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HEALTH: Rich and Poor Suffer Both Infectious and Noncommunicable Diseases

Gustavo Capdevila

GENEVA, May 13 2011 (IPS) - The world is experiencing a change in the geographic distribution of diseases. Traditionally, infectious diseases, which claim the lives of so many children, affected poor countries, and noncommunicable diseases like diabetes, cardiac ailments and cancer plagued rich countries.

But the latest statistics released by the World Health Organisation (WHO) Friday show that the income level of nations is no longer so important, and that all countries now face the burden of both kinds of diseases.

Up to now, noncommunicable diseases tended to be identified as the ills of opulence, limited to high-income countries, WHO director of Health Statistics and Informatics Ties Boerma told IPS.

However, due to changes caused by the ageing of the population, improvements brought about by the global effort to meet the Millennium Development Goals (MDGs), changes in birth rates and other factors, developing countries are now also fighting non-infectious diseases, he said.

Boerma noted that the phenomenon began in urban areas of developing nations, among the most highly educated population groups, but it is now expanding rapidly.

That was one of the central conclusions reached by WHO experts on the basis of the World Health Statistics 2011 report published Friday.

The study confirms that important progress has been made in improving the main health indicators, fighting poverty, bolstering gender equality and education, and moving towards the other goals outlined in the eight MDGs, which were agreed by the international community in the 2000 United Nations general assembly and have a 2015 deadline, Boerma said.

Over the last 10 years, the rate of improvement of infant and maternal mortality rates – key MDG targets – has been two times faster than the progress made in the 1990s.

Many countries are still lagging, some of them considerably, which means a huge effort is needed over the next five years to meet the MDGs, Boerma said. Nevertheless, the rate of progress is speeding up overall, he added.

In the case of child mortality, the world is only halfway to the MDG target, while in the case of maternal mortality, the world is only one-third of the way there, the WHO expert said.

The question of infant mortality will be evaluated again in September, when WHO and UNICEF, the U.N. children’s fund, release new statistics. For now, “we are still standing at 8.1 million” children under five who died in 2009, Boerma said, compared to 12.4 million in 1990.

With respect to the situation in the Americas, the WHO official said the statistics show that “very good progress” has been made in many countries.

In Brazil, Argentina and Chile, for example, “there have been steady but relatively fast declines in child mortality, and coverage intervention is high. And they also reduced the inequity between the poorest and the richest. Brazil has been a very good case study of where the poorest have benefited,” he said, adding that Mexico has also progressed.

At the other extreme, of course, is Haiti, he said, adding that the health indicators are still worrying in countries like Bolivia and Peru, which have made some advances but “still have a much longer way to go”.

Boerma also cited the case of Cuba, pointing out that although it is not a rich country, it “spends quite a lot on health” and does so “in a very equitable way.

“Everybody has (free) access to health services,” he said. “So in terms of life expectancy it ranks quite high and it has low child mortality and high coverage of intervention. So it is very successful in reaching the whole population and getting good value” for its investment, he added.

The expert also noted that the United States “is not at the top” in terms of health statistics in the Americas. He said “they are at the top when it comes to the amount of money they spend on health. But they are not at the top in terms of getting good results for their investments in health services.

“One reason,” he said, “may be that coverage of the whole population is not so good. So much of the expenditure goes to relatively expensive curative interventions or interventions that benefit a smaller proportion of the population.”

The WHO study also reported that average global life expectancy rose from 64 years in 1990 to 68 in 2009. In poor countries, the average is 56 years, while it has climbed to 80 years in wealthy countries.

Life expectancy for women is five years longer on average than for men. That difference has held fairly steady, between four and five years, over the last two decades.

The WHO figures show that there is still a huge gap in health spending between low- and high-income countries, averaging an annual 32 dollars per capita in the former and 400 dollars per capita in the latter.

The study reports that high-income countries have, per capita, 10 times more doctors, 12 times more nurses and midwives and 30 times more dentists, on average, than low-income countries.

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