AFR/RC59/3 16 July 2009
REGIONAL COMMITTEE FOR AFRICA Fifty-ninth session Kigali, Republic of Rwanda, 31 August–4 September 2009 Provisional agenda item 8.1
ORIGINAL: ENGLISH
TOWARDS REACHING THE HEALTH-RELATED MILLENNIUM DEVELOPMENT GOALS: PROGRESS REPORT AND THE WAY FORWARD
Report of the Regional Director
CONTENTS Paragraphs BACKGROUND ............................................................................................................................... 1–4 PROGRESS MADE ........................................................................................................................ 5–15 CHALLENGES ................................................................................................................................... 16 THE WAY FORWARD ................................................................................................................ 17–26 ANNEXES Page A: Official list of MDG indicators........................................................................................................ 6 B: Graphs of MDG trends..................................................................................................................... 9 C: Latest data on MDGs provided by Member States compared with UN data ................................. 20
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BACKGROUND 1. In 2000, world leaders adopted the United Nations Millennium Declaration and the millennium development goals (MDGs), setting the year 2015 as the date for reaching the targets. The MDGs constituted an unprecedented commitment by world leaders to comprehensively address peace, security, development, human rights and fundamental freedoms. 2. Three of the eight MDGs are health goals: they are Goal 4, Reduce child mortality; Goal 5, Improve maternal health; and Goal 6, Combat HIV/AIDS, malaria and other diseases. Several other MDGs are monitored through health-related indicators; they include Goal 1, Eradicate poverty and hunger; Goal 7, Ensure environmental sustainability; and Goal 8, Develop a global partnership for development (see the table in Annex A for an updated list). 3. Significant commitments to the MDGs have been demonstrated by countries of the WHO African Region. Examples of these commitments include the Abuja Declaration of 2001 requesting countries to allocate 15% of public expenditures to the health sector; the 2005 WHO Regional Committee for Africa resolution on achieving the millennium development goals;1 and the 2008 Ouagadougou Declaration on Primary Health Care and Health Systems in Africa.2 Similar commitments have been demonstrated by development partners through the United Nations Secretary-General's MDGs Africa Initiative and the Harmonization for Health in Africa mechanism. 4. This report provides an update on the progress made towards the achievement of the health and health-related MDGs; it further identifies the main challenges and proposes the way forward. PROGRESS MADE 5. The analysis of progress is based on data from the UN Statistical Division (UNSD) and data from World Health Statistics 2008 and 2009 when not available in UNSD. It focuses on agreed MDG targets and indicators. Trends are assessed on the basis of data between 1990 and the most recent year for which information was available as of July 2009.3 UN Member States earlier agreed to use the UNSD statistical database to monitor country progress towards reaching the MDGs. However the latest data on MDGs submitted by Member States are presented in Annex C. Health MDGs 6. Target 4A: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate. Six countries are on track to achieve this target (Algeria, Cape Verde, Eritrea, Malawi, Mauritius and Seychelles); 23 countries are making progress, although it is insufficient; and 16 countries have made no progress. In 2006, the mortality rate varied between 16 and 262 per 1000 live births (Annex B: Figure 2).
1
2
3
Resolution AFR/RC55/R2, Achieving the health millennium development goals: situation analysis and perspectives in the African Region. In: Fifty-fifth Session of the WHO Regional Committee for Africa, Maputo, Mozambique, 22–26 August 2005, Final report, Brazzaville, World Health Organization, Regional Office for Africa, 2005 (AFR/RC55/20), pp. 7–9. Resolution AFR/RC58/R3, The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa: achieving better health for Africa in the new millennium. In: Fifty-eighth Session of the WHO Regional Committee for Africa, Yaounde, Republic of Cameroon, 1–5 September 2008, Final report, Brazzaville, World Health Organization, Regional Office for Africa, 2008 (AFR/RC58/20), pp. 13–15. Although the MDGs were adopted in 2000, the baseline year for the targets was set from 1990.
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7. Target 5A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. MMR estimates for 2005 show that the Region has made no progress towards achieving this target.4 A total of 13 countries5 had maternal mortality ratios less than 550 deaths per 100 000 live births; 31 countries had very high MMRs of 550 or higher; and 12 countries had ratios of 1000 or higher. MMR estimates were not available for two countries (Annex B: Figure 3). 8. Target 5B: Achieve, by 2015, universal access to reproductive health. Between 1990 and 2007, there was a 30% increase in access to contraceptives in the Region among currently married women. The prevalence of contraceptive use among currently married women (15–49 years old) varied from 75% to 5% in 2007. Only five countries had contraceptive use rates higher than 50% (Algeria, Cape Verde, Mauritius, South Africa and Zimbabwe), while 27 countries had usage rates less than 33%. Trend data were not available for nine countries (Annex B: Figure 4). 9. Target 6A: Halt and begin to reverse, by 2015, the spread of HIV/AIDS. Among the 13 countries that have complete trend data, 11 have started to observe declines or stabilization in HIV prevalence trends among pregnant women aged 15–24;6 HIV/AIDS prevalence has increased in two countries (Burundi and Malawi). The most recent prevalence estimates in the 13 countries ranged between 1.7% and 27.1% (Annex B: Figure 5). 10. Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. Only a third of the population with advanced HIV infection in the Region had access to antiretroviral medicines in 2007. Three countries had coverage rates of more than 70% (Botswana, Namibia and Rwanda), while 39 countries had coverage rates below 50%. Trend data were not available for four countries (Annex B: Figure 6). 11. Target 6C: Halt and begin to reverse, by 2015, the incidence of malaria and other major diseases. Interpretation of the trends in malaria incidence and deaths using available data is difficult in the African Region due to incomplete reports, non-standardized reporting and reliance mostly on clinical diagnosis. Indicators of ITN and antimalarial coverage are preferred to measure progress toward the MDG targets. There were increases in the proportions of children under five sleeping under insecticide-treated bednets between 1999 and 2006 in all 18 countries with trend data, although coverage rates were lower than 50% (Annex B: Figure 7a). The use of antimalarial medicines for treating children with fever decreased between 1996 and 2006 in 14 countries out of 19 with complete trend data (Annex B: Figure 7b). This decrease is due to the shift from chloroquine treatment to the implementation of artemisinin-based combination therapy policy. 12. Five countries (Angola, Comoros, Eritrea, Seychelles and Zambia) are on track to achieve the target for tuberculosis, while eight countries7 have shown insufficient progress (Annex B: Figure 8). Of the 33 countries that are making no progress, 14 have prevalence of 500 or more per 100 000 population; between 1990 and 2007, estimated prevalence increased in 27 countries due to the HIV pandemic. The prevalence ranged between 39 and 941 per 100 000 population per year (Annex B: Figure 8). 4
5 6 7
WHO, Maternal mortality in 2005: Estimates developed by WHO, UNICEF, UNFPA and the World Bank, Geneva, World Health Organization, 2007; also see http://www.who.int/reproductive-health/publications/maternal_mortality_2005/index.html (accessed 29 October 2008). Algeria, Botswana, Cape Verde, Comoros, Eritrea, Gabon, Madagascar, Mauritius, Mozambique, Namibia, South Africa, Swaziland and Togo. Benin, Botswana, Eritrea, Ethiopia, Ghana, Lesotho, Namibia, Rwanda, Swaziland, Zambia and Zimbabwe. Cape Verde, Ghana, Guinea-Bissau, Mali, Mauritius, Namibia, Sao Tome and Principe, and South Africa.
