West Africa’s Development, the West African Diaspora, and Preparation for Future Pandemics: The Need for an ECOWAS University System

Abstract

This paper examines future pandemics in West Africa, the region’s development, the role of the West African diaspora, especially in the United States, and the need to establish an Economic Community of West African States (ECOWAS) University System. West African countries were not as seriously impacted by the COVID-19 pandemic in terms of infections and deaths. With an area of 6.144 sq. km (62% of the area of the United States), it is endowed with important natural resources, including, gold, diamonds, oil, natural gas, fish, uranium, timber, phosphates, bauxite, iron ore, arable land, coal, rubber, and hydropower. It has one of the fastest-rising and youngest populations in the world, increasing from 261 million in 2006 to 442 million in 2023. West Africa has made significant economic and social progress in the past two decades. Its infant mortality rate declined from 86.40 deaths per 1000 of the population in 2006 to 48.7 deaths per 1000 in 2020. Its death rate declined from 14.47 deaths per 1000 of its population in 2005 to 7.9 deaths per 1000 in 2020. Its GDP increased from $377.84 billion in 2005 to $1.714 trillion in 2021. West African immigrants in the United States, in addition to Black Americans of West African descent, are a big portion of the 50.1 million population, with a net worth of $6.21 trillion as of December 31, 2022. They have contributed substantially to the economic and social progress in West Africa. The spending power of Black Americans by 2020 was $1.6 trillion. By December 31, 2022, there were 5.547 million Black Americans aged 18 and over with at least a bachelor’s degree, and 442,000 with doctoral degrees. In 2019, West Africans accounted for 926,000 (44.2%) of the 2,094,000 African immigrants in the United States. In 2019, 41% of African immigrants in the United States aged 25 and over had at least a bachelor’s degree. In 2015, African immigrants in the United States earned $55.1 billion and paid $10.1 billion in federal taxes and $4.7 billion in state taxes. In 2022, remittances to West Africa were $33 billion. The paper recommends that to prepare for future pandemics, ECOWAS must establish a University System with campuses located in each member state. Each campus must have a university hospital, with research centers or institutes. ECOWAS must collaborate with the West African diaspora in the United States to teach or work at the ECOWAS University System in person or remotely. The West African diaspora must also establish a fund for the ECOWAS University System that must be no less than $2 billion.

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Kaba, A. (2024) West Africa’s Development, the West African Diaspora, and Preparation for Future Pandemics: The Need for an ECOWAS University System. Sociology Mind, 14, 69-94. doi: 10.4236/sm.2024.141005.

1. Introduction

During the period from the 1990s to 2005, the people of West Africa experienced many difficult interrelated challenges, including civil wars, disease epidemics, food scarcity, and low economic growth ( Ifediora & Aning, 2017 ; Kaba, 2006a , 2007a ; M’Cormack-Hale, 2013 ; Robinson, 2015 ). In addition, during this same period, when one compared West Africa to the other four regions of Africa on many development and social indexes, the region underperformed. For example, in 2006, while the infant mortality rate in Africa was 73.68 deaths per 1000 live births, the average was 86.40 (94.18 for boys and 78.39 for girls) deaths per 1000 for Western Africa. While as of 1995, 60.48% of people aged 15 or over in Africa could read and write, the figure was 40.7% in Western Africa. In 2004, of the 49 nations classified by the United Nations Population Division as least developed nations, African nations accounted for 34 (69%). Of the 34 African nations on the list, Western African nations accounted for 12 (35.3%), meaning that 12 (75%) out of the 16 nations of Western Africa were classified as least developed nations in 2004 ( Kaba, 2007a: pp. 79-80 ; Kaba, 2014 ).

However, by 2023, West Africa has made substantial economic and social progress when compared to itself three decades earlier or when compared with the other four regions of Africa during this same period. Indeed, this current paper shows that the region of Western Africa contributed to the total GDP and per capita GDP of Africa being as high as it is in 2021 (Tables A1-A6 in Appendix), despite the emergence of COVID-19 in January 2020, which resulted in both economic and human devastations ( Kaba & Nkweti Kaba, 2020 ), its GDP per capita in 2021 was $4115. The region is also withstanding the European World War between Russia and Ukraine and its North Atlantic Treaty Organization (NATO) supporters. The region of Western Africa is also experiencing relative peace and political and social stability, despite coup d’état in Burkina Faso, Guinea, Mali, and Niger in recent years. These events have not resulted in civil wars in West Africa such as what was experienced in Liberia or Sierra Leone in the 1990s. On the other hand, countries such as The Gambia, Ghana, Nigeria, and Sierra Leone have all had presidential and national elections in recent years without any significant post-election violence ( Luciano & Júnior, 2023 ; Júnior & Luciano, 2020 ). By 2023, one can argue by utilizing basic facts to illustrate that West Africa has relative peace when compared to Europe and the United States ( Piazza, 2023 ; Prazeres et al., 2023 ; Thompson & Tapp, 2023 ).

This paper examines the gradual economic and social progress of the region categorized by the United Nations Population Division as Western Africa in the past three decades and the preparedness of the region for future pandemics after not being severely impacted by COVID-19, especially infections and deaths from the virus. The reason for the focus on West Africa and ECOWAS is that the region was seriously impacted by the Ebola epidemic of 2014-2016, “… with more than 28,600 cases and 11,325 deaths” ( 2014-2016 Ebola Outbreak in West Africa, 2019 ). The paper begins by presenting natural resources, economic development, and social progress data illustrating that Western Africa has experienced visible economic and social progress in the past three decades. Next, the paper presents the factors responsible for the gradual economic and social progress in Western Africa. Next, the paper presents the implications as a result of this important development. Finally, the paper recommends that the Economic Community of West African States (ECOWAS) must establish a University System, with campuses in different parts of the region to prepare for future pandemics and improve the quality of life of the people in the region. The significance of this recommendation is that while West Africa was not seriously affected by the COVID-19 pandemic, it is important to prepare for future pandemics because of limited medical resources in the region to fight such pandemics.

