São Tomé and Principe

LOCATED IN WESTERN Africa astride the equator, the islands of São Tomé and Principe are dependent on subsistence agriculture and fishing for survival. Cocoa continues to be the main crop for São Toméans, but production has been vulnerable to drought and mismanagement. The islands are not self-supporting and must import all fuels, most manufactured and consumer goods, and much of its food. Economic growth on the islands is hampered by a lack of skilled workers. Some 54 percent of São Toméans live in poverty. Politically, the islands have been unstable since gaining independence from Portugal in 1975.

Economic prospects for São Toméans have brightened with the recent discovery of oil in the Gulf of Guinea, and the islands have great potential as a tourist mecca. In the immediate future, however, São Tomé and Principe must deal with huge foreign debts and an inability to control poverty, although the quality of life is slowly improving for its 187,410 residents. Accurate measures of São Toméan social indicators are hampered by a lack of data.

Life expectancy among São Toméans is higher than in most of sub-Saharan Africa. Between 1990 and 2000, male life expectancy rose from 60 to 63 years, and female life expectancy rose from 64 to 68 years. By 2005, the São Toméan life expectancy had risen to 66.99 years, and the median age was 16.12. Nearly half the people are under the age of 14 and less than four percent have reached the age of 65. The people of the islands have a 90 percent chance of living to the age of 40. São Toméans are susceptible to the food- and waterborne diseases that are common in the area, and malaria is prevalent. There are 47 physicians for every 100,000 residents on the islands, and one-half of the population has access to affordable lifesaving drugs.

Infant mortality in São Tomé and Principe rose from 69 deaths per 1,000 live births in 1990 to 75 deaths per 1,000 live births in 2003. The mortality rate of 118 per 1,000 children under 5 has not changed since 1990. Some seven percent of São Toméan children experience low birth weight, and 13 percent of children under the age of 5 are malnourished. Approximately 29 percent suffer from moderate to severe stunting, and four percent suffer from moderate to severe wasting.

UNICEF, the United Nations organization for children, has promoted programs designed to increase vaccination coverage, eliminate polio and neonatal tetanus, and improve the health and nutritional status of women and children. As a result, childhood immunizations have risen in São Tomé and Principe. In 2003, immunizations for children between the ages of 12 and 23 months were reported at 87 and 94 percent for measles and DPT3 respectively. In 2002, 99 percent of infants were immunized against tuberculosis, 85 percent against measles, 93 percent against polio, and 92 percent against DPT. Some 23 percent of children under the age of 5 sleep under insect-repelling netting. One-fourth of São [Page 956]Toméan children receive lifesaving oral rehydration therapy when needed, and 61 percent are given antimalarial drugs.

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