Health Challenges Past and Future

November 2014
with Cally Ardington, in The Oxford Companion to the Economics of South Africa, eds. Haroon Bhorat, Alan Hirsch, Ravi Kanbur and Mthuli Ncube (Oxford: Oxford University Press, 2014)

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In this chapter, we discuss what has happened to the health of the nation in the past 20 years. We examine evidence available on four major health issues: TB, AIDS, child malnutrition and, among women, obesity. Our findings are mixed. TB incidence rates have soared, and the country increasingly faces the challenges of treating multidrug-resistant TB. After a rocky decade in which AIDS took the lives of 2.6 million, there are signs that the arrival of anti-retroviral therapy (ART) has begun to slow the prevalence of AIDS. There has been a significant improvement in children’s anthropometrics – especially among children in the bottom quartile of the income distribution. The gains observed in rural areas were the most dramatic, closing the urban-rural gap in the rates of childhood stunting and wasting (Gummerson 2011). Stunting has fallen from a third to a quarter of young African children (PSLSD, NIDS). In contrast, we find no change in women’s obesity rates, which continue to put women at risk for chronic disease and early death.