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GlobalHealth

andW

hytheP

ressSho

uldCare

Dece

mber17,2003

NilsDaulaire,MD,MPH

GlobalHealthCouncil

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74year

s

LifeE

xpectancyfo

rChildrenB

ornThisYea

r

Top1/5ofthe131millionborn.

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64

years

74year

s

LifeE

xpectancyfo

rChildrenB

ornThisYea

r

Middle3/5ofallchildrenborn.

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48years

74year

s

64

years

LifeE

xpectancyfo

rChildrenB

ornThisYea

r

Bottom1/5

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48years

74year

s

64

years

(+2.7

)

(+2.7

) (+3.9)

(+3.9)

((--1.5)

1.5)

LifeE

xpectancyfo

rChildrenB

ornThisYea

r

H

owhavethings

changedoverthepastdecade?

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Todaysrealit

y:

Each

year,56m

illionpeoplediearoun

d

thew

orld.

Onethirdofglobaldeathsarepremature

andpreventable

.

Mostofthesepr

eventabled

eathsare

from

infectiousandreproductivecauses

amongthepoor.

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0

20

40

60

80

100

LRTI

HIV

Perinatal

Diarrheal

UnipolarDepression

IschemicHeart

Vaccine-Preventable

Cerebrovascular

Malaria

Nutritional

P

rincipalContributorsto

GlobalBurdenofD

isease

Source:WHO,1999

Disability-AdjustedLife-YearsLost(millions)

These10conditions

comprise46%

ofall

healthyyearsoflife

lostworldwide.

* *

* * *

*

*

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G

lobalhealthinequities:

Oneofevery7childrenbornintopoverty

inadevelopingcountrywillno

tsurviveto

age5.

Their

riskofdeat

his20timesashighasit

isforc

hildrenborn

intheUS.

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MainCauses

ofUnder

FiveMortality

Source:Evidencean

dInformationforPolicy/WHO,ChildandAdolescentHealthandDevelopment,2001.

Onlinewww.who.int/child-adolescent-health/inegr.htm

HIV/AID

S

4%

Diarrhea

12%

Measles

5%

Perinatal

22%

Allother

causes

29%

Pneu

monia

20%

Malaria

8%

Malnutrition

(underlyingfactor)

60%

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G

lobalhealthinequities:

Inma

nypoorcou

ntries,oneofevery14

youngwomenwilldiefrompregnancyor

childbirthbeforefinishingtheirchildbearing

years.

Their

riskofdeat

his300timesashighasit

isforw

omenintheUS.

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Womenpaythehighestprice

Over200mill

ionwomenbecome

pregnanteachy

ear.

Over28%ofthesepregna

nciesare

unintended.

Over40millionpregnanciesare

term

inatedbya

bortion,mostin

unsafeconditions.

Nearly600,00

0womendieeach

yearinpregnan

cyandchild

birth.

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G

lobalhealthinequities:

InsomesouthernAfricancou

ntries,the

likelihoodthatanygivenadole

scentwilldie

fromA

IDSisgreaterthanthatshewilllive

herlife

HIV-free.

Asof

today,barely300,000p

eopleliving

withA

IDSinpoorcountrieshaveaccessto

treatment;another6millionwouldbenefit

rightnow.

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010

20

30

40

50

60

Millions

1980

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

WorldwideHIVInfectionsand

AIDSDeath

s

AIDSDe

aths

HIVInfections

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05101520253035

%

15

16

17

18

19

Age

HIVPrevalen

ceAmongTeenagers

inaHigh

SchoolinKenya

Boys

Girls

Source:NationalAI

DSProgramme,Kenya,1999

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AIDSOrphan

s

14m

illionglobally

O

ver12millio

ninAfrica

Ove

r40million

projectedb

ytheyear2015.

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Tuberculosis

K

illsover2m

illionpeopleeach

year.

H

ighlyassociatedwithH

IV

infe

ction.

8millionpeoplebecomesickwith

TBeachyear.

O

nethirdoftheworldspopulation

isinfectedwiththeTBbacillus.

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Multidrug-resistantTB

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M

alaria

Kills1million

peopleeachyear.

90

%ofthesed

eathsaream

ong

child

ren.

Almost300millionpeoplebecome

acutelyillwithm

alariaeachyear.

NetcostforAfricanecono

mies

exce

eds$100billion.

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LifeE

xpectancyfo

rChildrenB

ornThisYea

r

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Publichea

lthandm

edicine

aresocialinterven

tions,

and

politicsarepublichealth

inthemostprofoundsense.

RudolfV

irchow,1848

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Glo

bal

H

ealt

h

Cou

ncil

www.g

lobalhea

lth.org