Global Health

and Why the Press Should Care

December 17, 2003

Nils Daulaire, MD, MPH
Global Health Council
Life Expectancy for Children Born This Year

74 years

Top 1/5 of the 131 million born.

Life Expectancy for Children Born This Year

74 years

64 years

Middle 3/5 of all children born.

Life Expectancy for Children Born This Year

74 years

48 years
64 years

Bottom 1/5
Life Expectancy for Children Born This Year

74 years
(+2.7)

48 years
64 years (-1.5)
(+3.9)

How have things changed over the past decade?

 Today’s reality:
• Each year, 56 million people die around
the world.
• One third of global deaths are premature
and preventable.
• Most of these preventable deaths are
from infectious and reproductive causes
among the poor.
 Principal Contributors to
Global Burden of Disease
0 20 40 60 80 100

* LRTI
* HIV
* Perinatal
* Diarrheal
Unipolar Depression
Ischemic Heart
*Vaccine-Preventable These 10 conditions
Cerebrovascular comprise 46% of all
* Malaria healthy years of life
Nutritional
lost worldwide.
*
Source: WHO, 1999 Disability-Adjusted Life-Years Lost (millions)
 Global health inequities:
• One of every 7 children born into poverty
in a developing country will not survive to
age 5.

• Their risk of death is 20 times as high as it

is for children born in the US.
 Main Causes
of Under Five Mortality
Perinatal
22%

Pneumonia
20%
Malnutrition All other
(underlying factor) causes
60% 29%

Malaria
8%

Measles HIV/AIDS
5% Diarrhea 4%
12%
Source: Evidence and Information for Policy/WHO, Child and Adolescent Health and Development, 2001.
On line www.who.int/child-adolescent-health/inegr.htm
 Global health inequities:
• In many poor countries, one of every 14
young women will die from pregnancy or
childbirth before finishing their childbearing
years.

• Their risk of death is 300 times as high as it

is for women in the US.
Women pay the highest price
• Over 200 million women become
pregnant each year.
• Over 28% of these pregnancies are
unintended.
• Over 40 million pregnancies are
terminated by abortion, most in
unsafe conditions.
• Nearly 600,000 women die each
year in pregnancy and childbirth.
 Global health inequities:
• In some southern African countries, the
likelihood that any given adolescent will die
from AIDS is greater than that she will live
her life HIV-free.

• As of today, barely 300,000 people living

with AIDS in poor countries have access to
treatment; another 6 million would benefit
right now.
 Worldwide HIV Infections and AIDS Deaths

60

50

40

30 Millions

20

10

1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000

AIDS Deaths HIV Infections

 HIV Prevalence Among Teenagers
in a High School in Kenya
35
30
25
20
%
15 Boys
10 Girls
5
0
15 16 17 18 19
Age
Source: National AIDS Programme, Kenya, 1999
 AIDS Orphans

• 14 million globally
– Over 12 million in Africa

• Over 40 million projected by the year 2015.

 Tuberculosis
• Kills over 2 million people each
year.
• Highly associated with HIV
infection.
• 8 million people become sick with
TB each year.
• One third of the world’s population
is infected with the TB bacillus.
Multidrug-resistant TB
 Malaria
• Kills 1 million people each year.
• 90% of these deaths are among
children.
• Almost 300 million people become
acutely ill with malaria each year.
• Net cost for African economies
exceeds $100 billion.
Life Expectancy for Children Born This Year
“Public health and medicine
are social interventions,
and politics are public health
in the most profound sense.”
Rudolf Virchow, 1848
 Global
Health
Council
www.globalhealth.org