Causes of Suffering in Africa: A Deep Dive

Communities across Africa, including those in Kenya, Nigeria, Ethiopia, and Somalia, are facing the worst food crisis in 40 years. This crisis is compounded by the Indian Ocean Dipole and El Niño phenomena, which have brought heavy rains to the region since the end of October. The daily reality for many is heartbreaking, with parents skipping meals so their children can eat, and children being taken out of school to earn money or beg.

Agnes with her son Jacob in Taita Taveta, Kenya. Image courtesy of the British Red Cross

Over 150 million people are affected, and the daily existence behind that number is bleak. We’ve heard tragic stories of families being forced to leave their homes to find food, sometimes leaving elderly loved ones behind because they are too weak to make the long journey on foot to an unknown destination. No one should be forced into making decisions like these.

While food security has improved in some parts of the world, the hunger crisis in Africa is deepening, putting millions of lives at risk. Driven by conflict, extreme weather, and economic instability, this crisis is having especially devastating impacts on women and children, who are bearing the brunt of malnutrition and displacement. The daily reality for people is heartbreaking.

Madimo and her child, Aisha, share a joyous moment. Madimo expressed deep gratitude for their care and treatment at a World Vision-supported health facility in Somalia, where Aisha recovered from malnutrition.

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These are resilient communities, but after back-to-back emergencies, their fortitude is fading. We know there is a way forward. In 2017, we pulled together to help avert catastrophe in the region, saving lives. Today, it's a race against the clock. This is urgent.

Conflict as a Catalyst for Suffering

Ongoing conflict, climate change, extreme poverty, displacement, and political instability can create conditions that ultimately lead to famine. The causes of famine are complex and often interlinked with numerous other world events. Conflict is often the main catalyst for famines. When war and violence occur, communities suffer.

Conflict can drive large quantities of people away from their homes and land, depriving them of food and clean water. Without access to farmland or income-generating opportunities, communities are at risk of extreme hunger. Displacement does not simply mean people leave and resettle elsewhere. Families are torn apart through dislocation, vulnerability to disease increases, and people risk falling into poverty.

Across Africa, conflict in countries such as Ethiopia, Yemen, and South Sudan have displaced millions of the most vulnerable people. But it is not just conflict on the African continent that is causing food shortages. The war in Ukraine, despite occurring thousands of kilometers away, is pushing up global food prices.

Countries in the Horn of Africa like Yemen, Somalia, Ethiopia, and Sudan depend heavily on wheat imports from Russia and/or Ukraine. Ethiopia and Kenya also rely on fertilizer for over 80% of their crops, making a shortage of this particular commodity a recipe for disaster. We have even seen this in Australia where, despite being far away from conflict, the war in Ukraine has led to an increase in food prices. However, in countries that are already struggling to find food, this threatens to push them to the breaking point.

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Examples of Conflict-Related Violence

  • In Burkina Faso, the military reportedly killed at least 223 civilians, including at least 56 children, in the villages of Soro and Nodin in February. Hundreds of civilians were reportedly killed in May by the military and its proxy forces during a supply operation against besieged towns in the east.
  • In Mali, army drone strikes killed at least 27 civilians, including 18 children in March, and eight civilians, including six children, in October. In Niger, an army drone strike in January reportedly killed around 50 civilians in the village of Tiawa, Tillabéri region. In Nigeria, military air strikes in Kaduna state killed 23 people in a village, including worshippers at a mosque and shoppers at a market.
  • Armed groups were responsible for some of the deadliest attacks against civilians. In Burkina Faso, the Group for the Support of Islam and Muslims (GSIM) reportedly killed around 200 people, including civilians, in Barsalogho in August.
  • In the DRC, most civilian killings occurred when armed groups, including the March 23 Movement, the Cooperative for Development of the Congo and the Allied Democratic Forces (ADF), battled with government forces in the east and west. In June the ADF killed more than 200 civilians in two separate attacks.
  • In Somalia, the UN Assistance Mission reported that Al-Shabaab was responsible for 65% of the 854 civilian casualties recorded in the country between January and September.
  • In Sudan, the Rapid Support Forces (RSF) continued its attacks on civilians, some of which were ethnically motivated.

