Researchers at the World Bank warn that health policies that put the emphasis on tackling non-communicable diseases among elderly people rather than on communicable diseases among younger people risk widening the global health gap between the richest and poorest countries.

Writing in Lancet, they point out that the 1996 global burden of disease study showed that non-communicable diseases had overtaken communicable diseases as the leading cause of death worldwide.

• However, the World Bank researchers recalculated the figures to compare the burden of disease among the poorest 20 percent of the world's population with that among the richest 20 percent.

• They found that among the poorest, communicable diseases were responsible for 59 percent of deaths as compared with 8 percent among the richest.

• In contrast, 85 percent of deaths among the richest were due to non-communicable diseases compared with 32 percent among the poorest.

Thus if the decline of communicable diseases were doubled, life expectancy by 2020 would be extended by an additional 4.1 years among poor people but it would be extended by less than six months among the richest people.

Source: Roger Dobson, "Global health gap widens says World Bank," British Medical Journal, August 21, 1999.

For text http://www.bmj.com/cgi/content
/full/319/7208/470