The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
The global economic crisis and climate change threaten to curtail already slow progress on meeting the social development targets of the Millennium Development Goals, says a new report by the Africa Progress Panel, an international review group headed by former United Nations Secretary-General Kofi Annan.
Economic progress has not increased social benefits to the majority of Africa's people despite the continent's unprecedented economic growth of an average six percent in the five years preceding the crisis, the report says.
It attributes the growth to "healthy macroeconomic policies, lower public debts, increased political freedom, increased openness to trade, and a favourable global environment of strong external demand, ample liquidity, extended concessional financing, and higher commodity prices."
But it notes that social protection and poverty reduction are still lacking.
"Despite strong economic growth, an overall improvement in the policy environment, and many success stories, particularly in the area of primary education, the continent as a whole is lagging behind on each of the relevant goals," the report said. "Progress, already too slow, now risks being further undermined by the effects of the global economic crisis and climate change."
The crisis has not only hurt economic growth and resulted in job losses but it also has affected government spending patterns.
"Effects are being transmitted to African societies through several channels. In terms of public expenditure on social sectors, the crisis is not only squeezing the ability of African governments to sustain the levels of investments they were able to make over the past few years, but it is also resulting in declines in public expenditure on social sectors as a percentage of GDP," according to the report.
"The lack of public social safety nets to offset the negative impacts on individuals and families is compounding the situation, with the working poor and other vulnerable groups enduring the greatest impacts of the crisis."
Progress has been made in meeting education targets, with 30 African countries on track to reach universal primary education by 2015, but much remains to be done with 50 million children still without access to primary education.
Climate change presents not only challenges but opportunities.
While changes in rainfall patterns, as well an increase in the occurrence and severity of natural disasters and lower agricultural
yields, present significant obstacles, climate change "also offers the continent new chances to profit from its vast carbon sinks, leapfrog dirty technologies, and embark on a path of low-carbon growth and clean development," the report says.
African countries are increasingly cooperating on climate issues as was evident from the "common negotiating position" at the COP 15 summit in Copenhagen, Demark.
"Nationally, many of them have formulated National Adaptation Programmes of Action and are pursuing reforms to encourage sustainable land management and combat deforestation."
The Millennium Development Goals were formulated and adopted by all the members of the United Nations in 2000. Eight goals were set with 21 "quantifiable targets" that should be achieved by 2015.
The goals, according to the United Nations Development Programme, aim to:
eradicate extreme poverty and hunger,
achieve universal primary education,
promote gender equality and empower women,
reduce child mortality,
improve maternal health,
combat HIV/AIDS, malaria and other diseases,
ensure environmental sustainability, and
develop a global partnership for development.
The Africa Progress Panel includes former heads of government Tony Blair and General Olusegun Obasanjo, human rights activist Graça Machel, micro-finance pioneer and Nobel Prize winner Professor Muhammad Yunus, Botswana banker Linah Mohohlo and musician Bob Geldof.
Also on the panel are: Michel Camdessus, former International Monetary Fund managing director; Peter Eigen, chairman of the Extractive Industries Transparency Initiative and founder of Transparency International; Robert Rubin, former secretary of the United States Treasury; and Tidjane Thiam, chief executive officer, Prudential PLC.
The Africa Progress Panel aims "to promote Africa's economic, social and political development" by:
contributing to and catalyzing initiatives by leaders, organizations and policy makers to develop clear positions on issues critical to the continent's future;
encouraging and monitoring the role of Africa's trading, donor and investment partners in supporting the continent's progress measured in a number of ways; including the coherence of policies as well as the levels of aid and investment;
engaging and intervening on specific issues, problems and opportunities in a politically timely manner, notably in advanceof critical decision making moments, whether in Africa or on the international stage."
The Africa Progress Panel Foundation is based in Geneva.