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Dear Eliana, Your suggestion about violence being possibly responsible for the large male-female life expectancy difference in Sri Lanka is not borne out by the available facts. The male-female difference in Sri Lanka is long-standing from at least the 1960s - long before any political violence occurred. This difference has been growing since at least that time, owing to stagnation in older adult male life expectancy, despite increasing female life expectancy. This is not a new observation - it was noted by the UN and Sri Lankan demographers as early as the 1970s, and is a rather old demographic observation. Intriguingly, this older male stagnation occurred even in the USA and many developed countries during the 1960s-70s, and was also noted in the 1970s in Malaysia. This trend has persisted and the gap has widened. Sri Lanka is fortunately one of the few developing countries which does count most of its dead as well as most of the children who are born (the latter a universal right not met in most other countries). So we have good data. These data show, as we have recently done in ongoing AAA work for the Bank, that the stagnation is due to rising mortality in older adult males from non-communicable disease (NCDs), and more specifically heart disease. In that respect, your concern about lack of health services is correct. To reduce NCD mortality in Sri Lanka will require substantially expanded healthcare for NCDs in older adults, particularly providing those cost-effective, cheap medical interventions (for the numbers, see the WB's own book on Disease Control Priorities (Ed. Jamison et al, 2004). However, and this is perhaps the rub, this will require a reorientation in focus by policy makers in Sri Lanka and also in agencies such as World Bank away from those kids less than five years of age, to their older fathers and mothers who are dying far too early from cheaply preventable and treatable NCDs. It is no longer adequate for Sri Lanka and its friends to ask if kids reach the age of five - the better and more urgent question is to ask how many Sri Lankans will never live to be as old as Peter O'Toole (77 years old) because they die far too early from NCDs that would have been treated if only they lived in London or Washington DC, where public money is used to provide those treatments. Just for the record, in a typical year in Sri Lanka less than 5,000 kids die before the age of 5, and less than 20,000 from violence, compared to more than 80,000 from NCDs, of which at least 20,000 are avoidable at minimal cost. So yes - life is absolutely important, but real concern needs to focus on where in the life cycle life is really shortened, and we need to avoid generalizing problems across the whole region, especially when dealing with Sri Lanka and the Maldives. I hope that the Bank will join Sri Lankans in making that case and encouraging Sri Lankans and their government to invest the needed tax monies in better care for NCDs. Regards, Ravi