287. Senegal has not yet attained the standards prescribed by the World Health Organization (WHO) in terms of coverage of health infrastructural facilities 101 and qualified personnel102, indicators which remain unequally distributed across the nation to the detriment of several rural communities. The same situation applies to the supply of medicines. In terms of demand, the extremely poor people have systematically not benefitted from the free programmes introduced, thus reducing their capacity to access healthcare to which they are entitled. 288. In terms of resources, the Government of Senegal, in its commitment to achieve the MDGs under healthcare, increased the budgetary allocation for health to the level recommended by the WHO, that is 9% of the total budget of the country103. Furthermore, investment in healthcare is viewed as an important vehicle for economic development because good health of the population promotes development through the interplay of different mechanisms:    Increase in productivity of the labour force promotes investment ; Development of human capital ; Demographic growth with the simultaneous improvement in the health situation and the level of education leads on the one hand, to decline in mortality rates, and decline in fertility rates, on the other. 289. The health situation of the population presents varied results. Malaria still remains the highest cause of morbidity in Senegal and it accounts for 42.6% of the causes of sicknesses. The efforts to control malaria resulted in a spectacular decline of malaria-related morbidity in proportional terms from 39.7%, in 2000, to 3% in 2009. 290. However, cardiovascular diseases have become a serious public health issue as they have increased across the entire country. Neglected for quite a long time as a result of the widespread nature of transmissible diseases, they now constitute the second cause of deaths after malaria in the health centres in Dakar. These are chronic and expensive diseases which create a huge burden of morbidity and mortality. Among the risk factors associated with cardiovascular diseases, one may mention high blood pressure (50%), smoking (47%), and obesity (23%), cholesterol (12.5% and diabetes (11.6%). Among the cardiovascular diseases, heart attack is a particularly disturbing problem as it is the primary cause of admission of patients to the cardiology departments of hospitals with a rate of between 37 and 40%. 101 In 2010, Senegal had 25 hospitals, 75 health districts with 78 health centres, with 23 of them offering full emergency obstetrical care, 1195 health posts, 270 health units and 476 maternity clinics. (AIDS Control Strategic Plan 2011-2015 of the Prime Minister’s Office, page 7) 102 Whilst the WHO proposes a ratio of 1 doctor to 1000 inhabitants, 1 nurse to 300 inhabitants and 1 midwife to 300 inhabitants, Senegal has 1 doctor to 11000 inhabitants, 1 nurse to 4200 inhabitants and 1 midwife to 4000 inhabitants. (AIDS Control Strategic Plan 2011-2015 of the Prime Minister’s Office, page 9) 103 Cf. National Statistical and Demographic Agency, Demand for Reproductive Health Services: The Case of Senegal, December 2009, page 7. 66