Aging, Youth Bulges, and Population

Population growth and aging are fueling a spectacular rise in noncommunicable diseases, such as cancers and cardiovascular diseases, in poor countries that are ill-prepared to handle them. 

According to the World Bank, almost one third of West Africa’s population, responsible for creating 56 percent of GDP, lives along the coast of the Gulf of Guinea. Because of global warming, sea levels around the world are likely to rise by more than thirty inches (2.5 feet) by the end of the century. Africa, the Gulf of Guinea in particular, is expected to be especially hard hit: the number of people who could be flooded in Africa is estimated to rise from 1 million a year in 1990 to 70 million a year by 2080. Lagos is now one of the largest cities in the world, and it’s population is growing explosively. The population of Lagos has grown from 5.3 million in 1991, to 16 million in 2006, and reached 21.3 million in 2015 (these figures are estimates, only). The shortcomings of the city’s infrastructure are notorious: crumbling roads, inadequate public transportation, insufficient water supply, and poor sanitation. However the successive administrations of Governors Tinubu and Fashola have been perhaps the best in the country. Much of the Lagos metropolitan area is only slightly above sea level and several entire neighborhoods consist of shacks built on stilts in the lagoon. This will leave more than 3.2 million inhabitants and $117.3 billion in assests exposed to the dangers of climate change. Hence, as water levels rise, it must be anticipated that a large percentage of the population of the city will be driven to move to the mainland where the elevations are higher.

ISIS and other Middle Eastern groups are notorious for kidnapping. However, for radical Islamist groups in the Sahel and northern Nigeria, ransom is also an important source of funding. In Nigeria, and probably elsewhere, most of the victims are indigenous. Families of kidnapping victims routinely pay to secure the release of loved ones. Kidnappers may widely publicize foreign victims, generating considerable pressure, especially on European governments, to pay ransom. Though they all deny it, there is plenty of evidence that they cave to popular pressure and pay, in some cases many millions of dollars. That, of course, merely leads to additional kidnappings. The United States is an honorable exception to this pattern. The policy of successive administrations has been never to pay ransom. A consequence is that there is evidence (again, largely anecdotal) that kidnappers are less interested in American citizens than in European nationals. The tragedy, of course, is that if Americans are part of a kidnapped group of other nationals, their likelihood of surviving is low; there is no incentive for the kidnappers to keep them alive, unlike other nationalities who are a valuable commodity. The New York Times reported on November 19 that the Obama administration is reviewing its policy on American hostages, but it has reaffirmed that the ban on ransom will not change. This is wise.

Across the racial rainbow, South Africans love sports. They excel in individual sports, such as golf, but also team sports. Since the end of apartheid, the Springboks, South Africa’s national rugby team, has twice won the Rugby World Cup (it is tied with New Zealand and Australia for the most titles). South African rugby is among the best in the world. South Africa’s football (soccer) team has won the African Cup of nations, and South Africa has hosted the FIFA World Cup. Bafana Bafana, the national team is usually regarded as one of the best in Africa. As in so many other areas, sport in South Africa is divided by race. Rugby is typically considered a “white” sport, and the Springboks have only a handful of coloured or black players on their squad. Football is considered a “black” sport, Bafana Bafana has a single white player. In part because of the world-wide prominence of South African rugby, critics complain that the very slow racial integration of the Springboks is symptomatic of the slow rate of racial transformation of the country since the coming of “non-racial” democracy in 1994. Accordingly pressure for greater racial integration has grown, both in the country at large and within the Zuma administration. Rugby managers, however, complain about the lack of black rugby talent, acknowledging that the opportunities and facilities for developing such talent are lacking. Accordingly, the South African Rugby Union has announced that it will introduce a quota system in domestic rugby. Beginning next year, teams must select a minimum of seven black players out of a 22-player squad. To start a match will require each team to have a minimum of five black players. This quota system is designed to promote and develop black rugby talent that can rise to the Springbok squad It remains to be seen whether the provincial teams will accept the quota system and make it work. For the time being, there are no sanctions for non-compliance, though they may come. There is no parallel effort underway to change the racial composition of Bafana Bafana. But, many, perhaps most, South Africans see rugby and the mostly-white Springboks as part of the heritage of apartheid, while football does not have those associations.

