Causes of death in low-income countries

Globally, about 60 million people die each year. But why people die and what risk factors lead to early death vary dramatically between countries. Non-communicable diseases, like chronic or cardiovascular conditions account for the majority of deaths in higher-income countries while infectious diseases are still among the leading causes of death in the world’s poorest countries. These diseases are also more likely to be associated with early death despite being completely preventable and treatable. Expanding access to primary health care and scaling interventions for the biggest diseases killers in low- and lower-middle income countries would save lives now and increase life expectancy over time.

HIV/AIDS

The global response to HIV/AIDS is a model for what’s possible when political will and funding are consistently directed toward a global health crisis. At its peak in 2004, AIDS was killing almost 5,479 people every day and new HIV infections doubled each year. Today that number has been reduced to 1,726 deaths a day. In 2022, 39.0 million people were living with HIV around the world, 53% of whom are women and girls.  

The global AIDS epidemic is still growing at an alarming pace. In 2022, 1.3 million people were newly infected with HIV globally. The pace of progress is well short of where it needs to be to end AIDS as a public health threat by 2030.

Malaria

For millions of people around the world, a mosquito bite can have deadly consequences. Malaria is a tropical disease caused by parasites and transmitted through the bite of an infected Anopheles mosquito.  About 95% of malaria cases and deaths globally occur in sub-Saharan Africa; just four African countries accounted for half of all malaria deaths worldwide (Nigeria, DRC, Tanzania, Mozambique). Control measures such as indoor residual spraying with insecticides, insecticide-treated bed nets, and antimalarial drugs have successfully reduced malaria cases and deaths. However, insecticide- and drug-resistance is a growing threat as these interventions continue to be scaled up. A promising new malaria vaccine recommended by WHO in 2021 could dramatically increase protection if successfully scaled up. 

Immunisation

Vaccines are one of the most cost-effective investments in health and development in history. They safely prevent sickness and death associated with infectious diseases and contribute to broader gains in education and economic development. But 1.5 million people are still dying from vaccine-preventable diseases. And climate change, conflict and urbanisation are together making it easier for infectious disease outbreaks to spread. In 2022, for the first time in three decades, global vaccination coverage among children declined. The backslide is being driven by disruptions caused by COVID-19, conflict, displacement and increasing vaccine misinformation. As a result, 25 million children are missing out on life-saving vaccines every year, placing them at risk from preventable diseases like measles and polio. The most poor and marginalised children – often most in need of vaccines – continue to be the least likely to get them.

Health expenditure

Financing for health in low-income countries has increased steadily over the past 20 years, but a closer look at the major sources of financing reveals some concerning trends: international support from donor countries is stagnant, domestic resources are not keeping pace with need, and people in the poorest countries, many of which are in sub-Saharan Africa, are far too often forced to pay for essential health services out of their own pockets.