A Health Horror Story in CAR

Researchers at Columbia Mailman School, in partnership with a global team of other experts, are sounding the alarm about the health and humanitarian emergency in the Central African Republic (CAR). Their findings, from a nationwide mortality survey of almost 700 households conducted in 2022, suggest that CAR has the world’s highest nationwide mortality rate, a rate that is four times what the United Nations estimated in 2010. The researchers estimate that 5.6 percent of the population is dying each year. (The U.S., in contrast, has a death rate of 1 percent per year.)

This crisis is likely due not only to COVID-19 but also to human rights abuses by Russian paramilitary organization the Wagner Group, which has been fighting rebel groups in the country. In addition to a high death rate, with malaria and diarrhea rampant, 82.3 percent of households reported eating less than one meal per day, and the country has relatively few children under age 3, a warning sign possibly linked with malnutrition and high risk of pregnancy loss. “The crisis level mortality rate suggests that the needs in CAR are being largely unmet,” note the authors, a group that includes Les Roberts, PhD, professor emeritus of Population and Family Health.