AS FORECASTS go, it鈥檚 not the most cheerful variety, but the latest prediction of the most prominent causes of death and disease a quarter of a century from now isn鈥檛 all doom and gloom.
The World 午夜福利1000集合 Organization has compiled its most comprehensive analysis yet of what people will suffer and die from in 2030, and the good news is that globally, the risk of dying before the age of 5 could be halved by then. More darkly, twice as many people will die from AIDS as now, and cigarettes will kill half as many again as at present, accounting for a tenth of all the world鈥檚 deaths in 2030. Depression will be second only to AIDS as a cause of debilitating illness.
鈥淲e鈥檙e not saying this is definitely what will happen,鈥� says Colin Mathers of the WHO in Geneva, who led the study. 鈥淏ut health officials should have the best idea we can arrive at now of what seems likely to happen, so they can prepare.鈥�
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So how good is the prediction? The WHO made its first long-range prediction of global health in 1996, but there have already been more cases of AIDS and fewer of tuberculosis than predicted. Mathers admits that the current study, published online in PLoS Medicine (vol 3, e442) is potentially prone to similar errors. The wild cards this time are evolving infectious diseases such as flu.
To make their predictions as accurate as possible, the team included a much larger set of up-to-date death and illness statistics than were available in 1996. They then modelled how those incidences will change, based partly on how the population is expected to grow and age over coming decades, and on trends in obesity and smoking.
However, the key factor is growing prosperity, says Mathers. As countries get richer, they can afford the hygiene and vaccination measures that wipe out diseases of poverty, mainly infectious diseases. 鈥淧eople die of heart disease when they鈥檙e 70 instead of diarrhoea when they鈥檙e 3.鈥� he says.
鈥淎s countries get richer, they can afford the hygiene and vaccination measures that wipe out diseases of poverty鈥�
The team therefore factored in the World Bank鈥檚 predictions of economic growth. The outlook is optimistic for Africa, where growth is forecast at 2 per cent per year, as opposed to the 0.5 per cent achieved in the 1990s. But if growth here is much slower 鈥� perhaps due to a large economic impact of AIDS 鈥� the WHO鈥檚 hopeful prediction of a 鈥渄ramatic鈥� shift in death from infancy to old age may not materialise.
AIDS deaths are predicted to soar from 2.8 million in 2002 to 6.5 million worldwide. Yet that figure still won鈥檛 overtake tobacco-related deaths, which will mushroom from 5.4 million in 2005 to 8.3 million 鈥� accounting for 1 in 10 deaths globally.
That said, the new projection鈥檚 two leading causes of death globally are the same as in the 1996 forecast: heart attack and stroke. And just as then, pneumonia, HIV and pulmonary diseases such as emphysema make up the rest of the top five.
Meanwhile, the leading causes of debilitating illness will be AIDS, depression and heart attack 鈥� unless prosperity really soars, and road accidents edge out heart attack as more people can afford to drive.
