In many parts of Africa, between 3 and 5 children out of 10 do not survive infancy, and of those that do, up to 40 per cent. do not live to adulthood. (Yet population is now fast increasing almost everywhere -- A).
In tropical Africa, the majority of people are habitually affected by one or more of the major tropical diseases such as malaria, sleeping sickness (trypanosomiasis), bilharziasis (parasitic worms) and yellow fever. Malaria has hitherto been the chief threat, although extermination of the anopheles mosquito, the carrier, is now being attempted in many areas. A debilitating as well as a killing disease, malaria probably accounts for many Africans' apparent lethargy. Sleeping sickness is the human variety of the tsetse-fly infection which also affects cattle (some of the worst tsetse areas have remained unoccupied for many years, particularly where the local peoples depend on cattle). Bilharziasis is most prevalent in Egypt, but spread to many other areas not long ago; about 60 million people now suffer from it. Widespread malnutrition both reduces resistance to disease, and brings with it specific diseases such as kwashiorkor (caused by lack of protein). Urban Africans, while relatively more secure from the main tropical diseases, often succumb to diseases caused by slum conditions and to those carried by Europeans, against which Africans may have no protective resistance; tuberculosis is a recent scourge that may appear wherever living conditions are unhealthy.
As well as tsetse, rinderpest is a major threat to cattle; and in the north and east, crops and vegetation are subject to devastating attacks by locusts, which, often breeding in the Arabian deserts, travel long distances in great hordes.
Tropical Africa has only about 7,500 doctors and 125,000 hospital beds, i.e. one doctor per 22,000 people, one bed per 1,300, less than a tenth of the average for advanced countries. But, while most cities have good modem hospitals, in many rural areas there is not even one doctor per 100,000 people. Mission hospitals have done fine pioneer work in remote places; but to make real inroads into Africa's vast health problems calls for prevention rather than cure, in the shape of improved living conditions, diets, water purity, etc., and governments are increasingly tackling the problem from that end. The UN's World Health Organization (WHO) and other international bodies play a role in helping and co-ordinating this work, with special concern for diseases and pests that can be checked only by international action (F, Q).