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Declining child mortality in Africa: an effect of prosperity, enhanced aid — or both?

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•  A version of this post appeared on the blog "Africa Works." The views expressed are the author's own.

Such are the changes in the African scene that the stunning evidence of declining child mortality in nearly all sub-Saharan countries is the source, not of disbelief or skepticism, but a serious, robust debate over what caused the decline: rising economic prosperity in Africa or improved international assistance.

To step back a moment: credit for attention to the improved health of African child goes to Michael Clemens, who in early May published an assessment of a World Bank analysis that prompted him to comment on what he described as the “stunningly rapid decline” in child deaths. “Nothing like it was occurring even as recently as the first half of the [last] decade,” he added.

The underlying evidence comes from two World Bank researchers based in Kenya who ask in an exhaustive comparative paper, what has driven the decline of infant mortality in Kenya.” Gabriel Demombynes and and Sofia Trommlerova find a complex set of reasons, including rising incomes and the targeted use of antimalarial bed-nets, prompted by aid agencies trying to combat infant deaths from malaria.

The debate over causes is nicely summarized by The Economist, which concluded: “The broad moral of the story is [that] aid does not seem to have been the decisive factor in cutting child mortality. No single thing was. But better policies, better government, new technology and other benefits are starting to bear fruit.”

The relative effect on child mortality of aid versus growth may never be sorted. More critical is the new image of an Africa that is starting to address the importance of improving lives for ordinary people even as the sub-regional economies of Africa continue to boom.  The whole affair is “is startling news for anyone who still thinks Africa is mired in unending poverty and death,” Clemens tells The Economist. “That Africa is slipping quickly away.”

In his comment, Clemens, whom I’ve actually never heard of before, is echoing my own perspective that the real problem of Africa today is wealth — what to do with it — and not poverty — which remains a scourge in Africa but which I believe will be most effectively addressed as a consequence of better management of African wealth.

G. Pascal Zachary, editor of Africa Works, is a professor of practice at Arizona State University, in the Walter Cronkite School of Journalism in Phoenix and the Consortium for Science Policy & Outcomes  in Tempe. 


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