Learning from Macron : Why simplified and antiquated assumptions about the world are a direct threat to public health

I went back and watched the French president’s full speech at this month’s G20 meeting in Hamburg, in the original language, in an attempt to gain an understanding of the point he was trying to make. Aware that the noise of the ‘soundbite’ media can often drown a well-intentioned message. I also listened to the original question posed that incited his response. For those of you who don’t know what was said, here is an English translation of the major points raised in the particular answer that caused the contention taken from The Independent.

“The problems Africa face today are completely different … and are ‘civilizational’…. What are the problems? Failed states, complex democratic transitions and extremely difficult demographic transitions

He also referred to the continent as “a land of opportunity”.

It’s by a more rigorous governance, a fight against corruption, a fight for good governance, a successful demographic transition when countries today have seven or eight children per woman…At the moment, spending billions of euros outright would stabilize nothing. So the transformation plan that we have to conduct together must be developed according to African interests by and with African leaders.

Emmanuel Macron / Ed Alcock / M.Y.O.P.

Let’s deal with this in parts.

  1. The Role of Opinion

In my opinion the problem here is exactly that. His statement is based largely on opinion and possibly also some outdated world views. But not on fact.

He was factually wrong. Completely wrong. There are no such states in Africa – where 7 – 8 children are born per woman.


  1. The Numbers

I sat down, created a spreadsheet; and using world bank data, carefully compiled a list of all 54 African states (excluding South Sudan, for which there is not yet data) and crunched the numbers.

The average number of babies per woman on the African continent is 4.32.

In terms of countries today that have seven or eight children per woman. There is only one such country in the world today. Incidentally, that nation is Niger: 7.51 children per woman. This is the only nation with an average of 7 or above in the continent. At 1.55 babies per woman, Mauritius has the lowest number followed by Tunisia – 1.97.

Presenting a skewed view of the world is dangerous. Without accurate information, we cannot effectively address REAL problems that exist in the world today; nor fully understand their causal factors. This is not just a development issue: it is a public health issue.

The number of babies per woman, globally, is (unsurprisingly) inversely proportional to infant and child mortality rates. It is therefore, no surprise that Niger, with the highest number of babies per woman, also has one of the continent’s highest child mortality rates at 95.5 per 1000 live births. Compared with Tunisia at 14 per 1000 live births.

This is a vital concept. Parents will have fewer children when their likelihood of survival to adulthood increases. And to frame this issue any other way would be a mistake. When child mortality falls, babies per woman fall too.


  1. The Point of Demographic Transition

I have yet to fully understand the demographic changes the French president is referring to. (Maybe someone will explain this to me.)

I cannot say I understand the elusion to ‘demographic transition’; outside of my assumption that he is making reference to the tensions created at the Berlin conference of 1884 – 1885, better known as the Scramble for Africa, when European leaders divided the continent between themselves with arbitrary borders, many drawn quite simply with a ruler, with no regard for the ethnic and religious groups living in those areas.

Or perhaps how many of these states were subsequently administrated in a way that was to the complete exclusion of African interests, creating areas of wealth and poverty, new forms of discrimination between ethnic groups, such as in Sudan (now Sudan and South Sudan) or Rwanda, and centres of commerce. Many of these centres placed particularly at ports ultimately leading to the creation of land locked developing countries, today some of the continents’ poorest, with little access to these newly formed trade routes, as opposed to the forms of trade that had existed for centuries.


  1. Spending Billions of Euros on…. ?

Just to clarify: ‘Western’ nations do not bail out ‘failing’ African economies as they do their own. Furthermore, to speak of ‘challenges facing African economies’ is to speak of nothing at all.

Africa is the most genetically diverse continent on the earth. A continent of 54 states. The majority of which were colonised; as were India, Bangladesh and what are now the independent states of Peru and Bolivia, respectively. Today, when European nations intervene in African politics these actions are almost exclusively to the benefit of their own interests. Not for the development of African states purely for the benefit of these states. (See: France Operation Serval in Mali 2013)

Nonetheless, I don’t think any of us Africans believe that billions of Euros were to be donated/invested in our economies had the president been aware of our “demographic” profile according to fact, versus fiction. Being a bit of a pet peeve, I have deliberately elected not to address the use of the term ‘civilizational’. The problems with this kind of phraseology are numerous and based on multiple assumptions. Nonetheless, we understand the sentiment being expressed here, so dissecting its misuse would be redundant given the subject matter.

‘Africa today’; to use the same language of the French president, and to acknowledge the validity of his closing remark in this question; will and must develop according to African interests (finally). And in my opinion this will take the continued cohesion within this highly heterogenous continent. And if nations such as France and other members of the G20, all foreign states with the exception of South Africa, wish to be part of accelerating Africa’s continued development, the participation of African leaders who hold the interests of their populations at heart is indeed vital.

True progress requires the involvement of all stakeholders and a comprehensive, representative, contemporary understanding of both the developmental and healthcare landscapes, by all parties. And a poor grasp of these can lead to ill-informed, unpointed, one-size fits all interventions that, despite best intentions, are functionally ineffective.


Images: politico.eu, naijamumsonline.com, cnn.com

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