Global health gains offset by HIV/AIDS epidemic and mortality in Eastern Europe

Substantial gains in health have been made by most populations between 1990 and 2001, reveals a study on the global burden of disease published in this week's issue of The Lancet. However, the period has been one of mixed progress state the authors, due to the HIV/AIDS epidemic in sub-Saharan Africa and setbacks in adult mortality in countries of the former Soviet Union.

The last Global Disease Burden study was done in 1990. In the latest study Alan Lopez (University of Queensland, Brisbane, Australia) and colleagues analysed mortality, incidence, and prevalence for 136 diseases and injuries in seven geographical areas/economic groupings in 2001. They found that worldwide there was a 20% reduction in global disease burden per head between 1990 and 2001, primarily due to progress in tackling infectious, nutritional, maternal, and perinatal* conditions. Worldwide over 56 million people died in 2001. Nearly 20% of these deaths were among children younger than 5 years. HIV/AIDS accounted for 2% of deaths in 1990, but for 14% in 2001. Malaria mortality also seems to have increased in the 1990s, primarily in sub-Saharan Africa. Heart disease and stroke were the leading causes of deaths in low-and-middle, and high income countries, together responsible for more than a fifth of all deaths worldwide. Lung cancer was the third leading cause of death in high-income countries but was not yet among the leading causes in low-and-middle income countries, where five of the ten causes of death remain infectious diseases.

Professor Lopez states: "Worldwide, HIV/AIDS and malaria are large growing causes of death and disease burden, especially in sub-Saharan Africa, where they have negated gains in reducing child mortality in Africa from measles, acute respiratory infections, and diarrhoea."

The authors also note a 'striking reversal' in the falling rates of adult mortality in Eastern Europe during the 1990s in the absence of effective health monitoring and po

Contact: Joe Santangelo

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