Wealth, it appears, is the biggest contributor to a long life. For the first time, difference in life expectancy between the richest and poorest countries is over 40 years, says the World Health Organisation's World Health Report (WHR) 2008 released on Tuesday.
Japan has the longest life expectancy at 81 years 6 months, while Zambia is the shortest at 32 years 8 months. The world's average life expectancy is 67 years. In India, the average life expectancy is 63 years, 62 for men and 64 for women.
Other inequities include annual government expenditure on healthcare varying from $20 per person to over $6,000. For 5.6 billion people in low and middle-income countries, more than half of all health care expenditure is through out-of-pocket payments. With the costs of health care rising and systems for financial protection in a mess, out-of-pocket payment on health is expected to push over 100 million people below the poverty line each year, reports the WHR.
In India, for example, the total health expenditure — including out-of-pocket spending — is 5 per cent of the GDP, but the government's spending on healthcare is barely 1 per cent of the GDP.
India also lags behind in mother and child health indices. The WHO estimates that 43 per cent — 58 million of 136 million — women the world over who will give birth this year will do so without medical assistance.
In India, 49 per cent women gave birth with assistance from a health professional, but the disparity between urban and rural India is pronounced — 75 per cent of urban women had medical help as compared to 39 per cent women in rural areas. In India, 59 per cent women still deliver their babies at home.
Similar disparities are apparent the world over, at times even between cities. In Nairobi, for example, the under-five mortality rate is below 15 per thousand in the high-income areas. In a slum in the same city, the rate is 254 per thousand.
“High maternal, infant, and under-five mortality often indicates lack of access to basic services such as clean water and sanitation, immunisations and proper nutrition,” said UNICEF Executive Director Ann M. Veneman. “Primary health care including integrated services at the community level can help improve health and save lives.”
To steer health systems towards better performance, the report calls for improved primary health care. The WHO estimates that better use of existing preventive measures could reduce the global burden of disease by 70 per cent.
Such lessons take on critical importance at a time of global financial crisis. "Viewed against current trends, primary health care looks more and more like a smart way to get health development back on track, " said WHO Director General Dr Margaret Chan.