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Improving people's health

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Acknowledgements Foreword Overview: Promoting Freedom, Security and Opportunity Chapter 1: Promoting Democratic Governance Chapter 2: Driving Economic Growth Chapter 3: Improving People's Health Chapter 4: Mitigating and Managing Conflict Chapter 5: Providing Humanitarian Aid Chapter 6: The Full Measure of Foreign Aid Last updated: 28     Jump to Overview Sections: >> 50 years of development gains >> Promoting democratic governance >> Driving economic growth >> Improving people's health >> Mitigating and managing conflict >> Providing humanitarian assistance >> The full measure of U.S. development assistance-official and private >> Notes >> Background papers >> References When it comes to health, developing countries are separating into two groups. In the first, larger group, health care has improved dramatically in recent decades-raising life expectancies, expanding workforces, and reducing deaths from communicable diseases. As a result, by 2020 these countries will have achieved international objectives for basic health indicators. They will have smaller populations under 5, and their median ages will approach those in industrial countries today. Moreover, noncommunicable diseases will be the leading cause of death. But these countries will still have subpopulations with health profiles similar to those in least developed economies. Further, there may be unexpected shocks that could cause countries to regress, such as the HIV/AIDS epidemic, social upheaval, and natural disasters. In a second, smaller group of developing countries which includes badly managed economies that have seen little or no growth in recent years health indicators have stagnated or worsened. Fertility and infant mortality rates are high. Life expectancies are low. And infectious diseases, including HIV/AIDS, are widespread. Though some of these countries are seeing slight improvements in demographics and mortality rates, they will not approach the levels of today’s industrial countries by 2020. These features offer opportunities and create challenges. In addition to maintaining basic public health services, the first group of countries must decide how to invest in new approaches and technologies. Global health programs can shift their focus from women of reproductive age and children under 5 to entire families, including income earners and elderly dependents. Better health outcomes will require better management of chronic diseases, from prevention through treatment. Sustainable progress in health will require health care institutions with both capital and recurrent financing. And systems will need to respond to rising expectations for health care and to the dominance of private flows in its funding. In the second group of countries public health interventions will have to remain focused on family planning and maternal and child health but, given serious quality problems, must radically revise the strategies used to do so. By 2020 nearly nine of 10 people in this group of countries will be African. New thinking is needed to generate more effective results from global health programs. In addition, consideration must be given to external concerns that affect health outcomes including income growth, education, water, sanitation, and good governance. page 2

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