Editing Sub-Saharan Africa (section)

==Health==
{{Further|HIV/AIDS in Africa|Demographics of Africa|Syphilis in sub-Saharan Africa}}
[[File:Komfo Anokye Teaching Hospital, Kumasi, Ghana.jpg|thumb|The Komfo Anokye Hospital in [[Kumasi]], Ghana ]]
Health challenges in Sub-Saharan Africa include [[HIV/AIDS in Africa]], [[malaria]], [[neglected tropical diseases]], [[tuberculosis]], [[onchocerciasis]], [[maternal mortality]] and [[infant mortality]].<ref>{{Cite web |title=Fact sheet about malaria |url=https://www.who.int/news-room/fact-sheets/detail/malaria |access-date=22 May 2024 |website=www.who.int |language=en }}</ref><ref>{{Cite journal |title=Neglected Tropical Diseases in Sub-Saharan Africa: Review of Their Prevalence, Distribution, and Disease Burden |first1=Peter J. |last1=Hotez |first2=Aruna |last2=Kamath |date=25 August 2009 |journal=PLOS Neglected Tropical Diseases |volume=3 |issue=8 |pages=e412 |doi=10.1371/journal.pntd.0000412 |doi-access=free |pmid=19707588 |pmc=2727001 }}</ref><ref>{{Cite web |date=21 May 2024 |title=Tuberculosis (TB) |url=https://www.afro.who.int/health-topics/tuberculosis-tb |access-date=22 May 2024 |website=WHO {{!}} Regional Office for Africa |language=en }}</ref><ref>{{Cite web |title=Onchocerciasis (river blindness) |url=https://www.who.int/news-room/fact-sheets/detail/onchocerciasis |access-date=22 May 2024 |website=www.who.int |language=en }}</ref><ref>{{Cite journal |title=Maternal Mortality in Africa: Regional Trends (2000–2017) |first1=Luc |last1=Onambele |first2=Wilfrido |last2=Ortega-Leon |first3=Sara |last3=Guillen-Aguinaga |first4=Maria João |last4=Forjaz |first5=Amanuel |last5=Yoseph |first6=Laura |last6=Guillen-Aguinaga |first7=Rosa |last7=Alas-Brun |first8=Alberto |last8=Arnedo-Pena |first9=Ines |last9=Aguinaga-Ontoso|first10=Francisco|last10=Guillen-Grima |date=12 October 2022 |journal=International Journal of Environmental Research and Public Health |volume=19 |issue=20 |pages=13146 |doi=10.3390/ijerph192013146 |doi-access=free |pmid=36293727 |pmc=9602585 }}</ref>

In 1987, the [[Bamako Initiative]] conference organized by the [[World Health Organization]] was held in [[Bamako]], the capital of [[Mali]], and helped reshape the health policy of sub-Saharan Africa.<ref>{{cite web |url=http://www.eldis.org/healthsystems/userfees/background.htm |title=User fees for health: a background |access-date=28 December 2006 |archive-url=https://web.archive.org/web/20061128203803/http://www.eldis.org/healthsystems/userfees/background.htm <!-- Bot retrieved archive --> |archive-date=28 November 2006 }}</ref> The new strategy dramatically increased accessibility through community-based [[healthcare reform]], resulting in more efficient and equitable provision of services.<ref>{{Cite book |title=Africa (a-z). |last=Godfrey. |first=Mugoti |date=2009 |publisher=Lulu Com |isbn=978-1435728905 |location=[Place of publication not identified] |oclc=946180025}}{{self-published source|date=February 2020 }}</ref>{{self-published inline|date=February 2020}} A comprehensive approach strategy was extended to all areas of health care, with subsequent improvement in the health care indicators and improvement in health care efficiency and cost.<ref>{{cite journal |vauthors=Knippenberg R, Alihonou E, Soucat A, etal |title=Implementation of the Bamako Initiative: strategies in Benin and Guinea |journal=The International Journal of Health Planning and Management |volume=12 |issue=Suppl 1 |pages=S29–47 |date=June 1997 |pmid=10173105 |doi=10.1002/(SICI)1099-1751(199706)12:1+<S29::AID-HPM465>3.0.CO;2-U }}</ref><ref>{{cite web |url=http://www.medicusmundi.ch/mms/services/bulletin/bulletin200201/kap01/07kuechler.html |title=Manageable Bamako Initiative schemes |access-date=28 December 2006 |url-status=dead |archive-url=https://web.archive.org/web/20071008211344/http://www.medicusmundi.ch/mms/services/bulletin/bulletin200201/kap01/07kuechler.html |archive-date=8 October 2007 }}</ref>

