Intended for healthcare professionals


The future of health care in Africa

BMJ 2005; 331 doi: (Published 30 June 2005) Cite this as: BMJ 2005;331:1

This article has a correction. Please see:

  1. Lola Dare (, executive secretary,
  2. Eric Buch, health adviser
  1. African Council for Sustainable Health Development (ACOSHED), 29 Aare Avenue, New Bodja Estate, Ibadan, Oyo State, Nigeria
  2. New Partnership for Africa's Development (NEPAD), Midrand, Pretoria, South Africa

    Depends on making commitments work in and outside Africa

    As the group of eight leading industrialised nations (G8) meets for its summit at Gleneagles, Scotland, next week Africa is at a crossroads. It faces a double edged crisis: its healthcare workforce is rapidly depleting, and its health systems are weak, fragile, and hanging on a precipice. A direct consequence of this is that the indicators for health development in the continent are dismal. About one in six African children die before their fifth birthday, with half of these dying from diseases preventable by vaccines; and one woman dies every two minutes from complications of pregnancy and delivery.1 From all such indications and current evidence, it would appear that very few countries in the continent will achieve the millennium development goals.2 The goal to reduce deaths among children aged under 5 (figure) is just one example.

    Progress in reducing mortality in children aged under 5 years, comparing sub-Saharan Africa with low and middle income countries in the rest of the world. Red represents sub-Saharan Africa, blue low income countries, green middle income countries (with solid lines indicating path to goal, dotted lines progress to date, and dashed lines projected progress at current rate)

    Chronic underinvestment, interventions by global partnerships that focus only on single diseases, and sporadic financing by both national governments and their partners have left African health systems prostrate. They are unable to deliver drugs, tools, and …

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