Armed groups frequently targeted places of worship, schools, hospitals and other civilian objects. In Burkina Faso, an armed group killed 15 worshippers at a Catholic church in Essakane, Sahel region on 25 February. On the same day, another armed GSIM group killed at least 14 worshippers at a mosque in Natiaboani, Est region. In August, GSIM killed 26 civilians at a church in Kounla, Boucle du Mouhoun region.

There was an alarming surge in cases of conflict-related sexual violence. In CAR, more than 11,000 cases of gender-based violence were reported in the first half of the year. In the DRC, the number of reported cases doubled in the first quarter of 2024, in comparison to the same period in 2023. In Sudan, the UN Independent International Fact-Finding Mission for the Sudan found that RSF members perpetrated widespread sexual violence during attacks on cities in the Darfur region and in Greater Khartoum. They frequently raped and gang-raped women and girls in front of their family members, particularly in the Darfur region and in Gezira state. Conflict-related sexual violence was also prevalent in Somalia and South Sudan.

The Impact of Climate Change and Environmental Factors

Africa’s current environmental challenges also create poverty-related issues. Drought, deforestation, and resource scarcity are all contributing factors. And there’s abundant evidence that climate change is exacerbating these problems. These environmental factors often lead to serious poverty-related issues, including food insecurity, the hardship of displacement, and increased competition for limited resources.

Access to clean water, arable land, and other natural resources is essential for sustainable development. When these resources are scarce or mismanaged, it perpetuates extreme poverty in vulnerable communities. Addressing these environmental issues is not only a matter of ecological stability but also a pathway to economic growth and sustainable development.

Failed rains have devastated crops in Kirundo province, northern Burundi, leaving families struggling to find enough food. Euphrasie, a mother of six, can no longer find work on farms as maize crops have dried up and yields have plummeted.

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Poverty and Economic Instability

Poverty levels in Africa remain among the highest in the world due to factors such as political instability, unequal distribution of resources, and climate change. These systemic challenges disproportionately affect rural and remote communities, limiting access to education, healthcare, and economic opportunities.

Africa has the highest extreme poverty rates globally, with 23 of the world’s 28 poorest countries having extreme poverty rates above 30%. Using the poverty line of $1.90 per day, Africa’s extreme poverty rate was recently estimated to be about 35.5%. This rate is 6.8 times higher than the average for the rest of the world.

One of the key factors contributing to poverty in Africa is economic instability. High rates of unemployment, income inequality, and economic policies that sometimes fail to prioritize the needs of the most vulnerable citizens of an African nation all play a role. For instance, in sub-Saharan Africa, youth unemployment rates are staggeringly high. This makes it difficult for young people to secure a stable livelihood.

The cost-of-living crisis deepened as prices of food, fuel and other basic necessities spiraled.

We can help stop the situation from getting worse. Red Cross teams are working on the ground across the continent, supporting people suffering from hunger, as they don't have enough of the food they need. We continue to help people adapt to the effects of climate change in Africa and build their long-term resilience to cope.

Health Issues and Access to Medical Care

A person’s physical health is central to their overall well-being. But many communities within several African nations lack access to adequate healthcare. This puts them at unusually high risk of preventable illness and a lack of injury treatment. These issues not only result in a lower day-to-day quality of life but also have wider-ranging implications for stifling economic growth and development. This is especially true for communities in rural and remote areas.

Health problems can lead to reduced productivity and increased healthcare expenses. These factors perpetuate an unending cycle of chronic poverty. When people are too ill or injured to work or attend school, they cannot make strides toward prosperity. Addressing these health challenges is essential to breaking this cycle.

The lingering impacts of the COVID-19 pandemic have exacerbated these concerns for children and communities who lack safety nets. The Institute for Security Studies states that about 30 million more Africans fell into extreme poverty (living on less than US $1.90 a day) when COVID-19 broke out in 2020.

