Disease Trends Highly Unlikely To Impact US, Regional Consequences Likely

Executive Summary:

It is highly unlikely that infectious and chronic disease trends in Burkina Faso, by themselves, will have any serious strategic implications for US interests over the next 10-15 years. That said, AIDS, bird flu and a variety of Neglected Tropical Diseases (NTDs) coupled with a poor health care system, weak economic prospects and a growing urban population make it likely that infectious diseases will contribute substantially to any instability in Burkina Faso itself with subsequent regional implications. Likewise, despite recent progress, Burkina Faso’s migrant workers (primarily to Cote D'Ivoire), high risk populations (including gold miners, truckers, soldiers and prostitutes) and its illegally trafficked women and children are likely to continue to spread a variety of infectious diseases throughout Burkina Faso and into adjoining states.

Discussion:

The poor, West African nation of Burkina Faso has few direct connections with the United States. It is one of the least developed countries in the world with a population of approximately 13 million and a GDP per capita of 400 USD. Total trade between the US and Burkina Faso was less than 3 million USD in 2005* and Burkinabe (citizens of Burkina Faso) accounted for only 2169 admissions* to the United States in 2005. Burkina Faso maintains a much stronger relationship with Europe and, in particular, France than with the United States.
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Despite recent improvements and an 18-year long period without significant conflicts, Burkina Faso still has a poor health care system capable of providing only rudimentary services outside of the capital city of Ouagadougou. The HIV virus is present in between 2.7 and 6 percent of the population and education regarding the virus is still quite poor. Maplecroft Maps, using its proprietary HIV/AIDS Index, ranks Burkina Faso's AIDS risk as "extreme", its highest category, though it also notes that the situation has improved somewhat since 2003. Molly Brady of the Lymphatic Filariasis Support Center* reports that five of the six NTDs are present in Burkina Faso. The Burkinabe have made progress, with significant aid from the United States, against only one of the NTDs, river blindness, while malaria, tuberculosis and meningitis continue to be intractable problems. Likewise, the World Health Organization reports that international medical officials have confirmed several occurences of bird flu in the southeastern and central regions of Burkina Faso. The Global Polio Eradication Initiative even considers Burkina Faso susceptible to polio due to its proximity to one of the remaining six areas of polio and its lack of an adequate containment plan should polio break out in the upper Volta. Burkina Faso is also at significant risk from some chronic diseases. For example, the WHO expects the number of individuals with diabetes to more than triple by 2030.external image Avian_influenza_in_West_Africa1.png

Burkina Faso is unlikely to be able to afford significant improvements in its health care system over the next 10-15 years. The economy is largely based on agriculture combined with some industry and mining, particularly gold and manganese. The US Commercial Service evaluated the investment climate in Burkina Faso as “good”* but the World Bank ranks Burkina Faso 163rd of 175 in “Ease of Doing Business”. Burkina Faso’s level of corruption is modest* and its 2005 growth rate of 4.8%* is good compared to many other African countries. However, its Foreign Direct Investment of 35 million USD (2004), its lack of an educated populace or significant natural resources coupled with its external debt of nearly two billion USD indicate that economic conditions are unlikely to improve substantially. Poor health care and a weak economy combined with a fast growing urban population (Ouagadougou is the fastest growing capital in Africa), provide a likely breeding ground for large-scale outbreaks of infectious diseases and the societal instability that is highly likely to accompany any such outbreak.

By focusing on high risk populations, such as gold miners, truckers, prostitutes and soldiers, the WHO reported some progress by the Government of Burkina Faso (GBF) and a variety of international partners in limiting the spread of AIDS. Burkina Faso is likely to be extremely susceptible, however, to any new diseases, particularly those returning migrant workers from Cote D’Ivoire* or trafficked women and children might bring into the country. Similarly, Burkina Faso, as a transit point for these activities, will also likely act as a largely unimpeded route for a variety of new or existing infectious diseases into other countries in the region.
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Additional Comments:

None.

Source Reliability: 7
Analytic Confidence: 4

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