text: availability of treatment some two million of the victims die annually. Leprosy also remains a disease of poverty in Africa, South-East Asia and the Middle East. There arc Five million registered leprosy cases world- wide. An emerging issue in 1989 was the incidence of ccrcbrospinal meningitis and the level of preparedness against epidemics in Sahclian Africa from Cape Verde to Ethiopia.BAMAKO INITIATIVE Since the 1987 resolution of African Ministers of Health, the Bamako Initiative gathered significant momentum in sub-Saharan Africa. In September 1988, guidelines were adopted for the implementation of the Initiative, addressing its three main components: » strengthening the community capacity to organize health actions and district- level management systems in order to increase and sustain PHC coverage; » strengthening the essential drugs supply system; » ensuring the financing of recurrent costs, with the aim of community self- reliance in five years. Many countries in sub-Saharan Africa have embarked on an analysis of the performance of the PHC system and the worsening health status of women and children in the harsh light of structural adjustment programmes. This led to a widespread recognition of the need to increase the effectiveness, efficiency and sustainability of PHC systems in order to improve MCH coverage- These preoccupations are reflected in the PHC strategies of the country pro- gramme recommendations and plans of operation for Botswana, Cape Verde, Chad, Mozambique, Sierra Leone and Uganda to be presented to the 1990 Executive Board. These strategics include integration of En and other essential PHC/MCH interventions; decentralization of PHC management including training of local health staff in planning, management and monitoring of PHC; essential drugs policies; contribution of communities to health financing and their participation in the management of local PHC services. The programmes for Benin, Guinea, Kenya, Nigeria, Sierra Leone and Togo
analysis: The text primarily focuses on the health sector, specifically on the availability of treatment and management of diseases such as leprosy and cerebrospinal meningitis. It also discusses the Bamako Initiative, which aims to improve primary healthcare (PHC) systems and increase coverage for maternal and child health (MCH). The text does not mention economic development, natural resources, industry, transport, communication, international trade, employment, humanitarian aid, culture, or science and technology.