Life expectancy falling in poorest countries

Posted: 6 January 2004

Life expectancy is falling and child mortality is rising in the world's poorest countries as the global gap in healthcare widens, says the WorldHealth Organization.

In its latest report on world health, the WHO says that more than one-third of Africa's children are at higher risk of death today than 10 years ago, while the spread of Aids has cut adult life expectancy in some southernAfrican countries by more than 20 years.

A new-born girl in Japan can expect to live for about 85 years, with access to the best available healthcare whenever she needs it, whereas a girl born in Sierra Leone has a life expectancy of just 36 years and may never see a doctor, nurse or health worker. "These global health gaps areunacceptable," said Lee Jong-wook, the WHO director-general.

The report said healthcare systems must be strengthened, especially at local level, if global health goals were to be met and everyone was to have access to basic services. This would require urgent investment and international support.

"Very poor countries can't build health systems alone, even if they doubled health spending to 20 or 30 dollars per person per year," said Robert Beaglehole, lead author of the report. "That is totally nsufficient."

Maternal mortality

Dr Lee, a WHO veteran who took over the top job from Gro Harlem Brundtland in July, has made delivering healthcare at country level a prime goal, involving a significant shift in resources and staff from the UN agency's Geneva headquarters to regional and country offices.

Building up national health systems and capacities is also part of recent WHO initiatives such as the "3 by 5" programme to provideanti-Aids drugs to 3m people by 2005, a renewed drive to cut maternal mortality and work on mental health.

The report said international help was needed to tackle some of the main obstacles to improving health services, including critical shortages ofhealth workers, inadequate health statistics, lack of finance and the need to focus on the poorest groups.

The continuing Aids pandemic, the Sars outbreak and problems in finally eradicating polio also reflected a failure to invest in health systems,according to the report. The inevitable emergence of new epidemics, local and global, made strengthening health systems a matter of urgency, Dr Lee said.

In its overview of world health, the WHO report said most people were living longer and healthier lives than their parents. Over the past 50 years average life expectancy at birth had increased by almost 20 years, from 45.5 years in the early 1950s to 65.2 years in 2002.

Eastern Europe

"The large life expectancy gap between developed and developing countries in the 1950s has changed to a gap between the very poorest developingcountries and all other countries," the report said. Child mortality has fallen overall but in 14 African countries it is higher than 10 years ago.

Meanwhile, gains in adult health have slowed, with reverses in sub-Saharan Africa and parts of Eastern Europe, and the burden of disease has become more complex.

Even in the poorest countries, non-communicable diseases such as cancer and heart disease now accounted for nearly half the disease burden, theWHO noted. In middle-income nations the proportion was over 70 per cent,compared with 80 per cent for rich countries.

See also: WHO