2. Examples Illustrating Economic and Social Progress in Western Africa in the Past Three Decades

The region categorized by the United Nations Population Division as Western Africa is a vast geographic area, with very fertile land for agriculture, and rich in natural and human resources. As of 2020, the 15 member nations of ECOWAS (Benin, Burkina Faso, Cabo Verde, Cote d’Ivoire, The Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone, and Togo) had a total area of 5.113 million sq. km (5,030,461 sq. km of land and 82,248 sq. km of water), which is 52% of the 9.8334 million sq. km of the United States (9.2 sq. km of land and 685,924 sq. km of water) ( Sackeyfio & Kaba, 2022: p. 206 ). Mauritania, a Western African country that is not an ECOWAS member has a total area of 1,030,700 sq. km (1,030,700 sq. km of land and 0 sq. km of water). This means that Western Africa’s total area of 6.144 million sq. km, is 62.5% of the 9.8334 million sq. km of the United States.

Pertaining to its great wealth in natural resources, according to the 2023 CIA World Factbook, These Western African countries are endowed with the following natural resources: Benin: small offshore oil deposits, limestone, marble, timber; Burkina Faso: gold, manganese, zinc, limestone, marble, phosphates, pumice, salt; Cabo Verde: salt, basalt rock, limestone, kaolin, fish, clay, gypsum; Cote d’Ivoire; petroleum, natural gas, diamonds, manganese, iron ore, cobalt, bauxite, copper, gold, nickel, tantalum, silica sand, clay, cocoa beans, coffee, palm oil, hydropower; The Gambia: fish, clay, silica sand, titanium (rutile and ilmenite), tin, zircon; Ghana: gold, timber, industrial diamonds, bauxite, manganese, fish, rubber, hydropower, petroleum, silver, salt, limestone; Guinea: bauxite, iron ore, diamonds, gold, uranium, hydropower, fish, salt; Guinea-Bissau: fish, timber, phosphates, bauxite, clay, granite, limestone, unexploited deposits of petroleum iron ore, timber, diamonds, gold, hydropower; Mali; gold, phosphates, kaolin, salt, limestone, uranium, gypsum, granite, hydropower, note, bauxite, iron ore, manganese, tin, and copper deposits are known but not exploited; Mauritania; iron ore, gypsum, copper, phosphate, diamonds, gold, oil, fish; Niger; uranium, coal, iron ore, tin, phosphates, gold, molybdenum, gypsum, salt, petroleum; Nigeria; natural gas, petroleum, tin, iron ore, coal, limestone, niobium, lead, zinc, arable land; Senegal: fish, phosphates, iron ore ; Sierra Leone: diamonds, titanium ore, bauxite, iron ore, gold, chromite: and Togo: phosphates, limestone, marble, arable land ( CIA World Factbook, 2023 ; Kaba, 2007a: p. 77 ; Musibau et al., 2022: p. 2 ). In addition, most of Western Africa is very green and fertile, with an abundance of water beneath and above its soil. Kohnert (2023) writes of the “West African regions where water is plentiful…”.

The most important natural resource of Western Africa is its massive young and talented population. Western Africa is also one of the most populous and youngest regions in the world, including the youngest country in the world (Niger) located in the region. The total population of Africa is rising rapidly compared with other regions of the world, contributing tens of millions of people to the estimated 80 million people added to the world population annually in the past decade. In recent years, the continent’s total population has been growing by 20 million to 30 million people annually, out of the total estimated 80 million annual increases to the world population. For example, Africa’s total population increased by an estimated 624.7 million from 823.5 million in July 2001 to 1.448 billion in July 2023. Western Africa is one of the five regions of Africa contributing substantially to this massive population increase in Africa. In July 2006, of Africa’s 910.84 million people, Western Africa accounted for 260.9 million (28.6%). In July 2023, of Africa’s total population of 1.448 billion, Western Africa accounted for 442 million (30.52%) ( Kaba, 2007a: pp. 78-79, Tables 1-6 ). From 2020 to 2023, Western Africa’s total population increased by 37.87 million (9.4%), from 404.14 million (30%) of Africa’s 1.341 billion people to 442 million. Of Western Africa’s 404.14 million people in July 2020, 40.6% were under the age of 15 ( Kaba, 2020: pp. 230-232 ). By July 2023, Western Africa’s population of 442 million is 102 million more than the 340 million people in the United States during this same period.

The relatively high total fertility rates in Western African countries have contributed substantially to the massive population increase in the region. The average total fertility rate in Africa is slowly declining. However, the rate for Western African countries is still relatively high, with Niger (7 births per woman) being the highest in the world. For example, in 2006, the average total fertility rate in Africa was 4.68 children born per woman. The figure was 5.22 in Western Africa ( Kaba, 2007a: pp. 78-79 ). This is the main source driving West Africa’s massive population growth in the 21st century. For example, as of 2020, the average total fertility rate in Africa was 4.3 births per woman. The figures were higher for the following Western African countries than the Africa average: Burkina Faso, 4.51; Sierra Leone, 4.62; Nigeria, 4.72; Guinea Bissau, 4.75; Liberia, 4.9; Guinea, 4.92; Benin, 5.53; Mali, 5.72; and Niger, 7. The following Western African countries have fertility rates higher than the world average of 2.42: The Gambia, 3.21; Mauritania, 3.65; Cote d’Ivoire, 3.67; Ghana, 3.9; Senegal, 4.04; and Togo, 4.22. The only country in Western Africa below the world average is Cabo Verde, 2.16 ( Kaba, 2020: pp. 234, 259 ).

Western African countries have experienced substantial progress in reducing their relatively high infant mortality rates in the past two decades. For example, in 2006, while the average infant mortality rate in Africa was 73.68 deaths per 1000 live births (79.67 for boys and 67.50 for girls), the average for Western Africa was 86.40 deaths per 1000 live births (94.18 for boys and 78.39 for girls) However, in 2020, the average infant mortality rate in Africa declined to 42.8 deaths per 1000 live births (47.4 deaths for males and 38 deaths for females), and the figure for Western Africa declined to 48.7 deaths per 1000 live births (53.7 deaths for males and 43.5 deaths for females) ( Kaba, 2020: pp. 235-236 ).

Western African countries have also experienced substantial declines in their overall death rates. For example, the average death rate in Africa in 1977 was 19 deaths per 1000 of the population, and the figure was 23 deaths in Western Africa. The world average in 1977 was 12 deaths per 1000 ( Abate, 1978: p. 15 ). In 2005, the average death rate in Africa was 14.76 deaths per 1000 of the population, and the figure was 14.47 deaths in Western Africa. By 2020, the average death rate in Africa improved to the point that it was lower than those of the United States, China, and the European Union. For example, in 2020, the average death rate in Africa was 7.8 deaths per 1000 of the population: 10.3 deaths in Southern Africa; 8.4 deaths in Middle Africa; 7.9 deaths in Western Africa; 7.6 deaths in Eastern Africa; and 5.6 deaths in Northern Africa. For comparison, in 2020, the average death rate in the world was 7.7 deaths per 1000; 10.7 deaths in the European Union; 8.3 deaths in the United States; and 8.2 deaths in China ( Kaba, 2020: p. 237 ).