Large proportions of the region’s population continued to face hunger. In the Southern Africa region, Angola, Botswana, Lesotho, Malawi, Namibia, Zambia and Zimbabwe were affected by the worst El Niño-induced drought in a century, and some of which responded by declaring a state of emergency. The drought destroyed crops and livestock, threatening food security for millions. Severe food insecurity was experienced in other parts of Africa, including in CAR, Somalia and South Sudan.

According to the World Health Organization report (WHO, 2003b), it has been estimated that, in 2002, nearly 60% of the 57 million total reported deaths in the world and approximately 47% of the global burden of disease is attributable to chronic diseases and cardiovascular diseases (CVDs) in particular. In Africa, the burden of communicable diseases is higher than those of non communicable diseases and injuries, whereas, in other regions, the burden of non communicable diseases is predominant.

With malnutrition as a common contributor, the five biggest infectious killers in Africa are acute respiratory infections, HIV/AIDS, diarrhea, malaria and tuberculosis, responsible for nearly 80% of the total infectious disease burden and claiming more than 6 million people per year. In five out of six WHO regions, the burden of non communicable disease is greater than that of communicable diseases.

Despite the success of vaccination programs for polio and many childhood diseases, malaria, tuberculosis, HIV/AIDS and others are still out of control in the majority of African countries. Children remain at high risk.

HIV Prevalence by Country. Image courtesy of Wikipedia.

Infectious diseases continue to be the major causes of mortality in Africa. Beyond mortality statistics, different methods can be considered to quantify the burden of disease expressed in terms of socio-economic costs such as productivity losses, care and treatment, hospitalization and handicap.

In Africa, respiratory diseases, HIV/AIDS, diarrhea, malaria, tuberculosis and other infectious diseases are directly affecting health and demographic indicators such as mortality rates, life expectancy, and sex and age distributions.

In the most affected countries by HIV/AIDS, life expectancy declined by 12.1 years during the period 1995-2000 and it is expected to decline by 29.4 years by 2010-2015.

In sub-Saharan Africa, HIV/AIDS and related diseases are mobilizing more than half of all hospital beds. In some countries, 30%-50% of hospital admissions and around 50% of out-patient visits are due to malaria which is also responsible for more than 30% of hospital deaths.

Worldwide, about 2 billion people have inadequate or no access to life-saving treatments. More than 80% of these deprived people are living in developing countries where infectious diseases constitute serious impediments to economic development by reducing productivity, setting aside saving possibilities and slowing economic growth in general.

It is estimated that malaria costs Africa more than US$12 billion a year, slowing its economic growth by 1.3% annually (Bartram et al., 2005). Contrary to the majority of diseases, HIV/AIDS kills and disables adults in the best productive part of their lives, affecting business, investment, industry and agricultural sustainability.

Sleeping sickness is having devastating consequences on the development in Africa. It causes over 3 million livestock deaths each year and an annual loss of US$4.5 billion in agriculture. Similarly, gains following lymphatic filariasis elimination are expected to approach US$4 billion per year.

Table: Impact of Infectious Diseases on Health Indicators

Disease Impact on Health Indicators Socio-Economic Costs
HIV/AIDS Reduced life expectancy, increased mortality rates Loss of productivity, strain on healthcare systems
Malaria High mortality rates, particularly in children Hospital admissions, reduced agricultural output
Tuberculosis Increased mortality rates, especially with HIV co-infection Strain on healthcare systems, reduced workforce
Diarrheal Diseases High morbidity and mortality in children Healthcare costs, reduced productivity
Respiratory Infections Leading cause of mortality from infectious diseases Healthcare costs, reduced productivity

Impact on Education

Education is the surest way to escape poverty. But in Africa, it’s not uncommon for children to face barriers to accessing quality education. Geographic distance from adequate schools and inadequate resources in existing schools create significant hurdles for students. Also, children in impoverished families must often contribute to the necessary work of subsistence living, such as fetching water from a distant source and irrigating crops by hand. These time-consuming tasks can prevent a child from finding the time to attend school. This perpetuates the cycle of poverty into the next generation.

