The 20th century has witnessed significant economic and social development worldwide, which has helped reduce mortality rates while prolonging man's longevity. However, Africa still remains the region with the highest mortality rates--and within the region, the Sahelian countries remain the least developed and have the highest mortality rates. The Sahel is characterized by famines, malnutrition, high fertility and mortality rates, and a high rural exodus. The principal differences between the rich and poor are not only economic and educational but they also reflect government policies. Studies correlate mothers' levels of education and economic status with infant survival rates; yet African countries are now facing a severe economic crisis which will further reduce families' ability to enroll their children in school, thus lowering their chances of survival. International assistance, through emphasis on structural adjustment schemes, will further reduce government's investment in health and education. The majority of African populations are the most vulnerable to these policies and will suffer the most. Recommendations include the implementation of government population policies aimed at lowering maternal and infant mortality rates and fertility rates.