All over the world, the COVID-19 pandemic is causing significant loss of life, disrupting livelihoods, and threatening recent advances in health and progress towards global development goals, according to the 2020 World Health Statistics published by the World Health Organization.
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.
But in a number of areas, progress has been stalling. Immunization coverage has barely increased in recent years, and there are fears that malaria gains may be reversed.
Also, there is an overall shortage of services within and outside the health system to prevent and treat noncommunicable diseases (NCDs) such as cancer, diabetes, heart and lung disease, and stroke. In 2016, 70 per cent of all deaths worldwide were attributable to NCDs, with the majority of deaths (85%) occurring in low and middle-income countries.
This uneven progress broadly mirrors inequalities in access to quality health services. Only between one third and one half the world’s population was able to obtain essential health services in 2017. Service coverage in low- and middle-income countries remains well below coverage in wealthier ones; as do health workforce densities.
In more than 40% of all countries, there are 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.
The inability to pay for healthcare is another major challenge for many. On current trends, WHO estimates that this year, 2020, approximately 1 billion people (almost 13 per cent of the global population) will be spending at least 10% of their household budgets on health care. The majority of these people live in lower middle-income countries.