The Central African Republic is one of the poorest nations in Africa, with a GDP of just $2,516.50 in 2021. The nation has a history of engulfment in humanitarian crises and political instability. The ongoing civil war, which began in 2012, detrimentally affected the health care system and increased the prevalence of transmittable diseases impacting the Central African Republic. About 33% of its health facilities are partially damaged and just 22% are operational, according to assessments from 2021. However, organizations are working to strengthen health systems and provide critical health care to the country’s people, particularly in rural areas.
Malaria is a life-threatening, tropical disease transmitted to humans via female mosquitoes. It is one of many endemic diseases impacting the Central African Republic, infecting a vast number of people annually. In 2020, malaria impacted 336 people per 1,000.
The civil war between Christian militias and Muslim rebels contributed to the rapid increase in malaria cases and deaths. Doctors Without Borders (MSF) states that malaria cases in Bossangoa increased by more than threefold to 6,507 in May 2014, with children under 5 accounting for close to 66% of infections.
The war displaced thousands of civilians as militias burned and looted villages, leaving villagers without shelter and protection from mosquito-borne infections. A 2012 report by the MSF said approximately 12,000 displaced individuals resided nearby MSF health care projects in Kabo and Batangafo. The CAR government had established an initiative to provide free malaria treatment to children under 5 but it lacked the capacity and resources to properly function.
The MSF is tackling diseases impacting the Central African Republic, like malaria. In 2020, it launched a “mass drug administration” to prevent malaria infections. The organization broadcasted its campaign via local radios and then visited households to distribute anti-malaria treatment to avoid crowded areas during the COVID-19 pandemic. MSF and other international medical humanitarian organizations had provided treatment to 39,631 people in Batangafo.
HIV is one of the most widespread diseases impacting the Central African Republic. In 2021, approximately 83,000 adults and children lived with HIV, UNAIDS says. The disease is controlled using antiretroviral therapy (ART), which involves taking a combination of HIV medicines to stop the virus from replicating.
Marie Charlotte Bantah Sana, the head of the program against communicable diseases at the CAR’s Health and Population Ministry, told MSF in 2020 that 30% of patients who test positive for HIV do not come back to undergo treatment due to financial constraints.
Since 2019, MSF has provided “free medical care and psychological support for patients” with advanced HIV and tuberculosis problems. MSF prioritized advanced care in Bangui, CAR’s capital, where the HIV incidence is double the national average. Outside of Bangui, MSF is prioritizing the treatment of individuals with advanced stages of HIV in Paoua, Carnot, Kabo and Batangafo.
MSF also established community antiretroviral (ARV) groups in several areas, which involve designated community members supplying HIV patients with ARV drug refills. This decreased transport expenditure and allowed people to avoid hospitals where stigma and discrimination are common. By the close of 2020, MSF had established 276 community ARV groups to represent 2,300 HIV-infected individuals.
HIV/AIDS incidence rates in the Central African Republic have declined as more patients received antiretroviral therapy. Between 2016 and 2019, the number of people receiving antiretroviral therapy rose from fewer than 25,000 to more than 47,000.
Tuberculosis is a highly infectious airborne bacterial disease that affects the lungs and is easily transmitted in crowded areas. It is one of many common diseases impacting the Central African Republic. In 2000, the Central African Republic reported 540 tuberculosis cases per 100,000 individuals. This value has remained unchanged from 2000 to 2021.
The COVID-19 pandemic negatively affected the CAR’s ability to detect tuberculosis as the country suffered shortages of skilled staff in labs. Fortunately, the World Health Organization (WHO) provided financial and technical support to strengthen the country’s laboratory network.
The WHO helped with the purchase of 11 out of the total 23 GeneXpert machines the Central African Republic received between 2020 and 2021. GeneXpert machines are utilized for instant diagnostic testing and can detect the presence of tuberculosis bacteria in less than two hours. The WHO trained staff on how to install, utilize and maintain the machines. The addition of GeneXpert machines helped laboratories conduct 4,690 tuberculosis tests in 2021 compared to 1,345 tests before the COVID-19 pandemic.
With the efforts of organizations such as MSF and the WHO, the prevalence of diseases impacting the Central African Republic is reducing.
– Dami Kalejaiye