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WHO 2013 Statistics Show Worldwide Improvements In Health, But Concerns Remain

World Health Organization
Although 2013 statistics show a narrowing gap between countries with the best and worst overall health status, Dr. Margaret Chan is not entirely optimistic. Creative Commons

The World Health Organization's (WHO) annual report indicates that substantial progress has been made in the past decade toward reducing child and maternal mortality, improving nutrition, and reducing morbidity and mortality due to HIV infection, tuberculosis, and malaria.

World Health Statistics 2013 attribute these current positive trends to the adoption of the Millennium Development Goals (MDG) and the diverse efforts made to meet the 2015 deadline for their associated targets.

"Intensive efforts to achieve the MDGs have clearly improved health for people all over the world," said Dr. Margaret Chan, director-general of WHO.

Chan, though, is not entirely optimistic. Despite a narrowed gap between the most-advantaged and least-advantaged countries' overall health status, she wonders if a real difference has been made in reducing the "unacceptable inequities" between the richest and poorest countries worldwide.

Children Under Five

Globally, significant progress has been made in reducing levels of mortality among children under five years of age. In an estimated one-third of all deaths of children under five years of age, undernutrition is the underlying cause of death. Between 1990 and 2011, under-five mortality declined by 41 percent and the proportion of underweight children in developing countries declined from 28 to 17 percent.

Over the same period, neonatal mortality rates dropped sharply from 32 per 1,000 live births to 22 per 1,000 live births, a reduction of over 30 percent. The leading cause of neonatal deaths is prematurity.

Despite significant wins, the current rates of decline remain insufficient to reach the global target of a two-third reduction in 1990 levels of mortality among children under five by the year 2015. The positive news is 27 diverse countries have reached the MDG target ahead of 2015. This suggests that rapid improvements are possible in a range of settings that vary in terms of their geography, epidemiological patterns, level of economic and social development, and population size.

Mothers

The past decade has seen a substantial decline in maternal deaths: an estimated 287,000 mothers in 2010 as compared to 543,000 in 1990. Nevertheless, this rate of decline would now need to double in order to achieve the MDG target of a three-quarter reduction between 1990 and 2015. The WHO African Region remains the site of highest ratio of maternal mortality.

In order to reduce maternal deaths, women need access to quality reproductive health services. The proportion of births attended by skilled personnel was above 90 percent in three of the six WHO regions for the period 2005-2012. However, less than 50 percent of births in the WHO African Region met the same standard.

Roughly 16 million girls between 15 and 19 years of age give birth each year.

Babies born to adolescent mothers account for about 11 percent of all births worldwide, and 95 percent of such births occur in developing countries. In low- and middle-income countries, complications from pregnancy and childbirth are a leading cause of death among adolescent girls, with an estimated three million unsafe abortions performed on such girls in 2008.

Adverse health effects of adolescent childbearing extend to infants. Perinatal deaths are 50 percent higher among babies born to mothers under 20 than among those born to mothers between 20 and 29 years old.

Malaria, Tuberculosis, HIV/AIDS, Other Diseases

Nearly half the world's population is at risk of contracting malaria. In 2010, country-level estimations show that about four-fifths of all malaria cases occur in 17 countries; the same number - four-fifths - of estimated deaths occur in just 14 countries. Approximately 219 million cases of malaria led to 660,000 deaths in 2010. On a positive note, distribution of insecticide-treated nets, indoor residual spraying, and other methods of intervention has greatly increased.

Mortality due to tuberculosis has fallen by 41 percent since 1990 and the incidence of tuberculosis in all six WHO regions is falling. Overall, the world is on track to reach a reduction by half in tuberculosis mortalities by 2015. The number of new cases of tuberculosis has been slowly declining since 2006, and of the estimated 8.7 million new cases in 2011, about 13 percent involved people living with HIV.

As access to antiretroviral therapy in low- and middle- income countries improves - 8 million people in such countries received treatment in 2011- it is expected that the population living with HIV will continue to grow. Global estimates found 34 million of people living with HIV in 2011. In that same year, it is estimated 2.5 million people were newly infected with HIV (a one-fifth reduction as compared to 2001) and 1.7 million people died from AIDS-related causes (nearly one-quarter less than in 2005).

"Neglected tropical diseases" refers to a group of 17 diseases that affect more than one billion people, causing severe pain, permanent disability, and death worldwide. Some of these diseases are in decline. Dracunculiasis is on the verge of eradication, and the reported number of new cases of the chronic form of human African trypanosomiasis fell by 76 percent between 1999 and 2011.

However, the incidence of dengue has grown dramatically with current estimates suggesting there may be 50-100 million dengue infections every year.

Water

Using 1990 as the baseline year, the MDG target is to halve the total number of people without sustainable access to safe drinking water and basic sanitation by 2015. The WHO/UNICEF Joint Monitoring Program (JMP) for Water Supply and Sanitation announced that the drinking water target had been met in 2010 when an estimated 89 percent of the world's population used an improved source of drinking water, compared to 76 percent in 1990.

Based on the current rate of progress, the WHO African Region and the WHO Eastern Mediterranean Region will fall short of the 2015 target. In 2011, more than one-third of the global population (2.5 billion people) still lacked access to improved sanitation facilities.

Other Trends

Between 2000 and 2011, the estimated number of measles deaths decreased by 71 percent as more countries achieved high levels of immunization coverage.

Almost 10 percent of the world's adult population has diabetes, placing them at risk for stroke and lower limb amputation.

Of married women between the ages of 15 and 49 (and those in a consensual partnership), about 63 percent were using contraception in 2010.

Source: World Health Organization. World Health Statistics 2013. WHO Press. 2013.

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