People tend to think of heart disease and cancer as the diseases of the rich world, while AIDS, malaria, and tuberculosis afflict the poor. The latter idea is certainly true: among those, only AIDS kills an appreciable number of people in rich states (though antibiotic resistant tuberculosis may start changing that).
Just because infectious diseases tend to kill a lot more people in poor states than in rich ones, it does not follow that infectious diseases are the greatest health threat there. According to the World Health Organization, heart disease and cancer kill more people in poor states, as well, and together cause 45.9% of all global deaths. Add in diabetes and other chronic diseases, and you find that 63.5% of all deaths are caused by chronic diseases, compared with 29.7% for all infectious diseases (injuries kill 9.3%).
A forecast for the period between 2006 and 2015 predicts that deaths from infectious diseases will fall by about 4% in poor countries, while deaths from chronic illnesses will rise by about 20%. Partly, this is the result of growing affluence – particularly the ability to afford cigarettes. People in China, Russia, and Indonesia already spend between five and six percent of total household income on cigarettes.
The Millennium Development Goals include two targets relating to infectious diseases:
- Halt and begin to reverse the spread of HIV/AIDS
- Halt and begin to reverse the incidence of malaria and other major diseases
While these are obviously worthy and important goals, there is a danger of funds not being well matched to where they can do the most good. Shedding a few misconceptions about the relative health challenges of rich and poor states may help avoid that. So too, the further recognition that lifestyle factors like diet, exercise, and smoking have an enormous influence on overall morbidity and mortality.