Disease Patterns Since 1960
Most African states became independent after 1960, but they have not been able to effect radical improvements in health conditions. Colonial medical services and their successors in sovereign African countries have tended to stress therapy over prevention, and to favor cities over the rural areas.
There has been some real progress. Smallpox has been eradicated, thanks to a concerted worldwide campaign. Vaccines, many developed only after 1960, have begun to make inroads against measles, diphtheria, polio, cerebrospinal meningitis, and other common infections, but new vaccines are urgently needed for other diseases, including malaria and the bacterial and viral agents of childhood diarrheas. The most urgent need is to improve rural water supplies and sanitation, which would greatly reduce the incidence of a host of infections. Greater attention to nutrition and to infant and child health is also essential.Malaria and schistosomiasis are still major causes of morbidity and mortality, and almost no progress has been made against the common intestinal parasites. Even yaws, which is readily treated with penicillin, has reemerged in areas such as Ghana where economic distress has curtailed medical services. Similarly, internal strife and misgovernment in Uganda have disrupted trypanosomiasis control, with predictable results. Campaigns sponsored by the World Health Organization and other groups against such major scourges as malaria, onchocerciasis, schistosomiasis, trypanosomiasis, and leprosy are promising, but high death rates, weak and sometimes declining economic and political systems, and the AIDS epidemic show that grave problems remain. More than ever, Africa’s disease environment is determined by its poverty.
K. David Patterson