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Because health is the product of a combination of political, economic, social, cultural, technical factors, the values of the indicators of health are an observatory of the African continent and its billion people in all their dimensions. So, the reading of the program of the 9(th) French-speaking international Congress of the Society of Exotic Pathology is significant of the state of Africa in this second decade of the 21(th) century. The age-old infectious plagues go alongside to emergent fevers there, but the program also dedicates a wide time to the chronic pathologies. This kaleidoscope invites to discuss the concept of epidemiological transition chosen by the Congress. What is its meaning when the order of magnitude of the values of the indicators of health was distended never also and became the most contrasted by the world, in all the scales of observation? Which is its meaning when, in Black Africa, unlike the processes observed in the countries which formed the Third World in 1950, the evolution observed for the last five decades is chaotic, made by a succession of advances, by a progress, by blockings, even by walking back, original expression of the health transition, the process which includes the evolution of the health and the answers of States and societies. The geography of the values of indicators shows the socio-territorial dynamics in process, which place societies in more or less protective systems for their health. More than ever, diverse worlds are next to a sum of challenges, of which that to improve the knowledge of the needs for health, in relatively fine scale to avoid generalizations and amalgams, and target priorities of health according to the socio-territorial contexts. |
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