Africa

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1

HIV/AIDS

To date, more than 70 percent of the victims of HIV/AIDS worldwide have been Africans. The world’s first case on record is traceable to a plasma sample from a man who died in 1959 in the Belgian Congo (present-day DRC), but clinical identification of the disease was not possible until the early 1980s. By then it had already reached epidemic proportions, with Uganda and Rwanda as the epicenter of occurrence. In subsequent years, the epicenter moved progressively southward, and now Botswana and South Africa are seeing the highest rates of infection. As yet, HIV/AIDS has progressed more slowly in West Africa, with the exception of Côte d’Ivoire, which has been hit hard. Rates are increasing, however, especially in Nigeria. West Africa also has cases of HIV-2, an apparently less virulent strain of HIV that seems to result in lower death rates. Few cases of HIV infection have as yet been reported in North Africa.

Two modes of transmission account for virtually all cases of infection in Africa. The most significant has been heterosexual intercourse. Spread of the virus has been facilitated by a tradition of men having multiple sexual partners. The increased mobility of the African population has also helped the spread of HIV. The earliest lines of transmission were along roads carrying heavy truck traffic, with the infection points being rest stops where prostitutes served truckers. Both populations soon became infected and began spreading the disease to others.

As it has progressed, infection rates have grown more rapidly among females, especially younger ones. Several factors are responsible for this trend. First and foremost, condom use is limited, either because its protective value is unknown or because it is disliked. In addition, teenage African girls often start their sex lives with older men—whether married to them or not—who are more likely to be infected than boys their age. At the same time, as knowledge of AIDS has spread, men have sought to have sex with even younger girls in the belief that they will not already be infected. And, in many large cities such as Nairobi and Cape Town, cases of rape are on the rise.

The increase of HIV among women brings about the second major mode of transmission, which is mother-to-child. More and more babies are entering the world infected, and many healthy newborns are infected through their mothers’ milk. Transmission through homosexual sex and intravenous drug use are uncommon in Africa.

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In general, African governments have been slow to respond to the HIV/AIDS epidemic, or even to admit that a problem exists. Two significant exceptions are Uganda and Zambia, where efforts to halt the spread of HIV/AIDS date to the mid-1980s. The Ugandan program has been especially effective, and the disease there is receding. Zambia has also begun to see infection rates fall among its most vulnerable population, pregnant teenagers.

The impacts of the HIV/AIDS epidemic are many and far-reaching. Countries where rates are very high, such as Botswana, will soon notice a “missing” adult population, leaving the country numerically dominated by the elderly and young. Numbers of orphans are on the rise, an unusual situation in Africa, where extended families and communities traditionally provide childcare. The missing adult population has already begun to affect economic productivity across the board, whether on farms or in factories. The teaching profession has been especially hard hit. AIDS is now by far the leading cause of death among teachers in the Côte d’Ivoire, and Zambia has found it cannot replace the number of teachers who have died or fallen ill.

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2

Malaria

Often called the “silent killer” due to the lack of attention it receives, malaria is spread by the bite of the female Anopheles mosquito. Worldwide, the disease afflicts between 300 million and 500 million people annually, and 90 percent of the cases occur in tropical Africa. In terms of mortality, children under age five are the most vulnerable group, with some 700,000 dying in Africa each year. This death toll exceeds that from AIDS. Adults are less likely to die from malaria, but still suffer from the sickness. Infection often peaks during the rainy season, and higher rates of bedridden workers affect the agricultural productivity of families, communities, and nations. Experts estimate that the annual costs of malaria treatment and lost productivity due to malaria total between $2 billion and $3 billion for the continent as a whole.

The World Health Organization (WHO) began malaria control programs in 1948, spraying mosquito-breeding sites with insecticides and administering antimalarial drugs. For a time, it appeared that the disease might be eliminated, or at least brought under control. But since the late 1970s malaria has resurged. Mosquitoes have developed resistances to insecticides, as have the malaria parasites to traditional chloroquine-based antimalarial drugs. Urban malaria is spreading, largely as a result of the growth of squalid shantytowns that provide numerous pools of standing water where mosquitoes can breed. Civil conflict and natural disasters such as floods are other contributors to malaria’s spread. The seriousness of the problem led the WHO and other international groups to launch Operation Roll Back Malaria in 1998. This operation aims to intensify monitoring, prevention, and treatment efforts, with the ultimate objective being the development of an antimalarial vaccine.

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Other Afflictions

Tuberculosis is another age-old disease that has become more widespread since the early 1980s, largely because it is a common opportunistic infection in AIDS cases. Drug-resistant varieties of tuberculosis are making treatment more difficult for all sufferers.