The proportion of people enrolled in tertiary education in Western Africa has increased significantly in recent decades. For example, in 1970, the gross enrollment ratio in tertiary education in Sub-Saharan Africa was less than 1%. By 2008 that figure increased to 6 percent, but an average of 26% for the world. However, in 1970, there were fewer than 200,000 students enrolled in tertiary education in Sub-Saharan Africa. In 2008, that figure increased to over 4.5 million students. The Gross Enrollment Ratio (GER) in tertiary education in Sub-Saharan Africa increased at an average rate of 8.6% every year from 1970 to 2008, but 4.6% during that same period for the world average. By 2009, the GER in tertiary education exceeds the 6% average for the following Western African nations: 14.9% in Cabo Verde; 9.2% in Guinea; 8.4% in Côte d’Ivoire; 8% in Senegal; and 6.2% in Ghana ( Kaba, 2020: p. 241 ).

From 2011 to 2018, the “school enrollment, tertiary (% gross)” was 9% in Sub-Saharan Africa. It was 5% or more in the following Western African nations: 24% in Cabo Verde (2018); 16% in Ghana (2018); 15% in Togo (2018); 13% in Senegal (2018); 12% in Benin (2017): 12% in Guinea (2014); 12% in Liberia (2012); 10% in Nigeria (2011); 9% in Cote d’Ivoire (2017); 7% in Burkina Faso (2018); and 5% in Mali (2017) and 5% in Mauritania (2017). The cumulative percent of women aged 25 and over in Western African nations who had completed “short-cycle tertiary” education with 5% or more are as follows: 13.8% in Nigeria (2006); and 10.5% in Cabo Verde (2015). The cumulative percent of men aged 25 and over in Western African nations who had completed “short-cycle tertiary” education with 5% or more are as follows: 20.8% in Nigeria (2006); 9% in Cabo Verde (2015); 7.1% in Cote d’Ivoire (2014); 6.9% in Senegal (2017); 5.2% in Guinea (2010); and 4.7% (almost 5%) in Ghana (2010) ( Kaba, 2020: pp. 240-241 ).

As a result of the examples presented above, Western Africa is gradually increasing its wealth. For example, Africa’s combined total GDP (PPP) was estimated at 2.366 trillion in 2005. Of that total, Western Africa’s share was $377.84 billion (16%) ( Kaba, 2007a: p. 80 ). In 2017, Western Africa’s total GDP of $1.608 trillion was 29.1% of Africa’s total GDP of $5.519 trillion ( Kaba, 2020: p. 239 ). In 2021, of Africa’s total GDP of $6.675 trillion, Western Africa accounted for $1.714 (25.7%) trillion, with a per capita GDP of $4115 (Tables A1-A6). This is despite the economic devastations of COVID-19 and the ongoing European World War.

3. Factors Responsible for the Gradual Economic and Social Progress in Western Africa

There are many interrelated factors that have contributed to the gradual economic and social progress in Western Africa. People of Black African descent now residing especially in the West for hundreds of years and those who emigrated in the post-World War II era are now contributing to West Africa’s development. According to Kaba (2011a) , there were four types of slavery that affected Black Africans during the period from 1400 to 1900: the Trans-Atlantic Slave Trade, the Trans-Saharan Slave Trade, the Indian Ocean Slave Trade, and the Red Sea Slave Trade. The Trans-Atlantic Slave Trade impacted the entire Western Africa region immensely. For example, from 1400 to 1900, estimates ranging from 9 million to 100 million people were captured in Africa and enslaved in the New World. Of the 19 African nations that lost at least 100,000 of their members through one or more of the four slave trades, 10 (52.6%) are from Western Africa: Angola, 3,607,020 (23%) of 15.68 million; Nigeria, 2,021,859 (12.9%); Ghana, 1,614,793 (10.3%); Ethiopia, 1,447,455 (9.2%); Sudan, 863,962 (5.5%); Mali, 841,697 (5.4%); Democratic Republic of the Congo, 766,515 (4.9%); Mozambique, 625,862 (4%); Tanzania, 534,826 (3.4%); Chad, 528,862 (3.4%); Benin, 456,583 (2.9%); Senegal, 376,926 (2.4%); Guinea, 350,149 (2.2%); Togo, 289,634 (1.8%); Guinea-Bissau, 180,752 (1.1%); Burkina Faso, 167,201 (1.1%); Mauritania, 164,434 (1%); Malawi, 125,431 (0.8%); and Madagascar, 125,275 (0.8%) ( Kaba, 2011a: pp. 93-95, 2012a ). The following 12 African nations lost at least 100,000 of their members to the Trans-Atlantic Slave Trade from 1400 and 1900, with 9 of them from Western Africa: Angola (3,607,020), Ghana (1,614,793), Nigeria (1,406,728), Democratic Republic of the Congo (759,468), Benin (456,583), Mozambique (382,378), Guinea (350,149), Mali (331,748), Togo (289,634), Senegal (278,195), Guinea Bissau (180,752), and Burkina Faso (167,201). Of the 6.635 million people captured in Western Africa and transported through all four slave trades from 1400 to 1900, 5.221 million (78.7%) were through the Trans-Atlantic slave trade ( Kaba, 2006b, 2011a: pp. 93-95, 106 ).

Today, in the New World, especially in the United States alone, people of Black African descent are now in the tens of millions and making important contributions to the United States and the world. For example, as of July 1, 2022, the Black population in the United States was over 50 million (50,087,750; 25,903,565 females and 24,184,185 males), accounting for (15%) of the 333,287,557 total population of the United States ( Annual Estimates of the Resident Population by Sex, Race, and Hispanic Origin for the United States: April 1, 2020 to July 1, 2022, 2023 ). As an entity, this nation of people of Black African descent outside of Africa is one of the richest and most highly educated entities in the world. For example, as of December 31, 2022, the net worth of people in the United States was $137.64 trillion: $113.2 (82.2%) trillion for Whites; $6.21 (4.5%) trillion for Blacks; $4.24 (3.08%) trillion for Hispanics; and $13.99 (10.16%) trillion for ‘others’ (e.g. Indians, Chinese, etc.). On March 31, 2023, the net worth of Black Americans increased to $6.25 trillion, accounting for 4.45% of the total net worth in the United States of $140.59 trillion. On March 31, 2013, the figure was $2.8 trillion ( Distribution of Household Wealth in the U.S. since 1989, 2023; Kaba, 2017 ). Melancon (2021) points out that: “In 2020, African American economic clout energized the U.S. consumer market as never before. The buying power of African Americans rose to $1.6 trillion, or 9% of the nation’s total buying power”.

