Past, present and future perspectives

Health and HIV/AIDS

The United Nations Development Programme (UNDP) has established that most African countries in sub-Saharan Africa experienced declines in per capita incomes during the past decade as a result of HIV/AIDS. In many African countries, HIV/AIDS has already had a devastating impact on many development sectors, such as agriculture, health and education. Of the world's 36 million people living with HIV/AIDS, more than 23 million, or 64 per cent of them, are in sub-Saharan Africa (UN 2000). It has been estimated that, by 2010, there could be 40 million orphans in sub-Saharan Africa as a result of HIV/AIDS.


Poverty encompasses a range of deprivations, including: lack of access to natural resources, health care and education; inability to access the political process; vulnerability to catastrophes; and the denial of opportunities and choices that are basic to human development. An estimated 40 per cent of people in sub-Saharan Africa live below the poverty line, and both income and human poverty are increasing (UNDP 1997). Poverty is a major factor in accelerating environmental degradation in the region. This is because the majority of the poor are heavily dependent on land and its resources for livelihood. The poor are forced to overexploit resources, such as fisheries, forests and water, in a desperate struggle to survive. Environmental degradation contributes markedly to many health threats, including: air and water pollution; poor sanitation; and diseases, such as malaria.

The Human Development Index (HDI) is a way of measuring quality of life, defined by the UNDP. It is clear from Table 1.5 that, in 2000, there were no African countries in the high (HDI) group. A number of countries were in the medium HDI group, while the majority were ranked in the low HDI group.

African governments now generally acknowledge that the overriding objective of development hinges on poverty reduction in the short term, and on its complete eradication in the long term. In reducing poverty, there is a need for strong political commitment combined with specific policy instruments targeting the poorest segments of society. To achieve average growth rates of 7 per cent per year-which estimates suggest would resuscitate Africa's economic performance and put the region on a path of sustainable development-an additional investment of 33 per cent of GDP is required.

Table 1.5 HDI ranking of African countries in 2000
African countries by HDI levels
Sub-regional grouping Low HDI Medium HDI High HDI

Northern Africa

Sudan (143)

Libya (72)
Tunisia (101)
Algeria (107)
Egypt (119)
Morocco (124)


Western Africa

Togo (145)
Mauritania (147)
Nigeria (151)
Cote d'Ivoire (154)
Senegal (155)
Benin (157)
Gambia (161)
Guinea (162)
Mali (165)
Guinea Bissau (169)
Burkina Faso (172)
Niger (173)
Sierra Leone (174)
Cape Verde (105)
Ghana (129)

Central Africa

Democratic Republic of
Congo (152)
Central African Republic
Chad (167)
Gabon (123)
Equatorial Guinea (131)
Sao Tome & Principe (132)
Cameroon (134)
Congo (139)

Southern Africa

Zambia (153)
Tanzania (156)
Angola (160)
Malawi (163)
Mozambique (168)
South Africa (103)
Swaziland (112)
Namibia (115)
Botswana (122)
Lesotho (127)
Zimbabwe (130)

Eastern Africa

Djibouti (149)
Uganda (158)
Eritrea (159)
Rwanda (164)
Burundi (170)
Ethiopia (171)
Kenya (138) none

West Indian Ocean States


Madagascar (140) Seychelles (53)
Mauritius (71)
Comoros (137)
Source: UNDP 2000 (Figures in brackets refer to world HDI rankings, from the highest ranking of 1, for Canada, to the lowest of 174, for Sierra Leone)