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The Facts

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THE FACTS:

Democratic Republic of the Congo (formerly Zaire)

• Population - 65,751,512

• Capital City – Kinshasa

• The DR Congo is of vital strategic importance because it’s size (2.5 million sq. km) and the fact that it is endowed with 50 per cent of Africa’s forests.

• The DR Congo ranks among the world’s largest producers of industrial diamonds.

• The macro-economic framework has recovered; inflation rates are down from 630 per cent in 2000 in less than 3% in the first quarter of 2004.

• First free elections in almost 40 years took place in July 2006.

• The Congo River at 2,720 miles long is one of the world’s mightiest river systems. It could provide hydroelectric power to the entire continent. It is the fifth-longest river in the world, and the second longest in Africa - second only to the Nile River in Northeastern Africa. It has recently reopened and it is the biggest transportation source in Central Africa.

• The DR Congo contains 80 per cent of world reserves of columbite-tantalite (coltan).

• Over 200 African ethnic groups of which the majority are Bantu; the four largest tribes - Mongo, Luba, Kongo (all Bantu), and the Mangbetu-Azande (Hamitic) make up about 45% of the population

• Religions: Roman Catholic 50%, Protestant 20%, Kimbanguist 10%, Muslim 10%, other (includes syncretic sects and indigenous beliefs) 10%

• Languages: French (official), Lingala (a lingua franca trade language), Kingwana, Kiswahili, Swahili, Kikongo, Tshiluba.


DR Congo Health Statistics

• The average life expectancy is 42-47 years. In 2003, approximately 2.5% of the population were 65 years old or older.

• The infant mortality rate in the Congo is 9.6%. In the United States, the rate is significantly smaller (0.6%).

• Nearly 20% of newborn children die before their fifth birthday.

• Poverty is an overwhelming problem in the Democratic Republic of the Congo. In 2002, the Gross Domestic Product (GDP) per capita was only $600. In contrast, the GDP per capita in the United States was $36,300.

• In 1995, the Congo had the biggest polio epidemic of the 20th Century.

• There are 150,000 new infections of tuberculosis each year.

• One out of every seven deaths is HIV/AIDS related.

• In 2001, there were eight times as many HIV/AIDS related deaths in the Congo (120,000) than in the United States (15,000), despite the fact that the population in the Congo is 1/5th the size of the U.S.

• Malaria is one of the leading causes of death. More than four millions new cases were reported in 2003.

• According to health ministry statistics, five percent of the 4.5 million people infected by malaria last year died of the disease.


The State of the Nations Health

Structure of the Health System

The Democratic Republic of the Congo has 11 provinces and 306 health zones. In each of these zones, a general hospital and 10 to 20 primary care health centers serve a population of 100,000 to 200,000 people. The Ministry of Health offers other programs, such as immunizations or services devoted to tuberculosis, leprosy, and onchocerciasis. These services vary in availability and integration into the primary care health system.

The government assigns teams of nurses to cover the health zones of the Congo. During these visits, an entire village gathers for examinations. Volunteers and staff carry supplies from the river to the village to set up the makeshift clinic, marked off by bamboo poles. Nurses weigh children and adults, measuring the circumference of heads and arms as one indicator of nutritional levels and growth progress. Expedition physicians listen to hearts and perform basic exams. They dispense immunizations and offer health education classes in family planning and nutrition.

To assist in the delivery of health care in the country, Catholic ad Protestant missions have developed and maintained hospitals and health centers since the early 1900s. Because of the beleagured circumstances of state institutions, these organizations have played strong supportive roles in the delivery of health care services.


World Health Organization – HIV/AIDS Situation Analysis 2005

The Democratic Republic of the Congo is facing a large-scale growing HIV/AIDS epidemic, with an estimated average adult prevalence of 4.2% and 1.1 million people 0–49 years old living with HIV/AIDS at the end of 2003. Of these, 570 000 are estimated to be women. The principal mode of transmission is heterosexual. The most severely affected age groups are 20–29 years among women and 30–39 years among men. The epidemic has severely affected children – an estimated 770 000 children younger than 17 years had lost one or both parents to AIDS at the end of 2003. Data available from isolated surveillance activities conducted in the eastern part of the country suggest that the prevalence of HIV infection is higher there than in the western part. The epidemic has been worsened by large-scale population movements that resulted from the armed conflict and political instability of the mid1990s, the related economic crisis, high levels of untreated sexually transmitted infections and weak health system infrastructure.

The Democratic Republic of the Congo was among the first African countries to design and implement a programme for HIV/AIDS awareness and prevention in the early 1980s. In 1987, the government established the National AIDS Control Programme to lead the fight against a rapidly increasing epidemic. However, progress was interrupted by the political and civil crisis that broke out in the mid-1990s. In 1999, a National Strategic Plan for an integrated response to HIV/AIDS covering the period 1999–2008 was adopted, including prevention, care and interventions related to the provision of antiretroviral therapy and essential drugs to treat opportunistic infections. With the end of hostilities and the establishment of a transitional government in 2003, the Democratic Republic of the Congo has witnessed a renewed commitment to the fight against the disease. Since June 2002, a joint publicprivate initiative piloted by the government has trained health workers, strengthened laboratory capacity and begun procuring generic antiretroviral drugs. The approach is multisectoral. As of May 2004, 74 physicians and 1868 nurses and midwives had been trained to deliver antiretroviral therapy in accordance with national standards, mostly in Kinshasa, the capital. Laboratory facilities for CD4 count are available in Kinshasa, Lubumbashi and Mbuji Mayi. In January 2005, the Democratic Republic of the Congo finalized its National Strategic Plan for Scaling Up Access to Antiretroviral Therapy for the Period 2005–2009. The Plan includes strategies for training additional health workers to deliver antiretroviral therapy, expanding prevention and care facilities, strengthening the capacity of national laboratories and improving the procurement and supply management systems for antiretroviral drugs and other supplies.

Many years of civil unrest have damaged the health care delivery system. The country is large, has a sizeable mobile population and health care services are inadequately decentralized. There is a severe shortage of human resources trained to deliver antiretroviral therapy. Access to antiretroviral therapy is limited in many provinces. Systems for procurement and supply management of drugs are inadequate, and the cost of treatment remains high. Coordinating mechanisms and monitoring and evaluation systems need to be strengthened. Rapidly scaling up access to antiretroviral therapy requires accelerating the training of health workers, expanding voluntary counseling and testing services, reducing the cost of antiretroviral drugs and diagnostics, extending access to antiretroviral drugs to rural areas and reinforcing synergy among the activities of various partner organizations.

 

 
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