[[File:HIV_prevalence_2022.png|thumb|left|A world map illustrating the proportion of population aged 15–49 infected with HIV in 2019. HIV is endemic especially in [[Southern Africa]].]]

In 2011, sub-Saharan Africa was home to 69% of all people living with [[HIV/AIDS]] worldwide.<ref>{{cite web |url=http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/20121120_FactSheet_Global_en.pdf |title=World Aids Day 2012 |publisher=Unaids.org |access-date=29 September 2015 |archive-date=27 March 2014 |archive-url=https://web.archive.org/web/20140327233932/http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/20121120_factsheet_global_en.pdf |url-status=live }}</ref> In response, a number of initiatives have been launched to educate the public on HIV/AIDS. Among these are combination prevention programmes, considered to be the most effective initiative, the [[abstinence, be faithful, use a condom]] campaign, and the [[Desmond Tutu HIV Foundation]]'s outreach programs.<ref name="DTHF">{{cite web |title=Desmond Tutu HIV Foundation: What we do |url=http://www.desmondtutuhivcentre.org.za/page/work |publisher=Desmond Tutu HIV Foundation |access-date=27 May 2013 |url-status=dead |archive-url=https://web.archive.org/web/20130116014630/https://www.desmondtutuhivcentre.org.za/page/work/ |archive-date=16 January 2013 }}</ref> According to a 2013 special report issued by the [[Joint United Nations Programme on HIV/AIDS]] (UNAIDS), the number of HIV positive people in Africa receiving anti-retro viral treatment in 2012 was over seven times the number receiving treatment in 2005, with an almost 1&nbsp;million added in the last year alone.<ref name="UNAIDS Press Release">{{cite web |url=http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/may/20130521prupdateafrica |title=UNAIDS reports more than 7 million people now on HIV treatment across Africa—with nearly 1 million added in the last year—while new HIV infections and deaths from AIDS continue to fall |publisher=Joint United Nations Programme on HIV/AIDS |date=21 May 2013 |access-date=29 September 2015 |archive-date=7 December 2018 |archive-url=https://web.archive.org/web/20181207073259/http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/may/20130521prupdateafrica |url-status=live }}</ref><ref name="UNAIDS Special Report">{{cite web |url=http://www.unaids.org/en/media/unaids/contentassets/documents/document/2013/05/20130521_Update_Africa.pdf |archive-url=https://wayback.archive-it.org/all/20171010214522/http://www.unaids.org/en/media/unaids/contentassets/documents/document/2013/05/20130521_Update_Africa.pdf |url-status=dead |archive-date=10 October 2017 |title=Special Report: How Africa Turned AIDS Around |publisher=Joint United Nations Programme on HIV/AIDS |date=2013 |access-date=29 September 2015 }}</ref>{{rp|15}} The number of AIDS-related deaths in sub-Saharan Africa in 2011 was 33 per cent less than the number in 2005.<ref name="UNAIDS 2012">{{cite web |title=UNAIDS Report on the Global AIDS Epidemic 2012 |url=http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/20121120_UNAIDS_Global_Report_2012_with_annexes_en.pdf |access-date=13 May 2013 |archive-date=5 October 2014 |archive-url=https://web.archive.org/web/20141005111142/http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/20121120_UNAIDS_Global_Report_2012_with_annexes_en.pdf |url-status=live }}</ref> The number of new HIV infections in sub-Saharan Africa in 2011 was 25 per cent less than the number in 2001.<ref name="UNAIDS 2012"/>

