Global Health Gap

Across the globe, there is a sharp gap between the health care available to the rich and that available to the poor [1A].

Measuring the Global Health Gap

Since the 1950s, national governments and international organizations have committed to eliminating disparities, and improving the health of the disadvantaged, albeit with mixed success.  Disparities persist.  These can be measured in terms of access to care (or lack thereof), quality of care, mortality rates, life expectancy, and prevalence of chronic illness among the population.

As of 2012, mortality rates were still more than twice as high among black South Africans as white South Africans [1B].  One in four cancers in developing countries is attributable to infection, therefore, largely preventable [1C].  Diphtheria immunization ranges from 32% to 98% across countries [1D].

Below is a breakdown which provides additional details [2]:

• Mexico – 1 in 8 adults suffers from diabetes.
• Peru – Funding for tuberculosis control is sufficient for only 26% of the population.
• Haiti – Fully 63% of births are unattended by trained health care personnel.
• Sierra Leone – 1 in every 100 pregnant women dies of complications. In the United States, 16.7 in 100,000 women die in childbirth [3A].  In the United Kingdom, that figure is 8.2 in 100,000 [3B][4].  In Italy, the figure is as low as 3.9 in 100,000 [3C].
• Liberia – Only $66 per person is spent on health care, annually. In the United States, that figure is $10,586 per person [6].
• Rwanda – There are only 6 physicians per 100,000. In the United States, that figure is 241 per 100,000.
• Lesotho – 1 in 10 children dies before the age of 5. In the United States, that figure is 1 in 143.
• Malawi – 10% of the adult population lives with HIV/AIDS. In the United States, that figure is approximately 0.6%. 
• Kazakhstan – 25% of newly diagnosed tuberculosis patients suffer from the multi-drug resistant form of the disease. Over 40% of the remainder eventually progress to it.

Improved Quality of Care

“High-quality care is neither an aspiration for a distant future nor the sole purview of rich countries; it is central for reaching global health goals and a basic obligation of every health system to its users [5A].”

Historically, the approach taken toward improving health care involved expansion of a short list of relatively simple health interventions [5B].  

Unfortunately, improved access to health care did not reduce excess deaths from conditions requiring more complex clinical care.  In India, for instance, a shift from home births to hospital births (via cash incentives) did not reduce maternal or newborn mortality. 

In many developing countries, fewer than half of health care facilities even have water on site or nearby.

Traumatic injuries, non-communicable diseases, mental illness, and addiction all require dynamic and/or long-term treatment [5C].  Outcomes depend not only on the quality of care, but factors like provider choice and travel time to a treatment facility.  It is estimated that 43.3% of the world’s population – fully 3.16 billion people – cannot reach a healthcare facility by foot within an hour’s time [7].

All this should matter to Christians.  Poverty and the global health gap which exists because of it result from the brokenness in the world.  That brokenness concerns God profoundly.

“Listen, my beloved brethren:  Has God not chosen the poor of this world to be rich in faith and heirs of the kingdom which He promised to those who love Him?” (James 2: 5).

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[1A – 1D]  The Lancet, “Bridging the global health gap”, 9/1/16, https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30190-5/fulltext.

[2]  Except where otherwise specified, the health statistics here are courtesy of the non-profit, Partners in Health http://phi.org.

[3A – 3C]  The Guardian, “Maternal mortality:  how many women die in childbirth in your country?”, 2016, https://www.theguardian.com/news/datablog/2010/apr/12/maternal-mortality-rates-millennium-development-goals.

[4]  Journal of the Royal College of Physicians, “Why Mothers Die”, 2005, https://www.rcpe.ac.uk/sites/default/files/why_mothers_die.pdf.

[5A – 5C]  The Lancet, “Time for a quality revolution in global health” by Margaret Kruk, et al, 9/1/16, https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30131-0/fulltext.

[6]  World Population Review, “Health Care Costs by Country”, https://worldpopulationreview.com/country-rankings/health-care-costs-by-country.

[7]  Nature Medicine, “Global maps of travel time to healthcare facilities” by D. Weiss, A. Nelson, and PW Gething, 9/28/20, https://www.nature.com/articles/s41591-020-1059-1.

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