Angola and Burundi are two sub-Saharan African countries with high levels of corruption and poverty, low food security, and severe human rights issues. Both countries are recovering from long civil wars that have severely affected their health status. In this essay, I will be comparatively analyzing different political, social, and geographic factors that may influence the health status of both of these countries with reference to composite indices.

Burundi’s civil war lasted 15 years, ending in 2008, and Angola’s civil war lasted 27 years, ending in 2002. Although both countries are not currently involved in any official political conflict, the effects of the wars have led to severe challenges regarding economic reconstruction and have created lasting political tensions leading to violence and abuses of government power. Both countries also struggle with food security, which has led to extreme numbers of chronic malnutrition and high child mortality rates. Overall, Burundi has a slightly worse health status despite the help from the World Food Programme (WFP), mainly due to higher human rights violations, few natural resources, and exposure to natural disasters which leads to low values of global food security and human development indices.

The struggling health statuses are linked to political violence in the past which are still current in their societies today, as well as extreme government corruption and abuse of power. After the civil war in Burundi, there has been minimal progress in the government’s attempt to make it more peaceful and equal with less corruption. The power still lies in the hands of the leading political party (CNDD-FDD), who’s youth branch, the Imbonerakure, is responsible for murders, abductions, torture, rapes, and grenade attacks. Authorities made matters worse by additionally banning the Ligue Iteka, a local human rights organization, with the support of President Pierre Nkurunziza. The party used this kind of violence against political opponents and their families to stay in power which is made easy as the justice system is often manipulated by the authorities. These acts of political violence contribute to the lower quality of life of Burundian civilians. Although Burundi is no longer officially in war, 400,000 Burundian refugees fled the country from 2015 to neighboring countries such as Tanzania.

In Angola, there are also extreme cases of government corruption leading to inequality. The government has a large budget of $40 billion, however, this is mostly used to benefit the affluent communities of Angola. There are abundant cases of ‘land grabbing’, where the government evicts residents of poorer communities and small farmers for the construction of expensive apartments occupying an exclusive portion of Luanda. They even installed a physical border, a fence running through Zango, for one half to be inhabited by the poor who rarely have running water in Luanda, and the other side inhabited by the elite who use government money to buy luxuries such as Ferretti Yachts and motorboats. Only 9% of Luanda’s population has access to running water and because the affluent parts of the city are prioritized, poor areas have little to none. The government is not willing to invest in the installation of taps and sanitary facilities in poorer areas. This results in higher rates of infectious disease amongst the poor which contributes to the low life expectancy of 52.7 years at birth. However, there is promise for improving future conditions for Angola. Unlike Burundi, Angola has generally been able to maintain political stability after their war, and they are a candidate for the UN human rights council of 2018-2020 which would adopt a human rights action plan, reinforce goals for advancing democracy and ensure equality of political coverage in the media among other improvements. Burundi does not have a clear plan to end their abuses of authority. The government has made threats to independent journalists and has terrorized political opponents due to a lack of local and international efforts for reform.

Health infrastructure needed to help populations with mitigating infectious diseases, STDs and nutrition-related diseases are dependent on a relatively strong economy, which in the case of both countries is lacking due to the success of exports of natural resources, effects of war, and international aid. Both Burundi and Angola have issues with much of the population’s lack of access to basic health services, which has led to many deaths related to diseases of poverty, such as diarrhea, lower respiratory, and other infectious diseases. Both countries have also been severely affected by the HIV/AIDS epidemic. In Burundi, 20.1% of the population are affected by infectious diseases, and 13.8% by HIV and AIDS. In Angola, 22.6% of the population are affected by infectious diseases and 13.2% by HIV and AIDS. For both countries, three of the top causes of mortality are unsafe sex leading to STDs, unsafe water and sanitation, and the top mortality risk comes from child and maternal malnutrition.

These risk factors in Angola and Burundi are largely due to the high poverty rates resulting from corruption, lack of natural resources, war, and, for Angola, the dropping of oil prices since 2014 which is very impactful on their economy as oil is 90% of their exports. Because of this poverty, mothers are not getting access to education for prenatal care, nutritional food, education for the population to learn about contraception, and sanitary importance, as well as access to basic health facilities. This has also resulted in average life expectancies in the 50s for the populations of both countries, with high birth and fertility rates due to lack of contraception. Both Burundi and Angola are receiving external aid to solve some of their worst issues. Angola accepts help from the Health System Performance Strengthening Project (HSPSP) to address some of these extreme health issues. The project has a US$65 million budget for improving the quality of health services and a US$25 million budget to strengthen enabling factors supporting the delivery of health services, which means better quality, and more accessible healthcare distributed throughout the country.

Burundi’s extremely weak food security is one of the most urgent issues the population struggles with due to the limited availability of health services and exposure to natural disasters. To evaluate food security, I will be looking at the Global Food Security Index (GFSI) which accounts for food affordability, availability, quality, and safety. Burundi scored a 25.1 on this index, the lowest score of all countries — 113th out of 113 countries. Because a large portion of the population is in poverty, it is difficult for people to be able to afford food grown by farmers who have very little financing to begin with. An average of 45% of household expenditure is spent on food, which is 28.6% higher than the world average.

Burundi has a hostile climate for food production, as the country is prone to disasters such as floods, hail storms, drought, torrential rain which easily ruins the crop. Families who only have enough money to buy food will buy the cheapest they can find which is mostly cassava or rice. This results in few people eating nutritional, protein-rich food and their consumption of protein is 43.2% lower than the world average. Angola’s food security also has a low score of 33.2 but Angola’s food production is more self-sufficient and of better quality. Burundi is also receiving external aid from the WFP, which provides services such as providing daily rations of food to 20,000 refugees from the Democratic Republic of the Congo, providing hot meals for 200,000 children attending primary school and nourishing 70,000 pregnant women. These efforts are good first steps but are not the solution to the problem. Serious strategies involving government spending on food production and efforts to make higher-quality foods more accessible and affordable must be developed in order to help more people in the long term.

The Human Development Index (HDI) is also a useful measurement when comparing the health status of Angola and Burundi. The HDI is a composite indicator that measures the progress of a country’s human development, focusing on the average length and health of life, access to education, and the standard of living. Angola scores a 0.533 on the HDI, and Burundi scores a 0.404. The Inequality-adjusted Human Development Index (IHDI) is an indicator of the loss in value when considering the inequality in a country, where Burundi would lose 31.5% of their HDI score which is significant, and Angola an even higher 37% of their HDI, which would leave their final IHDI scores at 0.336 for Angola and 0.277 for Burundi. Although the inequality in Angola is more severe, when calculating the effects of inequality on the country’s HDIs, Burundi’s still results in being in worse shape.

The analysis of these indices suggests that Burundi has a somewhat worse health status. Burundi has scores lower in the GFSI and the HDI composite indicators, and Burundi is not recovering from the violence of the civil war as well as Angola which dramatically lowers the quality of life for the citizens of Burundi. Both countries have a long way to finding solutions to internal and external issues including the abuse of government power and the diversification of their economy, especially for Angola whose economy has little room for growth as they rely on oil as their main contributor to their GDP. They also must work towards becoming more efficient in improving their access to health facilities to minimize instances of STDs and infectious diseases, two of the leading causes of death in both countries.