[[Life expectancy at birth]] in sub-Saharan Africa increased from 40 years in 1960 to 61 years in 2017.<ref>{{Cite web |url=https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=ZG |title=Life expectancy at birth, total (years) - Sub-Saharan Africa {{!}} Data |website=data.worldbank.org |language=en-us |access-date=30 October 2019 |archive-date=30 October 2019 |archive-url=https://web.archive.org/web/20191030175623/https://data.worldbank.org/indicator/SP.DYN.LE00.IN%3Flocations%3DZG |url-status=live }}</ref>

[[Malaria]] is an endemic illness in sub-Saharan Africa, where the majority of malaria cases and deaths worldwide occur.<ref>{{cite web |url=https://www.who.int/mediacentre/factsheets/fs094/en/ |title=WHO &#124; Malaria |publisher=Who.int |access-date=29 September 2015 |archive-date=3 September 2014 |archive-url=https://web.archive.org/web/20140903002027/http://www.who.int/mediacentre/factsheets/fs094/en/ |url-status=live }}</ref> Routine immunisation has been introduced in order to prevent [[measles]].<ref>{{cite journal |vauthors=Verguet S, Jassat W, Hedberg C, Tollman S, Jamison DT, Hofman KJ |title=Measles control in Sub-Saharan Africa: South Africa as a case study |journal=Vaccine |volume=30 |issue=9 |pages=1594–600 |date=February 2012 |pmid=22230581 |doi=10.1016/j.vaccine.2011.12.123 }}</ref> [[Onchocerciasis]] ("river blindness"), a common cause of [[blindness]], is also endemic to parts of the region. More than 99% of people affected by the illness worldwide live in 31 countries therein.<ref name="who.int">{{cite web |url=https://www.who.int/mediacentre/factsheets/fs374/en/ |title=WHO &#124; Onchocerciasis |publisher=Who.int |access-date=29 September 2015 |archive-date=16 March 2014 |archive-url=https://web.archive.org/web/20140316195959/http://www.who.int/mediacentre/factsheets/fs374/en/ |url-status=live }}</ref> In response, the African Programme for Onchocerciasis Control (APOC) was launched in 1995 with the aim of controlling the disease.<ref name="who.int"/> [[Maternal mortality]] is another challenge, with more than half of maternal deaths in the world occurring in sub-Saharan Africa.<ref name="autogenerated2">{{cite web |url=https://www.who.int/mediacentre/factsheets/fs348/en/ |title=WHO &#124; Maternal mortality |publisher=Who.int |access-date=29 September 2015 |archive-date=30 September 2015 |archive-url=https://web.archive.org/web/20150930184330/http://www.who.int/mediacentre/factsheets/fs348/en/ |url-status=live }}</ref> However, there has generally been progress here as well, as a number of countries in the region have halved their levels of maternal mortality since 1990.<ref name="autogenerated2"/> Additionally, the [[African Union]] in July 2003 ratified the [[Maputo Protocol]], which pledges to prohibit [[female genital mutilation]] (FGM).<ref>{{Cite news |last=Bonino |first=Emma |date=15 September 2004 |title=Opinion &#124; A brutal custom : Join forces to banish the mutilation of women |language=en-US |work=The New York Times |url=https://www.nytimes.com/2004/09/15/opinion/a-brutal-custom-join-forces-to-banish-the-mutilation-of-women.html |access-date=12 February 2023 |issn=0362-4331 }}</ref><ref>{{cite web |last=Feldman-Jacobs |first=Charlotte |date=February 2009 |title=Commemorating International Day of Zero Tolerance to Female Genital Mutilation |publisher=[[Population Reference Bureau]] |url=http://www.prb.org/Articles/2009/fgmc.aspx |archive-url=https://web.archive.org/web/20100213125942/http://www.prb.org/Articles/2009/fgmc.aspx |archive-date=13 February 2010 |url-status=dead }}</ref> Somalia, Guinea, Djibouti, Sierra Leone and Mali have the highest prevalence of FGM in the world.<ref>{{cite web |url=https://www.unicef.org/sites/default/files/press-releases/glo-media-FGMC_2016_brochure_final_UNICEF_SPREAD.pdf |title=Female Genital Mutilation/Cutting: A Global Concern |website=UNICEF |access-date=30 July 2024 }}</ref> [[Infibulation]], the most extreme form of FGM, is concentrated primarily in [[Northeast Africa]].<ref>{{cite web |url=https://dhsprogram.com/pubs/pdf/WP39/WP39.pdf |title=Numbers of women circumcised in Africa: The Production of a Total |website=DHS Program |publisher=United States Agency for International Development |access-date=30 July 2024 }}</ref>