Cholera, once uncommon on the continent, is now endemic in Africa. Outbreaks are associated with contaminated water supplies, and contamination has become ever more common in both rural and urban areas.

Malnutrition is another widespread health problem among infants and young children. Many babies are born underweight, often because their mothers suffer from malnutrition. Studies have shown that many African children experience a slowdown in growth following weaning, when their diet suddenly shifts from high-protein, high-energy mothers’ milk to predominantly starchy foods. Malnourished children often develop protein-energy malnutrition conditions such as marasmus (essentially infantile starvation) and kwashiorkor, characterized by body swelling. Both conditions can be fatal, the latter often in association with infectious and parasitic diseases such as measles and malaria, as well as diarrhea.

The People of Africa section of this article was contributed by James L. Newman.

IV

Economy

Since prehistoric times, the majority of Africans have been farmers and herders who raised crops and livestock for subsistence. In precolonial times, a few African states developed long-distance trade networks based on the exchange of raw materials and some specialized local goods. Starting in the 15th century, European colonization of Africa brought overseas demand for certain agricultural and mineral products. The colonizers built new transportation networks and introduced technological innovations and new crops. At the same time, they exported millions of able-bodied Africans as slaves, exploited African labor within the continent, and undermined local industries, crafts, trade networks, and governments. By the mid-20th century, European colonies in Africa had established one-way trade systems in which Africa’s wealth of raw materials were exported to enrich foreign coffers, with little regard for development within Africa.

As decolonization began in the late 1950s, the African economy was divided into two distinct sectors. Most of the population took part in the traditional rural sector, which featured subsistence production of food and simple manufactured products. The remainder was involved in a relatively modern sector, based in cities and mining and plantation centers. There, Africans worked for wages, producing mineral or agricultural raw materials for export to industrialized countries. Although people in most rural communities earned some money from seasonal work in the cities and modern industrial centers, the two sectors were largely separate.

In subsequent decades, African governments pursued various economic development initiatives in an attempt to improve the living standards of their people. In many countries, these efforts led to the growth of manufacturing of consumer goods and other products. Services—in education, health care, civil services, and other areas—also grew in economic importance.

Development efforts led to a greater degree of interaction and movement of people and money between the modern and subsistence sectors of the African economy. Yet, by the early 21st century, the sectors were still far from integrated. Most of the population still pursued traditional subsistence activities, which continued to provide sustenance for the majority of Africans. At the same time, despite increasing levels of industrialization in many countries, Africa’s raw materials continued to be produced primarily for export.

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Traditional Subsistence Sector

Despite economic development efforts, the traditional subsistence sector is a constant in the African economy. In general, the majority of African people farm, herd livestock, fish, make handcrafted products, and trade their goods much as they have for hundreds of years.

Farming is by far the most important subsistence activity, and it dominates rural production in the tropical forest and tropical savanna zones of West, Central, and southern Africa. Traditional agriculture is basic and at best yields enough food and income for the household to survive. The average rural household has no access to scientifically improved seeds, farm machinery, or sophisticated methods of farm management. On most African farms, the soil must be worked with hand tools or small, animal-drawn plows. Use of artificial fertilizers is almost nonexistent. Insects and vermin are constant threats, sometimes eating away more than half of the crops. Farmers raise crops primarily to supply food for the family. However, there may be small surpluses, and these are sold to purchase other foods and essential goods.

Cottage industry employs close to one-third of the rural labor force, not counting the many farmers who also engage in this activity on the side. It is largely responsible for the local supply of clothing, footwear, farm implements, and construction materials, as well as for processed foods. This sector also produces crafts, cloth, jewelry, and decorative artifacts to sell to tourists in urban areas and at tourist attractions.

Small-scale commerce, taking place in small, often periodic, markets, is vital to people's sustenance in Africa's rural areas. At these markets, rural Africans sell crop surpluses and cottage industry products to traders who, in return, sell them goods such as spices, condiments, kerosene (for domestic lighting), soap, matches, batteries, clothing, and spare parts for bicycles and carts. The small-scale traders then sell the crops and manufactured products to larger-scale traders. These small-scale traders have played a crucial role in bringing the subsistence sector into the larger economy by buying farm products and making consumer goods available to the rural producer.

Migratory herding, based on extensive and frequent movement of livestock, declined in importance over most of Africa in the second half of the 20th century. The area required for migratory herding has been greatly reduced as pasturelands have been taken over for agriculture—particularly modern plantations—and wildlife reserves. Fishing is a minor subsistence activity in most of Africa because of a general scarcity of good fishing grounds and because most of the continent’s rural population lives in the interior.

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