ESSAY 3

HEALTH IN THE TROPICS

STATE OF THE TROPICS

causes of mortality. Improvements in quality of life through improved health are harder to quantify accurately at scale.

Life Expectancy
Life expectancy is covered in detail elsewhere in the
State of the Tropics, and reports that between 1950 and 2010 the gap between life expectancy in the
Tropics and the Rest of the World has narrowed.
Over this period life expectancy in the Tropics increased by 22.8 years to 64.4 years and infant mortality reduced by 36%. The rate of change of mortality and morbidity has increased over the last two decades influenced by a range of different factors. Underlying life expectancy data are aggregated data, collected by the WHO to document the

changing patterns of mortality. Table E3.1 provides the top ten causes of mortality in rank order over the last decade.
Non-communicable diseases (NCDs) accounted for two-thirds of global deaths in 2011 and infectious diseases for one-third. In 2000 the relative proportions were 60% NCDs and 40% infectious diseases. This rapid shift reflects the massive scale up in recent efforts to prevent and treat a number of major infectious diseases.
Although improvements in maternal and child mortality have been made these still remain unacceptably high. In 2011, 6.9 million children under the age of five died, 99% of these in low and middle income countries. Malaria, despite the enormous scale up in control activities still accounted for 14% of the under-five mortality in the Tropics.

There are differences in the age at which mortality occurs stratified by income. In high income countries 70% of deaths occur in the over 70s and only one in 100 occurs in an individual under
15 years of age. In low income countries 40% of deaths occur in individuals under 15 years and 20% in those over 70. The