Poverty in Underdeveloped Countries—The Poorest of the Poor - The Poor In Africa

development children education malaria

The United Nations tracks trends in poverty worldwide using its Human Development Index (HDI; see Chapter 1), which measures overall well-being in underdeveloped and developing countries. In its Human Development Report 2005, the UN indicated that the HDI has risen since the 1990s in almost all developing and underdeveloped areas of the world but two: the Russian Federation and sub-Saharan Africa. (See Figure 3.1 and Table 3.1.) As Table 3.1 shows, thirteen of the eighteen countries that have experienced significant reversals in their HDIs since 1990 are in sub-Saharan Africa. According to the UN, the African countries that experienced the sharpest declines in their HDI rankings between 1990 and 2003 are South Africa, with a drop of thirty-five places; Zimbabwe, with a drop of twenty-three places; and Botswana, with a drop of twenty-one places. The main indicators on the human development index include life expectancy and health, literacy and educational attainment, and income.


According to the UN's Human Development Report 2005, life expectancy has fallen dramatically in the countries of sub-Saharan Africa since 1990, when it saw a brief increase. This is due largely to the spread of the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) on the continent. The UN's Human Development Report 2005 estimates that, of the three million people FIGURE 3.1 Human development improving in most regions, 1975, 1985, 1995, and 2003 "Figure 1.4. Human Development Improving in Most Regions," in Human Development Report 2005, United Nations Development Programme, 2005, http://hdr.undp.org/reports/global/2005/pdf/HDR05_complete.pdf%20(accessed April 10, 2006)worldwide who died of AIDS in 2004, 70% were in Africa. Of the thirty-eight million total people infected with HIV, 25.8 million live in sub-Saharan Africa. In a press release at the XV International Conference on AIDS (July 14, 2004), the UN reported that in Zambia, a country in southern Africa with a total population of 10.4 million people, 16.5% of adults ages fifteen to forty-nine were infected with HIV or AIDS, and life expectancy had dropped from 47.4 years in 1990 to 32.7 years in 2004. In Zimbabwe 25% of adults among the country's million people were HIV-positive, and life expectancy dropped from 56.6 years in 1990 to 33.9 years in 2002. Life expectancy in Swaziland, a small country bordering South Africa, dropped from 55.3 years in 1990 to 35.7 years in 2002; 38.8% of adults in Swaziland—with a total population of 1.1 million people—were HIV-positive in 2004. Human Development Report 2005 noted that chances of survival for a person born in sub-Saharan Africa between 2000 and 2005 are not much better than those of individuals living in England and Wales during the 1840s.

TABLE 3.1 Countries experiencing HDI (human development index) reversal, 1980–90 and 1990–2003 "Table 1.1. Countries Experiencing HDI Reversal," in Human Development Report 2005, United Nations Development Programme, 2005, http://hdr.undp.org/reports/global/2005/pdf/HDR05_complete.pdf%20(accessed April 10, 2006)

Countries experiencing HDI (human development index) reversal, 1980–90 and 1990–2003
1980–90 1990–2003
*Country does not have HDI data for 1980–90, so drop may have begun before 1990.
SOURCE: "Table 1.1. Countries Experiencing HDI Reversal," in Human Development Report 2005, United Nations Development Programme, 2005, http://hdr.undp.org/reports/global/2005/pdf/HDR05_complete.pdf%20(accessed April 10, 2006)
Congo, Dem. Rep. of the Botswana
Guyana Cameroon
Haiti Central African Republic
Niger Congo
Rwanda Congo, Dem. Rep. of the
Zambia Côte d'Ivoire
Moldova, Rep. of*
Russian Federation*
South Africa
Tanzania, U. Rep. of*

