Life Expectancy Increased, But COVID-19 Threatens Gains
Healthcare workers in Nigeria fight to maintain vaccination services during the COVID-19 pandemic.

Life expectancy has increased, particularly in low income countries, but COVID-19 threatens to throw progress off track, according to the World Health Organization’s annual roundup of worldwide disease and mortality trends.

“The good news is that people around the world are living longer and healthier lives. The bad news is the rate of progress is too slow to meet the Sustainable Development Goals and will be further thrown off track by COVID-19,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus of the 2020 World Health Statistics report.

The biggest gains were reported in low-income countries, which saw life expectancy rise 21% or 11 years between 2000 and 2016, compared with an increase of 4% or 3 years in higher income countries.

One driver of progress in lower-income countries was improved access to services to prevent and treat HIV, malaria and tuberculosis, as well as a number of neglected tropical diseases such as guinea worm. Another was better maternal and child healthcare, which led to a halving of child mortality between 2000 and 2018.

However, few gains were made in worldwide immunization coverage, which has remained stagnant at 85% since 2016. And there is still too little attention on non-communicable diseases (NCD) such as heart disease, stroke, diabetes, or cancers, which caused 70% of all deaths in 2016. Some 85% of NCD deaths occurred in low income countries.

But in the context of the COVID-19 pandemic, inequality between and within countries in NCD control and immunization may  grow with the disruption of essential health services, leaving populations more vulnerable to the virus. Gains against HIV, malaria, tuberculosis will likely stagnate or be rolled back if programmes targeting these diseases are disrupted, WHO, UNAIDS, and other NGOs and UN agencies have warned.

Inequality Has Left Some Countries More Vulnerable to COVID-19

Availability of healthcare services in low- and middle-income countries still remains much lower than in wealthier ones, and low- and middle-income countries still have too few healthcare workers, despite the gains in life expectancy. Additionally, many people in lower income countries lack access to safe sanitation and clean water, and live in poor housing facilities that pose additional barriers to preventing COVID-19.

“The COVID-19 pandemic highlights the need to protect people from health emergencies, as well as to promote universal health coverage and healthier populations to keep people from needing health services through multisectoral interventions like improving basic hygiene and sanitation,” said Dr Samira Asma, WHO assistant director-general.

More than 40% of all countries have fewer than 10 medical doctors per 10,000 people. Over 55% of countries have fewer than 40 nursing and midwifery personnel per 10,000 people.

More than half (55%) of the global population was estimated to lack access to safely-managed sanitation services, and more than one quarter (29%) did not have access to safe drinking water in 2017. Two in five households globally (40%) did not have basic hand-washing facilities.

The inability to pay for healthcare is another major challenge. Approximately 1 billion people will be spending at least 10% of their household budgets on health care in 2020, according to WHO estimates. The majority of these people live in lower middle-income countries.

Coupled with the increasing burden of NCDS in low- and middle-income countries, these inequalities have left low- and middle-income countries even more vulnerable to the pandemic.

“We know now that people living with noncommunicable diseases such as diabetes, heart disease, and kidney disease, as well as people with hypertension and obesity, are at much higher risk of suffering severe complications and dying from COVID-19,” said NCD Alliance CEO Katie Dain. “We must not forget that many of these conditions are preventable. This report reinforces what the current COVID-19 pandemic has already taught us –  that a failure to invest in health is a failure to invest in a country’s own security.”

Addressing these challenges is on the agenda for next week’s 73rd World Health Assembly, to be held online for the first time. The WHA will focus primarily on COVID-19, and Member States will meet from May 18 to 19.

“During the World Health Assembly next week, we will discuss with health leaders from across the world, not only how to defeat COVID-19, but also how we can build back stronger health systems, everywhere,” said Dr Tedros.

“The coronavirus is an unprecedented shock to the world. Through national unity and global solidarity, we can save both lives and livelihoods and ensure that other health services for neglected diseases, child vaccination, HIV, TB and malaria continue to improve…We have a once in a lifetime opportunity to prove that the world is more than just a collection of individual countries with colorful flags.”

Image Credits: Twitter: @WHOAFRO.