HEALTH AND FAMILY PLANNING IN AFRICA

Family Planning

Over the last 15 years Africa has experienced the most rapid reduction in fertilityrates that the world has ever seen. Nevertheless, fertility rates are still higher thananywhere else in the world, with annual population growth of 2.7%. Africa's population islikely to nearly double between 1997 and 2020, from about 614 million to more than 1.1billion.

Africa's population is young: nearly half of all Africans are under age 15. Thisdemographic reality places tremendous burdens on family incomes, the region's potentialfor economic growth and a range of social structures--such as educational and healthsystems. A promising trend suggests that population growth is slowing in several Africancountries. Botswana, Kenya and Zimbabwe are in the midst of this transition. Fertility inKenya, for example, dropped more than 20% in just four years with the help of USAIDprograms; in Zimbabwe fertility decreased 33% over 10 years. Ghana, Malawi, Madagascar,Tanzania, and Zambia, though at earlier stages of the transition, appear to be movingalong the same path.

Children's Health

USAID is one of the leaders in the effort to improve child survival, working closelywith a variety of other bilateral and multilateral donors. These collaborative effortshave resulted in remarkable advances.

Twenty years ago, fewer than 5% of children in developing countries were immunizedagainst measles, diphtheria, polio, and tuberculosis--now, more than 80% are immunized.Immunization coverage has increased by 10% in the region over the past three years. Therewas a 60% decline in reported measles cases and a 77% reduction in measles deaths in 1996.USAID and the World Health Organization helped 100 million children below age five receivetwo supplemental doses of oral polio vaccine. As a result, no poliovirus was isolated inEast Africa, including Southern Uganda, Kenya, Tanzania, and Zambia, or throughoutSouthern Africa. Over the last 10 years alone, death rates for children under 5 havedeclined by 25% in Africa. Declines in infant mortality continue on the continent,although infant mortality rates in the region are almost twice those found in Asia andLatin America.

HIV/AIDS

Unfortunately, AIDS is also reversing many improvements in infant mortality rates andlife expectance--AIDS is expected to decrease life expectancy in some countries by as muchas 20 years by the year 2000.

USAID's global AIDS prevention program provides education in behavior change andother interventions for more than 15 million people vulnerable to HIV infection. It hastrained more than 150,000 educators and counselors and has distributed 400 millioncondoms.

Malaria

USAID participated in multinational efforts to prevent and treat malaria by launchingthe Africa Integrated Malaria initiative in Kenya, Malawi and Zambia. In partnership withthe World Health Organization, USAID has helped 18 countries adopt systems to evaluate andmonitor malaria control. The agency has helped 39 countries establish or revise malariacontrol plans.

Other Advances

Drawing on American research capabilities, and in close partnership with other U.S.agencies and international donors, USAID continued to contribute to improving theapproaches and technology used in developing countries. In 1996, the vaccine vialmonitor--a simple heat-sensitive tag that indicates whether a vaccine has been kept coldas necessary or not--that was developed by USAID in partnership with the Program forAppropriate Technology in Health and other private sector partners, became required on allvials of oral polio vaccine procured through UNICEF. The World Health Organizationestimates that the monitors will reduce vaccine wastage by almost 50% and save $10 millionto $12 million a year.

USAID supported field tests showed that vitamin A supplementation, given to infants atbirth, can reduce mortality by as much as 64% in the first year of life.