Sub-Saharan Africa faces serious political, economic and social challenges. With an annual rate of growth of 2.2 per cent, its population is expected to increase from 906 million in 2005 to 1.1 billion in 2010.Â Twenty years of an almost 3 per cent annual population growth has outpaced economic gains, leaving Africans, on average, 22 per cent poorer than they were in the mid-1970s. Despite improved economic performance in recent years, the overall gross domestic product growth rate is below the 6 to 8 per cent that is required over a 10-year period in order to achieve the Millennium Development Goals. Life expectancy has decreased sharply due to AIDS.
The lack of access to information and reliable data on population issues has constrained sustainable development. Only 43 per cent of the region's countries have undertaken national population and housing censuses. Ensuring the collection, analysis and access to data needs to be a top priority in the coming decade.
Large-scale migrations of people trying to escape poverty and political instability is another serious issue. A contributor to this is the rapid increase of new entrants into the labour market because of the large youth population. High fertility rates are outpacing the capacity of economies to generate a commensurate number of jobs. Even in cases where slowing fertility is about to bring a demographic bonus, the lack of employment opportunities will make it difficult for countries to capitalize on the positive dependency ratios that accompany the early stages of a demographic transition.
Sub-Saharan Africa remains the region most affected by the AIDS epidemic. About half of African countries have declared AIDS as an emergency. Yet, in spite of an unprecedented global response, the rate and scale of implementation of programmes remain low. Access to condoms is only about 10 per cent. HIV continues to escalate, with over 22 million Africans living with HIV. In contrast to other regions, the majority of people (61 per cent) living with HIV are women. Young people account for half of the 1.7 million new infections (2007 figures).
The maternal mortality ratio is unacceptably high. Forty per cent of all pregnancy-related deaths worldwide occur in Africa. On average, over 7 women die per 1,000 live births. About 22,000 African women die each year from unsafe abortion, reflecting a high unmet need for contraception. Contraceptive use among women in union varies from 50 per cent in the southern sub-region to less than 10 per cent in middle and western Africa.
The feminization of AIDS and poverty, low literacy rates for girls, low representation of women in decision-making, gender-based violence and inadequate allocation of resources to gender issues are obstacles to development. The Maputo Plan of Action, which promotes an integrated approach to sexual and reproductive health and reproductive rights, will be the focus of future activities, including in conflict and post-conflict situations.