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2007-8 Africa Topic Guide

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The Affirmative

One of the things that makes this topic so great is that there is extensive literature that documents a developing health care crisis in Sub-Saharan Africa.  There are a number of causes of the current crisis.

First, structural adjustment programs (disadvantage essay, download) have put pressure on African governments to reduce spending by the public/governmental sector.  This has resulted in reductions in expenditures on public health care. Kasaje (2006) explains that African countries do not devote enough of their own resources to health care. 

Second, a “brain drain” of African health professionals to Western countries has reduced the number of people who are in Africa that can effectively treat many of the health problems that plague Africa. Africa is short at least a million health care workers.

Third, despite continued pledges, there is an inadequate amount of foreign assistance for Africa

Kaseje (2006) explains that as a result of the combination of these factors, Africa’s health system is on the brink of collapse.  

A number of problems have resulted from Africa’s declining health.  First, life expectancy is collapsing

Dr. Robert Rotberg, Harvard Medical School, AFRICA: PROGRESS & PROBLEMS AIDS & HEALTH ISSUES, 2007, p. 14

During the 1960s and 1970s, many African countries had effective public health systems.  During those decades the average African could expect to live until the age of 62.  However, since the 1980s, the average life expectancy has fallen dramatically.  As of 2000 life expectancy in sub-Saharan Africa (the region south of the Sahara desert) had plummeted to 47 years – 22 years less than the average lifespan of people living in East Asia (69 years) and 31 years lower than the average age at death in industrial nations (78 years). Although famine, accidents, warfare, and civil unrest account for some of Africa’s premature deaths, much of the decrease in life expectancy is due to infectious disease.

Second, the high death rate robs African societies of some of their most productive individuals, threatening economic development and the stability of governments.  Susan Rice, a Senior Foreign Policy Studies Fellow at the Brookings Institute notes that organized crime flourishes where states are weak.

Roger Kaplan wrote in a popular 1994 article in the Atlantic Monthly that disease-induced state collapse will spread war throughout Sub-Saharan Africa. There is some evidence that African instability will escalate to open warfare.

The Negative

Negative arguments against the current African health care crisis are difficult to find because the affirmative claims are simply true.  What the negative can do, however, is work to minimize the extent of the harms and work to prevent the affirmative from claiming exaggerated harms.

First, negatives can argue that private sector efforts are advancing in Africa and that that is improving the health care situation.  Second, the negative can cites examples of things that other countries or organizations, such as the EU are doing to improve health care in Africa

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