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Health-related MDGs 13. Target 1C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger. Only eight countries are on track to achieve this target.8 Although 18 countries are making progress, their progress is insufficient; 12 countries have made no progress. The proportion of malnourished children in these 38 countries varies from 3% to 44%. Trend data were not available in eight countries (Annex B: Figure 1). 14. Target 7C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. Nine countries9 are on track to achieve the safe water target. Six countries are making progress although it is insufficient, while 19 countries have made no progress (Annex B: Figure 9). The proportions of population using improved drinking water sources varied between 42% and 100% in 2006. Trend data were not available for 12 countries. Of the 36 countries with trend data, 34 countries have made no progress to achieve the target for basic sanitation while two countries are on track (Algeria and Mauritius) (Annex B: Figure 10). The few countries that are on track to achieve some of the targets represent between 5% and 15% of the total population of the African Region. 15. Target 8E: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries. The indicator for this target is the proportion of population with access to affordable essential medicines on a sustainable basis. The method for collecting data on this indicator was introduced only recently (see Annex A). Thus, adequate trend data were not yet available to assess countries’ progress on this target. CHALLENGES 16. The available evidence indicates that most of the countries in the African Region have not made sufficient progress towards the MDG targets. A number of key challenges need to be addressed effectively if countries are to attain the goals by 2015. These challenges include: (a) inadequate internal and external resources devoted to the achievement of the MDGs; (b) external resources which are unpredictable, non-sustainable, and not aligned to or in harmony with country priorities; existing resources which are inefficiently utilized; (c) weak health systems, particularly inadequate access to, and quality of, health services; weak human and institutional capacity; (d) persisting inequities in access to proven interventions, particularly against maternal mortality, but also against child mortality, HIV/AIDS, tuberculosis and malaria; (e) low priority accorded to health in national economic and development policies; (f) weak multisectoral response, and the poor progress in achieving the other MDGs; (g) inadequate trend data for a number of indicators, global reporting often being based on imputations and estimations using statistical techniques rather than on empirical and timely data collection.
8 9
Algeria, Botswana, Republic of Congo, Ghana, Guinea-Bissau, Malawi, Mauritania, and Sao Tome and Principe. Botswana, Burkina Faso, Cote d'Ivoire, Ghana, Guinea, Malawi, Mauritius, Namibia and South Africa.
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THE WAY FORWARD 17. Progress on the goals of the health-related MDGs is mostly very slow in the African Region. Countries and their development partners should increase resources significantly and explore new and innovative ways to ensure progress.
18. Countries should allocate at least 15% of public expenditure to the health sector as set out in the 2001 Abuja Declaration.10 In addition, they need to strengthen existing structures and mechanisms for sustainable, effective and efficient mobilization and utilization of internal and external resources. 19. Countries can strengthen health systems by fully implementing the 2008 Ouagadougou Declaration on Primary Health Care and Health Systems in Africa to ensure better access to, and quality of, health services; a strong health workforce; an effective health information system; equitable access to essential medical products, vaccines and technologies; a functioning health financing system; and a robust leadership and governance structure. 20. It is necessary for countries to increase their attention to areas where progress has been limited, particularly to improve maternal health, by providing sufficient financing to strengthen maternal and other reproductive health services. 21. Both countries and partners should build international partnerships, sustain the gains achieved and scale up interventions to achieve the necessary reductions in under-five mortality as well as combat HIV/AIDS, malaria and tuberculosis. 22. Countries should strengthen leadership and institutional capacity within ministries of health, especially in macroeconomic analysis and strategic planning and budgeting. There is a need to increase dialogue between health and oversight ministries such as finance and planning. 23. National efforts should follow the “Three Ones” principle of one national plan, one coordination mechanism and one monitoring and evaluation plan while striving to achieve the MDGs. 24. Countries can improve the monitoring of progress towards the MDGs in collaboration with all stakeholders and international partners by: (a) improving the frequency, quality and efficiency of national health surveys; (b) strengthening birth and death registration; (c) improving the availability of demographic data by completing the 2010 census round; (d) improving surveillance and service statistics; (e) enhancing monitoring of health systems strengthening; and (f) strengthening the analysis, evaluation and use of data for decision-making.11 25. Unless current trends are drastically changed, most countries of the African Region are unlikely to achieve any of the health or health-related MDGs. However, progress is possible if Member States 10 11
Recent estimates show that only five countries—Botswana, Burkina Faso, Liberia, Malawi and Rwanda—have achieved the 2005 Abuja target of at least 15% of public expenditure to the health sector. WHO, Strengthening the monitoring of progress on the health-related MDGs in the African Region. Report submitted to the HHA Regional Directors Meeting, Nairobi, 11–14 November 2008, Brazzaville, World Health Organization, Regional Office for Africa, 2008.
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work with development partners to devote more resources, strengthen health systems, including the data sources for monitoring MDG progress, and improve access to proven interventions. 26. The Regional Committee is requested to take note of this progress report and encourage countries to adopt the proposed actions as the way forward for reaching the targets of the millennium development goals.
