Influenza in Sub-Saharan Africa

While sub-Saharan Africa only accounted for an estimated 7,000 influenza deaths in 2015, this remains the most common and deadly global disease. The mortality rate of influenza in sub-Saharan Africa affects children under the age of five and those over 75. Though the mortality rate seems low compared to the U.S., it does not take into account the presence of healthcare services in Africa versus the U.S. In contrast to Africa, the U.S. had 22,705 influenza deaths in 2015. While these statistics are higher, the U.S. also has more accessible healthcare.

Furthermore, studies have shown that influenza affects many more people than accounted for. Research from the World Health Organization (WHO) shows 40% of antibodies for flu (B) were found in community members 40 years of age and older. This reveals that the virus continued to circulate with no monitoring processes. Importantly, this lack of surveillance contributes to countries’ and NGO partners’ ability to prepare for the next outbreak.

Higher rates of influenza in sub-Saharan Africa are typically found in low to middle-income regions with little resources and access to sanitation and healthcare. In particular, influenza puts nearly “two-thirds of the 34 million” persons infected with HIV at a higher risk for infection and mortality. Existing diseases such as HIV thus put a significant amount of the African population at risk for influenza.

Healthcare in Africa

Africa continues to possess one of the world’s worst healthcare infrastructures, despite funding from the U.S. In 2006, the U.S. gave R100 billion to the South African National Health Insurance (NHI). However, the U.S. provided $28.8 billion to those uninsured in the U.S. during that year, nearly twice the amount granted for all international health.

Rural regions in sub-Saharan Africa account for 60% the population, while urban areas contain 40%. Rural regions lack accessible healthcare compared to urban regions. Due to industrialization, urban areas have greater access to healthcare facilities and university hospitals.

Across many parts of Africa, the ratio of doctors to patients “is below 1/1000 population, with the ‘ratio of physicians per 1000 population essentially unchanged between 2004 (0.77) and 2011 (0.76).” Demand for physicians within these regions is increasing. However, although Africa is producing more physicians, many migrate to the U.S. This leaves rural regions of sub-Saharan Africa with few qualified healthcare providers.

Solutions and Aid

Awareness and aid are crucial to improving infrastructure and healthcare in Africa, so that it can respond to influenza outbreaks. The W.H.O. has created the Africa Flu Alliance, finding factors leading to the underfunding of healthcare to assess its overall impact. Similarly, the Africa Flu Alliance created a “strategic road map” of targets to control influenza in sub-Saharan Africa. It hopes to influence organizations, private funding and projects to support the organization’s initiatives.

Private sectors and nonprofits contribute to approximately half of Africa’s total healthcare funding and expenditures. Twenty-two organizations and nonprofits are working to combat the gap between health services in rural and urban areas. In addition, The African Network for Influenza Surveillance and Epidemiology (ANISE) was created in 2009, with a growing network alongside the CDC. Continual meetings from 2009 to 2012 allowed officials and representatives to discuss achievements and areas of improvement.

Reducing Aid Dependency: Can It Work?

Despite the reliance on Western assistance for years, President Trump’s foreign aid budget cuts could be incredibly harmful or begin for Africa. Given the situation, governments within Africa will need to strive for improvements in monetary policies, transparency and reduced corruption. To improve self-sufficiency, experts recommend regional integration, or “the process by which two or more nation-states agree to co-operate and work closely together to achieve peace, stability and wealth.” Initiatives like Africa’s Continental Free Trade Area (CFTA) will enable 54 countries to trade freely. This will improve Africa’s economic stability by an estimated 50% increase in trade.

The battle of influenza in sub-Saharan Africa correlates directly with the absence of monitoring for significant health concerns. Expanding upon the existing healthcare infrastructure can not only contain and treat disease but also help grow Africa’s economy. Surveillance will be key in this process, as statistics tell actors what they need to improve. But with the support NGOs, funding can help control influenza in sub-Saharan Africa.

– Allison Lloyd
Photo: Flickr