As of December 31, 2022, of 18.798 million Black women aged 18 and older in the United States, 3.18 million had at least a bachelor’s degree; 1.591 million with a master’s degree; 158,000 with professional designers, such as MD or JD; and 281,000 with doctoral degrees such as Ph.D., Ed.D., etc. For 15.987 million Black men aged 18 and older in December 2022, the figures were 2.367 million with at least a bachelor’s degree; 862,000 with a master’s degree; 128,000 with professional degrees; and 161,000 with doctoral degrees ( Table 1. Educational Attainment of the Population 18 Years and Over, by Age, Sex, Race, and Hispanic Origin: 2022, 2023 ; Kaba, 2009a , 2011b , 2013 ).

In the general labor force in the United States, in 2021, of the 140.516 million people aged 25 and over in the civilian labor force in the United States, 60.827 million (43.3%) had at least a bachelor’s degree: 29.965 million (40%) out of 74.939 million for men; 30.863 million (47.1%) out of 65.577 million for women; 2.510 million (29.7%) out of 8.440 million for Black men; and 3.532 million (38.1%) out of 9.283 for Black women ( Labor Force Characteristics by Race and Ethnicity, 2021, 2023, Table 6 ). In 2021, of 152.581 million people aged 16 and over in the civilian labor force in the United States, 42.4% were in management, professional, and related occupations, the top job category in the country; 38.5% out of 80.829 million males; 46.9% out of 71.752 million females; 47.7% out of 54.476 million White females; 39.6% out of 9.851 million Black females; 38.7% of 63.814 White males; and 27.6% out of 8.875 million Black males ( Labor Force Characteristics by Race and Ethnicity, 2021, 2023, Table 7 ).

Pertaining to those Africans who emigrated to the United States in the post-World War II era, according to Tamir and Anderson (2022) , in 2019, there were 4.6 million Black people residing in the United States who were born in another country. The Black African-born population in the United States increased from 560,000 in 2000 to 1.9 million in 2019 (p. 7). According to Lorenzi and Batalova (2022) , out of 2,094,000 African immigrants in the United States in 2019, 926,000 (44.2%) were from Western Africa ( Lorenzi & Batalova, 2022 ). It is reported that: “The share of Western African migrants residing in North America rose from 3 percent of all emigrants from Western Africa in 1990 to 10 percent at mid-year 2020, and the share in Europe rose from 12 percent to almost 19 percent during the same period” ( Migration Data in Western Africa, 2023 ; Kaba, 2011c ).

African immigrants in the United States: “… punch well above their weight in many respects. For example, they naturalize at high rates. They attain higher levels of education than the overall U.S. population as a whole, and are more likely to have earned their degree in a Science, Technology, Engineering, and Math, or STEM, field. They also make meaningful contributions to several vital sectors of the economy—including healthcare—where employers have persistent challenges finding enough workers” ( Power of the Purse, 2018: p. 1 ). The United States has benefited enormously from the immigration of highly educated and highly skilled people from Western Africa. Most Africans including Western Africans who earn their doctoral degrees in the United States decide to stay and work in the United States. It is noted that: “… the United States was the destination for 59 percent of Nigeria’s high-skilled immigrants and 47 percent of those from Ghana. In addition to their high levels of education, 70 percent of African immigrants arrive in the United States with full fluency in English, a significant advantage on the job market that also helps ease their assimilation into American society” ( Power of the Purse, 2018: p. 10 ).

According to Gambino et al. (2014: p. 9) , from 2008 to 2012, 27.6% of the foreign-born population in the United States had a bachelor’s degree or more: Africa born, 41.5%; Ghana, 34.9%; and Nigeria, 60.9%. In 2015, the proportion of African immigrants in the United States aged 25 and over with at least a bachelor’s degree was 40%, compared with 30.9% of the U.S.-born population and 29.7% of the immigrant population. “Almost one out of every six African immigrants had … [at least a graduate degree] in 2015, compared to 11.4 percent of natives” ( Power of the Purse, 2018: p. 9 ). Corra (2023: p. 8) notes that in 2015: “… a total of 16% of African immigrants had a master’s degree, medical degree, law degree or a doctorate, compared with only 11% of the U.S.-born population…” (also see Thomas, 2023: pp. 246-271 ). According to Tamir and Anderson (2022) , in 2019, the proportion of all immigrants in the United States aged 25 and over with at least a bachelor’s degree was 33%; and 31% for Black immigrants. However, the figure was 41% for African immigrants: Nigeria, 64%, Cameroon, 53%, Kenya, 47%, Ghana, 41%, Liberia, 34%, Ethiopia, 30%, Trinidad and Tobago, 28%, Jamaica, 25%, Guyana, 24%, Dominican Republic, 19%, Haiti, 18%, Somalia, 11%; and U.S. Immigrants, 33%, U.S Black Immigrants, 31% (p. 21; Mazrui & Kaba, 2016 ; Kaba, 2007b ).

It is noted that “Sub-Saharan African immigrants with a college degree are also considerably more likely than the broader population to have studied the Science, Technology, Engineering, and Math (or STEM) fields that help U.S. employers remain competitive”. In 2015, among immigrants from Sub-Saharan Africa with a college degree, 33.4% majored in a STEM discipline. For those born in the United States, it is 25.2% ( Power of the Purse, 2018: p. 10 ; Corra, 2023: p. 8 ).

In 2015, the proportion of African immigrants in the United States older than 65 years was 6.7%, but 14.9% for people born in the United States. There were 90,000 entrepreneurs in the United States who were born in Africa in 2015 ( Power of the Purse, 2018: p. 8 ). It is noted that African immigrants in the United States: “… are overwhelmingly of prime working age, with 73.4 percent—or close to 1.3 million people—falling between the ages of 25 and 64. By comparison, less than half of the U.S.-born population falls into that age band, a reality that has created strain in recent years on everything from the housing market to our country’s entitlement programs” ( Power of the Purse, 2018: p. 8 ). African immigrants in the United States are also reported to be “… more likely to be contributing to the U.S. workforce than they are to be disabled, sick, or still in school” ( Power of the Purse, 2018: p. 8 ). Pertaining to African immigrant women in the United States aged 16 and over, 69.2% were in the labor force in 2015, compared with 58.6% of native-born women, and 55.5% of immigrant women ( Power of the Purse, 2018: p. 9 ).