AFR/RC59/3 Page 6 ANNEX A Official list of MDG indicators
MDG monitoring framework revised to include new targets and indicators, as noted by the 62nd UN General Assembly. Health targets and indicators are in gray. All indicators should be disaggregated by sex and urban/rural as far as possible. Effective 15 January 2008 Millennium Development Goals (MDGs) Goals and targets (from the Millennium Declaration) Goal 1: Eradicate extreme poverty and hunger Target 1.A: Halve between 1990 and 2015, the proportion of people whose income is less than one dollar a day Target 1.B: Achieve full and productive employment and decent work for all, including women and young people 1.1 1.2 1.3 1.4 1.5 1.6
Indicators for monitoring progress i
Target 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
Proportion of population below $1 (PPP) per day Poverty gap ratio Share of poorest quintile in national consumption Growth rate of GDP per person employed Employment-to-population ratio Proportion of employed people living below $ 1 (PPP) per day 1.7 Proportion of own-account and contributing family workers in total employment 1.8 Prevalence of underweight children under-five years of age 1.9 Proportion of population below minimum level of dietary energy consumption
Goal 2: Achieve universal primary education Target 2.A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling 2.1 2.2 2.3 Goal 3: Promote gender equity and empower women Net enrolment ratio in primary education Proportion of pupils starting grade 1 who reach last grade of primary Literacy rate of 15-24 year-olds, women and men
Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015
3.1 Ratios of girls to boys in primary, secondary and tertiary education 3.2 Share of women in wage employment in the nonagricultural sector 3.3 Proportion of seats held by women in national parliament
Goal 4: Reduce child mortality Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate 4.1 4.2 4.3 Under-five mortality rate Infant mortality rate Proportion of 1 year-old children immunized against measles Maternal mortality ratio Proportion of births attended by skilled health personnel Contraceptive prevalence rate Adolescent birth rate Antenatal care coverage (at least one visit and at least four visits) Unmet need for family planning
Goal 5: Improve maternal health Target 5.A: Reduce by three quarters, between 19990 and 2015, the maternal mortality ratio 5.1 5.2
Target 5.B: Achieve, by 2015, universal access to reproductive health
5.3 5.4 5.5 5.6
AFR/RC59/3 Page 7 Goal 6: Combat HIV/AIDS, malaria and other diseases Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS 6.1 6.2 6.3 6.4 HIV prevalence among population aged 15-24 years Condom use at last high-risk sex Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years Proportion of population with advanced HIV infection with access to antiretroviral drugs Incidence and death rates associated with malaria Proportion of children under 5 sleeping under insecticide-treated bednets Proportion of children under 5 with fever who are treated with appropriate anti-malaria drugs Incidence, prevalence and death rates associated with tuberculosis
Target 6.B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
6.5
6.6 6.7
6.8
6.9
6.10 Proportion of tuberculosis cases detected and cured under directly observed treatment short course Goal 7: Ensure environmental sustainability Target 7.A: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 Proportion of land area covered by forest CO2 emissions, total per capita and per $ 1 GDP (PPP) Consumption of ozone-depleting substances Proportion of fish stocks within safe biological limits Proportion of total water resources used Proportion of terrestrial and marine areas protected Proportion of species threatened with extinction Proportion of population using an improved drinking water source Proportion of population using an improved sanitation facility ii
Target 7.B: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate loss Target 7.C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation
Target 7.D: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers Goal 8: Develop a global partnership for development Target 8.A Develop further an open, rule-based, predictable, non-discriminatory trading and financial system
7.10 Proportion of urban population living in slums
Some of the indicators listed below are monitored separately for the least developed countries (LDCs). Africa, landlocked developing countries and small islands developing States. Official development assistance (ODA) 8.1 Net ODA, total and to the least developed countries, as percentage of OECD/DAC donors’ gross national income 8.2 Proportion of total bilateral, sector-allocable ODA of OECD/DAC donors to basic social services (basic education, primary health care, nutrition, safe water and sanitation) 8.3 Proportion of bilateral official development assistance of OECD/DAC donors that is untied 8.4 ODA received in landlocked developing countries as a proportion of their gross national incomes 8.5 ODA received in small island developing States as a proportion of their gross national incomes Market access 8.6 Proportion of total developed country imports (by value and excluding arms) from developing countries
Includes a commitment to good governance, development and poverty reduction – both nationally and internationally Target 8.B: Address the special needs of the least developed countries Includes: tariff and quota free access for the least developed countries export, enhanced programme of debt relief for heavily indebted poor countries (HIPC) and cancellation of official bilateral debt, and more generous ODA for countries committed to poverty reduction Target 8.C: Address the special needs of landlocked developing countries and small island developing States (through the Programme of Action for the Sustainable Development of Small Island Developing States and the outcome of the twenty-second special session of the General Assembly)
AFR/RC59/3 Page 8 and least developed countries, admitted free of duty 8.7 Average tariffs imposed by developed countries on agricultural products and textiles and clothing from developing countries 8.8 Agricultural support estimate for OECD countries as a percentage of their gross domestic product 8.9 Proportion of ODA provided to help trade capacity Debt sustainability 8.10 Total number of countries that have reached their HIPC decision points and number that have reached their HIPC completion points (cumulative) 8.11 Debt relief committed under HIPC and MDRI Initiatives 8.12 Debt service as a percentage of exports of goods and services 8.13 Proportion of population with access to affordable essential drugs on a sustainable basis
Target 8.D: Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term
Target 8.E: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries Target 8.F: In cooperation with the private sector, make available the benefits of new technologies, especially information and communications
8.14 8.15 8.16
Telephone lines per 100 population Cellular subscribers per 100 population Internet users per 100 population
The Millennium Development Goals and targets come from the Millennium Declaration, signed by 189 countries, including 147 Heads of State and Government in September 2000 (http//www.un.org/millennium/declaration/ares552e.htm) and from further agreement by Member States at the 2005 World Summit (Resolution adopted by the General Assembly – A/RES/60/1, http//www.un.org/Docs/journal/asp/ws.asp?m=A/RES/60/1. The goals and targets are interrelated and should be seen as a whole. They represent a partnership between the developed countries and the developing countries “to create an environment – at the national and global levels alike – which is conducive to development and the elimination of poverty”.
___________ i ii
For monitoring country poverty trends, indicators based on national poverty lines should be used, where available. The actual proportion of people living in slums measured by a proxy, represented by the urban population living in households with at least one of the four characteristics (a) lack of access to improved water supply; (b) lack of access to improved sanitation; (c) overcrowding (3 or more persons per room); and (d) dwellings made of non-durable material.
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ANNEX B Graphs of MDG trends
AFR/RC59/3 Page 10 Figure 1: Percentage of under-five children with moderate or severe malnutrition in 2001-2006 (darker bars) and the MDG target* rate in the African Region Countries showing no progress towards the target** 0 10 20 23 11.2 30 40 50
Countries with insufficient progress 0 10 10.8 19.9 11.2 20 12.4 20.2 11.9 20.3 13.2 20.4 12.8 21.8 14.4 22.5 14.6 22.6 14.6 23.7 13.5 24 13.1 25.8 11.6 28.7 17.9 31.1 17.2 33.2 20.0 36.7 19.4 38.4 23.8 39.6 20.5 0 10 3.7 4.6 9.2 6.5 12.5 8.6 14.4 7.0 17.7 13.7 19.4 12.5 19.4 13.6 31.8 23.8 20 30 40 50
20 17.3
30
40
50
Senegal Kenya Zambia Cote d'Ivoire
African Region
2001-2006 South Africa Zimbabwe Cameroon Lesotho Comoros Togo Central African Republic Sierra Leone Burkina Faso Burundi Madagascar Niger 11.5 4.6 16.6 7.8 19.3 6.8 19.8 7.9 24.9 9.3 26 9.5 28.5 13.7 30.4 13.6 37.4 16.4 39.2 22.6 41.9 19.6 44.4 21.3
2001-2006 MDG target (2015)
MDG target (2015)
Gambia Uganda U R Tanzania Rwanda Benin Mozambique Namibia Guinea Nigeria D R Congo Mali Chad Ethiopia Eritrea
Countries on track to achieve the target
Algeria Sao Tome and Principe Botswana Congo Ghana Guinea-Bissau Malawi Mauritania
Note: *MDG Target 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger ** Countries and regions are classified according to the following thresholds: On track: Average annual rate of reduction (AARR) is greater than or equal to 2.6 per cent, or latest available estimate of underweight prevalence (2000 or later) is less than or equal to 5 per cent, regardless of AARR. Insufficient progress: AARR is between 0.6 per cent and 2.5 per cent. No progress: AARR is less than or equal to 0.5 per cent. Data was not available for eight countries: Angola, Cape Verde, Equatorial Guinea, Gabon, Liberia, Mauritius, Seychelles and Swaziland. Source for country data UNSD - accessed 7 July 2009. Source for data for the average of the African Region: WHO, World health statistics 2008, Geneva, World Health Organization, 2008.
