MDG 5, HUMAN RIGHTS, AND MATERNAL HEALTH IN AFRICA
deaths in Africa. The countries of South Africa, Swaziland, and Zimbabwe
starkly illustrate the threat of HIV/AIDS-induced reversals in gains made in
protecting the health and wellbeing of mothers in Africa. In 1990, maternal
mortality in these countries was amongst the lowest in the region—230,
260, and 390 deaths per 100,000 live births respectively but sharply rose to
410, 420, and 790 in 2008.78 Although a combination of several factors
might have produced this deplorable situation, the emergence of the
HIV/AIDS epidemic and its concentration in the Southern horn of Africa is
certainly a key factor. Recent estimates put the HIV prevalence in South
Africa at 17. 8 percent of the population, 25. 9 percent in Swaziland, and
14. 3 percent in Zimbabwe. 79 These figures represent the worst cases
anywhere in the world and account, in no small measure, to plunging
maternal health indicators in these countries. 80
Although other parts of Africa are not as badly affected as countries in
the Southern peninsula, they have not been spared the scourge and tragedy
of HIV/AIDS. Strikingly, women in sub-Saharan Africa are
disproportionately affected, at 3. 4 percent compared to 1. 4 percent of males,
and this has significant implications for maternal health in the region. 81
There are many ways HIV/AIDS negatively affects maternal health. In
addition to increasing pregnancy- and childbirth-related complications, such
as miscarriage, anemia, PPH, puerperal sepsis, and post-surgical
complications, HIV during pregnancy also increases these women’s
vulnerability to malaria and other opportunistic infections. 82 The experience
from Rakai, Uganda exemplifies how these complications negatively
impact maternal health. There, the maternal mortality amongst HIV-infected women was 1,687 per live births, but only 310 among women who
were not infected. 83
At ten percent, sub-Saharan Africa leads the rest of the world in the
number of HIV-related maternal deaths. 84 Of these deaths, formally known
as “AIDS related indirect maternal deaths,” totaling 19,000 globally, sub-Saharan Africa was responsible for 17,000 or ninety-one percent. 85 So,
what is the solution? Aside from broad-based scaling up of HIV
78. WORLD HEALTH STATISTICS 2011, supra note 47, at 70.
79. Id. at 72.
80. See id. at 58-72.
81. UNAIDS, GLOBAL REPORT: UNAIDS REPORT ON THE GLOBAL AIDS EPIDEMIC 2010,
82. WORLD HEALTH REPORT 2005, supra note 10, at 23.
83. N.K. Sewankambo et al., Mortality Associated with HIV Infection in Rural Rakai
District, Uganda, 14 AIDS 2391, 2391-2400 (2000).
84. MILLENNIUM DEVELOPMENT REPORT 2012, supra note 28, at 31.