According to the AIDS Epidemic Update, December 2005, published jointly by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), AIDS in Africa cannot properly be called a single epidemic. Rather, each region and country has experienced its own trends in HIV/AIDS infection. Countries in southern Africa, for example, are considered the "epicenter" of the global epidemic. The report notes, however, that the epidemics in Zimbabwe, Kenya, and Uganda have, for the first time, shown signs of slowing down. Surveys have shown that the prevalence of HIV infection among pregnant women in Zimbabwe has fallen from 26% in 2002 to 21% in 2004. In the late 1990s HIV rates among adults in Kenya were as high as 10%; by 2003 the rate had dropped to 7%. In Uganda, which has experienced the most success among African countries in lowering rates of HIV/AIDS infection, 15% of the adult population was infected in the early 1990s; 2004 surveys found that the rate had dropped to 7%, although in some regions of the country surveys suggested that rates were rising among fifteen- to twenty-four-year-olds. In all three countries that have seen a decreasing rate of infection, there is strong evidence to suggest that changes in sexual behavior are the cause of the drops in rates—most notably, an increase in condom use.

While AIDS is certainly the most notable factor contributing to Africa's low life expectancy, it is not the only disease that takes millions of African lives a year and threatens the continent's economic stability. FIGURE 3.2 Security risks shifting to Africa, 1946–89 and 1990–2003 "Figure 5.2. Security Risks Are Shifting to Africa," in Human Development Report 2005, United Nations Development Programme, 2005, http://hdr.undp.org/reports/global/2005/pdf/HDR05_complete.pdf%20(accessed April 10, 2006). Data calculated on the basis of data on armed conflict from Strand, Wilhelmsen and Gleditsch 2005.Preventable disease is both a cause and a result of poverty. Unable to afford simple prevention, families often lose their primary breadwinner to these diseases, leaving them even deeper in poverty. Additionally, violent conflict has made Africa one of the most dangerous places on earth. Warfare that has become a routine part of life for Africans in many countries leads to malnutrition and outbreaks of disease, which sometimes kill more people than the violence itself. (See Figure 3.2.)

Malaria, a highly infectious but preventable disease that is spread through tropical regions by mosquitoes, is perhaps the most prominent example of this. According the World Health Organization (WHO), malaria costs Africa about $12 billion each year in lost gross domestic product and accounts for 40% of public health expenditures. Countries with high rates of malarial infection are known to have significantly lower GDP, slower rates of economic growth, and higher rates of poverty than those without. In the case of sub-Saharan Africa, the disease has had a significant impact on labor force participation and school attendance; children who suffer from repeat infections often develop permanent neurological damage that cuts short their education and hampers their ability to participate fully in the labor force as adults.

In the early twenty-first century poverty researchers began to recognize malaria's role in increasing impoverishment at the micro (family and community) level and diminishing economic advancement at the macro (national and global) level in countries prone to epidemics of the disease. Aside from the obvious difficulties facing poor families who cannot afford treatment or prevention, the wider effects of frequent epidemics include impeded market activity and tourism industries as traders and potential tourists avoid areas with heavy infection rates. Even agricultural trends can shift with malaria rates; farmers dependent on the availability of workers during harvest seasons will be less likely to plant labor-intensive cash crops, instead relying on subsistence crops.

According to the World Malaria Report 2005, published by the Roll Back Malaria (RBM) campaign—a global partnership of the World Health Organization, UNICEF (United Nations Children's Fund), the World Bank, and the United Nations Development Program—66% of the total population of Africa is at risk of developing malaria. There are as many as twelve million cases of malaria reported every year in Africa, more than a million of them fatal in 2002; about 90% of all deaths from malaria worldwide occur in Africa. Children are particularly vulnerable to the disease. In those under age five, nearly 20% of all deaths in sub-Saharan Africa are directly attributable to malaria. Considerably more are believed to be indirectly related to the disease because repeated malarial infections can lead to severe anemia, which in turn makes children more susceptible to other illnesses. Additionally, infection of pregnant women raises the rate of infant mortality because it can cause low birth weight and other complications.

The WHO reports that malaria is particularly common in sub-Saharan Africa because of the prevalence of plasmodium falciparum (http://www.rbm.who.int/cmc_upload/0/000/015/370/RBMInfosheet_3.htm)—the most deadly strain of the disease—and of the species of mosquito most likely to spread the disease. In addition, the infection's resistance to the most effective and affordable antimalarial drug, chloroquine, is high in African countries, and resistance to the second most commonly used drug, sulfadoxine-pyrimethamine, is growing. More effective drugs are available, but they are prohibitively expensive.