AFR/RC59/3 Page 11 Figure 2: Under-five mortality (per 1000 live births) in 2007 (darker bars) and the MDG target* rate in the African Region Countries showing no progress towards the target** 0 50 100 150 145 61 200 250 300
Countries with insufficient progress R ate in 2007 0
African Region
MDG4-target rate for 2015 50 100 80 83 77 107 168 78 161 68 158 87 150 78 133 78 131 53 127 51 123 62 119 68 54 50 56 51 49 37 34 29 40 40 68 66 116 114 112 109 100 91 84 150 200 198 196 189 176 250
Countries on track to achieve the target 300 0 50 100 150 110 74 70 49 37 23 32 20 17 8 16 6 200 250 300
Sierra Leone Chad Burkina Faso Rw anda Burundi Central African Republic Zam bia Equatorial G uinea Cam eroon Congo Kenya Mauritania G hana Sao Tom e and Principe G abon Zim babw e South Africa 67
262 96 209 191 69 181 58 180 63 172 57 170 60 150 57 148 46 125 34 121 32 118 44 115 40 99 33 91 31 90 25 59 20
G uinea-Bissau Mali Nigeria Niger Mozam bique Dem ocratic Republic of Congo Angola G uinea Liberia Uganda Côte d'Ivoire Benin Ethiopia United Republic of Tanzania Senegal Madagascar G am bia Togo Sw aziland Lesotho Nam ibia Com oros Botsw ana 19
Malaw i Eritrea Algeria Cape Verde Mauritius Seychelles
Note: *MDG Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under five mortality rate **Country and regional assessments of progress towards MDG 4 are based on average annual rates of reduction (AARR) in U5MR observed for 1990–2007 and required during 2008–2015 in order to reach the MDG target of reducing U5MR by two thirds by 2015, according to the following thresholds: On track: U5MR is less than 40, or U5MR is 40 or more and AARR observed for 1990–2007 is 4.0 per cent or more. Insufficient progress: U5MR is 40 or more and AARR observed for 1990–2007 is between 1.0 per cent and 3.9 per cent. No progress: U5MR is 40 or more and AARR observed for 1990–2007 is less than 1.0 per cent. Source: WHO, World health statistics 2009, Geneva, World Health Organization, 2009.
AFR/RC59/3 Page 12 Figure 3: Estimates of maternal mortality ratio (per 100 000 live births) in 2005 (darker bar) and the MDG target* ratio in the African Region Countries with MMR between 550 and 980 0 500 228 300 163 185 205 275 233 350 223 203 233 235 248 143 400 193 153 300 175 300 550 560 560 680 690 700 720 740 810 820 830 840 880 910 950 960 970 980 980 0 500 138 140 228 235 250 325 140 325 375 375 300 450 1000 1000 1100 1100 1100 1100 1100 1200 1300 1400 1500 1800 2100 1500 2000
1000 900
1500
2000
African Region
Countries with MMR less than 550** 0 500 15 30 1000 1500 2000
Mauritius Algeria Cape Verde Namibia Botswana Swaziland South Africa Comoros Eritrea Madagascar Togo Gabon Mozambique
40 48
180 210
210 93
Year 2005 380 390 400
63 140 58
MDG target (2015)
400 238 450 350 510 123 510 160 520 125 520 375
Uganda Kenya Ghana Equatorial Gambia Burkina Faso Ethiopia Congo Côte d'Ivoire Mauritania Zambia Benin Zimbabwe Guinea U R Tanzania Lesotho Mali Central Senegal
Countries with MMR of 1000 or higher
Cameroon Malawi Guinea-Bissau D R Congo Nigeria Burundi Liberia Rwanda Angola Chad Niger Sierra Leone
Note: *MDG Target 5.A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. **Due to the large margins of uncertainty around these estimates, country-level trend analysis is problematic. Progress towards this MDG is therefore assessed based on the latest available estimates and is classified according to the following thresholds: Very high: MMR of 550 or more; High: MMR of 300–549; Moderate: MMR of 100–299; Low: MMR below 100. Data was not available for San Tome and Principe and Seychelles. Source: Maternal mortality in 2005: Estimates developed by WHO, UNICEF, UNFPA and the World Bank, WHO, 2007. http://www.who.int/reproductive-health/publications/maternal_mortality_2005/index.html (accessed on 29/10/08) and WHO, World health statistics 2009, Geneva, World Health Organization 2009.
AFR/RC59/3 Page 13 Figure 4: Prevalence of contraceptive use (per cent) among currently married women 15–49 years old, in 2000–2007 (darker bars) and 1990–1999 (lighter bars) in the African Region* Countries with prevalence less than 33% 0 10 20 21.3 16.4 4.8 2.6 5.4 4.1 6.2 8.1 8.0 8.0 8.0 4.1 8.2 6.7 9.1 4.0 11.4 4.1 11.8 10.5 12.6 8.2 12.6 10.7 12.9 13.2 13.6 11.8 13.8 9.9 15.3 17.5 16.5 5.6 17.8 16.4 21.0 21.2 21.3 23.5 22.8 14.8 23.0 19.4 23.5 14.8 25.7 21.0 26.0 7.7 26.0 17.7 27.3 19.4 32.5 17.5 30 40 50 60 70 80
African Region Sierra Leone Chad Angola Eritrea Mauritania Mali Guinea Ethiopia Senegal Niger Nigeria Cote d'Ivoire Gambia Burkina Faso Rwanda Mozambique Benin Ghana Togo Uganda Madagascar Central African Republic Comoros D R Congo Cameroon U R Tanzania Malawi
2000-2007 1990-1999
Countries with prevalence of 33% or more**
0
10
20 22.0
30
40 34.2 34.3
50
60
70
80
Zambia Lesotho Kenya Namibia Botswana Zimbabwe South Africa Cape Verde Algeria Mauritius
23.2 39.3 35.9 43.7 28.9 44.4 47.6 60.2 50.8 60.3 56.3 61.3 52.9 61.4 53.9 75.9 74.7
Note: *MDG Target 5.B: Achieve, by 2015, universal access to reproductive health. **Trend data is incomplete for nine countries: Burundi, Congo, Equatorial Guinea, Gabon, Liberia, Guinea-Bissau, Sao Tome and Principe, Seychelles, and Swaziland. Source: UNSD - accessed 7 July 2009.
