Life
Expectancy Falls In
Poorest Countries
By Barry Mason
World
Socialist Website
12 January 2004
Stark
global inequalities in health are revealed in the latest World Health
Organisation (WHO) report. World Health Report 2003 highlights the
slowing of gains and the widening of health gaps.
A baby girl born
in Japan can expect to live to 85 years of age, have sufficient food,
vaccinations and a good education. On average she will have $550 spent
on medication per year for her needs, with more available if necessary.
If she were born
in Sierra Leone she would have a life expectancy of just 36 years, not
be immunised, be undernourished and if she survived childhood would
marry as a teenager and give birth to six children. Childbirth would
represent a high risk to her. One or more of her children would die
in infancy. She could expect only $3 a year to be spent on medication.
Life expectancy
has increased globally by almost 20 years over the last half century.
In 1950-1955 it was 46.5 years and in 2002 it was 65.2 years. But this
overall rise masks a terrible decline in life expectancy in the poorest
countries. In parts of sub-Saharan Africa adult mortality rates are
now higher than they were 30 years ago.
In Botswana, Lesotho,
Swaziland and Zimbabwe the life expectancy for men and women has been
reduced by 20 years. A man in Zimbabwe can now expect to live to 38
years of age.
It is not only Africa
which has suffered a decline in life expectancy. In Eastern Europe and
the former Soviet Union a man can expect to live to only 58.
Even countries that
have seen an improvement in life expectancy now face a sharp decline.
China rates as a low mortality developing country, with less than 10
percent of deaths currently occurring below the age of five years. In
Africa 40 percent of deaths are in this age range. But this relatively
favourable position is threatened by the destruction of the Chinese
health care system with the reintroduction of unfettered capitalism
and the mounting AIDS epidemic.
Worldwide an estimated
10 million children are dying unnecessarily every year. Most of these
preventable child deaths occur in developing countrieshalf in
Africa. Of the 20 countries with the highest child mortality rates,
19 are in Africa, the only exception being Afghanistan.
Rates of child mortality
in some countries are also increasing. While the global trend is for
child mortality to decline, 16 countries, of which 14 are in Africa,
have higher rates than in 1990. In nine countries, of which eight are
in Africa, the child mortality rate is higher than those recorded over
20 years ago.
The report attributes
this reversal to the impact of HIV/AIDS. The causes of childhood deaths
in some of the developing countries, in the Eastern Mediterranean, Latin
American and Asia, have shifted toward the pattern of childhood deaths
in the developed countries. It lists these as birth asphyxia, birth
trauma and low birth weightthe conditions that arise in the perinatal
period. The pattern of deaths in sub-Saharan Africa, however, is dominated
by malnutrition, diarrhoea, malaria and infections of the lower respiratory
tract.
Some of these conditions
such as malaria and diarrhoea could be easily prevented given clean
water and basic precautionary measures such as insecticide-treated nets
and more effective malarial drugs if resources were available. The HIV/AIDS
endemic raging in Southern Africa is exacerbating child mortality. About
90 percent of all HIV/AIDS and malaria deaths in children in developing
countries occur in sub-Saharan Africa.
Non-communicable
disease amongst adults, such as cardiovascular disease and lung cancer,
is also becoming more prominent in developing countries. Tobacco companies,
faced with a more restrictive marketing climate combined with a certain
level of heath education on the harmful effects of smoking in the developed
world, are targeting developing countries. In an overview of the report
the WHO states, The consumption of cigarettes and other tobacco
products and exposure to tobacco smoke are the worlds leading
preventable cause of death, responsible for about 5 million deaths in
2003, mostly in poor countries and poor populations. The toll will double
in 20 years unless known and effective interventions are urgently and
widely adopted.
Lee Jong-wook the
Director General of the WHO wrote last December in the British medical
journal the Lancet, recalling how in 1978 the WHO had laid out its commitment
to health equality in the Alma-Ata declaration. Its goal was for all
people to have sufficient health to have a dignified and productive
life by the year 2000. That goal was not achieved. He attributes
this failure to lack of political commitment, poverty and the impact
of HIV/AIDS.
He acknowledges
that provision of health care has been reduced as governments privatise
services. He says, delegates at Alma-Ata could not have anticipated
todays complex service delivery landscape in which non-governmental
organisations and the private sector operate in the gap left by states
withdrawal from healthcare provisiona withdrawal often encouraged
by international financial institutions and interests uncritically supportive
of healthcare provision.
While the report
tries to put the most positive gloss possible on these disastrous figures,
and the WHO has announced yet new health goals, there is no strategy
for reversing a growing trend toward rising mortality rates in the worlds
poorest countries. It is a trend that arises not from the failure of
this or that government or the inadequacies of some particular health
initiative, but from a long term and systematic assault on the living
standards of the vast majority of the worlds population by a tiny
minority of the obscenely wealthy and the giant corporations they run.
In a period when medical technology and public health measures could
ensure an increasing life span for evermore people, the figures published
in the WHO report are a damning indictment of an economic system and
a social order that is costing the lives of millions.