This is a guest post by Thomas Zuber, intern for the Council on Foreign Relations Africa Studies program. He is currently pursuing a Master’s in International Political Economy and Development at Fordham University.  The Ebola crisis in West Africa has distracted international attention from developments in other parts of Africa, notably in the Central African Republic (CAR). On September 15, the UN Multidimensional Integrated Stabilization Mission in Central African Republic (MINUSCA) initiated peacekeeping operations in a country divided by civil war. It began working alongside two thousand French soldiers already on the ground and is integrating African Union troops into what will be a twelve thousand strong peacekeeping mission. Since October 7, violence has escalated in CAR’s capital, Bangui. This most recent renewal of hostilities has already displaced 6,500 people. On October 9, a UN convoy was attacked on the outskirts of Bangui. The mission repelled an attack on the interim president’s house on October 11. These developments serve as reminders of the obstacles facing MINUSCA: continued sectarian violence between two main factions, the Selaka and anti-balakas (anti-machete), the weakness of the current interim government, and one of the worst food crises in the country’s history. As of September 12, Associated Press estimated that 5,186 people had died from the violence since late 2012. In December 2012, a loose coalition of rebels, the Seleka, marched on Bangui and overthrew the government in March 2013. In the following months, self-proclaimed president Michel Djotodia lost control of Seleka factions, which perpetuated violence throughout the country. In response, anti-balaka militias formed, resulting in extreme violence between the two groups. In January 2014, Djotodia resigned due to pressure from regional leaders; in his place, Catherine Samba-Panza, a non-partisan, was installed as interim president. She inherited a country torn by a conflict that was taking on religious-ethnic dimensions and a catastrophic humanitarian crisis. MINUSCA starts at a time when the government is faced with a crisis of legitimacy, compounded by the recent allegations that president Samba-Panza mis-used aid from Angola. Seleka and anti-balaka factions exhibit no faith in the government. On October 8, Bangui experienced violent demonstrations by anti-balaka forces demanding Samba-Panza step down. These demands were subsequently withdrawn, though violence in the country seems to be increasing. Despite reticence to present this conflict in religious terms, religion has been used to foment division among the population. Earlier this week, a faction of the anti-balaka beheaded a Muslim man in Bangui. Many Muslims (the religion of most Seleka) are fleeing as they are often targeted by the anti-balaka. The violence of this year has created a partition between Muslims and Christians within the country on a scale not seen before. These political developments are exacerbated by a serious humanitarian crisis. According to the World Food Program (WFP), as of May 2014, more than 600,000 people have been internally displaced and 1.6 million people (over half of CAR’s population) are food insecure. Despite these realities, WFP’s restricted budget has not been able to focus on CAR’s humanitarian crisis, instead concentrating on Syria, DRC, and South Sudan. Furthermore, persistent threats to aid organizations by in-fighting constrict their ability to provide basic services to the population. Within this context, MINUSCA and the Central African government face a great deal of challenges. Despite foreign governments reestablishing full embassy missions in Bangui, conflict persists. The Seleka have refused to recognize Samba-Panza’s government. The vast numbers of internally displaced people and refugees add a further strain to the country and the region’s numerous challenges. MINUSCA faces great challenges and great responsibilities, in what has been dubbed the UN’s most ambitious mission. The months ahead will be a test for the Samba-Panza government and the international community’s responsiveness in stabilizing a country already too ravaged by war.

Ebola and Marburg are both hemorrhagic fevers and belong to the same family of viruses. The hosts for both are identified as animals, especially fruit bats—both diseases cross over from animals to humans. Incubation periods are around twenty-one days. The two diseases have similar symptoms and similarly high mortality rates. Both diseases spread through contact with bodily fluids, making family members and health care workers especially vulnerable. There is no pharmaceutical that cures either disease, and patients are treated in much the same way. The ill are isolated and medically supported until they recover or die. Efforts must be made to trace all those who came into contact with the ill. Ebola at present is centered in west Africa, but it was first publicized in what is now the Democratic Republic of the Congo. Marburg is also found in the Congo, where between 1998 and 2000 it is reported that there were 154 cases and 128 deaths attributed to the disease. In Angola in 2005, there were 374 cases of Marburg, and 329 deaths. In 2007, 2008, 2012 and 2014, in Uganda there were cases of Marburg in the single digits with very high mortality rates, ranging from 50 to 100 percent. When Ebola first appeared in west Africa, it was an unfamiliar disease, one reason among many why the response to it was slow. In east Africa, however, there is greater familiarity with Marburg, and officials move quickly to respond to the threat of an outbreak. Accordingly, officials in Rwanda and Uganda are closely monitoring their common border for a possible outbreak of Marburg after a confirmed case in Kampala, Uganda. As a safety precaution the Ugandan government has isolated ninety-nine people, none of whom have tested positive. The World Health Organization is saying that Ebola is now “entrenched” in Conakry, Monrovia, and Freetown – it has become an “urban” disease. Marburg, however, appears to remain primarily in rural areas. West Africa’s high rate of urbanization has helped facilitate the rapid spread of Ebola, especially in urban slums. Urbanization in east Africa could have a similar impact.

