1. Combating disease and improving health Presented by ROSANNA AGBLE at Taking Action for the World’s Poor and Hungry People Beijing, China October 17–19, 2007

2. High-income countriesMiddle-income countriesLow-income countries DiseaseDeaths in millions % of deaths DiseaseDeaths in millions % of deaths DiseaseDeaths in millions % of deaths Coronary heart disease1.3417.1Stroke and other cerebrovascular diseases 3.0214.6Coronary heart disease3.1010.8 Stroke and other cerebrovascular diseases 0.779.8Coronary heart disease2.7713.4Lower respiratory infections 2.8610.0 Trachea, bronchus, lung cancers 0.465.8Chronic obstructive pulmonary disease 1.577.6HIV/AIDS2.147.5 Lower respiratory infections 0.344.3Lower respiratory infection 0.693.3Perinatal conditions1.836.4 Chronic obstructive pulmonary disease 0.303.9HIV/AIDS0.623.0Stroke and other cerebrovascular diseases 1.726.0 Colon and rectal cancers0.263.3Perinatal conditions0.602.9Diarrhoeal diseases1.545.4 Alzheimer and other dementias 0.222.7Stomach cancer0.582.8Malaria1.244.4 Diabetes mellitus0.222.7Trachea, bronchus, lung cancers 0.572.7Tuberculosis1.103.8 Breast cancer0.151.9Road traffic accidents0.552.6Chronic obstructive pulmonary disease 0.883.1 Stomach cancer0.141.8Hypertensive heart disease 0.542.6Road traffic accidents0.531.9

3. Causes of death by age group

4. Causes of death by age group 2. Women Africa accounts for 20% of the world’s births but 40% of world’s maternal deaths. Chance of dying in pregnancy or childbirth: one in 16 Result from cumulative effects of malnutrition in childhood, lack of adequate housing and sanitation, poor educational opportunities and lack of access to health care.

5. Top 10 major preventable risks globally childhood and maternal underweight; unsafe sex; high blood pressure; tobacco; alcohol; unsafe water, sanitation and hygiene; high cholesterol; indoor smoke from solid fuels; iron deficiency and overweight/obesity.

6. Major preventable risks in developing countries Underweight Deficiencies in micronutrients like iron and zinc Unsafe sex Unsafe water, sanitation, and hygiene Indoor smoke from solid fuels, the leading risks examined in those countries.

7. Selected Major Risk Factors and What to Do About Them

8. Underweight/under-nutrition The most cost effective strategy to reduce under-nutrition and its consequences combines a mix of preventive and curative interventions. – Micronutrient supplementation and fortification - Vitamin A, zinc and iron – is very cost-effective. –Maternal counselling to continue breast feeding, and targeted provision of complementary food as necessary. –Routine treatment of diarrhoea and pneumonia, major consequences of under-nutrition

9. High blood pressure and cholesterol Reducing salt in processed foods Cutting dietary fat, Encouraging exercise Higher consumption of fruits and vegetables Lowering smoking.

10. Unsafe Water and Sanitation Improved water supply and basic sanitation, if extended globally, could prevent 1.8 billion cases of diarrhoea If universal piped and regulated water supply were achieved, 7.6 billion cases of diarrhoea (69.5 per cent reduction) would be prevented annually. In the short term, the most cost-effective strategy evaluated is disinfection of unsafe water at the point of use.

11. Iron deficiency Affects an estimated two billion people with consequences for maternal and perinatal health and child development. 800,000 (1.5 per cent) of deaths worldwide are attributable to iron deficiency, 1.3 per cent of all male deaths and 1.8 per cent of all female deaths. Interventions -- Iron fortification

12. Conclusion Implementing these interventions require bold policies by Governments. Health ministries, have to play a stronger role –in formulating risk prevention policies –give top priority to developing effective, committed policies for the prevention of large risks to health, –increase and encourage intersectoral and international collaboration to reduce major extraneous risk to health (unsafe water and sanitation or a lack of education)