After two and a half years as the Gates Foundation's first ever Africa Director, I am moving on and it is a good time to reflect. During my time leading the foundation's policy in Africa, my team and I have posted several blogs, particularly on the progress we see in many African countries.
As the United Nations' MDG Report 2013 sets out, Africa is on track to meet the three Millennium Development Goals on education, gender equality and HIV, TB and Malaria. But even on the other five goals, there has been progress on all of the goals in at least some, sometimes many African countries.
Cameroon and Guinea have achieved the MDG1 target to halve poverty, while Senegal, The Gambia, Swaziland, Uganda, Mauritania and Ethiopia are very close. Most African countries are on track to get all children into primary school by 2015.
Fourteen African countries have a higher proportion of women in Parliament than the UK and the average in developed countries. About one in 3 African countries are making fast progress on equalising the number of girls and boys attending primary school. One of these countries is Senegal.
Africa has really accelerated progress on MDG4 to reduce child deaths by 2/3rds by 2015. Deaths fell by less than 1% between 1990 and 1995 but by 4.1 percent between 2005 and 2012. AS a result of recent fast progress, four African countries, Ethiopia, Tanzania, Liberia and Malawi, have already met the 2015 goal to reduce deaths by 67%.
Maternal health and sanitation are the two goals where progress has been slowest. But even here, there are signs of what can be done with the right commitment. Four countries in Africa, have already achieved the goal to reduce maternal deaths by 75% by 2015, including Rwanda. In Rwanda, the government has increased the proportion of Rwandan babies born in the presence of a skilled attendant from one in 4, to about three out of 4.
Sanitation coverage increased just 4 percentage points over 1990–2010—to reach 30 per cent of the population. Cleary, something radical is needed to make faster progress. We believe that improved technology, community led demand, and new small business models will, combined, make a huge impact. Dakar, the capital of Senegal, is on its way to becoming a world leader in urban sanitation. Last year, they privatized the operations of the 3 sewage treatment plants in Dakar. And they established a call-in center, so people can call in whenever they need to have their pit or septic tank emptied. When a call comes in, 9-15 trucks are invited to participate in an immediate auction where the lowest price earns the opportunity to do the emptying. Since this system has gone into place, the average emptying fee to the household has dropped over 15% and the new convenience has led to more emptying jobs, so the truck operators and truck owners are also happy. The plants are now running at a much higher profit, and 25% of the profit goes back to the authority, which is now making more money than when they used to run the whole thing themselves.
How has Africa made this progress?
Lots of people have played their part. As I have set out in previous blogs, lower levels of conflict have been critical to the progress made in Africa since 1990. Conflict has gone up a little in the last two years which is a worrying sign, but hopefully a blip rather than a new trend. Democracy and good governance have increased. Economic growth is among the highest in the world. Of course technology, especially mobile phones, have had a huge impact on almost everything. And assistance from other countries has supported some of this progress. Development assistance to Africa increased by 50% over the last ten years. It is small by comparison to domestic government and private sector finances, but it can be catalytic.
With some of these fundamentals in place, Africa has a lot of opportunities ahead. Large new oil, gas and mineral resources will be available in the next two decades. If governments invest this windfall in infrastructure, education, health and agriculture and prevent corruption, it could transform countries that have avoided the oil curse. Growing investment and new technology from fast growing economies like China and Brazil, can accelerate Africa's progress. African countries that ensure all women and men have access to voluntary family planning will gain a 'demographic dividend' as the share of working age people grows compared to the number of children.
The most important opportunity though is to make sure that Africa builds its economy in a way that makes the most of everyone's full potential. This particularly means ensuring that everyone is healthy, gets a good education, and transforming those sectors that employ the largest numbers of poorer people, and farming is the main one.
Equity is the guiding principle of our foundation. For us, ensuring growth benefits everyone is a moral imperative. We believe all lives have equal value, so it’s wrong when some lives are treated as if they’re worth less than others. But drawing on the talents of everyone is also essential to successful development. Ultimately, broad-based growth is the only recipe for stability and permanent prosperity.
I am pleased to say that my successor will be based in Africa. I'm sure s/he will continue the story here soon.