Prevention of malaria is relatively simple. The most effective way to prevent its spread is the use of insecticide-treated mosquito nets (ITNs) draped over beds at night, when most disease-carrying mosquitoes bite. Early trials of the nets in the 1980s and 1990s showed that they could help reduce malaria-related deaths in children by 20%. Unfortunately, the RBM campaign has found that there are two ongoing problems with the use of ITNs. First, the nets and the materials used to make them have been subject to high taxes and import tariffs that make them too expensive for most African families to afford. As of 2005, negotiations were underway throughout Africa to reduce or eliminate taxes and tariffs on the nets and the materials used to make them; twenty countries had already done so. Second, WHO studies have shown that, even when ITNs are used routinely, fewer than 5% are regularly retreated with insecticide to continue their effectiveness. The WHO has been working with ITN manufacturers to develop nets that would require less frequent or no re-treating and is encouraging families to participate in community "dipping" events to re-treat their nets at least once a year. Additionally, African governments are instituting public health education campaigns to promote the use of ITNs.

In June 2005 U.S. President George W. Bush announced plans for a $1.7 billion aid package for Africa, $1.2 billion of which was to go to combating malaria infection (Peter Baker, "Bush Pledges $1.2 Billion for Africa to Fight Malaria," Washington Post, July 1, 2005). Scheduled to be distributed over five years, the money would be used for insecticide spraying, stronger combination drug therapies, and longer-lasting ITNs. In June 2006 R. Timothy Ziemer was named U.S. Malaria Coordinator for the President's Malaria Initiative to oversee all malaria programs and policy at USAID, the U.S. government foreign aid agency.

In October 2005 the Bill and Melinda Gates Foundation announced it would donate $258.3 million to fund research on malaria—$107.6 million toward developing a vaccine, $100 million for new treatment drugs, and $50.7 million for ITNs and other forms of mosquito control (http://www.gatesfoundation.org/globalhealth/pri_diseases/malaria/announcements/announce-051030.htm). In November 2005 the Gates Foundation, which was founded by Microsoft pioneer Bill Gates and his wife, Melinda, helped organize a project to combat the disease in Zambia, donating another $35 million. Zambia, where 30,000 people die annually of the disease, had already begun waging a somewhat successful campaign to cut malaria-related deaths. Money from the Gates Foundation will be used to step up the campaign, in the hopes of providing effective protection for 80% of Zambia's population ("A Model Fight against Malaria," New York Times, November 22, 2005).

Literacy and Education

According to the Millennium Development Goals Report 2005 (United Nations, http://unstats.un.org/unsd/mi/pdf/MDG%20Book.pdf), 42% of children in sub-Saharan Africa did not attend school in 2001. The United Nations Educational, Scientific, and Cultural Organization (UNESCO) reported in EFA Global Monitoring Report 2006: Literacy for Life. Regional Overview: Sub-Saharan Africa that in more than half of the countries in the region only about 6% of children were enrolled in preprimary education during 2002; on average, 63% of children were enrolled in primary TABLE 3.2 Estimates of adult illiterates and literacy rates, population aged 15 and over, by region, 1990 and 2000–04 "Table 2.6. Estimates of Adult Illiterates and Literacy Rates (Population Aged 15+) by Region, 1990 and 2000–2004," in Education for All Global Monitoring Report 2006: Literacy for Life, United Nations Educational, Scientific and Cultural Organization, 2005, http://www.unesco.org/education/GMR2006/full/chapt2_eng.pdf%20(accessed April 8, 2006). Copyright © UNESCO, 2005school; an average of 28% of children were enrolled in secondary school. Children in sub-Saharan Africa spend an average of 7.8 years in school (versus an average of twelve years in developed countries); of those who enroll in school, fewer than 60% complete their education.

