Modern Africa: what shapes the great continent

Start with scale

Africa is home to roughly 1.5 billion people, and United Nations projections suggest that number could approach 2.5 billion by 2050. It is also the youngest continent, with a median age of about nineteen, compared with around thirty-eight in the United States. Those two facts sit underneath almost every policy debate on the continent: how to educate, employ, house and govern a generation that is large, young and increasingly urban.

East and Southern Africa show the range. Kenya, Tanzania, Uganda and Ethiopia are growing fast and urbanizing quickly. South Africa and Botswana are further along the demographic transition, with lower fertility, older populations and different pressures, such as unemployment among educated young adults.

The urban demographic transition

Roughly 45 percent of Africans now live in towns and cities, and the share rises every year. Dar es Salaam, Nairobi, Addis Ababa, Kampala and Lusaka have all grown at rates that would strain any city government. Dar es Salaam in particular is often projected to become one of the world’s megacities within a few decades.

Urbanization changes families. Fertility falls faster in cities than in rural areas, as education, cost of living and access to health care all shift choices. Economists describe a possible demographic dividend: a window in which the working-age share of the population rises relative to children and elders, creating room for faster growth. But the dividend is not automatic. It depends on jobs, and many young urban workers are still in the informal economy, earning day to day without contracts, pensions or protections.

Cities are responding with infrastructure. Addis Ababa opened a light rail system in 2015, one of the first modern systems in sub-Saharan Africa. Dar es Salaam launched a bus rapid transit network in 2016. Nairobi opened an elevated expressway in 2022. Each project raised the same debates found in any big city, including Baltimore: who the new transport serves, what it costs, and who is displaced along the route. The hardest problem remains housing. Large informal settlements house a significant share of urban residents, and upgrading them without pushing people out is one of the defining policy challenges of the era.

Modernizing the civil service

A state is only as good as the people who run its offices. Across the region, governments have worked to make civil services more accountable and easier to deal with.

• Payroll integrity. Biometric registration and payroll audits have removed “ghost workers”, names on the payroll with no real employee behind them, saving significant sums in several countries.
• Performance contracts. Rwanda’s imihigo system, in place since 2006, has local officials sign public performance targets and report against them each year.
• One-stop service. Kenya’s Huduma Centres, opened from 2013, bring many government services under one roof, and its eCitizen portal moved many applications online. Rwanda’s Irembo platform does similar work.
• Service culture. South Africa’s Batho Pele (“people first”) principles, adopted in 1997, set out standards for how public servants should treat citizens. Botswana has long been cited for a professional, relatively low-corruption public service.

Digital government brings new obligations. Kenya passed a Data Protection Act in 2019, and South Africa’s Protection of Personal Information Act came fully into force in 2021. The open question in many seminars is how to keep services usable for people without smartphones, reliable connectivity or formal identity documents.

Mobile money as infrastructure

Kenya’s M-Pesa, launched by Safaricom in 2007, changed how a whole country handles money. It lets people store value on a basic mobile phone and send it by text message, cashing in and out through a dense network of small agents in shops and kiosks. Today the large majority of Kenyan adults use mobile money.

The effects reach well beyond convenience. A widely cited study by economists Tavneet Suri and William Jack, published in Science in 2016, estimated that access to M-Pesa lifted around two percent of Kenyan households out of extreme poverty, with especially strong effects for households headed by women. Being able to receive money quickly from relatives in a crisis, or to save safely, turned out to matter a great deal.

Other countries followed with their own systems. Tanzania became a regional leader in making different providers’ wallets work with each other. MTN Mobile Money spread across Uganda, Zambia and beyond, and Ethiopia launched telebirr in 2021. Savings, credit and insurance products have been layered on top. So have risks: easy digital loans can trap borrowers in debt, fees fall hardest on the poorest users, and fraud follows money wherever it goes. Central banks now treat mobile money as critical financial infrastructure, and cross-border systems such as the Pan-African Payment and Settlement System aim to make payments between African countries cheaper.

Public-health university partnerships

Some of the most productive long-term relationships in global health are partnerships between African and American universities, and Baltimore’s academic medical centers are part of that story.

Makerere University in Uganda and Johns Hopkins have worked together for decades, including through the Rakai Health Sciences Program, which began in the late 1980s. Research in Rakai was part of the evidence, alongside trials in Kenya and South Africa, showing that male circumcision substantially reduces HIV acquisition in men, a finding that shaped prevention programs across the region. In Kenya, the AMPATH partnership links Moi University in Eldoret with a consortium led by Indiana University. In Botswana, a long partnership with the University of Pennsylvania has supported clinical training and research. The University of Maryland’s Institute of Human Virology has run treatment and training programs in several African countries.

The best of these partnerships share some lessons. Local leadership matters most. Training African clinicians and researchers builds capacity that outlasts any grant. Data and samples should benefit the communities that provide them. Critics rightly warn against “parachute research”, where visiting scientists collect data and leave. The founding of the Africa Centres for Disease Control and Prevention in 2017 signaled a continent setting more of its own public-health agenda.

Questions worth asking

For students coming to these topics through a Baltimore seminar, a few questions help cut through the headlines:

1. Which country and which city is this claim about? Continental averages hide enormous variation.
2. Who benefits from this infrastructure, and who pays for it?
3. Is this reform measured by its outputs, such as offices opened and apps launched, or by its outcomes for citizens?
4. In this partnership, who sets the research questions, and who owns the results?

For quiet places to read up before your next class, and the rest of our seminar notes, return to the RMH Baltimore resource guide.