Global Health and Global Inequity

UNC Global Health Seminar

September 15, 2004

Nils Daulaire, MD, MPH

Global Health Council

74 years

Life Expectancy for Children Born Last Year

Top 1/5 of the 131 million born in that year.

64 years

74 years

Life Expectancy for Children Born Last Year

Middle 3/5 of all children born.

48 years

74 years

64 years

Life Expectancy for Children Born Last Year

Bottom 1/5

48 years

74 years

64 years

(+2.7)(+2.7)

(+3.9)(+3.9)(-1.5)(-1.5)

Life Expectancy for Children Born Last Year

How have things changed over the past decade?

Global health inequities:

• One of every 7 children born into poverty in a developing country will not survive to age 5 – 20 times the risk faced here.

Global health inequities:

• One of every 7 children born into poverty in a developing country will not survive to age 5 – 20 times the risk faced here.

• In many countries, one of every 12 young women will die from pregnancy or childbirth before reaching the end of her reproductive years – 250 times the risk faced here.

Global health inequities:

• One of every 7 children born into poverty in a developing country will not survive to age 5 – 20 times the risk faced here.

• In many countries, one of every 12 young women will die from pregnancy or childbirth before reaching the end of her reproductive years – 250 times the risk faced here.

• 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.

Premature Deaths in Developing Countries

Injuries17%

Chronic/ Non-communicable

30%

Infectious and Reproductive

Causes53%

Source: WHO, 2001

0 20 40 60 80 100

Pneumonia/ARI

HIV

Perinatal causes

Diarrhea

(Unipolar Depression)

(Ischemic heart disease)

Vaccine-Preventable

(Cerebrovascular)

Malaria

Nutritional deficiencies

Principal Contributors to Global Burden of Disease

Source: WHO, 1999 Disability-Adjusted Life-Years Lost (millions)

These 10 conditions comprise 46% of all healthy years of life lost worldwide.

*

*

**

*

*

*

Children under 5 bear the greatest burden…Children under 5 bear the greatest burden…

Source: Adapted from Murray & Lopez, 1996

Proportion of global burden of selected diseases borne by children 0-4 years (estimated, year 2000)

Pneumonia Diarrhea Malaria Measles

Percentage of deaths occurring among: Children 0 – 4 yearsAll other age groups

54% 85% 79% 89%

Laxmi’s Short LifeLaxmi’s Short Life

0 3 6 9 12 15 18 21 24 27 30 33 36

ARI

ARI

ARIARI

ARI

ARI

ARI

ARI

ARI

ARI

ARIARI

ARIARI

ARI

ARI

M

D

D

D D D DDDDD

FEVER

D DD D

D

D

D

D

D

2

3

4

5

6

7

8

9

10

11

12

13

14

15

KEYARI – Acute Respiratory InfectionD – Diarrhea M – MeaslesFEVER – Fever Unknown Origin

AGE IN MONTHS

Kg

X