Also, the role of education in empowering adults cannot be overstated. Job skills training, literacy, and community development project competency all equip people with the skills and knowledge they need to improve their lives. But the lack of educational opportunities in impoverished areas hinders progress even for adults.

While the AU committed to build resilient education systems, conflict and insecurity kept millions of children out of school. In violation of the Safe Schools Declaration (an intergovernmental agreement for the protection of education in armed conflict), hundreds of schools in conflict zones were destroyed in attacks or became shelters for the displaced.

In Sudan, more than 17 million children remained out of school, with Save the Children reporting in May that attacks on schools had increased fourfold since the start of the conflict in April 2023. In West and Central Africa, UNICEF reported that more than 14,000 schools were closed due to conflict as of September, affecting 2.8 million children.

As stressed in the Millennium Development Goals, education is essential for human development and needs to be enhanced especially in sub-Saharan African countries. Unfortunately, malaria, tuberculosis, HIV/AIDS and infectious diseases in general, are reversing the trend towards the achievement of universal primary education in most African countries.

Denial of Rights

Governments continued to fail to uphold their pledges made in the Abuja Declaration over two decades earlier to allocate 15% of their national budgets to healthcare. With governments spending on average only 7.4% of national budgets on healthcare, public health systems struggled to deliver quality services. Meanwhile, healthcare costs remained high, while the WHO warned in December that governments’ heavy reliance on people to pay for their own healthcare was pushing more than 150 million people into poverty across the region.

Excessive use of force by security forces was common. Police killings and mass arrests of protesters were documented in countries including Guinea, Kenya, Mozambique, Nigeria and Senegal. Brutal repression of protests by security forces was also reported in Angola, Benin, Botswana, Côte d’Ivoire, Equatorial Guinea and Uganda.

In other countries, including Chad, Tanzania, Togo and Zambia, authorities banned protests. Governments targeted critics with intimidation, arrest and judicial harassment. Several governments sought to introduce new restrictions on the right to freedom of expression. Governments ignored a call by the African Commission on Human and Peoples’ Rights (ACHPR) in March to refrain from interrupting telecommunication and internet services and/or blocking access to digital platforms.

Crackdowns against journalists fostered a climate of fear leading to self-censorship. Journalists were threatened, physically assaulted and/or arbitrarily arrested in Angola, Chad, Guinea, Kenya, Lesotho, Nigeria, Tanzania, Togo, Zimbabwe and other countries. Civil society organizations’ ability to organize and freely conduct their activities were curtailed. Arbitrary arrests and detentions of opposition activists and human rights defenders were witnessed in many countries.

Enforced disappearances remained pervasive, including in Angola, Burkina Faso, Burundi, Guinea, Kenya, Mali, Sierra Leone and Tanzania.

Community-Led Solutions and Building Resilience

Outreach International is making a tangible difference in the lives of communities in several African countries. We’re dedicated to empowering local communities through innovative solutions and sustainable development projects. Our goal is to demonstrate to people who live in even the most extreme poverty that they have the power within themselves to improve their own lives.

Outreach International is working with communities in the African countries of DR Congo, Zambia, and Malawi. We help communities solve their poverty-related issues with the methodology of community-led development. This work is based on the idea that improvements are most likely to be sustained if the people who benefit from the solution are involved in the process.

Every community has a unique set of issues that keep it in a state of chronic poverty. This is why the people who live with these issues are the ones who are most qualified to identify and solve them. By involving community members in development projects, we empower them to learn, lead, and begin to solve issues on their own.

The British Red Cross is working at regional, national and local levels across the Sahel. We have set up the Sahel Livelihoods programme to build resilience across communities and to help them prepare for future crisis.

The Somali Red Crescent has supported more than 500,000 people so far, including over 100,000 through clinics and mobile health clinics in the most affected areas. More than 98,000 people have been reached with health services, including malnutrition screening and referrals to health centres.

One key aspect of World Vision’s work is livelihood skills training, which equips families with tools they need to navigate a food crisis on their own.

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