Health in Sub-Saharan Africa: HIV, TB and Malaria Epidemiology

Abstract

Tuberculosis (TB), HIV/AIDS and malaria have been defined as the greatest health challenges of humanity. International commitment over the past 15 years has produced major changes in epidemic trends and burden of those diseases, saving over 50 million lives. A successful response has been registered in the annual decrease of general incidence rates, with a more pronounced decline for the HIV/AIDS epidemic: in fact, new cases of HIV dropped from 3.1 million in 2000 to 2.0 million in 2014, resulting in fewer children below 15 years of age acquiring HIV. Also, it can be said that the Millennium target of halting malaria by 2015 has been globally met convincingly. Conversely, TB incidence needs to accelerate annual decrease in order to achieve the global 2020 target of “End TB Strategy”.

Despite major progress in epidemic trends and the reducing burden of such diseases, much remains to be done: HIV, TB and malaria continue to pose a major public health threat, killing nearly 3 million people every year. The number of TB-related deaths has slowly decreased in recent years, so that TB is still considered one of the top 10 causes of death worldwide, ranking above HIV/AIDS as one of the leading causes of death from an infectious disease, especially in low- and middle-income countries where TB and HIV overlapped. At the same time, more than 1 million people worldwide are still dying from HIV-related causes, a number still quite unacceptable. Moreover, malaria remains a major killer of children under 5 years, claiming the life of one child every 2 min. Particularly sub-Saharan African countries continue to be afflicted by those three epidemics (sub-Saharan African region still accounts for 90% of global cases of malaria) and mostly in regions where the gender imbalance and social inequalities are more pronounced.

Sustainable Development Goals (SDGs) do not neglect the impact of these diseases on global health and indeed emphasize in target 3.3 the health goal calls for an end of AIDS, TB and malaria epidemics by 2030. The successes obtained in the past 15 years inspire international confidence that SDG target can be achieved, but there is an urgent need of rapid and effective implementation of the World Health Organization’s recommendations in order to achieve such global targets.