This is a guest post by Brooks Marmon, Accountability Architect at the Accountability Lab.  Brooks was previously based in the Lab’s Liberia office and recently completely an extended assignment in Zimbabwe and South Africa. West Africa may be at the center of the ongoing Ebola crisis, but the fear of the virus is pan-African. Much of the world sees Ebola as an African problem and Africans are beginning to internalize this perception as well. The continent’s response to the virus is seen domestically and internationally as a litmus test of the capacity and abilities of national governments which are using the crisis as a means to assure their citizens and international partners of their newfound capacities and crisis response potential. In southern Africa, Zambia was one of the first countries to announce restrictions on travel from the Ebola affected countries in early August. Shortly thereafter, Kenya Airways halted flights to countries at the center of the Ebola epidemic.* South Africa, a major destination of travelers from West Africa, blocked visitors from the affected countries a few weeks later despite advice to the contrary from the World Health Organization. Namibia and Botswana followed suit soon after. More recently, the continued spread of the virus has started to impact travel within Africa even outside of the Ebola hotspots. In late September, Namibia’s health minister advised Namibian nationals not to visit Zimbabwe due to Ebola fears. Zimbabwean officials in turn have encouraged their citizens to avoid all of West Africa, explicitly requesting that they cancel visits to popular Nigerian preachers. Delving further into the Zimbabwe example, the Ebola crisis regularly makes headlines in the national press there. The country has adopted stringent Ebola prevention measures; including placing nearly one hundred travelers from West Africa under close observation for twenty-one days. Doctors and nurses have received Ebola training and a forty-bed Ebola treatment center has been established in Harare. Ebola has severely disrupted customary cultural greetings in West Africa and Zimbabwe’s minister of health has similarly advised Zimbabweans to avoid handshakes and other intimate greetings. From HIV testing centers in the high-density township of Chitungwiza, to Africa University near the border with Mozambique, Ebola awareness posters are common across the country, indicating that both the state and its citizens take the disease very seriously. Despite the precautionary measures, rumors of Ebola deaths at several Zimbabwean hospitals have gained traction. As a result of these fears, there have been major cancellations of reservations in resort towns like Victoria Falls and postponement of public events. Opponents of the governing party have used the disease as a political tool, leveraging that with Zimbabwe’s decaying health infrastructure and susceptibility to diseases like cholera, Ebola is positioned to devastate the country. Following successful containment efforts in Nigeria and Senegal, Ebola now appears to be confined to the countries of the Mano River Basin. However, the inadequate conditions that allowed the disease to spread in those countries can be found across the continent. Citizens of countries like Zimbabwe, vividly remember similar failings of their governments to contain impending disasters, such as the initial voices of dissent from war veterans that culminated in the violent appropriation of farmland and hyperinflation. For much of the world, Africa is seen as a monolithic block, and Ebola perceptions will tarnish the whole continent, not only the countries where people are suffering from the virus. Despite previous failings, authorities in Zimbabwe are demonstrating a significant commitment to ensure that the virus does not penetrate their borders. As the embarrassing American response to a case of Ebola in Texas shows, response to the unprecedented outbreak is not easy. While Ebola has sparked panic across Africa, its states are engaged in major efforts to limit the impact of the virus. Some countries are better equipped to respond to the crisis than others – these efforts, combined with international assistance, are critical to ensure that the virus is defeated and that the destruction it causes, both physical and reputational, is minimal. * There have been recent indications that many regional flights to the countries most severely impacted by the Ebola crisis in West Africa will soon resume.

