Global Health and Global Inequity UNC Global Health

Global Health and Global Inequity UNC Global Health Seminar September 15, 2004 Nils Daulaire, MD, MPH Global Health Council

Life Expectancy for Children Born Last Year 74 years Top 1/5 of the 131 million born in that year.

Life Expectancy for Children Born Last Year 74 years 64 years Middle 3/5 of all children born.

Life Expectancy for Children Born Last Year 74 years 48 years 64 years Bottom 1/5

Life Expectancy for Children Born Last Year 74 years (+2. 7) 64 years (+3. 9) 48 years (-1. 5) 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 Source: WHO, 2001

Principal Contributors to Global Burden of Disease * * * * Source: WHO, 1999 These 10 conditions comprise 46% of all healthy years of life lost worldwide. Disability-Adjusted Life-Years Lost (millions)

Children under 5 bear the greatest burden… Proportion of global burden of selected diseases borne by children 0 -4 years (estimated, year 2000) Pneumonia Diarrhea Malaria Measles 54% 85% 79% 89% Percentage of deaths occurring among: Source: Adapted from Murray & Lopez, 1996 Children 0 – 4 years All other age groups

Laxmi’s Short Life Kg 15 14 13 12 11 M 10 D ARI 9 D D ARI FEVER ARI 8 ARI 7 D ARI D 6 5 D D D ARI 4 3 D ARI X D D ARI KEY ARI – Acute Respiratory Infection D – Diarrhea M – Measles FEVER – Fever Unknown Origin ARI 2 0 3 6 9 12 15 18 21 AGE IN MONTHS 24 27 30 33 36