AFR/RC59/3 Page 14 Figure 5: HIV prevalence in pregnant women aged 15–24 years in 2004–2007 (darker bars) and in 2000–2003 (lighter bars) for 13 countries with trend data in the African Region*
Botswana Swaziland Lesotho Zimbabwe Zambia Namibia Ethiopia Rwanda Ghana Eritrea Benin 5.6 4.0 4.6 2.5 3.0 1.8 2.1 1.7 1.7 10.4 16.8 24.2 15.3
27.1 25.9
33.2 34.4
25.2 14.9 16.2 14.7 17.9 2004-2007 2000-2003
Burundi Malawi 0
5.5
15.5 14.3 13.3 10 20
For these two countries the prevalence has increased between 2000 and 2007
30
40
50
Note: *MDG Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS. Source: WHO-AFRO dataset–7 July 2009.
AFR/RC59/3 Page 15 Figure 6: Percentage of population with advanced HIV infection with access to antiretroviral medicines in 2007 (darker bars) and in 2006 (lighter bars) in the African Region*
Countries with coverage rate of 20% or less**
Countries with coverage rate of 21–30% 0 20 6 21 22 24 23 23 15 12 16 16 24 24 25 25 26 22 26 27 26 28 28 29 40 60 80 100
Countries with coverage rate of 31% or more 0 20 21 31 40 60 80 100
0
20 4 3 10 8 13 11 13 12 15 12 17 12 17 10 17 11 18 19 19 18 20 14 20 9 20 12
40
60
80
100
Central African Republic Mauritius 2007 2006 Burundi Mauritania DR Congo Mozambique Angola Cameroon Lesotho Nigeria Guinea Cote d'Ivoire South Africa Ethiopia
Madagascar Niger Chad Eritrea Ghana Congo Liberia Zimbabwe Gambia Togo Algeria Guinea-Bissau Sierra Leone
African Region Equatorial Guinea UR Tanzania Uganda Malawi Burkina Faso Kenya Mali Gabon Swaziland Zambia Benin Senegal Rwanda Botswana Namibia 14 14
31 31 27 21 33 35 35 31 38 41 43 42 39 42 35 46 42 49 56 57 52 71 79 76 68 88
17 8
2007
2006
27
13
26
19 21 18
Note: *MDG Target 6.B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. **Trend data not available for four countries: Cape Verde, Comoros, Sao Tome and Principe and Seychelles. Source for country data UNSD - accessed 7 July 2009. Source for data for the average of the African Region: WHO/UNAIDS/UNICEF--Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector--progress report 2008.
AFR/RC59/3 Page 16
Figure 7a: Percentage of under five children sleeping under insecticidetreated bednets* in 2003–2006 (darker bars) and 1999–2002 (lighter bars) in the African Region**
Figure 7b: Percentage of under five children with fever being treated with anti-malarial medicines in 2002–2006 (darker bars) and 1993–2001 (lighter bars) in the African Region*** 0 20 12.3 9.2 62.6 55.2 61.8 60.7 58.2 53.4 48.8 31.5
40
60
0
10
20
30
40
50
60
70
Rwanda
Kenya Cote d'Ivoire Sierra Leone Cameroon Senegal Niger Burundi Uganda Rwanda Central African Republic U R Tanzania Malawi Benin Zambia Togo Guinea-Bissau Sao Tome and Principe Gambia
4.6 2.9 4.9 1.1
5.3 1.5
These five countries have shown an increasing trend in coverage between 1999 and 2006
Gambia Ghana U R Tanzania Burkina Faso
7.0 1.3
7.1 1.7
2003-2006
7.4 1.0
Ethiopia 1999-2002
3.0 3.0 24.7 61.2 26.2 27.0 26.8 36.2 30.0 31.3 33.0 48.1 34.2 60.7 36.0 57.5 45.7 58.4 47.7 60.0 51.9 60.7 54.9 58.0 55.5 66.1 57.0 68.8
8.3 1.3
Sao Tome and Principe Malawi
9.7 0.2
13.0 4.3
Senegal Burundi Niger
15.1 1.5
16.0 2.1
Madagascar 18.9
2.8
Cote d'Ivoire 20.2 7.4
Guinea-Bissau 22.8
3.8
Togo 38.4
2.0
Sierra Leone Zambia 46.0
39.0 7.4 22.5
Cameroon Central African Republic
49.0 14.7
*MDG Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases. **Trend data on ITN overage is not available for 28 countries. ***Trend data on treatment overage is not available for 27 countries. Source for country data UNSD - accessed 7 July 2009.
AFR/RC59/3 Page 17 Figure 8: Prevalence of tuberculosis (/100 000 pop) in 2007 (darker bars) and the MDG target* rates (lighter bars) in the African Region **
Countries showing no progress toward the target (Prevalence of 500 or more in 2007) 0 200 400 600 475 166.5 800 1000
Countries showing no progress toward the target (Prevalence less than 500 in 2007)
Countries on track (Angola, Comoros, Eritrea, Seychelles and Zambia) and countries with insufficient progress (the rest) 1200
African Region
0
200
400
600 497 485
800
1000
Chad Sierra Leone Swaziland Togo Zimbabwe D R Congo Burundi Botswana Rwanda Côte d'Ivoire Ethiopia Lesotho Mauritania Nigeria Mozambique 139 504 149 123 666 133 647 153.5 622 147 590 100.5 582 165 579 153.5 568 127 559 288 521 941 245.5 812 332.5 750 387.5 714
127 125.5
Congo Equatorial Guinea Senegal Guinea Uganda Central African Republic Madagascar Gambia Burkina Faso Liberia Gabon U R Tanzania Kenya Malawi Niger Cameroon Benin Algeria
469 88 189 127 148 168 182.5 173.5 168.5 166.5 191.5 135 319 66.5 160.5 157.5 195 96.5 70 56 22 135 305 292 398 379 337 425 417 404 403 468 448 426 0 200 400 600 800 692 387 599 357.5 532 337 387 318 353 266 294 257 280 206.5 276 201.5 240 172.5 134 115.5 83 93 55 56.5 39 25 1000 1200
South Africa Mali Namibia Zambia Ghana
Year 2007
Angola Cape Verde Guinea-Bissau
MDG target (2015)
Sao Tome and Principe Eritrea Comoros Seychelles Mauritius
Note: *MDG Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases. ** Countries are classified as: On track: If average annual rate of reduction (AARR) is greater than or equal to 2.6 per cent; Insufficient progress: AARR is between 0.6 per cent and 2.5 per cent. No progress: AARR is less than or equal to 0.5 per cent. Source: WHO, World health statistics 2009, Geneva, World Health Organization, 2009.
