Africa’s infrastructure drive must take into account health and gender to be sustainable

Jun 11, 2015

Photo: UN Photo

Strengthened environmental and social impact assessments can improve access to health and improve gender equality

Pretoria, South Africa – As African countries undertake significant infrastructure development to transform their economies, it is critical that they take into account the impact of these capital projects on the health of workers and nearby communities, and on women and girls in particular, to ensure inclusive and sustainable growth.

“Large capital projects are a key driver of employment and growth, and for development to be achieved, we must minimise environmental and social damage,” said Ms. Geraldine Fraser-Moleketi, Vice President and Special Envoy on Gender at the African Development Bank (AfDB).

Ms Fraser-Moleketi was speaking at the opening of the three-day Second Technical Meeting on Health, HIV and Gender in Capital Projects, that brought together more than 90 representatives from health, environment, mining, transport, infrastructure and civil society from 18 African countries, as well from regional economic communities.

The meeting, co-hosted by the AfDB and the United Nations Development Programme (UNDP), together with the African Union Commission, provided a forum to discuss the integration of HIV, and broader health issues associated with large capital projects such as tuberculosis (TB), malaria, non-communicable diseases into the environmental assessment process. The linkages between gender, health and human rights were also explored.  A key aspect of the discussion focused on how environmental assessments for such projects could be used as an entry point to mobilize resources for health in Africa.

Capital projects such as roads and mines draw huge numbers of workers, particularly men, to sites away from their homes for long periods of time. Their working and living conditions, usually in close quarters, are seen as potential drivers of infectious diseases such as TB. A study by South Africa’s National Institute for Communicable Diseases finds that TB is the leading cause of death among mine workers, with prevalence about three times higher than in the general population.

At the same time, mobile workers’ disposable income is usually spent on commodities such as alcohol and sex in nearby communities, increasing the risks of HIV infection, especially for women and girls.

Risks have also been identified related to increased incidences of malaria. Poor water management and workers’ limited access to good health care due to prohibitive costs, can drive up cases of malaria where large capital projects are being developed.

African countries have made significant investments in infrastructure in recent years, however a USD 96 billion annual infrastructure deficit remains, according to the AfDB. Closing this gap is necessary if the continent is to reach its full development potential and achieve meaningful employment creation and poverty alleviation, in line with the African Union’s Agenda 2063.

As all sub-Saharan Africa countries require environmental assessments prior to launching significant infrastructure projects UNDP and the AfDB are working with countries to advocate for and strengthen capacity to make these assessments more robust to help mitigate health and gender-related risks that come with mobile workers with money.

While some countries have made progress in mainstreaming health and gender into their impact assessments, participants identified areas for improvement.

Among the recommendations, participants highlighted the need for harmonized legal frameworks at the regional level to ensure better integration of social issues particularly health (communicable and non-communicable), into impact assessments, and increased capacity and financial resources to conduct evidence-informed assessments and ensure monitoring and compliance.

They also recommended more advocacy and emphasis be placed on strategic environmental assessments given the scale of capital projects planned across the continent.

The Guidelines for Integrating HIV and Gender-Related Issues into Environmental Assessment in Eastern and Southern Africa, prepared in 2013, form the basis of action for participants, and call on governments to take the necessary steps to mitigate health and gender-related risks in the development of infrastructure and execution of large capital projects.

Following this meeting, the Guidelines will be revised to include broader health issues such as TB, malaria, and occupational health and safety, as well as workplace rights.

Participants included representatives from Angola, Cameroon, Chad, Ethiopia, Ghana, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Seychelles, South Sudan, Swaziland, Tanzania, Zambia, Zimbabwe, Tanzania, Uganda, as well as the International Labour Organisation, the International Organisation for Migration and the World Health Organisation.

Contact information

Annah Muja Rutebuka, Principal, AFDB Social Safeguards Specialist,

Sandra Macharia, UNDP Communications Advisor,

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