UNKNOWN AFRICA. MYTH 7: Africa Suffers from Healthcare Crises

Writer, journalist, Ph.D., professor at the University of Cambridge, author of the bestselling book How Asia works

UNKNOWN AFRICA. MYTH 7: Africa Suffers from Healthcare Crises

Art design: huxley.media via Photoshop

The concept of a «stereotype» was introduced back in 1922 by American sociologist Walter Lippmann. Since then, humanity has repeatedly realized how difficult it is to step beyond the «picture in one’s head». Joe Studwell is one of the few who has managed to overcome the inertia of thought and build a bridge of understanding between cultures.

For more than 20 years, he served as the editor of China Economic Quarterly. His years of research resulted in the bestselling book The Asian Management Model (How Asia Works). Today, Studwell takes on an equally ambitious challenge: helping us understand how Africa works.

In an exclusive interview for Huxley, he debunks nine myths about Africa that persist in Western cultural consciousness. Let’s embark on an engaging and stereotype-free journey across the African continent with him.

he main reason why Africa remained the most sparsely populated region of the world is the exceptionally high disease burden on the continent. Malaria, sleeping sickness caused by the trypanosome parasite transmitted by the tsetse fly, bilharzia, and hookworm are just a few of the diseases that have taken a demographic toll.

The impact of malaria in Africa is particularly severe. Outside the continent, malaria-carrying mosquitoes mostly feed on animal blood, while the African Anopheles mosquito has evolved with an overwhelming preference for human blood. Africans develop partial immunity to malaria through constant exposure, but only if they survive infancy.

Historically, mortality rates were extremely high. In 1922, Émile Brumpt, president of the French Zoological Society, wrote: «In East Africa, 50% of local children die before the age of four, mainly from malaria». Today, despite mosquito eradication campaigns, improved medications, and the widespread use of bed nets, the World Health Organization (WHO) estimates that Africa accounts for more than nine out of ten malaria deaths worldwide — over 400,000 annually — mostly among children under the age of five.

Sleeping sickness (trypanosomiasis) — transmitted by the tsetse fly, which is unique to sub-Saharan Africa — likely had an even greater impact on population growth than malaria. The tsetse fly’s preferred temperature range covers one-third of the continent, including many of its most fertile and densely populated regions. Eradication programs for this insect have proven largely ineffective.

However, following the end of an epidemic in the 1970s, by the late 1990s, fatal cases of sleeping sickness had significantly declined thanks to screening and treatment. Medications effective against the disease have existed since the 1920s, but only began to be widely used in recent decades.

Much less progress has been made in combating animal trypanosomiasis. The Food and Agriculture Organization of the United Nations (FAO) estimates that the disease kills three million head of livestock in Africa each year.

Among other parasitic diseases that have affected population growth and labor productivity in Africa is bilharzia (schistosomiasis). It is transmitted through contaminated water — either by ingestion or skin contact. Parasitic worms, or «flukes», enter the body, not always causing death but leading to severe physical weakness and limiting the ability to perform physical labor.

Despite unprecedented public health challenges, African countries have made tremendous progress over the past decades. Life expectancy in sub-Saharan Africa has increased by four months each year since the 1960s and approached 61 years by 2022. This was the fastest growth among all regions monitored by the World Health Organization (WHO), and the gap between countries with the best and worst indicators has significantly narrowed.

Africa has been more severely affected by the HIV/AIDS epidemic than any other continent — though the impact varies from country to country — and it remains one of the top three causes of premature death, along with lower respiratory infections and diarrheal diseases. However, early mortality in Africa was halved between 2000 and 2015. According to WHO, deaths due to HIV/AIDS decreased by 58%. At the same time, the latest data shows that 26 million people in Africa are living with HIV.

Africa has also suffered from the Ebola virus, first identified in 1976, particularly during the major outbreak in West Africa in 2014–2016, which affected around 29,000 people, of whom 11,000 died. Subsequent outbreaks were quickly contained by African health authorities, which had gained a high level of competence in epidemic response. Several effective vaccines against Ebola have been developed, although, unfortunately, not for all strains of the virus.

It is worth noting that a growing threat to the health and well-being of Africans is climate change. The Intergovernmental Panel on Climate Change (IPCC) describes the risk to the continent as the least studied of any world region due to a lack of historical data. Without data, it is impossible to determine the normal levels of temperature and precipitation across different areas of the continent. Still, there is an understanding that certain regions are at risk.

In the climatically unstable Sahel, rising temperatures and sudden floods in recent years have led to the loss of livelihoods, increased migration, and favorable conditions for conflict. Nomadic herders, having lost pastures, began moving their livestock into traditionally sedentary agricultural lands, leading to violent clashes. Governments lacked obvious solutions to this issue, which fueled anarchy. The problem of climate change is especially acute for the vast stretch of land south of the Sahara running from West to East Africa.

In other regions, the available data presents a mixed picture. In some parts of West Africa, the average annual rainfall has declined by 25–50 mm per decade since 1950. In parts of East and Southern Africa, rainfall has increased by 5–50 mm per year over the same period. Current forecasts suggest that in East Africa, rainy seasons will become more intense and droughts less severe over the course of this century.

Across the continent, scientists most confidently predict that under high levels of global warming (three to four degrees — the upper end of current projections), Africa will be especially hard hit. This will result in shrinking areas suitable for growing cereal crops, worsening the spread of insect-borne diseases such as malaria and sleeping sickness, and accelerating the spread of other infections as sudden floods inundate villages, towns, and megacities with poor sanitation and no sewage systems.

Climate change presents immense challenges for a continent that is now home to 17% of the world’s population, but is responsible for only 4% of historical greenhouse gas emissions.