The Global Burden of Disease Study 2010 (GBD 2010), a systematic effort to assess the global distribution and causes of major diseases, injuries, and health risk factors, was launched last week in London.
And a special issue of The Lancet has published its results (http://www.thelancet.com/themed/global-burden-of-disease).
What are some of the main findings for Africa that can be drawn from the GBD 2010?
- Since 1990, the largest gains in life expectancy worldwide occurred in sub-Saharan African countries, especially in Angola, Ethiopia, Niger and Rwanda, where life expectancy increased by 12-15 years for men and women. Overall, male life expectancy increased from 48.8 in 1990 to 53.2 years in 2010 in central sub-Saharan Africa, 50.9 to 59.4 years in eastern sub-Saharan Africa, and 53.0 to 57.9 years in western sub-Saharan Africa.
Swaziland and Lesotho are among the countries with the highest HIV prevalence in the world.
Recent nationally representative estimates reveal an adult HIV prevalence equal to 26% in Swaziland1 and 23.2% in Lesotho2.
These countries have two other main features in common: they are small countries bordering South Africa and, during the past decades, they were exposed to massive recruitment efforts to work in South African mines. For more than a century, about 60 percent of those employed in the mining sector in the Republic of South Africa were migrant workers from Lesotho and Swaziland3.
In a recent paper4 with Lucia Corno, we started from this set of facts and investigated whether the massive percentage of migrant workers employed in the South Africa’s mining industry for a long period might be one of the main explanations for the high HIV prevalence observed in Swaziland and Lesotho.
Under-5 mortality is often used—perhaps implicitly—as a measure of “population health”. But what is happening to adult mortality in Africa?
In a recent working paperi , we combine data from 84 Demographic and Health Surveys from 46 countries, and calculate mortality based on the sibling mortality reports collected from female respondents aged 15-49. The working paper is available here and the database we used for the analysis can be found here.
We find that adult mortality is quite different from child mortality (under-5 mortality)1. This is perhaps obvious to most readers, but is clearly illustrated in figure 1. While in general both under-5 and adult mortality decline with per-capita income, and over time, the latter effect is much smaller for adult mortality, which has barely shifted in countries outside Africa between 1975-79 and 2000-04.
But in sub-Saharan Africa, contrary to under-5 mortality everywhere and to adult mortality outside of Africa, adult mortality increased between 1975-79 and 2000-04 and the relationship between adult mortality and income became positive in Africa as indicated by the upward sloping line in 2000-04.
This diverging and dramatic trend for sub-Saharan Africa is mainly driven by the HIV/AIDS epidemic.
Sexual transmission is considered to be the main source of the spread of the HIV/AIDS epidemic in Africa1.
In rich countries, when economic growth declines by three or four percentage points, people lose their jobs and possibly their houses, but they regain them when the economy rebounds. In poor African countries, children get pulled out of school—and miss out on becoming productive adults. In some cases, children die before they have a chance to go to school. If t
Even though it is the least integrated with the global economy, Africa may be the worst hit region by the global economic crisis. Each of the four channels through which the crisis is affecting Africa has a particularly nefarious impact.
I gave one of the keynotes (based on joint work with Markus Goldstein) at the recent ICASA 2008 in Dakar, Senegal on the title of this post. The fight against AIDS involves allocating scarce resources to multiple uses; and contracting, avoiding, preventing, testing for, and treating the disease all involve behavioral choices.