U.S. Public Health Assistance to Africa by Michael Hall

Resolved: The United States federal government should substantially increase its public health assistance to Sub-Saharan Africa.

Sub Saharan Africa (SSA)

Where Might “Public Health Assistance” Come From?  The Department of State recognizes five types of US Foreign Aid. ● Economic Aid to Support US Political and Security Objectives ● Military Assistance ● Humanitarian Assistance ● Multilateral Assistance ● Bilateral Development Assistance

Where Might Development Assistance Come From?  When looking at Economic and Development Assistance together, there are 7 accounts Congress funds. Among these accounts are two that are explicitly health related:  Child Survival and Health (CSH)  Global AIDS Initiative (GAI)

Where Might Development Assistance Come From? OOOOther health programs are funded through the Development Assistance. The two largest are:  Family planning and reproductive health; and  Infectious disease prevention other than HIV/AIDS

Where Might Development Assistance Come From? AAAAll told, the Department of State calculates that more than $2.5 billion was spent in global health programs in 2004.

What Does “Public Health Assistance Mean?”  “Public health assistance” in not a term found in the US Foreign Assistance Budget.  “Public health assistance” is a term found in other federal regulations.  The Code of Federal Regulations says public health assistance is the provision of health services designed to protect the health of the general public.

Like What Kind of Services? Public health services “including, but not limited to, immunizations for immunizable diseases, testing and treatment for tuberculosis and sexually-transmitted diseases, and family planning services.”

Public Health In SSA – The Big Picture  The CIA statistics on life expectancy reveal the following:  Of the 31 lowest ranking nations in life expectancy, 28 were in SSA  The average person born in SSA can expect to live 46 years, which is 32 years less than most Western Countries  Zimbabwe, Zambia, Angola, and Swaziland are all below 40 years.

Public Health In SSA – The Challenges  Of the more than 40 million people in the world living with HIV/AIDS, it is estimated that 2/3 of them are in SSA – that’s more than 26 million people!  Challenge #1: HIV/AIDS  HIV/AIDS is the #1 killer of people in Africa – more than 7% of the population is HIV positive and as many as 2 million per year die

Public Health In SSA – The Challenges  Challenge #2a: Other Infectious Diseases – Malaria  More than 80% of global cases and 95% of deaths are in SSA  There are between 300 million and 500 million cases in SSA every year  Between 750 thousand and 1 million children in SSA die each year

Public Health In SSA – The Challenges  Challenge #2b: Other Infectious Diseases – Tuberculosis  In 2005, WHO estimates that 2.5 million were infected with TB in SSA. More than 500 thousand died.  29% of all global TB cases occurred in SSA. The only region with more cases was South-East Asia, a region with more than double the population.

Public Health In SSA – The Challenges  Diarrhea is the #1 cause of infant mortality in Africa. More than 600 thousand die of Rotavirus alone.  Challenge #3: Dehydration from Disease  Diarrhea can be caused by a number of diseases. In Africa, the most common are Cholera and Rotavirus.