AFR/RC59/3 Page 18 Figure 9: Percentage of the population using improved drinking water sources in 2006 (darker bars) and MDG target* (lighter bars) in the African Region Countries showing no progress towards the target** 0 10 20 30 40 50 60 59 70 80 75 90 100
African Region
Ethiopia Niger Equatorial Guinea D R Congo Madagascar Nigeria Angola U R Tanzania Kenya Zambia Togo Eritrea Liberia Benin Rwanda CentralAfricanRepublic Burundi Algeria Comoros
42 42 43 46 47 47 51
57 71 72 72 70 75 70 55 57 58 59 60 64 65 65 66 71 71 75 0 10 20 30 40 50 60 60 67 60 69 64 70 80 90 100
Countries on track to achieve the 75
Countries with insufficient Guinea Burkina Faso Malawi Ghana MDG Target (2015) Cote d'Ivoire Namibia 75 77 84 81 89
0
10
20
30
40
50
60
70 70 73 72 67
80
90
100
75 72 79 82 83 79 85 85 85
Mali Mauritania Uganda Cameroon Senegal 97 97
Year 2006
76 71 80 78 81 84 93 79 93 91 96 97 100 100
72 70
South Africa Botswana Mauritius
Zimbabwe
Note: *MDG Target 7.C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. ** Countries were classified according to the following thresholds: On track: Use of improved sources of drinking water in 2006 was less than 5 per cent below the rate needed for the country/region to reach the MDG target, or use was 95 per cent or higher. Insufficient progress: Use of improved sources of drinking water in 2006 was 5 per cent to 10 per cent below the rate needed for the country/region to reach the MDG target. No progress: Use of improved sources of drinking water in 2006 was more than 10 per cent below the rate needed for the country/region to reach the MDG target, or the 1990–2006 trend shows unchanged or decreasing use. Trend data was not available for 12 countries: Cape Verde, Chad, Congo, Gabon, Gambia, Guinea-Bissau, Lesotho, Mozambique, Sao Tome and Principe, Seychelles, Sierra Leone and Swaziland. Source: UNSD - accessed 7 July 2009.
AFR/RC59/3 Page 19 Figure 10: Percentage of the population using improved sanitation facilities in 2006 (darker bars) and MDG target* (lighter bars) in the African Region (All countries (except Algeria and Mauritius) have made no progress** towards achieving the target) 0 African Re gion Eritre a Nige r Chad Ghana Ethiopia Togo M adagas car Bur k ina Fas o Guine a Rw anda Cote d'Ivoire M auritania Se ne gal Be nin Nige r ia D R Congo Ce ntral African Re public Libe r ia Uganda U R Tanzania Nam ibia Com oros Burundi Ke nya M ali Zim babw e Bots w ana Angola Equatorial Guine a Cam e roon Zam bia South Africa M alaw i Alge r ia M auritius 5 7 9 10 11 12 12 13 19 23 24 24 28 30 30 31 31 32 33 33 35 35 41 42 45 46 47 50 51 51 52 59 60 63 76 70 71 78 73 94 94 94 97 56 63 58 56 70 65 68 63 59 72 70 68 72 69 10 20 30 33 52 52 53 53 52 57 54 53 57 65 60 60 63 40 50 60 65 70 80 90 100
Ye ar 2006
M DG targe t (2015)
Note: *MDG Target 7.C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. ** Countries were classified according to the following thresholds: On track: Use of improved sanitation facilities in 2006 was less than 5 per cent below the rate needed for the country/region to reach the MDG target, or use was 95 per cent or higher. Insufficient progress: Use of improved sanitation facilities in 2006 was 5 per cent to 10 per cent below the rate needed for the country/region to reach the MDG target. No progress: Use of improved sanitation facilities in 2006 was more than 10 per cent below the rate needed for the country/region to reach the MDG target, or the 1990–2006 trend shows unchanged or decreasing use. Trend data was not available for eleven countries: Cape Verde, Congo, Gabon, Gambia, Guinea-Bissau, Lesotho, Mozambique, Sao Tome and Principe, Seychelles, Sierra Leone and Swaziland. Source: UNSD - accessed 7 July 2009.
AFR/RC59/3 Page 20 ANNEX C Latest data on MDGs provided by Member States compared with UN data MDG1; Target 1C: Percentage of under-five children with moderate or severe malnutrition Member States Most recent UN data 2001-2007 Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea 3.7 … 22.6 12.5 37.4 39.2 19.3 … 28.5 36.7 24.9 14.4 20.2 31.1 … 39.6 38.4 … 20.3 17.7 25.8 4.3 45.5 40 39.6 8.1 … 20.3 13.9 21 2006 2008 2008 MICS 2008GHDS MICS 2008 MoH 2006 2007 2009 MoH DHS MoH 14 27.3 2001-2006 MoH UNICEF 38 6.3 37.4 5.6 19.3 8 2006 QUIBB 2006 2001–2006 2006 2007 MoH MoH MICS UNICEF MDG 4: Under-five mortality (per 1,000 live births) Most recent UN data 2007 37 158 123 40 191 180 148 32 172 209 66 125 127 161 150 70 119 91 109 115 150 84 148 50 70 123 60 131 80 163 2005 2005 2006 2008 2005 EDHS MoH MICS 05/06 2008GHDS EDS 2005 2007 2009 MoH DHS MoH 125 76 141.9 176 144 28.6 176 209 113 2003 Census 2006 2007 2006 2005 2009 2007 2006 MoH DHS Census MICS MoH MoH MICS MDG 5: Maternal Mortality Ratio(per 100,000 live births) Most recent UN data 2005 180 1400 840 380 700 1100 1000 210 980 1500 400 740 810 1100 680 450 720 520 690 560 910 Valid 673 519 Valid 451 980 2007 2005 MoH EDS 2005 2005 EDHS MoH 380 781 543 549 2005 2007 2003 Census MoH MoH DHS
Most recent Member State data Data 3.7 Year 2006 Data source* MICS
Most recent Member State data Data 31.4 Year 2006 Data source* MICS
Most recent Member State data Data 92.6 6.2 397 157 307.3 615 669 41.9 1355 2006 2005 2006 2005 2009 2006 2006 MoH MoH Census MICS MoH MoH MICS Year 2006 Data source* MICS
Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey … Data not available. Blank cells: Data not provided.
