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2 - Communicable Diseases
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- By Anne Mills, Professor of Health Economics and Policy London School of Hygiene & Tropical Medicine, Sam Shillcutt, Research Fellow Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine
- Edited by Bjørn Lomborg
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- Book:
- How to Spend $50 Billion to Make the World a Better Place
- Published online:
- 27 July 2009
- Print publication:
- 12 June 2006, pp 19-32
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Summary
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.
2 - Communicable diseases
- Edited by Bjørn Lomborg, Aarhus Universitet, Denmark
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- Book:
- Global Crises, Global Solutions
- Published online:
- 22 September 2009
- Print publication:
- 25 October 2004, pp 62-128
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Summary
Summary
The Challenge of Communicable Disease
Between the 1950s and the 1990s, the world saw enormous health improvements. However, developing countries have benefited unequally from health gains, with many, especially in sub-Saharan Africa (SSA), continuing to experience high mortality. Children bear a major burden of ill health, with infectious and parasitic diseases the main killers. Adults experience substantial premature mortality. Within countries, poorer groups have considerably worse health than the better off. Analysis of avoidable mortality highlights the importance of communicable disease, which represents around 90 percent of all avoidable mortality in almost all age—sex groups. The benefits of research mean that tools and approaches now exist to address the great majority of communicable disease, most notably malaria, TB and HIV/AIDS, as well as vaccine preventable diseases. However, large numbers of people do not have effective access to prevention and treatment, and die as a result.
The chapter focuses on three opportunities:
Malaria control
HIV/AIDS control
Strengthening basic health services.
This categorisation has been chosen largely because malaria and HIV/AIDS are major causes of disease burden and economic losses; cost-effective interventions are known to exist for their control; there is recent literature which can be drawn on to estimate costs and benefits; and these diseases are currently the focus of world attention.