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WHO SETS OUT WORLD'S DEADLY TOP 10
By Andy Coghlan
Wednesday, October 30, 2002
Just 10 avoidable risk factors, including malnutrition, unsafe sex, smoking
and poor sanitation, account for a massive 40 per cent of global deaths each
year, warns the World Health Organization.
The WHO's new data on patterns of death and illness appear in its World
Health Report 2002, launched on Wednesday. The WHO says that cheap remedies
exist and that governments of all countries can do more to prevent
unnecessary and premature death. It concludes such countermeasures could
extend average life expectancy by five to 10 years.
"This report provides a road map for how societies can tackle a wide range
of preventable conditions that are killing millions of people prematurely
and robbing tens of millions of healthy life," says Gro Harlem Brundtland,
WHO director general.
The risks are starkly different between "haves" and "have-nots". Whereas
poor people typically die through lack of food and clean water, the rich die
through diseases of overindulgence. The reasons may be obvious, but the WHO
describes them as "shocking".
Indoor air pollution
Of the 10 risk factors, the five that dominate in poor countries are:
abnormally low body weight, unsafe sex, iron deficiency, unsafe water and
exposure to indoor smoke from solid fuels.
"Indoor air pollution was a complete surprise," says Christopher Murray,
overall director of the report. The smoke causes pneumonia in children and
lung disease in women.
In richer countries, the five key killers are tobacco, alcohol, high blood
pressure, high blood cholesterol and obesity.
Murray says that a big surprise was the unexpectedly large impact of high
blood pressure, cholesterol and alcohol on intermediate-level countries such
as India and China.
"They've always been perceived as problems of high-income countries," says
Murray. So countermeasures now, as countries industrialise, could have
disproportionately large benefits in the future, he says.
Cheap but effective measures to combat these diseases of "affluence" include
slapping higher taxes on tobacco to combat cancer and heart disease. WHO
reports that consumption falls by two to 10 per cent for every 10 per cent
increase in price.
And mandatory reductions in the amount of salt added to processed foods
could reduce strokes and heart attacks caused by high blood pressure.
In poor countries, abnormally low weight in infants and mothers is the major
avoidable risk factor, killing 3.4 million in 2000. Children who are lower
in weight are weak and more prone to infection because they are
malnourished, lacking simple dietary essentials such as calories, proteins,
vitamins and minerals such as iron.
Among the cheap remedies, the WHO advocates adding micronutrients such as
vitamin A, zinc and iron to food, plus counselling to encourage mothers to
Unsafe sex is also a massive killer, with HIV/AIDS causing 2.9 million
fatalities in 2000. WHO says that life expectancy at birth is in sub-Saharan
Africa is 47 years, but would be 62 without AIDS.
Remedies include a mixture of measures, from counselling and education to
provision of condoms and treatment of pregnant mothers with antiviral drugs
to prevent HIV spreading to their babies.
If governments act on its advice, the WHO estimates that 16 healthy years
could be added to lifespans in parts of Africa where expectancy has fallen
as low as 37 years. And in rich countries, healthy lifespans could be raised
by five years.
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