The mission report of the Assistance Publique des Hôpitaux de Paris (APHP), carried out from February 26 to March 3, 2023, aims to improve the care pathway for vulnerable patients at the Outpatient Treatment Center (CTA) in Nouakchott and to strengthen the skills of caregivers for monitoring specific populations. The objectives include the promotion of sexual health, screening and treatment of sexually transmitted infections (STIs), as well as the prevention of cervical cancer and mother-to-child transmission of infections. The report highlights low overall health coverage in Mauritania, with only 60% of women giving birth in health facilities and vaccination coverage of around 60%. HIV prevalence is estimated at 0.29%, stable for ten years, except in Chami where an increase in the population has been observed. In gynecology/obstetrics, the National Hospital Center of Nouakchott (CHNN) has 50 beds and records 3,800 deliveries per year, with a cesarean rate of 37%, which is constantly increasing.

Governance, Public Administration, Health, Couverture sanitaire

Amnesty International’s 2023 annual report on Mauritania highlights several human rights concerns. In May, after the ruling party won legislative, regional and local elections, allegations of fraud were raised by some opposition parties. In December, former President Mohamed Ould Abdel Aziz was sentenced to five years in prison for corruption. The report denounces cases of torture and ill-treatment, including the death in police custody of human rights defender Souvi Ould Jibril Ould Cheine in February, attributed to traumatic asphyxiation by strangulation. Freedom of expression has been restricted, with mobile internet cuts in June following protests, and during national reviews to prevent cheating. The UN Committee on Enforced Disappearances has also highlighted the lack of thorough examination of proposals for a truth and reconciliation mechanism concerning human rights violations between 1989 and 1992.

Governance, Human Rights, Torture

In this op-ed published on March 15, 2023, Jean‑Pierre Olivier de Sardan questions the effectiveness of security strategies in the Sahel. Jihadism is spreading not only in Mali, Burkina Faso, and Niger, but also into northern regions of coastal countries like Benin, Ghana, Togo, and Côte d’Ivoire . Where state authority has collapsed, jihadist groups have imposed a “de facto government” based on extortion, propaganda, and terror. He notes that military responses, including Operation Barkhane, have failed to halts their expansion . Instead, he advocates for a comprehensive approach: strengthening public services, restoring a protective state, offering alternatives for jihadist defectors, engaging in negotiations with moderate insurgents, and supporting rural development and humanitarian aid. The core argument stresses the need for people‑centered security rather than a standalone military focus.

Governance, Security, Jihad, Services publics

The article “Burkina Faso: rethinking territorial administration and development planning (first part)” analyzes the country's social, political and security crises, attributed to ineffective governance and inadequate local development. He proposes a reform of territorial administration, suggesting regionalization inspired by the Kenyan model, where the regions would have increased autonomy and limited legislative powers under the control of the central state. This approach aims to strengthen the legitimacy of local governments, improve territorial governance and involve populations more in decision-making, while preserving national unity.

Governance, Public Administration, Local development, Réforme

Since 2014, the Tillabéri region in western Niger has been plagued by growing insecurity due to armed groups, crime, and community conflict. Until 2020, these groups primarily targeted local authorities and defense forces, while extorting civilians without resorting to physical violence. However, in 2021, they intensified their direct attacks on civilians, leading to a 52% increase in deaths related to this violence between 2020 and 2021, according to ACLED. Faced with the weak military presence, some communities have formed self-defense groups, such as the one in Banibangou. Although violence decreased in 2022, with 192 deaths recorded compared to 465 in 2021, instability persists. The military coup of July 26, 2023, which overthrew Mohamed Bazoum, could influence the security situation of civilians in the affected areas.

Governance, Conflict, Jihad, Violence, Insécurité, Groupes armés non étatiques

The World Bank’s June 2022 report on the G5 Sahel (Burkina Faso, Chad, Mali, Mauritania, Niger) highlights that these economically fragile countries face challenges such as political instability, growing insecurity, uncontrolled urbanization, declining agricultural productivity, and a food crisis affecting millions of people. Climate change is exacerbating these vulnerabilities, increasing migration and social exclusion. However, the region has untapped assets, including a growing young population and renewable energy resources. Smart climate investments and strengthening policies and institutions could improve resilience to the impacts of climate change and avoid carbon-intensive growth. A stronger state presence is crucial to improve the quality of services, especially in the post-COVID context and in the face of supply chain disruptions due to the Russia-Ukraine crisis. A green and resilient Sahel requires accumulated commitment from states at all levels

Governance, Agriculture, Food security, Urbanisation, Crisis, Insécurité