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When it comes to medical care, improvements are being seen thanks to increased government spending and the development of national health care programs. Another area where progress has been made is health and wellness, which is covered in the SPI category Foundations of Well-Being. Many of the western, middle, and southern African nations scored well in this area, as life expectancy, obesity rates, suicide rates, and the percentage of premature deaths due to indoor air pollution improved. In some countries the improvement was due to new programs in place to test, counsel, and support thosewith AIDs and other diseases. The third area of social progress for these countries is tolerance/inclusion and personal rights. Although tolerance for gay and lesbian populations, as well as for some religions, is still a challenge in many countries, some, such as Angola and Gabon, have become much more inclusive. Benin and Liberia received strong scores in the area of personal rights, which means their governments do not control media outlets and what religions are practiced within their borders. In contrast, Central African Republic is considered one of the worst in the world when it comes to guaranteeing personal rights and freedoms, as you’ll discover in Chapter 3. Areas of social progress in which most of these countries need the most improvement arewater, sanitation, and shelter. Since a number of themhave had to putmost of their resources towarddefending themselvesorbecoming independent, they have struggled to fund the infrastructure that will ensure improved drinking water. Finding adequate shelter for thousands of people who have been displaced due to civil wars has also been a challenge in several of these countries. Another struggle for most of these countries has been in sustaining ecosystems. In some cases, this is because of stress on thewater supply. Countries

12 A FRICA : M IDDLE , W ESTERN , AND S OUTHERN