National health systems vary between countries. In [[Ghana]], most health care is provided by the government and largely administered by the [[Ministry of Health, Ghana|Ministry of Health]] and [[Ghana Health Services]]. The healthcare system has five levels of providers: health posts which are first-level primary care for rural areas, health centers and clinics, district hospitals, regional hospitals, and tertiary hospitals. These programs are funded by the government of Ghana, financial credits, Internally Generated Fund (IGF), and Donors-pooled Health Fund.<ref>{{cite book |title=Public Health and Education Spending in Ghana in 1992-98 |date=April 2001 |publisher=World Bank Publication |first1=Sudharshan |last1=Canagarajah |first2=Xiao |last2=Ye |url=http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2001/05/08/000094946_01042509523051/additional/109509322_20041117140518.pdf |page=21 |access-date=29 August 2014 |archive-date=6 March 2014 |archive-url=https://web.archive.org/web/20140306151327/http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2001/05/08/000094946_01042509523051/additional/109509322_20041117140518.pdf |url-status=live }}</ref>

[[Ebola virus disease]], which was first identified in 1976, occasionally occurs in outbreaks in tropical regions of Sub-Saharan Africa.<ref>{{Cite web |url=https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease |title=Ebola virus disease |website=www.who.int }}</ref> The 2013–2016 [[Western African Ebola virus epidemic]] originated in Guinea, later spreading to neighbouring Liberia and Sierra Leone.<ref>{{Cite journal |title=Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections |date=16 October 2014 |journal=The New England Journal of Medicine |volume=371 |issue=16 |pages=1481–1495 |doi=10.1056/NEJMoa1411100 |pmid=25244186 |pmc=4235004 |author1=WHO Ebola Response Team |last2=Aylward |first2=B. |last3=Barboza |first3=P. |last4=Bawo |first4=L. |last5=Bertherat |first5=E. |last6=Bilivogui |first6=P. |last7=Blake |first7=I. |last8=Brennan |first8=R. |last9=Briand |first9=S. |last10=Chakauya |first10=J. M. |last11=Chitala |first11=K. |last12=Conteh |first12=R. M. |last13=Cori |first13=A. |last14=Croisier |first14=A. |last15=Dangou |first15=J. M. |last16=Diallo |first16=B. |last17=Donnelly |first17=C. A. |last18=Dye |first18=C. |last19=Eckmanns |first19=T. |last20=Ferguson |first20=N. M. |last21=Formenty |first21=P. |last22=Fuhrer |first22=C. |last23=Fukuda |first23=K. |last24=Garske |first24=T. |last25=Gasasira |first25=A. |last26=Gbanyan |first26=S. |last27=Graaff |first27=P. |last28=Heleze |first28=E. |last29=Jambai |first29=A. |last30=Jombart |first30=T. |display-authors=1 }}</ref>