This is a guest post by Diptesh Soni. Diptesh is currently a consultant in UNICEF’s public advocacy section and a recent graduate of the Columbia University School of International and Public Affairs (SIPA). The views expressed below are his personal views and do not reflect those of his employer. You can follow him on twitter at @dipteshpsoni. A recent report by the United Nations Children’s Fund (UNICEF) forecasts that if current trends persist, one in every four people on the planet will be African by the year 2100. Even accounting for a decline in fertility brought on by greater prosperity, UNICEF predicts that by 2050 alone, the number of Africans under the age of eighteen may swell to around one billion. The report concludes that more emphasis must be placed on access to reproductive health services, girls’ education, and vital statistics systems. Such numbers should inform development strategies and common perceptions on the African continent. The notion of a “demographic dividend” in Africa seems largely misguided, and should not be passively viewed as inevitable. The dividend arises when fertility rates fall due to better health outcomes, but this process has been slow to arrive in Africa. Some claim that a large pool of labor can provide an engine of growth through expanded light manufacturing, but the fact is that African labor markets are currently unable to absorb a vast and growing supply of workers. With some notable exceptions, low-wage manufacturing jobs have remained in Asia and the steady growth in labor saving technology also bodes poorly for a manufacturing revolution in Africa, all while service-led growth has severe limitations. Education must be made a key priority for donors and governments across the continent. Although school enrollment for children in Africa has improved significantly in absolute numbers over the last two decades, these gains have been undermined by the steadily increasing population (see chart below). Evidence abounds that investments in education, especially when targeted towards girls and women, help develop a productive and resilient workforce. Recent studies from the Center for Global Development in Washington, DC, reinforced by Nobel laureate Erik Maskin of Harvard University, show that investing in quality education can boost skills development and reduce in-country inequality. No country exemplifies the challenges and ambiguities of demographic and economic growth like Nigeria. News of Nigeria overtaking South Africa as the largest economy on the continent was met with much excitement. However, with a rapidly growing population of almost 180 million and an adjusted GDP per capita less than one fifth of South Africa’s, Nigeria is desperately poor by any measure. Its economy remains dependent on oil exports and much of the new foreign investment ventures are directed at tapping the growing market for fast-moving consumer goods, rather than expanding labor absorbing industries. With little economic diversification and a weak education system the chances that Nigeria’s youth of today or tomorrow will find productive employment and sustainable livelihoods are reduced. A population that is both underemployed and undereducated breeds an environment of discontent that can provide a large recruitment base for extremist groups like Boko Haram. The Ebola crisis has shown that problems of poverty are not beholden to national boundaries. If African governments, their donors, and their private sector partners do not adapt strategies to mitigate the dangers of demographic explosion, future generations of Africans and non-Africans will be much worse for it. Explore the data for Generation 2030 | Africa here: data.unicef.org/gen2030/

On June 5 the Wall Street Journal reported that Boko Haram has “tightened its grip” over a 1,200 square mile area of northeastern Nigeria. For the sake of comparison, this area is about the size of the state of Rhode Island, including Narragansett Bay. It looks like Boko Haram’s strategy has been to destroy all vestiges of authority in the affected area, centered on the Gwoza local government area.  Earlier, Boko Haram murdered the emir of Gwoza, Idrissa Timta, who had publicly warned against Boko Haram. Boko Haram has carried sustained attacks on villages in the district, burning the houses and killing hundreds of residents. If Boko Haram has destroyed government and traditional authorities in Gwoza, it has not replaced that governance with its own; it has not established any state structures apparent to outside observers. However, the Boko Haram black flag is flying in several villages, according to the BBC. According to the Wall Street Journal, Boko Haram is using rocket-propelled grenades, night-vision goggles, pickup trucks with heavy machine guns, and satellite phones. The government’s Joint Task Force (JTF), which includes army and police units, appears unable to stop Boko Haram in the Gwoza region. Where is Boko Haram going next? On June 4, it attacked two villages on the outskirts of Maiduguri (Borno state’s capital), killed forty-eight in one, and forty-five in the other, according to the Wall Street Journal. Maiduguri was long the center of Boko Haram until 2011 when government forces largely cleared the city of its operatives. It now may be seeking to retake the city, which in 2014 had an estimated population of about one million. It is hard to know how many people are there in Maiduguri however, since media and other access has been severely curtailed by the violence. Presumably many town dwellers have gone elsewhere as Boko Haram violence has increased. On the other hand, there likely has been an influx of internally displaced persons to the city who have fled Boko Haram attacks in villages. Maiduguri has a large military base, Giwa Barracks, which was successfully attacked by Boko Haram in March though they did not attempt to hold it. In the aftermath of that attack, the JTF carried out atrocities against detainees charged with no crime that was widely reported by human rights organizations and the media. The town is also the seat of the federal University of Maiduguri. If Boko Haram were to take Maiduguri, it presumably would be forced to establish some type of administration, which it has not done in any region under its influence up to now. Controlling a large and complex city would likely require Boko Haram to move in new directions.