewww.unaids.org http://www.theglobalfund.org/en/ http://www.gatesfoundation.org/default

4. Supply constraints Insufficient provision of health services Bias against rural areas and PHC Initiatives: 1978: Alma Atta Conference 1987: Bamako Initiative Despite commitments and reforms, the supply of services remain inadequate quantitatively and qualitatively

5. “Demand” issues Several constraints: User fees Distance Perception of low quality Inability to buy medicines Patients’ feelings and pride hurt by providers “Access to PHC in Mali by women” Research shows that many poor women prefer alternative providers even when PHC facilities are in the near vicinity  failure of the health reforms??

6. Men take decisions for their wife’s health Source: Unicef, The State of the World’s Children 2007, Fig. 2.1 [online at: http://www.unicef.org/sowc07/docs/sowc07.pdf] http://www.unicef.org/sowc07/docs/sowc07.pdf

7. Challenges Incorporate traditional medicine Train health personnel on provider- patient relationships Take seriously specific cultural and social barriers Language issue

8. Broader connections Poverty Migration and trans-national movements Poor quality of water, hygiene and sanitation Low levels of education Political instability and wars Economic reforms International drug trade and IPRs agreements Brain drain Cause or consequence of lack of facilities?

9. The economic costs of poor health Lost days at work and lower productivity Poor children’s school attendance Increase in care activities by HH members and decrease in productive employment Greater poverty (as income is spent on drugs and treatment) Low levels of FDI All these factors amount to significant lower saving, investment and growth rates: is there a measure of the lost growth potential for your own country?