Estimates of adult illiterates and literacy rates, population aged 15 and over, by region, 1990 and 2000–04
Number of illiterates (thousands) Literacy rates (percent) Change from 1990 to 2000–2004 in:
Number of illiterates Literacy rates
1990 2000–2004 1990 2000–2004 Thousand Percent Percentage points
Note: Figures may not add to totals because of rounding
SOURCE: "Table 2.6. Estimates of Adult Illiterates and Literacy Rates (Population Aged 15+) by Region, 1990 and 2000–2004," in Education for All Global Monitoring Report 2006: Literacy for Life, United Nations Educational, Scientific and Cultural Organization, 2005, http://www.unesco.org/education/GMR2006/full/chapt2_eng.pdf%20(accessed April 8, 2006). Copyright © UNESCO, 2005
World 871,750 771,129 75.4 81.9 −100,621 −12 6.4
Developing countries 855,127 759,199 67.0 76.4 −95,928 −11 9.4
Developed countries 14,864 10,498 98.0 98.7 −4,365 −29 0.7
Countries in transition 1,759 1,431 99.2 99.4 −328 −19 0.2
Sub-Saharan Africa 128,980 140,544 49.9 59.7 11,564 9 9.8
Arab states 63,023 65,128 50.0 62.7 2,105 3 12.6
Central Asia 572 404 98.7 99.2 −168 −29 0.5
East Asia and the Pacific 232,255 129,922 81.8 91.4 −102,333 −44 9.6
South and West Asia 382,353 381,116 47.5 58.6 −1,237 −0.3 11.2
Latin America and the Caribbean 41,742 37,901 85.0 89.7 −3,841 −9 4.7
Central and Eastern Europe 11,500 8,374 96.2 97.4 −3,126 −27 1.2
North America and Western Europe 11,326 7,740 97.9 98.7 −3,585 −32 0.8

The prevalence of disease—particularly HIV/AIDS—takes an especially heavy toll on school-age children in sub-Saharan Africa. Along with the many children who must leave school because they suffer from such diseases as HIV and malaria, many others are indirectly affected; the UN reports that in 1999 almost one million children in the sub-Saharan region lost teachers to AIDS. The likelihood of qualified teachers becoming available quickly to take the place of the millions who have died of AIDS is small. Carole Palma, acting director of USAID, projected in October 2004 that 15% to 20% of teachers in the sub-Saharan region would have died of AIDS by 2005. Moreover, children whose parents or other family members become ill with or die from diseases such as AIDS usually must leave school, either to care for the sick relative or to go to work to support the family. At the broader level, the African educational system overall suffers from a lack of funding because of the drain of AIDS on public monies and human resources.

The persistent military conflicts in many African countries also make it nearly impossible for many children, particularly those living in rural areas, to attend school, even if schools still exist. Decades of political, economic, and social turmoil have decimated the educational sector on the continent. Schools have been destroyed; students and teachers have been killed; teaching materials and supplies are virtually nonexistent. For many children merely walking to school can be deadly; as of 2001 there were an estimated nine to fifteen million land mines in Angola and more than two million in Mozambique, as well as an unknown number newly laid along the border of Eritrea and Ethiopia ("Reconstruction from War in Africa: Communities, Entrepreneurs, and States," CSAE Conference 2001: Development Policy in Africa—Public and Private Perspectives, Center for the Study of African Economies, University of Oxford, March 29-31, 2001).

The EFA Global Monitoring Report 2006: Literacy for Life. Regional Overview: Sub-Saharan Africa reports that rates of adult literacy in Africa range from below 40% in Benin, Burkina Faso, Chad, Mali, Niger, Senegal, and Sierra Leone to more than 90% in Seychelles and Zimbabwe. Only South and West Asia have a lower literacy rate than sub-Saharan Africa. (See Table 3.2.) According to UNESCO, 140.5 million adults in sub-Saharan Africa are illiterate. Countries with the highest rates of poverty have correspondingly high rates of illiteracy; similarly, the larger a country's rural population is, the higher its rate of illiteracy will be.

Not all of the news about Africa's educational sector is bad, however. In the early twenty-first century some countries have seen marked improvements in access to education and literacy among children. In Zambia, for example, a Primary Reading Program was instituted in 1998 to increase literacy at all grade levels by focusing on reading and writing activities in grades one through seven. Within a year, the literacy rate of children in primary schools—87% of which are located in rural areas—rose 64% (Francis K. Sampa, "Zambia's Primary Reading Program [PRP]: Improving Access and Quality Education in Basic Schools," Association for the Development of Education in Africa, 2005). One of the main goals of the program, and of Zambia's Ministry of Education overall, has been to provide free education for all, including girls, rural and poor children, special needs children, and orphans. The Primary Reading Program also includes texts about HIV/AIDS and other social issues in its materials for school children.

