The Global South, that groups together low- or middle- income countries mainly located in Africa, Asia and Latin America, concentrates most of the world population. Population ageing, caused by the demographic transition and a large decrease in fertility and mortality rates, make these countries face numerous challenges. Among regions in the Global South, the differences in life expectancy at birth were still large in 2022: almost 74 years in Latin America and the Caribbean but only 60 years in sub-Saharan Africa, with some countries barely exceeding 50. Due to many factors that play on health transition, high mortality countries suffer a cumulative burden from both infectious and non-communicable diseases (NCDs). In addition, the lack of old-age mortality data is a dramatic issue when studying longevity in these countries.

Humans live longer today than ever before. The remarkable rise in longevity occurred in a brief period of human history, roughly since the eighteenth century, and was driven by persistent efforts against epidemics, famines, health insecurity and chronic diseases. This chapter covers essential concepts regarding this extraordinary achievement for the human race, such as the demographic transition model, distinguishable from the earlier Neolithic demographic transition, which both led in their unique way to substantial alterations in the cause and age distribution of deaths. To account for the shift in disease patterns over time, the concept of epidemiological transition was originally proposed by Abdel Omran in the early 1970s and later evolved into broader conceptual frameworks, including the health transition. The chapter concludes by briefly addressing whether increased human longevity is matched by improved health and its future sustainability.

The ’good life’ many people aspire to has many component. Three of them I call ’pillars of development’: health, education and mobility (HEM). Health has greatly improved for many people, due to a decline in mortality and morbidity rates. It shows up in the rise in life expectancy worldwide. This is primarily thanks to better food, hygiene and medical services. Because casues of mortality shifted from infectious diseases to chronic non-communicative degenerative ailments, the notion of health transition has been introduced. The level of formal education is also rising worlwide, with important consequences for political organization and rights for women. Mobility has experienced an enormous growth, which has resulted in ever larger distances travelled within an hour due to changes to faster modes (walk - bicycle - car/train/bus - plane). Many technological, economic and sociopolitical developments affect the future of HEM-infrastructure and services. All three have an inherent public-good character, which gives rise to divergent worldviews regarding their provision and quality (private versus state, efficiency versus availability).