Médecins Sans Frontières (MSF) has described the Central African Republic (CAR) as being in a state of “chronic medical emergency” and is calling on donor governments and development agencies to provide additional funding and take urgent action.
The NGO sounded the alarm in a 13 December report, Central African Republic: A Silent Crisis based on a countrywide survey conducted over the past 18 months.
According to the report, CAR has one of the high mortality rates in the world, in some areas three times over the emergency threshold of one death per 10,000 inhabitants per day. The country also has the second lowest life expectancy in the world, at 48 years. This situation is mainly attributed to conflict, displacement and an absence of basic healthcare provision.
“The health system has been eroded by years of political and military instability and has massive structural problems… Access to basic healthcare is extremely limited and all these factors contribute to high mortality rates,” says Olivier Aubry, head of the MSF mission in CAR.
Malaria is the country’s leading health problem and primary cause of death, with every inhabitant infected at least once a year. MSF has a shortage of essential drugs, while the state’s failure to adhere to a policy of providing free malaria treatment to all children under five is a major contributing factor to the disease’s mortality rate. The NGO recommends a widespread distribution of treated nets.
About 11,000 people die every year from HIV/AIDS; the prevalence rate is 5.9 percent in the 15-49 age group. A total of 15,000 patients are receiving antiretroviral drugs out of approximately 45,000 people and 14,000 children needing urgent assistance, according to the National Committee for the fight against AIDS (CNLS).
In 2011, MSF was providing treatment to just fewer than 1,000 HIV patients. The report said fewer than 20 percent of the 19,000 people thought to have tuberculosis, the latent form of which is often activated by HIV infection, were receiving treatment and that this prevalence rate was “certainly an under-estimate given the lack of diagnostic facilities in most of the country”. National programmes to deal with HIV and tuberculosis are ineffective, mainly due to shortage of drugs and funds from the government and international organizations.
“We are aiming towards the Millennium Development Goals and recognize the need to make more effort to achieve these goals, which implies the need for more financial resources and a coordinated aid effort,” said Modeste Hoza, director of communications at the Ministry of Health.
“In developing countries it is difficult to mobilize resources and take urgent action, which is why we are asking for support from external partners. In principle, 15 percent of the budget should be dedicated to health, but in reality only 9 percent is. When it comes to disbursements, what is disbursed is not what is allocated,” he said.
“This report has positives and negatives to it. Negative, because when we ring the alarm, we give the impression that nothing is being done. Positive, because we can get attention, take action and move forward,” he added.
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