Global health gains offset by HIV/AIDS epidemic and mortality in Eastern Europe

Substantial health gains in many parts of the world since 1990 are being offset by malaria and HIV/AIDS, according to the latest World Health Organisation (WHO) Global Burden of Disease Study.

The study, led by The University of Queensland’s Professor Alan Lopez, also shows a "striking reversal" in the falling rates of adult mortality in Eastern Europe during the 1990s.

This was in the absence of sustained health monitoring and policies, which was also setting back global health progress.

Professor Lopez, Head of the University’s School of Population Health said that findings from the study published in this week’s The Lancet, show that the period since 1990 has been one of mixed progress.

“While we’ve seen a significant reduction in infectious, nutritional, maternal and perinatal* deaths, we have also observed a massive increase in HIV/AIDS and malaria in sub-Saharan Africa,” Professor Lopez said.

In the latest study, the team led by Professor Lopez, one of the world’s leading experts on mortality and burden of disease, analysed mortality, incidence, prevalence, and years lost to disability for 136 diseases and injuries in seven geographical areas/economic groupings in 2001.

They found that worldwide there was a 20% reduction in global disease burden per head between 1990 and 2001 due to progress in tackling infectious, nutritional, maternal and perinatal* conditions.

HIV/AIDS accounted for 2% of deaths in 1990, but for 14% in 2001. Malaria mortality also increased in the 1990s, primarily in sub-Saharan Africa.

“Worldwide, HIV/AIDS and malaria are large growing causes of death and disease burden, especially in sub-Saharan Africa, where they have negated gains in reducing child mortality in Africa from measles, acute respiratory infections, and diarrhoea,” Professor Lopez said.

Heart disease and stroke were the leading causes of deaths in low, middle, and high income countries, together responsible for more than a fifth of all deaths worldwide.

Lung cancer was the third leading cause of death in high-income countries but was not yet among the leading causes in low-and-middle income countries, where five of the ten causes of death remain infectious diseases.

In Australia, cancer is now the country’s biggest burden of disease, knocking cardiovascular disease off the top spot for the first time in more than thirty years.

Professor Lopez said efforts to reduce cardiovascular disease, for example, through anti-smoking campaigns, were responsible for the shift.

“It’s not that there is more cancer – it’s that there is less cardiovascular disease,” he said.

Worldwide over 56 million people died in 2001. Nearly 20% of these deaths were among children younger than 5 years. 99% of these children lived in low and middle income countries.

Media contacts:
Professor Alan Lopez telephone 07 3365 5280 a.lopez@sph.uq.edu.au

Vanessa Mannix Coppard telephone 042 420 7771 v.mannixcoppard@sph.uq.edu.au

Note to editors
*The perinatal period is just before and just after birth.