World Bank Issues Regional Health Reports

Hassana Ousmane rests her head against the bed where her 21-month-old daughter, Zeinab, suffering from malaria, rests at the Princess Marie Louise Children's Hospital in Accra, Ghana, April 25, 2012.

The World Bank has released new reports outlining the health challenges facing six major regions. Those challenges include not only many types of disease, but road accidents as well. The bank says the reports will help policymakers develop evidence-based health programs after the Millennium Development Goals expire. The World Bank has released the reports in conjunction with the Institute for Health Metrics and Evaluation. Timothy Evans is the bank’s director of Health, Nutrition and Population. “What we see when we look beyond the global picture is that there’s a lot of regional specificity to trends in the burden of disease. And so the regional focus just allows us more detail and attention to what’s happening in different regions of the world.” He said the world is too diverse to have a one-size-fits-all health plan. “That doesn’t work anywhere,” he said, “That doesn’t work globally. It doesn’t work regionally. It doesn’t even work within a country. So the more understanding you have of context and need the better able the system is to respond appropriately.” Evans outlined the ongoing health challenges for sub-Saharan Africa. “The big one remains communicable diseases. That relates to HIV and malaria, but also the childhood killers – diarrhea and pneumonia – being two of the biggest. And of all the regions in the world, sub-Saharan Africa is the only region where there are more deaths and life years lost from communicable diseases than other types of illness or injury,” he said. Dramatic progress has been made against malaria through insecticide treated bed nets and indoor spraying. As for HIV/AIDS, greater access to antiretroviral drugs has saved many lives. Nevertheless, the World Bank regional report says these two diseases remain major health problems. Road accidents are also a top killer, not only in sub-Saharan Africa, but in most of the regions studied. Evans said, “What we’re seeing is a dramatic surge in mortality and injury from road traffic accidents. And this is a reflection of many, many, many more vehicles on the road – great increases in vehicle ownership -- and very inadequate investments in the infrastructure related to road traffic safety.” The World Bank official said that the road accident fatality rates in Africa are a hundred times greater than those in the United States. In North Africa and the Middle East, the MENA region, the health concerns are a bit different than those in sub-Saharan Africa. “The large majority of the burden of disease is tied up in what we call the non-communicable diseases – the chronic illnesses -- diseases of aging and lifestyle. And so problems with high blood pressure, diabetes, obesity, stroke. These are the lion’s share of the burden of disease in the MENA region,” he said. Much of North Africa and the Middle East has experienced and is experiencing violence and conflict. Evans says that has a direct effect on the health of populations in those countries – Syria, Libya and Egypt, for example. Evans said, “Health does well in conditions of security. Health is really threatened in conditions of insecurity and it relates to some of the terrible violence that you see, which is often associated with situations where the normal rule of law has been lost and there’s armed violence and other sorts of problems. But the second is that the uncertainty often leads to mass movements of people across borders [and] into territories where they’re not necessarily welcome.” What’s more, violence and conflict cause many skilled professionals to leave causing a brain drain. The World Bank has also issued health reports for other four other regions. In South Asia, much progress has been made regarding communicable diseases and maternal health. However, the region is hard hit by chronic illnesses, such as diabetes and cardiovascular disease. Child undernutrition also remains a big problem. East Asia and the Pacific have some of the world’s highest rates of diabetes and a high fatality rate from road accidents. In Eastern Europe and Central Asia, the World Bank says alcohol related illnesses are a major problem, along with communicable diseases, such as HIV. And the Latin America and the Caribbean region is seeing an increase in ischemic heart disease or reduced blood flow to the heart, as well as big increases in depression and low back pain. The World Bank provides two forms of support for the regions: loans and information to help formulate health plans. The information is expected to be used to evaluate the success of the expiring Millennium Development Goals and in deciding what, if anything, will replace them after 2015.