In 2005, out of 58.03 million people who died globally, an estimate of 10.9 million (18.8%) were from the WHO African region . HIV/AIDS (19%) was responsible for the majority of the deaths (64%) that occurred in the region, lower respiratory infections (10%), malaria (8%), diarrhoeal diseases (7%), cerebrovascular disease (4%), ischaemic heart disease (3%), tuberculosis (3%), measles (3%), low birth weight (2%), birth asphyxia and birth trauma (2%) and maternal conditions (2%). Although there are effective public health interventions that can prevent most of the deaths, the coverage is insufficient due to weak and under-resourced health systems. Some of the weakness can be generated from the challenges related to leadership and governance; health workforce; medical products; vaccines and technologies. Information, financing and service delivery .
Firstly, the leadership and governance is inefficient, which includes weak public health leadership and management ; inadequate health-related legislation and their enforcement; limited community participation in planning, management and monitoring of health services; weak inter-sectoral action; horizontal and vertical inequities in health systems ; inefficiency in resource allocation and use ; and weak national health information and research systems .
Secondly, extreme shortages of health workers exist in 57 countries of which 36 are in Africa . The crisis has been exacerbated by inequities in workforce distribution and brain drain. Thus, the delivery of effective public health interventions to people in need is compromised particularly in remote rural areas.
Thirdly, there is rampant corruption in medical products and technologies procurement systems, unreliable supply systems, unaffordable prices, irrational use, the wide variance in quality and safety . This has contributed to the current situation where 50% the population in the Region lack of access to essential medicines .
Fourthly, there is a dearth of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills limiting capacities of national health management information systems (HMIS) to generate, analyze and disseminate information for use in decision-making .
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