In Nigeria there are an estimated 9.3 million nomads, 3.1 million of them children. Only about 0.2% to 2% of Nigerian nomads—most of whom earn their living herding sheep and fishing—are literate (Gidado Tahir et al., "Improving the Quality of Nomadic Education in Nigeria: Going beyond Access and Equity," Association for the Development of Education in Africa, 2005). Nomadic people have a difficult time sending their children to school consistently for several reasons: they relocate frequently to find grazing and water for their livestock and to find more available fish; children are an essential source of labor, which makes adults reluctant to send them to school; the rigid time schedules of traditional schools do not account for the nomadic lifestyle; nomads often live in inaccessible areas where terrain is difficult to navigate; and, in Nigeria, a land tenure system often prohibits nomadic people from acquiring permanent settlement land. In response to these problems, the Federal Ministry of Education of Nigeria developed the Nomadic Education Program (NEP), under the direction of the National Commission for Nomadic Education (NCNE), established in 1989. Key components of the NEP include developing a curriculum that is relevant to the experience of nomadic children, who are generally regarded as living outside the mainstream in almost every way; educating nomadic parents and adults about the importance of schooling for their children; and creating flexible, "moveable" schools that take into account the nomads' seasonal relocations. The case study "Access to Basic Education: A Focus on Nomadic Populations of Nigeria" presented at the 1999 biennial meeting of the Association for the Development of Education in Africa found that, in the ten years since the creation of the NCNE, total school enrollment among nomadic children rose from 18,831 in 1990 to 155,786 in 1998. The number of nomadic schools rose from 329 in 1990 to 1,098 in 1997. Gender parity in schools (the ratio of girls to boys attending school) rose from 54% in 1990 to 85% in 1998. In addition, the number of nomadic children completing school rose from 2,077 in 1994 to 7,632 in 1998. According to the NCNE, by 2002, 229,944 nomadic children were enrolled in school.

Economic Well-being in Africa

In its World Development Report 2006: Equity and Development, the World Bank notes:

An individual's consumption, his or her income, or his or her wealth have all been used as indicators of the command of an individual over goods and services that can be purchased in the market and that contribute directly to well-being. It is clear too, that individuals' economic status can determine and shape in many ways the opportunities they face to improve their situations. Economic well-being can also contribute to improved education outcomes and better health care. In turn, good health and good education are typically important determinants of economic status.

The interconnectedness of health, education, and economic status is true in countries around the world. As was discussed above, however, certain circumstances in Africa—the colonial presence, government corruption, the AIDS epidemic—have led to a long and well-documented history of extreme poverty. In the large West African country Mali, for example, the average monthly income in 1994 was $54 a month (less than two dollars a day), whereas the average monthly income for Americans in 1994 was $1,185 a month (World Bank, World Development Report 2006). Poverty researchers agree that it is not merely a coincidence that the people of Mali spend an average of less than two years in school.

According to the World Bank, poverty rates worldwide have declined since the 1980s in almost every region of the world but sub-Saharan Africa, where, in 1981, there were about 160 million people living on less than one dollar a day; by 2001 the number had doubled, to 313 million. In 2003 the region's total unemployment rate for people ages fifteen to twenty-four was 21.1%-18.6% among women and 23% among men. Unemployment in this age group represented 62.8% of sub-Saharan Africa's total jobless rate.

According to the United Nations Development Program's Human Development Index, average annual income for women in sub-Saharan African countries in 2003 ranged from a low of $325 in Sierra Leone to a high of $10,771 in Equatorial Guinea. For men, average annual income in 2003 ranged from $717 in Malawi to $27,053 in Equatorial Guinea. By comparison, men in the United States earned an average of $46,456 in 2003, while U.S. women averaged annual incomes of $29,017 (http://hdr.undp.org/statistics/data/pdf/hdr05_table_25.pdf).

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over 5 years ago

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