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
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