AFR/RC59/3 Page 21 MDG1; Target 1C: Percentage of under-five children with moderate or severe malnutrition Member States Most recent UN data 2001-2007 Guinea Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome & Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 19.4 19.9 19.8 … 41.9 19.4 33.2 31.8 … 23.7 24 44.4 28.7 22.5 9.2 17.3 … 30.4 11.5 … 26 20.4 21.8 20 16.6 16 22 14 2007 ZDHS 2008 MOH 30 082 cases 7.5 2005 2007 MoH MoH 29 44.4 27.1 22 9.2 17.3 2006 2006 2008 2005 2006 2005 DHS EDSIM DHS DHS MoH DHS 20.5 32 29.8 … 2006 … 2007 MICS MoH MICS Most recent Member State data Data 5.6 19.9 14.4 19 Year 2006 2001–2007 2007 2007 Data source* MICS MoH LNNS LDHS MDG 4: Under-five mortality (per 1,000 live births) Most recent UN data 2007 198 121 84 133 112 110 196 118 17 168 68 176 189 181 99 114 16 262 59 91 100 131 116 170 90 69 198 157 103 52 121 14.8 140 57.6 120 123 137 91 119 82 2006 2006 2008 2007 2006 2005 2008 2008 2003 2006 2006 2006 2007-2008 2007 2006 DHS EDSIM DHS DHS MoH DHS MoH SLDHS DHS MoH MICS2006 UDHS THIMS ZDHS ZDHS Data 223 74 113 110 94 122 96 122 16.4 MDG 5: Maternal Mortality Ratio(per 100,000 live births) Most recent UN data 2005 1100 560 960 1200 510 1100 970 820 15 520 210 1800 1100 1300 … 980 … 2100 400 390 510 550 950 830 880 401 1 maternal death 857 124 589 478 435 578 591 555 2005 2008 2008 2002 2007 2005 … 2004-2005 2007 2005 DHS MoH SLDHS STATS, SA DHS DHS HSPR TDHS ZDHS ZDHS 449 648 800 750 2006 2006 2003 2005 DHS EDSIM MoH DHS 464 686 0.38 … 2007 2008 MoH MICS
Most recent Member State data Year 2006 2008-2009 2004 2007 2003-2004 2006 … 2007 2008 Data source* MICS DHS-PR (Preliminary report)
Most recent Member State data Data 818 560 762 994 469 Year 2006 2005 2004 2007 2003-2004 Data source* MoH MoH LDHS LDHS DHS
LHDS LDHS MSPF MICS MoH MICS MoH
Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey … Data not available. Blank cells: Data not provided.
AFR/RC59/3 Page 22
MDG5b: Prev of contraceptive use Member States
MDG6a: HIV prevalence in pregnant women 15-24 (%)
MDG6b: Prop of pop with advanced HIV infection with access to ARV (%) Most recent UN data 2007 20 25
UN data (Median) 2000-2007
Most recent Member State data Data Year Data source*
AFRO data (Median) 2004-2007 … …
Most recent Member State data Data Year Data source*
Most recent Member State data Data Year Data source*
Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea
61.4 6.2 17.8 44.4 13.8 … 26.0 61.3 23.5 5.4 25.7 … 12.9 26.0 … 8.0 11.4 … 13.6 21.0 9.1 8.0 13.9 37.7 … 17 9 2008 2005 2008GHDS EDS 2005 2006 EDHS WHS2009 6 2007 DHS 6.2 42.5 17.4 8.4 26.0 34.1 19 3 19.4 2000-2007 2006 2000-2007 2004 MoH MICS MoH MoH 2006 2006 2006 2008 MoH DHS MICS MoH
1.7 27.1 … 15.5 … … … … … 2.6 … … … 1.8 5.6 … … 2.5 …
2.0 24.6
2006 2007
MoH MoH
49 79 35
98.8
2007
MoH
35 30 25 2007 MoH
15.5 4.8
2004-2007 2004
MoH DHS
23 25 …
6.3
2006
MoH
21 13 … 17 100 2008 MoH
4.3 3.4
2005 2007
MoH MoH
28 24 31
0.1 5 1.7 58 68 47.8 18 31 52
2006 2007 2008 2008 2009 2008
MoH MoH MoH MoH MoH MoH
0.9 5.6 5.6 …
2008 2008
MoH UNGAS UNGAS
13 29 42 18 15
2008 2008
2008GHDS MoH
3.4
2008
ENSS
27
Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey … Data not available. Blank cells: Data not provided.
AFR/RC59/3 Page 23
MDG5b: Prevalence of contraceptive use (%) Member States UN data (Median) 2000-2007 Guinea Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome & Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe … 39.3 34.3 … 23.0 32.5 8.2 8.0 75.9 16.5 43.7 12.6 12.6 15.3 … 11.8 … 4.8 60.3 … 21.3 22.8 27.3 34.2 60.2 19.6 28 40.8 60.2 2006 2004-2005 2007 2006 UDHS TDHS ZDHS ZDHS 51 2007 MoH 11.8 44.1 (1549 age) 6.7 2005 2008 2008 EDS4 MoH SLDHS 46 11.7 9.7 27 2006 2006 2008 2007 NDHS EDSIM DHS DHS 9.3 2007 MICS
MDG6a: HIV prevalence in pregnant women 15-24 (%) AFRO data (Median) 2004-2007 … … 16.8 … … 14.3 … … … … 14.7 … … 4.0 … … … … … 25.9 … … 7.4 14.9 15.3 28 (2024 years) 38.0 3.4 6.4 6.8 16.0 2006 2008 2006-2007 2006 Jun-05 2006 MoH MoH MoH UDHS NACP MoH 27.9 per 10 000 2008 MoH 4.2 4.3 2008 2007 FMoH DHS 14.2 2006 NDHS 0.8 0.5 2007 2008 MICS MoH
Most recent Member State data Data 10.3 46 37.3 11 24 Year 2006 2008-2009 2004 2007 2006 Data source* MICS DHS-PR LDHS LDHS MoH
Most recent Member State data Data … … 18.7 5.3 14.0 2007 2007 2007 MoH MoH MoH Year Data source*
MDG6b: Prop of pop with advanced HIV infection with access to ARV (%) Most recent UN data Most recent Member State data 2007 20 38 26 17 4 35 41 23 22 24 88 10 26 71 … 56 … 20 28 42 19 33 31 46 17 52 32 39 46.8 60 2008 2007 … Jun-05 … MoH MoH MOH MoH HMIS 66 26.6 27.7 83 (Adult >15 years) 24.7 64.01 100 65 2007 2007 2008 2007 2007 2007 2008 2008 NDHS MoH FMoH UNGASS MoH UNGASS MoH SLDHS 20-30 27.4 2007 2007 MoH MoH Data 20 38 25 Year 2008 2007 2007 Data source* MoH MoH MoH
Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey … Data not available. Blank cells: Data not provided.
