Though the facts and figures of world health are disturbing, progress has been made. A brief look at quality of life standards shows dramatic improvement in the last 30 years:

• infant mortality rate cut nearly in half;
• life expectancy up by nearly a decade;
• undernourished people down by 100 million;
• literacy up to nearly 80 percent.

However, as population growth, urbanization and development proceed apace, problems ensue, many of which were addressed in August of 2002 at the UN's Johannesburg summit on Sustainable Development. THE ECONOMIST, queried in anticipation of the event, echoed Gandhi, "How many planets will we need if we continue to develop at the same rate?"

• Get additional facts and figures about population and development.
• Calculating Disease Costs — DALYS - Disability Adjusted Life Years
• The World Health Organization's World Health Report 2002: Reducing Risks, Promoting Healthy Life
• Poverty and Health: Who Lives on Two Dollars a Day?

The World Health Organization reports that most deaths from infectious diseases — almost 90% — are caused by a handful of diseases. Pneumonia, tuberculosis, diarrhoeal diseases, malaria, measles, and HIV/AIDS account for half of all premature deaths, affecting mostly children and young adults. Although most of these could be at least partially controlled by antibiotics and other drugs, progress in this area is severely slowed by financial challenges as well as a dramatic upsurge in drug-resistant microbes. Prescription of the wrong antibiotic or incorrect dosage for a particular infection, non-compliance by patients, and misuse of human antimicrobials as growth promoters for animals are just some of the reasons that have made the most commonly prescribed drugs ineffective.

• Infectious Disease Information from the CDC on pneumonia
• More information on tuberculosis
• UNICEF's Facts for Life: Diarrhoea
• UNICEF Malaria program
• WHO Malaria Program
• Global Laboratory Network For Measles Surveillance
• More information on HIV/AIDS
  

Vaccines are part of medicine's greatest success stories. NOW reported on the effort to wipe out polio with a special photo essay. However, not all parts of the globe have equal access to these important lifesavers. According to the Global Alliance for Vaccine and Immunization, 2,386,350 deaths could be prevented by vaccines each year. The following numbers are global statistics from eight vaccine-preventable diseases:

• Polio: 3,500 annual cases; 350 annual deaths
• Diphtheria: 30,000 annual cases; 3,000 annual deaths
• Pertussis: 45 million annual cases: 296,000 annual deaths
• Measles: 30-40 million annual cases; 777,000 annual deaths
• Tetanus: 309,000 annual deaths
• Haemophilus influenzae b: 2-3 million annual cases; 450,000 annual deaths.
• Hepatitis B: 5,682,000 annual cases; 521,000 annual deaths
• Yellow fever: 200,000 annual cases; 30,000 annual deaths.

• State of the World's Vaccine Program Report

In December 2002, the Joint United Nations Programme on HIV/AIDS issued the following update:

• Number of people living with HIV/AIDS total = 42 million
  • Adults = 38.6 million
  • Women = 19.2 million
  • Children under 15 years = 3.2 million
• People newly infected with HIV in 2002 total = 5 million
  • Adults = 4.2 million
  • Women = 2 million
  • Children under 15 years = 800,000
• AIDS Deaths in 2002 total = 3.1 million
  • Adults = 2.5 million
  • Women = 1.2 million
  • Children under 15 years = 610,000

There has been some progress on the HIV/AIDS front in the last year. South African President Thabo Mbeki, previously against the dispensing of AIDS drugs, has changed his controversial stance. In late 2002, the South African government released a policy statement on a new strategic plan for dealing with AIDS.

The new plan includes a comprehensive care package for survivors of sexual assault, including anti-retrovirals and continued research on nevirapine (a drug thought to slow the reproduction of HIV when used in combination with other anti-retrovital drugs) and roll-out of the drug to pregnant women.

On the global funding front, President Bush pledged $15 billion to fight AIDS worldwide in his 2003 State of the Union Address.

• Why the Children? Photo Essay and Interview
• Living and Dying with AIDS: Stories
• Numbers in perspective. AIDS Deadly Toll
• WHO HIV/AIDS Program
• The MTCT-Plus Initiative, Mailman School of Public Health

Dangerous Environments

Millions of deaths occur each year from diseases, infections and accidents related to their surrounding environments. United Nations and WHO figures are stark:

• Between 5 and 6 million people in developing countries die each year from water-borne diseases and air pollution.
• Poor environmental quality contributes to 25% of all preventable illness in the world today.
• 60% of the 2.2 million deaths a year in children under five caused by acute respiratory infections are associated with indoor air pollution (mostly from burning biomass fuels in confined spaces), lack of adequate heating and other unsanitary living conditions.

There's no doubt about it — water means life. It is necessary to grow food, and clean water is imperative for health. According to WHO, 13,000 people die each day from water-related diseases — that's about 1.7 million annually. The Millennium Summit goals aim to cut in half the number of people without access to safe water supplies. This means that an additional 1.5 billion people will need to be served.

The poster pictured at left is Myanmar's publication of the year 2003 World Health Day Campaign. This year's campaign focuses on Healthy Environments for Children.

• World Health Day 2003 — Healthy Environments for Children
• Get additional facts and figures on world water consumption.
• Kids and Chemicals — Information and strategies to safeguard neighborhoods and kids
• UN Progress Since with World Summit for Children
  
  

Tuberculosis (TB) is caused by airborne bacteria that attack the lungs, and is one of the most contagious diseases in the world, killing approximately 2 million people each year. Like the common cold, it spreads through the air. Left untreated, a person with active TB will infect on average between 10 and 15 people each year. Overall, one-third of the world's population currently are infected with TB.

First reaching epidemic proportions in the 19th century, tuberculosis saw a dramatic decline in the 20th century with medical advances, new public health measures and early detection programs. However, in 1984 the rate of tuberculosis cases suddenly began to increase — and with the new outbreak came new drug-resistant strains. In 1993, the World Health Organization took an unprecedented step, declaring tuberculosis a global emergency. The factors thought to have contributed to this reversal of the decline include:

• The HIV/AIDS epidemic, as sufferers are highly susceptible*;
• Antibiotic resistance, brought on by poor compliance with treatment**;
• Increased global trade and air travel over the past 40 years, aiding to the spread of TB***;
• In the United States, the elimination in 1972 of federal funding dedicated to fighting TB.

It is estimated that between 2002 and 2020, approximately 1000 million people will be newly infected, over 150 million people will get sick, and 36 million will die of TB if control is not further strengthened.

• Division of Tuberculosis Elimination
• Information on TB from the Virtual Children's Hospital