Hubbard and Lundh (2023) claim that in 2021, 719,000 Black immigrants were employed in the healthcare and social assistance industry, accounting for 3.3% of its total workforce: 152,000 employed as home health and personal care aides; 130,000 as registered nurses; and 16,000 as physicians. It is noted that in 2015, 339,491 African immigrants worked in healthcare and social services industry, accounting for 30% of them employed in the healthcare sector, compared with 13% of the U.S.-born population working in the healthcare sector ( Power of the Purse, 2018: p. 10 ). “In 2015, 6.5 percent of the foreign-born African population—or more than 73,000 workers—held STEM jobs” ( Power of the Purse, 2018: p. 11 ). In 2015, there were 46,663 African immigrant nurses in the United States, 13,240 postsecondary teachers, and 15,720 physicians and surgeons ( Power of the Purse, 2018: p. 12 ). In 2015, there were 90,000 entrepreneurs in the United States who were born in Africa ( Power of the Purse, 2018: p. 2 ). In 2015, 24% of African immigrants “…were working as nursing, psychiatric, and home health aides. Another 19 percent worked as registered nurses, while five percent were physicians or surgeons” ( Power of the Purse, 2018: p. 11 : also see Hubbard & Lundh, 2023 ).

In 2019, the median income for Black immigrant-headed households in the United States was $54,700; and $58,600 for all immigrant-headed households. “In 2019, a third of African-born immigrant households owned their homes, while around half of Caribbean immigrant households (49%) owned their homes” ( Tamir & Anderson, 2022: p. 31 ). In 2019, 19% of African immigrant households had income of $50,000 to $74,999; 12% had household income of $75,000 to $99,999; and 23% had incomes of $100,000 or more ( Tamir & Anderson, 2022: p. 28 ).

These factors for West Africa’s gradual economic and social progress cited above are the foundation for the region’s place in the international community in the future. They are the engines that will drive the region’s development in the decades and centuries to come.

4. Implications of West Africa’s Gradual Economic and Social Progress

These two groups of Africans in the United States discussed above have advocated for West African nations and African nations in general in the United States federal and state governments, and in the international community. They have also sent remittances to Western Africa and Africa and are also making various investments in the region and in Africa as a whole. For example, Kaba (2004) and M’Cormack-Hale and Kaba (2015) present many examples illustrating the support of the Black American population from West Africa and Africa within the United States federal government. Since the emergence of COVID-19 in January 2020, a significant number of people of Black African descent have bought land in Africa and built homes, wells, or boreholes, planted fruit-producing trees, and built structures. Many diasporans from the West now spend significant time during the year in Africa ( Kaba, 2021 ; Agoro, 2018 ). A significant number of people of West African descent, who are descendants of the European slave trade, are influential and hold many important positions in almost every sector in the United States ( Kaba, 2006b , 2007c , 2010 ). They are prominent or world-class scholars and scientists of all kinds, politicians, professional athletes and entertainers, writers and poets, businessmen and women, etc. ( Kaba, 2004 , 2007a: p. 85 , 2012b , 2012c , 2019 ). As Holsey (2020) notes:

“The late 20th century has seen the travel of diasporic subjects to West African countries including Ghana, The Gambia, and Senegal, which have fashioned themselves as African homelands. Artists, activists, and migrants continue to travel back and forth between West Africa and various points in the African diaspora and, in doing so, shape the contours of the Black Atlantic World. The continuous communication and contact between West Africa and the diaspora constitute an ongoing dialogue that has led to cultural innovations on both sides of the Atlantic.”

Agoro (2018) points out that: “… new diaspora-focused strategies should be devised to more efficiently support the continent economically. One related project could involve diaspora seeding of high-production local businesses such as raw-materials-processing and pharmaceuticals factories, which in turn could help stem talent outmigration”. Kaag et al. (2019: pp. 4, 7) note that: “Starting from the question about how land investments and migration trajectories of West African youth and their families are interrelated, each case study has explored the influence of remittances, return migration, and character of the diaspora (old, new, males, families) on land investments… Houses built through diaspora investments are often long-term projects of incremental building. These depend on how well the migrant fares abroad and how much he is able to save and send home”.

In 2022, remittances to Sub-Saharan African countries accounted for $53,137,381,322. Of that total, Western African countries accounted for $33,015,357,923 (62.13%): $20,127,614,151 to Nigeria; $4,664,284,053 to Ghana; $2,500,000,000 to Senegal; $1,131,000,000 to Mali; $650,385,610 to Togo; $615,432,852 to The Gambia; $588,577,500 to Burkina Faso; $527,275,700 to Guinea; $500,000,000 to Niger; $360,180,000 to Côte d’Ivoire; $346,244,092 to Liberia; $313,360,800 to Cabo Verde; $232,000,000 to Sierra Leone; $231,000,000 to Benin; $178,003,165 to Guinea-Bissau: and $50,000,000 to Mauritania ( Personal Remittances, Received (Current US$)—Sub-Saharan Africa, 2024 ; Ratha & Plaza, 2011 ). Agoro (2018) claims that: “The World Bank Household Survey 2009, conducted in Burkina Faso, Nigeria, Senegal, Kenya, and Uganda, confirmed that food, health, education, and new home construction are among the most common uses for diaspora remittances”.

Black immigrants in the United States, including those from Africa contribute substantially to the economy of the United States. They are also increasing their naturalization rates, which is resulting in increasing political influence in national elections in the United States. For example, Hubbard and Lundh (2023) claim that in 2021, Black immigrant households in the United States earned $153 billion and paid $39 billion in taxes, including $24 billion in federal income tax and $15 billion in state and local taxes, leaving them with $114 billion to spend “money households used to support American businesses, invest in housing, and more. As the Black immigrant population grows, so does their spending power—it increased by 7.1% from 2018 to 2021”. In 2015, African immigrant households in the United States earned $55.1 billion, and they paid $10.1 billion in federal taxes and $4.7 billion in state and local taxes, with $40.3 billion left to spend ( Power of the Purse, 2018: p. 2 ).