AFR/RC59/3 Page 24
MDG6c: Percentage of children under five sleeping under ITN Member States
MDG6c: Percentage of under-five children with fever treated with antimalaria drug Most recent UN data 2002-2006 … …
MDG6c: Prevalence of tuberculosis(per 100 000 population) Most recent UN data 2007 56 294 135 135 511 2007 2006 WHS2009 MoH
UN data (Median) 2003-2006
Most recent Member State data Data Year Data source*
Most recent Member State data Data Year Data source*
Most recent Member State data Data Year Data source*
Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea
… … 20.2 … 5.6 8.3 7.0 … 15.1 … … 6.1 4.9 … … … 1.5 … 49.0 12.7 0.3 48.3 42 55 49.0 28.2 4.5 2008 2008 2008GHDS MICS 2003-2006 2007 2008 MoH MIS MoH 3 6 2006 2007 MICS MoH 26.4 2008 MoH 20 … 9.6 8 7.0 2006 2005 MICS MICS 2006 MoH
54.0 … 48.8 30.0 55.5 … 57.0 … … 48.0 36.0 … … … 3.0 … 62.6 61.8 43.5 7.5 … 44.0 62.6 43.0 74.0 2008 2008 2008GHDS MICS 2008 MoH 2003-2006 MoH 25.9 0.2 2006 2007 MICS MoH … 48.0 30.0 55.5 2006 2005 MICS MICS
622 403 647 195 280 425 497 83 485 582 666 469 134 579 379 404 353 448
780 195 57
2006 2007 2006
MoH WHS2009 MoH
20
2008
MoH
666 576 50 543 379 404 353 448
2007 2009 2005 2009 2007 2007 2007 2007
WHS2009 MoH MoH MoH WHS2009 WHS2009 WHS2009 WHS2009
Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey … Data not available. Blank cells: Data not provided.
AFR/RC59/3 Page 25 MDG6c: Percentage of children under five sleeping under ITN Member States MDG6c: Percentage of under-five children with fever treated with antimalaria drug Most recent UN data 2002-2006 45.7 … … 2.6 36 2007 2004-2005 LDHS DHS … 34.2 26.2 … 50.9 2003-2006 MoH 33.4 … 14.9 11 54.93 5.5 60 53.3 16.4 N/A 25.8 2006 2006 2008 2007 2007 2006 N/A 2008 DHS ENCM DHS DHS MoH ENP MoH SLDHS … 33.0 33.9 12.3 24.7 26.8 … 51.9 … 44 2008 MoH … 47.7 10.5 36 27 2006 2007-08 2006 UDHS THMIS MIS 61.8 58.2 54.9 4.7 57.0 58.0 2007-08 2006 THMIS MIS 66.0 2007 MoH 22.0 N/A 30.1 2006 N/A 2008 ENP MoH SLDHS 33.3 21.4 2008 2007 DHS DHS 10 2006 DHS 9.5 2007 MICS 59.0 2007 LDHS MDG6c: Prevalence of tuberculosis(per 100 000 population) Most recent UN data 2007 276 319 568 398 417 305 599 559 39 504 532 292 521 590 240 468 55 941 692 812 750 426 337 387 714 426 176 568 2009 '2006 2007 GTC MOHSW MoH 812 2007 GTR 241 504 6.9 2006 2007 2008 2008 MoH SLDHS MoH 556 292 650 2006 2007 2008 DHS WHS2009 FMoH 140 2006 MoH 97 2006 MoH
UN data (Median) 2003-2006
Most recent Member State data Data 74.8 46.1 Year 2005 2008-2009 Data source* MoH DHS-PR
Most recent Member State data Data 70.0 23.2 Year 2005 2008-2009 Data source* MoH DHS-PR
Most recent Member State data Data 139.3 319 Year 2007 2007 Data source* MoH MoH
Guinea Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome & Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe
39.0 4.6 … 2.6 … 18.9 … 2.1 … … … 7.4 1.2 13.0 46.0 7.1 … 5.3 … … 38.4 9.7 16.0 22.8 2.9
Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey MIS: Malaria Indicators Survey; N/A: Not applicable … Data not available; Blank cells : Data not provided.
AFR/RC59/3 Page 26
MDG7c: Percentage of the population using improved drinking water (%) Member States Most recent UN data 2006 Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea 85.0 51.0 65.0 96.0 72.0 71.0 70.0 … 66.0 48.0 85.0 71.0 81.0 46.0 43.0 60.0 42.0 87.0 86.0 80.0 70.0 70 2006 UN 76 48.2 44 Valid 59 65 85.1 2007-2008 2006 2006 MWR SEEG MICS2005/6 2006 2007 2009 MICS DHS MoH 42.7 2003 Census 77.3 64 Valid 84.9 2006 QUIBB 2006 2005 MICS MICS 66.3 2006 MoH Data
MDG7c: Percentage of the population using improved sanitation facilities (%) Most recent UN data 2006 94.0 50.0 30.0 47.0 13.0 41.0 51.0 … 31.0 9.0 35.0 20.0 24.0 31.0 51.0 5.0 11.0 36.0 52.0 10.0 19.0 19.0 2006 UN 84.0 2006 MICS2005/6 49.0 18.0 21.1 9.0 47.0 2006 2007 2009 2006 2007-2008 MICS DHS MoH MoH MoH 36.9 32.0 Valid 30.4 52.5 2006 2006 QUIBB MICS 2006 2005 MICS MICS 37.0 2006 MoH
Most recent Member State data Year Data source*
Most recent Member State data Data Year Data source*
Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey … Data not available. Blank cells : Data not provided.
AFR/RC59/3 Page 27 MDG7c: Percentage of the population using improved drinking water (%) Member States Most recent UN data 2006 Guinea Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome & Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 57.0 57.0 78.0 64.0 47.0 76.0 60.0 60.0 100.0 42.0 93.0 42.0 47.0 65.0 86.0 77.0 … 53.0 93.0 60.0 59.0 64.0 55.0 58.0 81.0 67.1 54 / 77 59 2008 2006, Rural / Urban 2006 MoH MOHSW LCMS 87 50.3 84.7 51 2002 2008 2007 2006 MoH SLDHS 90 41.4 46.4 69 38 2006 2006 2007 2007 2006 DHS DHS MICS EICV MoH 50.5 2007 MICS Data 60 57.0 64 65 MDG7c: Percentage of the population using improved sanitation facilities (%) Most recent UN data 2006 33.0 42.0 36.0 32.0 12.0 60.0 45.0 24.0 94.0 31.0 35.0 7.0 30.0 23.0 24.0 28.0 … 11.0 59.0 50.0 12.0 33.0 33.0 52.0 46.0 71 72.0 31.7 21.0 47.0 68.0 2006 2006 2006 2008 '2007 2006 MoH MICS MoH PHDR LCMS 94 2002 33 8.4 39.0 38 30.0 2006 2006 2007 2005 2006 DHS DHS MICS DHS MoH 32.2 2007 MICS
Most recent Member State data Year 2006 2006 2004 2007 Data source* MICS MoH LDHS LDHS
Most recent Member State data Data 23.0 42.0 23.6 10.0 Year 2006 2006 2004 2007 Data source* RAMRN MoH LDHS LDHS
Data source* MoH: Ministry of Health. DHS: Demographic and Health survey. MICS: Multiple Indicators Cluster Survey … Data not available. Blank cells : Data not provided.