It is ironical that Sub-Saharan Africa (SSA) has invested in education as a means of accelerating the development process; the current economic crisis and the structural adjustment programs (SAP's) have greatly affected the strides made in education. During the 1980's many countries in SSA significantly had to cut their budgets in education. In Zaire, for example, 46,000 teachers lost their jobs due to the devaluations during 1983 and 84 and these cutbacks had a strong effect on the educational system. Free education was only available after independence--it was quickly abandoned due to the burden of the expense on the budget and the rapidly growing demographic problem. Today school is only available for those who can pay for it, and this financial constraint has enabled boys to become better educated than girls. However, once educated, graduates can no longer find employment. SAP's did not take into account the short-term needs of the newly educated Africans and the public sector in countries such as Liberia, Mali and Benin have not been able to pay their employees their salaries. Africa faces additional constraints where 80% of the population is rural and working in agricultural activities which are at the opposite end of the process of development and modernization. The lack of opportunities have forced urban and rural youth alike to return to working the land. If the majority of African children never get beyond primary school, why should they even go to school? For what purpose? Perhaps more efforts should be made to integrate the educational system with the needs of the rural population to begin developing appropriate infrastructure and personnel in the rural areas. Such vision would give millions of African youth a new found confidence lost in today's world.
On April 1, 1990 the World Health Organization (WHO) stated there were 237,110 cases of AIDS among its member states, but the estimated number of cases of infected persons plus those with the disease will probably surpass 6 million by the year 2000. The modes of transmission are sexual, blood and mother to child. Sub-Saharan Africa (SSA) also has heterosexual transmission and is responsible for 80% of all new cases of AIDS worldwide. This tragedy is compounded because the majority of infected persons are women in the fertile ages who will affect the high levels of morbidity and mortality in years to come. 5-10% of infected adult cases and 25% among children are due to blood transfusions in maternity hospitals, to malnourished children and because of malaria. The problem of reusing unsterilized needles and instruments used for sacrifice, circumcision, excisions and other traditional practices has complicated the transmission of AIDS, but it is hard to estimate to what degree. In 1988 WHO stated the 9 East and Central African countries accounted for 2/3 of all infected cases in SSA. West Africa has a lower prevalence with the Ivory Coast and Guinea Bissau at 4% as compared to 12% in Uganda. The discovery of HIV-2 in this area allows for its continued surveillance. The recommended behavior to prevent AIDS until the discovery of a vaccine includes: 1) avoid high risk sex; 2) avoid multiple sex partners; 3) use a condom; 4) strong epidemiological controls in blood banks; 5) use of sterile materials in the laboratories; and 6) provide counseling to AIDS patients.
There are 23 types of sexually transmitted diseases (STD). In Sub- Saharan Africa (SSA) AIDS is considered to be a type of STD because an estimated 80% of its transmission is heterosexual. The epidemiology of STDs are due to several factors: 1) the age of young people with STD has now decreased to 16-24 as compared to the 1960's when it was 20-30; 2) sexual liberation; 3) multiple sex partners; 4) clandestine prostitution; 5) ignorance regarding the effects of STDs 6) self treatment; and 7) the number of asymptomatic STDs such as chlamydia trachomatis. Complications from STDs are increasing such as infertility, extra-uterine pregnancies and cervical cancer. The prevalence of AIDS is also increasing, pressuring society as it relates to hospitalizations and the cost of caring for these patients. The prevention of STDs requires training physicians, biologists, paramedical personnel, pharmacists and commercial workers. The public should be sensitized to the morbidity and mortality indicators of STDs. Senegal, as other African countries, has instituted a national committee for AIDS and STDs and has regional committees responsible for coordinating and disseminating its goals nationally and regionally. These committees should play key roles in IEC to inform the public about the socio- cultural, traditional and political implications of such disease. To avoid any misunderstandings, the information can be given as results from surveys with recommendations that include abstinence, loyalty among couples and the use of condoms for extra marital affairs.