It is reported that the spending power of households led by foreign-born African immigrants was $4.7 billion in Texas; $4.6 billion in California; $4 billion in Maryland; and $3.4 billion in New York. “In fact, despite their relatively small numbers, households led by foreign-born Africans hold spending power greater than $1 billion in a total of 12 U.S. states. This group includes states as varied as Georgia, Virginia, and Minnesota” ( Power of the Purse, 2018: p. 3 ). In 2015, African immigrants in the United States were also reported to have paid $5.8 billion in taxes to the Medicare system, and $1.6 billion in taxes to the Social Security system in the United States ( Power of the Purse, 2018: p. 3 ).

In 2015, there were 20 million naturalized immigrant citizens in the United States eligible to vote in U.S. elections, and that figure was projected to increase to 21.2 million in 2020 ( Power of the Purse, 2018: p. 16 ). Hubbard and Lundh (2023) claim that although Black immigrants in the United States are relatively small in size, they tend to be concentrated in selected cities and states. In the past two decades, national elections, including presidential elections in the United States have been very close. Therefore “every vote counts”. As a result, “ … they may be able to exert more considerable electoral pressure in state or local elections. For example, while there were 2.4 million eligible Black immigrant voters in the United States in 2021, a full 38.7% of those voters lived in either New York state or Florida”. It is noted that, African immigrants “… are one of the most politically engaged immigrant groups in the United States” ( Power of the Purse, 2018: p. 16 ). In 2015, 53.2% of African immigrants in the United States were naturalized U.S. citizens. In the 2014 national elections in the United States, 38% of eligible naturalized African immigrants voted; the rate was 34% for all immigrants; and their turn out rate in that 2014 national elections was 43 percent. “In cities that have been home to large African populations for decades—namely Minneapolis, Minnesota, and Clarkston, Georgia—African immigrants have run for local government and been elected to city council positions” ( Power of the Purse, 2018: p. 16 ; also see Kaba, 2009b , 2011d ). Let us now examine the need to prepare for future pandemics by establishing an ECOWAS University System.

5. Establishment of an ECOWAS University System

To prepare for future pandemics, which are almost certain to emerge, this paper recommends that ECOWAS establish a University System in the region, with campuses located in every member state based on the country’s strategic location, demographic profile, and current infrastructure. Each ECOWAS University campus must have a medical school, a hospital, and medical research center or institute. These medical research centers shall collaborate with existing hospitals and medical research centers that are already established by the national government of each member country of ECOWAS.

In an article arguing for a fully-fledged African Union, Kaba (2009b: p. 108) recommends that the African Union must establish a continent-wide University System, with at least one major campus in each of the five regions of the continent. The evidence shows that as each of the five regions in Africa continues to form and strengthen economic and political organizations such as the East African Community (EAC), the Common Market for Eastern and Southern Africa (COMESA), and the Southern Africa Development Community (SADC), ECOWAS is observed to be making meaningful and gradual progress, especially as it pertains to the free movement of people. Indeed, this free movement of people in ECOWAS member countries, with an ECOWAS passport in recent years, may be contributing to the gradual economic, political, and social progress in the region as the examples presented above illustrate.

In mid-year 2020, of the 7.4 million migrants residing in Western Africa, “nearly 90%” were from other Western African countries. Of the 7.4 million migrants living in Western Africa in mid-year 2020, 2,564,857 (34.6%) were living in Côte d’Ivoire; 1,308,568 (17.6%) in Nigeria; 723,989 (9.8%) in Burkina Faso; 485,829 (6.6%) in Mali; 476,412 (6.4%) in Ghana; 394,276 (5.3%) in Benin; 348,056 (4.7%) in Niger; 279,936 (3.8%) in Togo; 279,929 (3.8%) in Senegal; and 215,659 (2.9%) in The Gambia. In addition, the Top 10 Migration Corridors in Western Africa in mid-year 2020 are as follows: 1,376,350 people from Burkina Faso to Côte d’Ivoire; 562,117 people from Côte d’Ivoire to Burkina Faso; 522,146 people from Mali to Côte d’Ivoire; 377,169 people from Benin to Nigeria; 238,284 people from Ghana to Nigeria; 195,271 people from Côte d’Ivoire to Mali; 172,481 people from Mali to Nigeria; 167,516 people from Guinea to Côte d’Ivoire; 158,262 people from Togo to Nigeria; and 154,739 people from Senegal to The Gambia ( Migration Data in Western Africa, 2023 ). These figures also illustrate that ECOWAS countries must stop implementing sanctions against one another because doing so inflict economic and social pain on their own countries. As the examples above illustrate, the people of Côte d’Ivoire are the people of Burkina Faso, just as the people of The Gambia are the people of Senegal, or the people of Nigeria are the people of Benin.

According to Vhumbunu and Rudigi (2020) :

“United Nations Economic Commission for Africa’s African Regional Integration Index According to UNECA’s African Regional Integration Index Report of 2016, ECOWAS had the highest number of countries that were performing well in the facilitation of free movement of people. This is based on the indicators of whether member states had ratified the REC protocol on free movement of people, proportion of member states whose nationals do not require visas for entry, and proportion of REC member states whose nationals are issued with a visa on arrival. All the ECOWAS member states were implementing the ECOWAS Protocol on the Free Movement of People of 1979, which is assisting to facilitate intraregional trade. Thus ECOWAS was the best performing REC in facilitating the free movement of people with an index score of 0.80, followed by EAC (0.71 score), SADC (0.53 score), AMU (0.49 score), CEN-SAD (0.47 score)” (p. 56; also see Luciano & Júnior, 2023 ; Júnior & Luciano, 2020 ).

Agoro (2018) points out that in 2013, Africa accounted for 1.3% of global R&D expenditure. In 2013, there were 91 researchers per million inhabitants in Sub-Saharan Africa, compared with 495 researchers per million inhabitants in North America. In 2007, there were 1083 researchers in Sub-Saharan Africa per one million inhabitants. The share of international scientific publications for Sub-Saharan Africa in 2014 was 2.6 percent.

The development of West Africa must be in partnership with the West African diaspora in the West. Individual members of the West African diaspora in the West, especially in the United States, are now making significant contributions across the region. Agoro (2018) points out that The African Union refers to the African diaspora as the “… ‘sixth region’ of Africa, consisting of peoples of African origin living outside the continent, irrespective of their citizenship and nationality, who are willing to contribute to the development of the continent”. Agoro (2018) adds that: “Indeed, despite having acquired citizenship elsewhere, many diaspora Africans maintain close ties, often family ties, and intimate interest in their countries of origin”.

