WHO urges intensified health efforts
World Health Statistics 2013 shows considerable progress has been made in reducing child and maternal deaths, improving nutrition and reducing deaths and illness from HIV infection, tuberculosis and malaria. A dramatic improvement has been seen in the poorest countries as well as narrowing of the gap between countries with the best and worst health.
The United Nations Millennium Development Goals (MDGs) are eight goals that 194 UN Member States have agreed to make strides to achieve by the year 2015. They encompass poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women.
“Intensive efforts to achieve the MDGs have clearly improved health for people all over the world,” says Dr Margaret Chan, Director-General of WHO. “But with less than 1000 days to go to reach the MDG deadline, it is timely to ask if these efforts have made a difference in reducing the unacceptable inequities between the richest and poorest countries.”
The most impressive improvements are found in the lowest 25 per cent health status category. A good example of the improvement is the narrowed gap in child mortality between the top and bottom countries. Death rates were reduced from 171 per 1000 live births in 1990 to 107 per 1000 live births in 2011.
WHO projects that diabetes will be the 7th leading cause of death in 2030. Diabetes is known to damage the heart, blood vessels, eyes, kidneys and nerves. Diabetes is among the leading causes of kidney failure and 50 per cent of diabetics die of cardiovascular diseases.
The number of new HIV infections narrowed from 360 to 261 people per 100 000 between 1990 and 2011. Countries with the highest rates of HIV have cut new infections by 27 per cent.
“Our statistics show that overall the gaps are closing between the most-advantaged and least-advantaged countries of the world,” said Ties Boerma, Director of the Department of Health Statistics and Information Systems at WHO. “However, the situation is far from satisfactory as progress is uneven and large gaps persist between and within countries.”
Mother and child disease burden
15 million newborn babies are delivered prematurely per year and as a result 1 million die. These staggering statistics now ranks preterm birth as the world’s leading killer of newborns. Despite improvements, the current progress will not be enough to reach the MDG goal of two-thirds reduction in child mortality.
Maternal mortality rate improvements associated with childbirth needs to be doubled to meet the goal. Almost 15 per cent of deaths in women of reproductive age are associated with preventable complications of pregnancy and childbirth. Annually, over 500 000 women die from complications from lifestyle induced disease and lack of care before, during and after childbirth.
20 million children worldwide are severely malnourished and 10 million children under the age 5 will die each year according to the WHO statistics. Under-nutrition is the underlying cause of death for 30 per cent but the remaining can be significantly reduced through simple and cost-effective interventions and programmes.
Severe bleeding after birth can kill a healthy woman within two hours if she is unattended. One of the primary causes of excessive bleeding is high blood pressure and poor clotting factors in the blood. Both of these conditions can be improved, managed or reversed with improved nutritional support.
The risk of death is directly related to the access and availability of proper healthcare services. A woman’s lifetime risk of maternal death – the probability that a 15-year-old woman will eventually die from a maternal health factor – is 1 in 3800 in developed countries versus 1 in 150 in developing countries.
Women who are attended by trained healthcare professionals are scarcer than you think. Nearly half of all childbirths in developing countries are not attended to properly. Attended childbirths still pose the risk of complications such as infections if cleanliness and hygiene standards are not strictly adhered to.
There are over 18 million unsafe abortions that are carried out every year that result in over 46 000 deaths. Half of these abortions are considered unsafe. The WHO defines unsafe abortion as a “procedure for terminating a pregnancy that is performed by an individual lacking the necessary skills, or in an environment that does not conform to minimal medical standards, or both.”
Slowing HIV transmission
HIV transmission can occur during pregnancy, childbirth and breastfeeding. Almost half of the 1.49 million pregnant women living with HIV have received the most effective regimens of antiretroviral medicine to prevent mother-to-child transmission of the virus. Substantial progress has been made in the awareness, prevention and treatment of HIV/AIDS but the transmission rates still remain high.
An estimated 390 000 children were newly infected with HIV in 2010, 30 per cent fewer than the peak of 560 000 children newly infected annually in 2002 and 2003 according to the WHO.
There’s no vaccine to prevent HIV but it’s possible to protect yourself and others from infection. Practicing safe sex is one of the most important preventative techniques to reduce this global threat. When used properly and consistently, condoms are extremely effective at preventing the transmission of HIV.
The surest way to avoid transmission of HIV is to abstain from sex or to be in a long-term mutually monogamous relationship that has been tested and is not infected. The reduction in the number of sexual partners can decrease the risk of HIV as well.
Cardiovascular diseases emerging
The rates increase with age, from 1 in 10 people in their 20s and 30s to 5 in 10 people in their 50s. The prevalence of high blood pressure is the highest among the African decent, with over 40 per cent of adults thought to be affected.
Cardiovascular diseases (CVDs) have a broad meaning. It’s not a single condition or disorder in itself. Rather, it’s a collection of diseases and conditions. In fact, some types of cardiovascular disease can cause other types of cardiovascular disease. It’s normally seen as chain reaction associated with conditions like obesity, diabetes and kidney disease.
CVDs are the number one cause of death globally; more people die from CVDs than from any other cause. An estimated 17.3 million people died from CVDs in 2008, representing 30 per cent of all global deaths. Of these deaths, an estimated 7.3 million were due to heart disease and 6.2 million were due to stroke.
Over 80 per cent of CVD deaths take place in low- and middle-income countries and occur almost equally between men and women. The number of people who die from CVDs – mainly heart disease and stroke – is projected to increase to 23.3 million by 2030 if aggressive action doesn’t take place.
Addressing risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity, high blood pressure, diabetes and raised cholesterol can prevent the most common causes of cardiovascular disease.
Dr Cory Couillard is an international healthcare speaker and columnist for numerous newspapers, magazines, websites and publications throughout the world. He works in collaboration with the World Health Organization’s goals of disease prevention and global healthcare education. Views do not necessarily reflect endorsement.
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