The challenge of communicable disease

The second half of the twentieth century saw enormous improvements in health across the whole world. Indeed, life expectancy in developing countries has increased faster than in the industrialized world, albeit from a lower baseline. People in many developing countries have life expectancies close to those in more advanced economies, but there is now a big gap between them and another group of countries, mainly in sub-Saharan Africa (SSA), where high mortality persists.

In 2002, there were 57 million deaths worldwide. Of these, 20% were children under five, and 98% of these childhood deaths occurred in developing countries. Communicable diseases represent seven out of the top 10 causes of child deaths in developing countries, and account for around 60% of all such deaths: more than 6 million deaths annually. A further problem in developing countries is premature mortality of adults (15–59), which represents 30% of all deaths, compared to only 20% in developed economies. As ever, it is the poorest in these countries who suffer disproportionately.

Non-smokers in the richest countries have a lower risk of dying throughout their life than other population categories. Deaths in excess of the rate in this category can be considered avoidable, and certain sectors of developing country societies, particularly infants and young women, are disproportionately affected. Around 90% of these avoidable deaths are caused by communicable diseases.