By 2023, driving along the newly constructed paved highways on the Western coast of Western Africa from Mauritania down to Nigeria, one would observe active construction projects going on. Indeed, as the remittances data above show, the West African diaspora is pumping tens of billions of dollars into the region annually—funds being utilized for various capital expenditure projects in the region ( Kaag et al., 2019 ; Kaba, 2011c ).

Agoro (2018) points out that:

“Along these lines, ‘African brainpower’ in the diaspora can be said to consist of professionals such as scientists (medical doctors, researchers, and academics), lawyers, and businesspeople. These professionals could work together with African governments and civil-society groups to boost development and accelerate progress toward ending extreme chronic poverty. African diaspora scientists, especially, while still maintaining their work abroad, could assess how their S&T expertise might most effectively spur African development. In doing so, they can work closely with Africa-based entrepreneurs as well as international philanthropists to find the best tools for continental development.”

In the 2000/2001 academic year in the United States, there were 1269 international scholars from Sub-Saharan Africa in the United States. In the 2021/2022 academic year, that figure increased to 2220. There were 29,399 African students from Sub-Saharan Africa enrolled in U.S. colleges and universities during the 2000/2001 academic year. That figure increased to 42,518 students from Sub-Saharan Africa enrolled in U.S. colleges and universities during the 2021/2022 academic year. Of the 42,519 students from Sub-Saharan Africa enrolled in U.S. colleges and universities during the 2021/2022 academic year, those from Western Africa accounted for 22,974 (54%) ( International Students by Place of Origin, 1949/50-2021/22, 2023 ). Of the 2220 international scholars from Sub-Saharan Africa in the United States in the 2021/2022 academic year, 1064 (49.9%) were from West Africa ( International Scholars by Place of Origin, 2000/01-2021/22, 2023 ).

In 2021, of the 17,638 temporary visa holders who earned their doctoral degrees in the United States, 71.3% said they intend to stay in the United States: 74% out of 758 from Africa; 75.5% of 11,557 from Asia; 74.4% of 6148 for China; 86.1% out of 2291 for India; 78.2% out of 193 for Nigeria; 79.5% out of 88 for Ghana. In the seven-year period from 2015 to 2021, there were 5036 temporary visa holders from Africa who earned doctoral degrees from the United States; 954 for Nigeria; and 640 for Ghana ( Table 2-8. Research Doctorate Recipients with Temporary Visas Intending to Stay in the United States after Doctorate Receipt, by Country or Economy of Citizenship: 2015-21, 2023 ).

The West African diaspora should create a fund, with no less than $2 billion at all times, to be utilized for various projects pertaining to the newly established ECOWAS University System. In addition, the West African diaspora must create a system to send experts from various academic fields to go and work at the new ECOWAS University for a year or more. A system must also be set up for remote teaching or instruction in order to tap into the great and massive talent of experts of Western African descent in the diaspora ( Kaba, 2009b: p. 108 ; Agoro, 2018 ).

6. Conclusion

This paper began by explaining that Western Africa has made substantial economic and social progress in the past three decades when compared with itself and with the other four regions of Africa. By 2023, the region is relatively peaceful especially when compared with Europe and the United States. The paper claims that Western Africa is one of the richest regions in the world in natural resources, including human resources. The paper continues by providing examples illustrating the wealth of Western Africa. For example, the region, with a total area of 6.144 sq. km (62% of the area of the United States) is endowed with important natural resources, including, gold, diamonds, oil, natural gas, fish, uranium, timber, phosphates, bauxite, iron ore, arable land, coal, rubber, and hydropower. Western Africa, which has one of the youngest populations in Africa and the world, increased from 261 million in 2006 to 442 million in 2023. Western Africa improved its infant mortality rate from 86.40 deaths per 1000 of its population in 2006 to 48.7 deaths per 1000 of its population in 2020. The death rate in Western Africa declined from 14.47 deaths per 1000 of its population in 2005 to 7.9 deaths per 1000 in 2020. Western Africa’s GDP increased from $377.84 billion in 2005 to $1.714 trillion in 2021, despite the COVID-19 pandemic and the European World War between Russia and Ukraine and its NATO supporters.

One important factor cited for the economic and social progress in Western Africa is the contributions from the African diaspora, especially in the United States. At 50.1 million people in 2022, this powerful group of people of Black African descent in the United States is made up of two main groups: descendants of enslaved Africans, with the majority of them coming from Western Africa, and the post-World War II African emigration to the United States, with Western Africans accounting for 44% of that population in 2019. These two groups of Africans in the United States are among the wealthiest and most educated groups in the world. For example, by December 31, 2022, the net worth of the Black American population was $6.21 trillion. Their spending power by 2020 was $1.6 trillion. By December 31, 2022, there were 3.18 million Black women and 2.367 million Black men aged 18 and over with at least a bachelor’s degree, and 281,000 Black women and 161,000 Black men with doctoral degrees. The African immigrant population in the United States is one of the most educated, with 41% of them aged 25 and over with at least a bachelor’s degree in 2019, and 1 out of every 6 of them with at least a master’s degree. In 2015, African immigrants in the United States earned $55.1 billion and paid $10.1 billion in federal taxes and $4.7 billion in state taxes, leaving them with $40.3 billion to spend in that year alone. These two groups of Africans in the United States have made important contributions to the economic and social progress in Western Africa and Africa as a whole. Among the most powerful people in the world, they have advocated for Western Africa in the United States and in the international community. They have also sent massive amounts of remittances to Western Africa, with the Western African diaspora across the world sending $33 billion in remittances to the region in 2022 alone.

Finally, the paper recommends that to prepare for future pandemics, ECOWAS must establish a University System with campuses located in each member state. Each campus must have a university hospital, with research centers or institutes. ECOWAS must collaborate with the West African diaspora in the United States to teach or work at the ECOWAS University System in person or remotely. The West African diaspora must also establish a fund for the ECOWAS University System that must be no less than $2 billion at any given moment.

