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Unité d'Enseignement et de Recherche en Démographie, Ouagadougou, Burkina Faso, 12-14 February 2004
The Scientific Committee on Emerging Health Threats was established by the IUSSP in 2001 with a four-year remit to promote research into a range of new and resurgent threats to health that are leading to stagnation and reversals in trends towards lower mortality. The Committee organised its first seminar on the Determinants of Diverging Trends in Mortality hosted by the Max Planck Institute for Demographic Research in Rostock in June 2002.
In this second seminar on "HIV, the Resurgent Infections and Population Change in Africa"the Committee re-visited the concept of a global health transition involving a universal trend towards low mortality. Its primary focus was on the most recent evidence on the level and determinants of resurgent and new infectious diseases in Africa. Analyses concerned principal determinants of HIV, tuberculosis and malaria in the region, mortality effects of infectious disease, interaction between infectious disease and socio-economic development and population trends.
The seminar addressed the following issues:
- the dynamics of infectious diseases and trends in mortality
- the current burden of infectious diseases such as HIV, tuberculosis and malaria
- the major determinants of infectious disease spread such as mobility and urbanization, governance, health care systems, poverty and social exclusion
- impact of environmental changes, such as climate and agricultural systems
- successes and limitations in prevention and care strategies
- modeling the impact of infectious diseases on mortality and demographic trends.
In order to maximise participation of demographers and other researchers from Africa (especially young researchers who find it difficult to obtain funds to attend meetings held outside the region) the seminar was held in Ouaguadougou (Burkina Faso) February 12-14 of 2004 where it was hosted by Unité d'Enseignment et de Recherche en Démographie (UERD).
The seminar was co-sponsored by the IUSSP, Wellcome Trust, WHO, and UNAIDS and brought together over fity-five participants from Africa, Europe and North America. Students and young researchers in demography and public health as well as public health officials and representatives of international and national NGO's working on health care and HIV/AIDS prevention in the region attended the seminar. (For more details on participants and seminar programme please go to the the List of participants and Seminar Programme ).
Twenty-five papers were presented during ten sessions. The seminar papers provided new evidence for the complexity of the global health transition and further documented the re-emergence of infectious diseases in sub-Saharan Africa. AIDS is becoming more and more prominent as a cause of death, especially in Southern and Southeastern Africa. This has led to increases in other infectious diseases such as tuberculosis. In other parts of the continent, other infectious diseases are the leading causes of death and disability among the population. Diseases such as malaria for example were found to play a key role in the reversal of the decades-long decrease in child mortality. Researchers identified numerous factors that explain the resurgence of infectious diseases on the continent and the severity of the new AIDS pandemic. These factors are health-related and non health-related and lie at different levels. They involve individual behaviours, the health system, the economic, social and cultural context, the climate and environmental changes and the global context. Cases of positive behavioural change and decreases in infection were also identified. In many cases, however, signs of improvement are still weak and in many cases the situation continues to worsen.
Participants concurred on the need for control programmes to address deep underlying factors in addition to the straightforward promotion of behavioural change and improvements in medication. In doing so, researchers from different fields as well as local communities should be involved in the identification of the problems, the search for solutions and the design and implementation of intervention programs.
During the seminar, interesting discussions emerged regarding the quality of data and usefulness of methodologies. The HIV epidemic, resurgent infections and population change in Africa raises a number of complex issues that can only be adequately addressed with solid data. Although mathematical modelling provides opportunities for understanding current trends and an outlook into the future, it can not substitute for the continuous lack of very basic demographic, socio-economic and medical data.
The seminar was an opportunity to bring together population specialists from diverse fields with different types of research and types of evidence. Participants expressed the hope that these diverse approaches would contribute scientifically to relieve the overall burden on Africa.
The seminar facilitated both the South-North and South-South scientific collaboration and contributed to regional capacity building by giving young African researchers an opportunity to participate in research activities. D. Ouedraogo, Director of UERD, promised to disseminate the findings of the seminar at the national level and to share them with the Union for the African Population Studies (UAPS). UERD will also use them for its doctoral program and for its up-coming population follow-up project.
V. Shkolnikov, Chair of Committee on Emerging Health Threats, informed participants that after consideration of all papers the CEHT had decided that a number of high-quality papers from the seminar were sufficient to prepare a book on Population and Infectious Disease in Africa for the new IUSSP series with Kluwer Press. The editorial committee consists of M. Caraël, J. Glynn and I. Timæus
More information about the seminar can be found in the long report or at the Emerging Health Threats page of the IUSSP website.