III

Next Steps: Ideas for the Present and Future of Africa
Africa is not easily generalized. There are fifty-three countries in Africa of different races, religions, cultures, and stages of development. Yet it is also true that sub-Saharan Africa is by and large poor, victim to some of the world’s deadliest diseases, and plagued by a history of poor governance and many devastating conflicts. A number of African countries are moving out of this morass. Ghana is stably democratic, enjoying solid economic growth, has instituted a national health insurance system, and is moving to reduce the economic disparities within the country. South Africa has maintained one of the strongest constitutional democracies in Africa or for that matter most anywhere in the developing world. Mozambique, Botswana, Mali, Benin, and other African states are moving ahead on both better governance and sound economic management. But issues of governance and deeply entrenched aspects of poverty remain for most of the continent. While much of the literature on African development focuses on economic issues, in this section two authors address more fundamental issues of governance and leadership. Stephen Ellis takes a hard look at the problems of weak or failing states and criticizes the international community for its responses to date. Ellis believes a longer-term focus on building strong institutions and stronger state capacities, along with better accountability, will be the determining factor in whether weak African states fall back into conflict or, almost as bad, stagnation. Robert I. Rotberg focuses on the failure of African leadership since independence and how [149]
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John Prendergast and Colin Thomas-Jensen to build a new generation of more responsible and capable leaders. Rotberg’s analysis corresponds with the view of many African analysts of the fundamental problem in Africa to date. Laurie Garrett calls attention to another more subtle challenge to African success. Some years ago, Jeffrey Sachs pointed out why improvements in health, vital to productivity, needed to be addressed as an investment in growth, not the by-product of economic development. Garrett indicates how health in Africa not only impedes African development but endangers global health. In this age of globalized commerce, heavy international travel, and the emergence of new health threats such as avian flu or drugresistant tuberculosis, health crises can spread rapidly from Africa to the United States and other countries. She points out how international health protection relies on monitoring systems, quick reaction capabilities, and institutional strengths that often do not exist in much of Africa. Once the interdependence of the world’s health systems is understood, the challenge of addressing Africa’s health needs becomes more than a humanitarian undertaking, but one essential to the health of all.

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