Table 1. Educational Attainment of the Population 18 Years and over, by Age, Sex, Race, and Hispanic Origin: 2022 (2023). United States Census Bureau. https://www.census.gov/data/tables/2022/demo/educational-attainment/cps-detailed-tables.html

Table 2-8. Research Doctorate Recipients with Temporary Visas Intending to Stay in the United States after Doctorate Receipt, by Country or Economy of Citizenship: 2015-21 (2023). Survey of Earned Doctorate. National Science Foundation. https://ncses.nsf.gov/pubs/nsf23300/data-tables

Tamir, C., & Anderson, M. (2022, January 20). One-in-Ten Black People Living in the U.S. Are Immigrants. Pew Research Center. https://www.pewresearch.org/race-ethnicity/2022/01/20/one-in-ten-black-people-living-in-the-u-s-are-immigrants/

Thomas, K. J. A. (2023). Highly Skilled African Immigrants: Fields of Study, Education-Occupation Matching, and Earnings in the US Labor Market. In M. Zhou, & H. Mahmud (Eds.), Beyond Economic Migration: Social, Historical, and Political Factors in US Immigration (pp. 246-271). New York University Press. https://doi.org/10.18574/nyu/9781479818570.003.0013

Thompson, A., & Tapp, S. N. (2023, July 5). Criminal Victimization, 2021. Bureau of Justice Statistics. United States Department of Justice. NCJ 305101. https://bjs.ojp.gov/content/pub/pdf/cv21.pdf

Vhumbunu, C. H., & Rudigi, J. R. (2020). Facilitating Regional Integration through Free Movement of People in Africa: Progress, Challenges and Prospects. Journal of African Union Studies, 9, 43-64. https://doi.org/10.31920/2050-4306/2020/9n2a3

Appendix

Table A1. Population of Africa, July 1, 2021, and July 1, 2023, GDP, GDP Growth Rate, and GDP per Capita, 2021.

Source: Data compiled and computed by author based from the 2021 and 2023 CIA World Factbook from July 10, 2023 to August 27, 2023 from: https://www.cia.gov/the-world-factbook/about/archives/2021/africa/; and https://www.cia.gov/the-world-factbook/countries/. Note: Data for Mayotte are from the 2010 World Factbook (2010 population estimates and 2005 GDP and GDP per capita data) and Reunion from the 2006 World Factbook (2006 population estimates and 2005 GDP and GDP per capita data). France has combined the data for these two nations with the population of France. The GDP and GDP per capita figures for Eritrea are 2017 estimates; the GDP and GDP per capita figures for South Sudan are 2017 estimates; the GDP and GDP per capita figures for the Western Sahara are not available, and population totals for Africa for 2021 and 2023 do not include Western Sahara; and data for Saint Helena (GDP and GDP per capita data for FY09/10 est.).

Table A2. Population of Eastern Africa, July 1, 2021, and July 1, 2023, GDP, GDP Growth Rate, and GDP per Capita, 2021.

Source: Data compiled and computed by author based from the 2021 and 2023 CIA World Factbook from July 10, 2023 to August 27, 2023 from: https://www.cia.gov/the-world-factbook/about/archives/2021/africa/; and https://www.cia.gov/the-world-factbook/countries/. Note: Data for Mayotte are from the 2010 World Factbook (2010 population estimates and 2005 GDP and GDP per capita data) and Reunion from the 2006 World Factbook (2006 population estimates and 2005 GDP and GDP per capita data). France has combined the data for these two nations with the population of France. The GDP and GDP per capita figures for Eritrea are 2017 estimates; the GDP and GDP per capita figures for South Sudan are 2017 estimates.

Table A3. Population of Middle Africa, July 1, 2021, and July 1, 2023, GDP, GDP Growth Rate, and GDP per Capita, 2021.

Source: Data compiled and computed by author based from the 2021 and 2023 CIA World Factbook from July 10, 2023 to August 27, 2023 from: https://www.cia.gov/the-world-factbook/about/archives/2021/africa/; and https://www.cia.gov/the-world-factbook/countries/.

Table A4. Population of Northern Africa, July 1, 2021, and July 1, 2023, GDP, GDP Growth Rate, and GDP per Capita, 2021.

Source: Data compiled and computed by author based from the 2021 and 2023 CIA World Factbook from July 10, 2023 to August 27, 2023 from: https://www.cia.gov/the-world-factbook/about/archives/2021/africa/; and https://www.cia.gov/the-world-factbook/countries/. Note: The GDP and GDP per capita figures for the Western Sahara are not available, and population totals for North Africa for 2021 and 2023 do not include Western Sahara.

Table A5. Population of Southern Africa, July 1, 2021, and July 1, 2023, GDP, GDP Growth Rate, and GDP per Capita, 2021.

Source: Data compiled and computed by author based from the 2021 and 2023 CIA World Factbook from July 10, 2023 to August 27, 2023 from: https://www.cia.gov/the-world-factbook/about/archives/2021/africa/; and https://www.cia.gov/the-world-factbook/countries/.

Table A6. Population of Western Africa, July 1, 2021, and July 1, 2023, GDP, GDP Growth Rate, and GDP per Capita, 2021.

Source: Data compiled and computed by author based from the 2021 and 2023 CIA World Factbook from July 10, 2023 to August 27, 2023 from: https://www.cia.gov/the-world-factbook/about/archives/2021/africa/; and https://www.cia.gov/the-world-factbook/countries/. Note: Data for Saint Helena (GDP and GDP per capita data for FY09/10 est.).

Geographic Breakdowns of the Five Regions of Africa (n = 58)

Eastern Africa (n = 20): Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mayotte, Mozambique, Reunion, Rwanda, Seychelles, Somalia, South Sudan, Tanzania, Uganda, Zambia, and Zimbabwe.

Middle Africa (n = 9): Angola, Cameroon, Central African Republic, Chad, Republic of the Congo, Democratic Republic of the Congo, Equatorial Guinea, Gabon, and Sao Tome & Principe.

Northern Africa (n = 7): Algeria, Egypt, Libya, Morocco, Sudan, Tunisia, and Western Sahara.

Southern Africa (n = 5) Botswana, Lesotho, Namibia, South Africa, and Swaziland.

Western Africa (n = 17): Benin, Burkina Faso, Cabo Verde, Cote d’Ivoire, The Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Togo, and Saint Helena.

Source: “Composition of macro geographical (continental) regions, geographical sub-regions, and selected economic and other groupings” Retrieved on January 29, 2019 from: https://unstats.un.org/unsd/methodology/m49/.

Conflicts of Interest

The authors declare no conflicts of interest regarding the publication of this paper.

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