Combating disease and improving health Presented by ROSANNA AGBLE at Taking Action for the World’s Poor and Hungry People Beijing, China October 17–19, 2007

High-income countriesMiddle-income countriesLow-income countries DiseaseDeaths in millions % of deaths DiseaseDeaths in millions % of deaths DiseaseDeaths in millions % of deaths Coronary heart disease Stroke and other cerebrovascular diseases Coronary heart disease Stroke and other cerebrovascular diseases Coronary heart disease Lower respiratory infections Trachea, bronchus, lung cancers Chronic obstructive pulmonary disease HIV/AIDS Lower respiratory infections Lower respiratory infection Perinatal conditions Chronic obstructive pulmonary disease HIV/AIDS Stroke and other cerebrovascular diseases Colon and rectal cancers Perinatal conditions Diarrhoeal diseases Alzheimer and other dementias Stomach cancer Malaria Diabetes mellitus Trachea, bronchus, lung cancers Tuberculosis Breast cancer Road traffic accidents Chronic obstructive pulmonary disease Stomach cancer Hypertensive heart disease Road traffic accidents

Causes of death by age group

Causes of death by age group 2. Women Africa accounts for 20% of the world’s births but 40% of world’s maternal deaths. Chance of dying in pregnancy or childbirth: one in 16 Result from cumulative effects of malnutrition in childhood, lack of adequate housing and sanitation, poor educational opportunities and lack of access to health care.

Top 10 major preventable risks globally childhood and maternal underweight; unsafe sex; high blood pressure; tobacco; alcohol; unsafe water, sanitation and hygiene; high cholesterol; indoor smoke from solid fuels; iron deficiency and overweight/obesity.

Major preventable risks in developing countries Underweight Deficiencies in micronutrients like iron and zinc Unsafe sex Unsafe water, sanitation, and hygiene Indoor smoke from solid fuels, the leading risks examined in those countries.

Selected Major Risk Factors and What to Do About Them

Underweight/under-nutrition The most cost effective strategy to reduce under-nutrition and its consequences combines a mix of preventive and curative interventions. – Micronutrient supplementation and fortification - Vitamin A, zinc and iron – is very cost-effective. –Maternal counselling to continue breast feeding, and targeted provision of complementary food as necessary. –Routine treatment of diarrhoea and pneumonia, major consequences of under-nutrition

High blood pressure and cholesterol Reducing salt in processed foods Cutting dietary fat, Encouraging exercise Higher consumption of fruits and vegetables Lowering smoking.

Unsafe Water and Sanitation Improved water supply and basic sanitation, if extended globally, could prevent 1.8 billion cases of diarrhoea If universal piped and regulated water supply were achieved, 7.6 billion cases of diarrhoea (69.5 per cent reduction) would be prevented annually. In the short term, the most cost-effective strategy evaluated is disinfection of unsafe water at the point of use.

Iron deficiency Affects an estimated two billion people with consequences for maternal and perinatal health and child development. 800,000 (1.5 per cent) of deaths worldwide are attributable to iron deficiency, 1.3 per cent of all male deaths and 1.8 per cent of all female deaths. Interventions -- Iron fortification

Conclusion Implementing these interventions require bold policies by Governments. Health ministries, have to play a stronger role –in formulating risk prevention policies –give top priority to developing effective, committed policies for the prevention of large risks to health, –increase and encourage intersectoral and international collaboration to reduce major extraneous risk to health (unsafe water and sanitation or a lack of education)