AN EXCELLENT READ

Sunday, 23rd of January 2011

‘Improving Global Health: Forecasting the Next 50 Years’

This online publication of the Oxford University Press is a gold mine of information. As a searchable .pdf document, it permits you to go through to see what it says, in text and tables, about your respective countries. A check for Nigeria yields 26 references in text and tables; a check for the Maldives, not quite the size of Nigeria, yields 22, including up to date statistical references assembled in one place from many sources.
Online at http://www.ifs.du.edu/assets/documents/PPHP3/PPHP3V1.pdf

The authors look over the horizon to when the current battles against communicable disease will be fought and won. What then? Excerpts from concluding chapter, pp. 157-158.

'One of the central forecasts of the volume is that progress against communicable diseases will likely continue at a quite rapid pace. In our base case forecast, the battle against communicablediseases will largely be won by the end of our primary forecast horizon in 2060. Sometime between 2040 and 2050 the annual global deaths attributable to communicable diseases will very likely fall below 10 percent of those from noncommunicable diseases (from about 50 percent now), and will also fall below the numbers due to injuries. Within this global pattern there are variations by country and by region; we have traced the patterns by region within the volume, and present them for individual countries in the end tables at the back of this volume.

'Our forecast of continued quite rapid decline of communicable diseases has broad demographic ramifications. Since communicable diseases mainly strike the young, the reduction’s early impact will be a demographic dividend. Over the longer run it will add to the challenges of old age dependency and chronic diseases. Another important implication is that the effort to reduce specific risk factors that affect the earlier stages of the risk transition will have special importance in the window of time through about mid-century, by which time the world will have largely passed through those earlier stages and the character of dominant risks will have shifted significantly. We have seen that risk factors as different as undernutrition; unsafe water, sanitation, and hygiene; and indoor air pollution each tend to contribute to between 1 and 2 million deaths annually, most of those falling among the roughly 16 million deaths from communicable diseases (and most among the roughly 9 million deaths of children under five years of age). By mid-century, the total deaths from communicable diseases could fall to about half that level (with child deaths falling below 2 million by 2060), largely because of the extensive attacks mounted on such risk factors and on key diseases such as AIDS and malaria.'

'The speed of progress in this period is literally a matter of life and death, and of reduced morbidity burden and better life-course health, for many tens of millions. As the world as a whole increasingly moves through and beyond the receding pandemic stage of the broad epidemiologic transition, other risk factors will become steadily even more important, including overweight, smoking, road traffic accidents, and outdoor air pollution. While deaths from communicable diseases will likely decline by 50 percent toward mid-century, those from both noncommunicable diseases and injuries will probably each more than double.'

Good reading. BD

From the preface: 'We consider changing mortality and morbidity patterns, including the remarkable ongoing reduction of global deaths from communicable diseases, a pattern that hopefully will be consolidated and extended. We consider also the growing burden of noncommunicable diseases and injuries, especially as populations age nearly everywhere. And we examine possible alternative patterns of 15 specific causes of death and disability and their impacts. The volume analyzes not only the drivers of change in human health, including advances in income, education, and technology, but also a number of more immediate risk factors (undernutrition, obesity, smoking, road traffic accidents, inadequate water and sanitation, indoor and outdoor air pollution, and climate change) and their health impacts. We focus heavily on the role of human effort in shaping health outcomes, as well as the roles of the natural environment and biological constraints. Human health interacts closely with broader human development. Therefore, this volume devotes attention not only to the drivers of change in health prospects but also to the ways in which those prospects affect broader demographic and economic futures. Among the advantages of the IFs modeling system is the manner in which it links health forecasting to larger human systems. Putting these pieces together, this volume uniquely looks forward across half a century at human health for 183 countries and the regions and groupings into which they fall, exploring a broad range of causes of disease and death, probing the deeper and more immediate drivers of change in human health prospects, and linking that analysis to the dynamics of the larger human development system. Our analysis recognizes the great uncertainty around such forecasts and attempts to explore the bases for alternative health futures and their implications. We hope this broad and deep exploration can contribute to the collective effort to assure improved health and well-being for peoples around the world. Those who wish to explore or extend our analysis will find the full IFs system at www.ifs.du.edu.'