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Africa’s hurdles to achieving MDGs

- By Kemantha Govender

Less than 10 countries in Africa have achieved at least one Millennium Development Goal, according to Dr Margaret Mungherera, one of the panelists at the Ethics Alive discussion held at Wits last week.

According to Mungherera, some of the reasons for African countries not being able to meet more Millennium Development Goals (MDGs) relates to poverty, natural disasters, wars and political instability, epidemics, infectious and non-communicable diseases and weak health systems.

“About seven countries in Africa have just come out of war and roughly about seven are in ongoing conflict. We have epidemics such as Ebola outbreaks which have contributed greatly to and continue to contribute to the high burden of disease in Africa,” said Mungherera.

“Africa’s most important asset is its people. But the high morbidities and mortalities means less people who are able to work, save and invest. Approximately half of the people in Africa live on less than one US dollar a day, which is below the poverty line,” she added.

Mungherera, immediate past president of the World Medical Association, was joined by Dr Joe Phaahla, Deputy Minister of Health; Professor Sebastian van As, Head: Trauma Unit, Red Cross War Memorial Children’s Hospital and Nicola Whittaker, Senior Legal Officer at the South African Human Rights Commission.

The Steve Biko Centre for Bioethics in the Wits Faculty of Health Sciences hosted the panel discussion which formed part of Ethics Alive Week at the Wits Medical School. The theme for this year’s discussion was Millennium Development Goals in 2015: The Ethical Conundrums

Of the eight MDGs, number four to six deals with the reduction of children dying before reaching five years of age by two thirds, improving maternal health and addressing Malaria, TB and HIV/AIDS respectively.

“Ethiopia has done very well in the Sub-Saharan countries having achieved MDGs four and five long before 2015. They were able to reduce the number of children who died by the age five years by two thirds,” said Mungherera.

Mungherera said that all departments in all countries should have health related policies because dealing with health issues is bigger than the health sector itself. She also stressed that strategies to address mental health and the integration of traditional healers’ integration into the national system should be put into place.

She said the underlying principles to medical ethics consist of compassion, competence and professional autonomy or clinical independence.  Mungherera said that focus must be placed on basic counseling skills and doctor-patient communication.

“Ethical challenges include health literacy which receives grossly inadequate attention by governments, health planners and health professionals,” she continued. In addition, the work load of health workers and the regulation and supervision of health workers still pose ethical dilemmas for many countries.

Meanwhile, Phaahla highlighted some of South Africa’s achievements which include halving the proportion of people whose income is less than $1 a day between 1990 and 2015.

Phaahla said that South Africa has made notable progress with MDG number four, which focused on eliminating gender disparity in primary and secondary education, preferably by 2005. Some of the achievements include the proportion of seats held by women in national parliament and the number of women in overall employment. An area which has been lacking is in the share of women in wage employment in the non-agricultural sector. He said literacy rates in the country have also increased.

He noted that in some areas such as child mortality, availability of accurate data is problematic but there is an improvement in addressing this challenge, despite there still being a long way to go. Phaahla said that South Africa is not doing well in the area of condom use.

“We have excellent examples of health professionals who are contributing to the MDGs. Clinicians are at the forefront, they diagnose and treat patients, hence we have the largest number of HIV positive patients on treatment. We have world class researchers working in the area of HIV and TB, for example,” said Phaahla.