African countries are in no way homogeneous, and present many different stages of health sector development. For most of the countries the past two decades have been characterized by economic decline, a dramatic increase in poverty, and serious erosion of the important human development achievements of the 1970s and 1980s, including a general deterioration in both access to and quality of primary health care. Health infrastructures are underfunded and weak, while health coverage remains inadequate. In Africa as a whole, the present severe economic crisis together with currency devaluations has accentuated the steeply rising costs of essential drugs and has upset the delicate balance of existing cost recovery schemes, as in the Bamako Initiative. The application of structural adjustment policies has led in many countries to a reduction in resources available for the health and social sectors.
Most women go through childbirth without trained health assistance.
Around 3 million African children under the age of five die each year from acute respiratory infections, malnutrition, diarrhoeal diseases, malaria and measles. The third largest cause of childhood mortality in Africa, diarrhoea also aggravates undernutrition which makes the African child an easy prey to a host of other diseases. Malaria is by far the most important tropical parasitic disease, causing immense suffering and loss of life. There has been a rise in the incidence of life-threatening communicable diseases. The incidence of tuberculosis in almost all African countries is more than 100 cases per 100 000.