To talk about health conditions in Africa, and in this case of North Africa, it is essential to consider the virus of Ebola. According to the UN, Ebola represents a humanitarian, social and economic crisis. This means that, often, when individuals talk about health in a country, they must consider the context and the consequences that entails its development in a particular region.

The statistics and country facts website Index Mundi, shows that Libya is the North African country with one of the lowest mortality rates. The Sub-Saharan Africa countries and Sudan instead, have the highest number of deaths. Initially, even Egypt was characterized as a North African country with a high life expectancy at birth. Everything changed with the so-called Arab Springs, which caused millions of deaths according to a UN report.

This is important to mention because often, as soon as people think about the issue of health, they focus on diseases. What is most threatening to the health system of a country, especially a developing one, is the health of an individual or, in general, of the entire population. It is surely a crucial aspect, but other issues also must be considered: corruption, poverty, hunger, lack of individual freedoms, human rights violations, unemployment, increase in the price of food, popular discontent, desire for renewal of the political regime etc. Also, the flow of migration must be mentioned among one the bad issues for health.

Despite the existing differing opinions, like the one of the economist Richard Smith, health is a global public good. Globalization has helped diseases to spread more easily around the world and thus contributed to the disruption of the Health on a global scale. In regards to immigration, we talk about the so-called “Emergency in North Africa exists”. This emergency is made up of two streams of refugees from North Africa to Italy: a first group of refugees who are mainly Tunisian citizens and a second flow of migrants coming from Libya. The two flows have both been arising from the the Arab Springs. These events, in addition to causing a period of instability in Tunisia and a serious civil war in Libya, generated an “exceptional” flux of refugees towards Europe, towards Italy in particular.

However, after a period of political and social disorder, the economic activity started to increase again in North Africa. In 2014, the growth has stabilized at 2.6%. Then, it accelerated to reach 3.2% in 2015 thanks to the global economic recovery and the positive signs of political consensus in some countries of North Africa. These changes are important because they have surely guaranteed a general improvement within the health sector. However, the situation has yet to be improved.

We are facing a vicious circle because a better political system can contribute to a better health care system and a better health care system can contribute to a better political system. At the same time, a great level of health can ensure a higher economic growth, and so forth. For instance, many studies demonstrate that North African countries characterized by a weak health system, have a lower labour productivity. In 2003, the World Health Organization suggested that the health determinants included early childhood development, social exclusion, unemployment, availability of healthy food, availability of healthy transportation.

Moreover, it is right to take into consideration other crucial factors:

1) Public debt with a negative impact on the economy of the euro area especially with regards to energy prices, oil and gas.

2) Inadequate supply.

3) No decent sanitation. Only the 58% of the population has access to health services.

4) Efficient health care facilities in the area.

5) Socio-cultural level: rural isolation, and illiteracy.

6) Negative economic opportunities.

7) Social services and state structures do not work efficiently.

8) A shortage of vaccines due to a lack of money and facilities for the vaccination of children.

In particular, the last two factors are really significant. Despite the fact that in 2012 the infant mortality rate in North Africa was one of the lowest (for example it was 12 respect deaths / 1,000 live births in Libya) in comparison to other African regions, the rate is still high. This generates destructive consequences for the entire apparatus of North Africa. First, there are some improvements for the population but also an aging of itself. Even if North Africa, like Africa in general, gives much importance to seniority, it is counterproductive for the development of the country. Second, sick children cannot go to school, so they do not receive an education, which is another negative result of a bad health system.

Furthermore, a generalized lack of health infrastructures and/or the long distances between these and the villages, are another issue that have always concerned the asset of the North-African society. Consequently, there is a strong requirement for the State’s intervention. Firstly, it has to contribute to the creation of basic public health infrastructures; without them, no country can be considered stable and safe. Secondly, it has to ensure that the local and international communities work together towards accessible prevention procedures. The latter must include suitable hospitals and qualified staff. Indeed, no single state can stop the various diseases that are affecting North Africa. Therefore, there is the need for an international coalition working together to stop the disease.

Regarding this last point, the UN system has launched the so-called UN Mission for Ebola Emergency Response (UNMEER) to fight against the tragedy finding accurate means. For instance, providing financial support through the World Bank for the countries hit by the socio-economic consequences of the disease; establishing adequate medical teams; monitoring the urgent laboratory testing of an experimental Ebola vaccine. The Secretary General of UN Ban Ki-Moon, argues that there is the expectation that the eruption of Ebola could be contained by mid-2015. However, at the same time, he underlined the need to strengthen the governmental apparatus.

The UNMEER mission must be a big task for governments, international agencies and all organizations seeking to work together to end the crisis. This can be a resilient example to stress that policies influence and shape the conditions where individuals live and work, and these conditions may have positive or negative consequences for the health of a given population. A policy, program and project could potentially change the social determinants of health, which are the social and economic conditions of a population. Nonetheless, the protection of the population’s health represents the main goal of any existing country.

In particular, the activities of the international communities are crucial. They must stay vigilant and find new practices to stop the scourge. A solution may be the increase of awareness campaigns that actually are decreasing or at least they have never been so effective. Moreover, procedures for monitoring, managing and training of visitors must be made effective.

The health situation in North Africa is improving and is better than the one in Central Africa. But, if the improvement is not constant, it can affect other countries of the world with the potential of compromising the international peace and safety. Then, there is the need to find more funds from the governments for the prevention of the diseases and the construction of a better society from an economic and social point of view.

There has been important progresses but a scaling-up in the overall response remains necessary. The States of North Africa have to collaborate, also with the other African states. They have shown a strong reaction to increase financial, technical and human support.

There are great efforts that ensure the progress in combating diseases, but the problem is still alive. Countries, organizations and individuals should take into consideration the fact that the whole world has the aim to participate to the battle for a better health care system. In addition, they must do more to ensure that serious resources support the momentum. There is the need for a common policy, which unifies the single initiatives and generates a unique sense of duty to fight against illnesses for the good of humanity.

BEATRICE CASELLA

Master’s degree in International Relations (LUISS “Guido Carli”)