The Lobito Corridor Dilemma: Economic Gains vs Health Risks in Angola’s Heartland

The Lobito Corridor, an ambitious infrastructure project stretching from Angola to Zambia and the Democratic Republic of the Congo, is rapidly gaining momentum as a potential game-changer in regional trade and connectivity. With funding and support from international players like the European Union and the United States, this modern transport initiative aims to breathe new life into the historic Benguela Railway. But beyond its economic allure, the corridor has become the focus of a critical policy brief from the World Health Organization’s Regional Office for Africa, developed in collaboration with UNAIDS, the International Organization for Migration (IOM), and the Health Information Systems Team. This brief underscores the dual nature of development, highlighting the corridor's capacity to improve livelihoods while simultaneously raising the alarm on potential adverse public health outcomes for millions living along its path.

Deep Health Inequities Along the Corridor’s Route

Spanning the Angolan provinces of Benguela, Bié, Huambo, Moxico, and Moxico Leste, the Lobito Corridor cuts through regions where approximately 26 percent of the national population resides, nearly half of whom live in rural areas. The health infrastructure in these areas is alarmingly weak, leaving residents highly vulnerable to both communicable and non-communicable diseases. A detailed analysis using three key indices, the Reproductive, Maternal, Newborn and Child Health (RMNCH) index, the Infectious Diseases Index (IDI), and the Service Capacity and Access Index (SCAI), reveals a dire situation. Only Benguela exceeds the national average in RMNCH capacity, scoring 53 out of 100. Bié and Huambo trail behind with scores of 31 and 33, respectively, while Moxico and Moxico Leste score just 20. Alarmingly, antenatal care coverage remains low, with only 39 percent of pregnant women across the five provinces receiving the recommended four visits, far below the national average of 51.2 percent. Immunization rates tell a similar story, with Moxico reporting a meager 9 percent coverage for the Penta3 vaccine. Maternal mortality remains high at 170 per 100,000 live births, while institutional birth rates hover under 40 percent. Chronic malnutrition affects up to 23 percent of children in provinces like Bié.

Infection, Isolation, and Inadequate Care

The burden of infectious diseases across the Lobito Corridor is another pressing concern. The IDI scores in the five provinces range from 20 to 35 out of 100, with Bié and Moxico showing particularly poor performance. HIV testing and awareness are notably deficient; only 23.9 percent of men and 27.2 percent of women have ever been tested, compared to national averages of 37 and 52 percent, respectively. Antiretroviral therapy (ART) coverage is severely lacking, with Bié at just 14 percent and Huambo reaching 34 percent. Similarly, malaria prevention is inadequate, with only 8 percent of surveyed households using insecticide-treated bed nets. While Angola has increased its healthcare workforce by 46 percent in recent years, mainly through the recruitment of general practitioners and nurses, service access remains limited. Hospital infrastructure is abysmally poor, with some provinces reporting fewer than one hospital bed per 10,000 residents. The SCAI score hovers around 11 percent nationally, painting a grim picture of health system resilience in the face of rising demand.

Economic Gains with Health Risks

Despite the daunting statistics, the WHO report does not discount the Lobito Corridor’s transformative potential. Improved roads and railways are expected to connect remote populations to health care facilities, bolster emergency response, and streamline supply chains for critical health commodities. Economic growth may also lift household incomes, alleviating poverty-related health issues like malnutrition and inadequate housing. Moreover, regional collaboration between Angola, Zambia, and the Democratic Republic of the Congo could enhance disease surveillance and foster joint strategies to address transnational health challenges. However, these gains will not materialize automatically. The report warns that the influx of migrants, traders, and transport workers could overwhelm existing health services and facilitate the spread of HIV, malaria, tuberculosis, and even emerging diseases like COVID-19 and Ebola. Women, particularly those engaged in informal trade, are likely to face increased risks of gender-based violence, sexual exploitation, and human trafficking. Environmental degradation due to deforestation, mining, and pollution could compound public health hazards by contaminating air and water sources.

A Call for Health-First Development

To ensure the Lobito Corridor becomes not just a symbol of economic opportunity but also a beacon of public health advancement, the WHO brief lays out a detailed set of recommendations. Chief among these is the urgent need to expand and equip healthcare facilities along the corridor, particularly in underserved areas. Training and retaining health workers, especially for maternal and child health, is critical. Expanding access to prenatal, postnatal, and immunization services, especially among mobile and rural populations, must be prioritized. A robust disease surveillance system that spans national borders is essential for early outbreak detection and containment. The report also urges the integration of gender-sensitive programming to address the heightened risk of gender-based violence. Investments in clean water, sanitation, and hygiene (WASH) services, as well as enforcement of environmental health regulations, are equally crucial. Finally, public awareness campaigns on HIV, maternal health, and hygiene can empower communities to take preventive action.

The Lobito Corridor holds the promise of transforming Angola’s economic and social landscape. But without sustained, coordinated efforts to address the pressing health needs of the populations it touches, that promise could come at a steep human cost. The WHO and its partners emphasize that health considerations must be woven into every phase of the corridor’s development to ensure it becomes not only a lifeline for commerce but also a catalyst for community well-being.