AIDS to Be 3rd Leading Cause of Death
Pastor Dale Morgan
AIDS to Be 3rd Leading Cause of Death*
By MARIA CHENG
The Associated Press
Monday, November 27, 2006; 8:56 PM
LONDON -- Within the next 25 years, AIDS is set to join heart disease
and stroke as the top three causes of death worldwide, according to a
study published online Monday.
When global mortality projections were last calculated a decade ago,
researchers had assumed the number of AIDS cases would be declining.
Instead, it's on the rise.
Currently ranked fourth behind heart disease, stroke, and respiratory
infections, AIDS is set to become No. 3, say researchers in a new report
in the Public Library of Science's Medicine journal. It accounts for
about 2.8 million deaths every year. But the researchers estimate a
total of nearly 120 million people could die in the next 25 years.
Overall, the researchers predict that in three decades, the causes of
global mortality will be strikingly similar worldwide _ apart from the
prevalence of AIDS in poorer countries. Most people will be dying at
older ages of noninfectious diseases like cardiovascular disease, stroke
and cancer.
The paper by Dr. Colin Mathers and Dejan Loncar of the World Health
Organization estimates that at a total of least 117 million people will
die from AIDS from 2006 to 2030. In an optimistic future projection, if
new HIV infections are curbed and access to life-prolonging
antiretrovirals is increased, 89 million people will die from the disease.
"What happens in the future depends very much on what the international
community does now," Mathers said.
These marked differences should spark changes in current approaches to
controlling AIDS now, say some experts.
"It will be increasingly hard to sustain treatment programs unless we
can turn off the tap of new HIV infections," said Dr. Richard Hays,
professor of epidemiology at London's School of Hygiene and Tropical
Medicine, who was not linked to the study. "These AIDS numbers point to
a need to do more in prevention."
Simply focusing on treatment or politically uncontroversial prevention
methods will not suffice. "You can't put all your eggs in the abstinence
basket," said Hays. "We need a menu of strategies for real people," he
said, adding that condom distribution as well as new methods, such as a
vaccine, are needed.
Mathers and Loncar analyzed data from more than 100 countries. The
authors looked at the links between mortality trends and income per
capita, as well as factors including education levels and tobacco use.
Their research also used U.N. estimates for projected AIDS infection
rates and the World Bank's numbers for future income per capita.
Mathers and Loncar then took all of this information and plugged it into
a complex modeling equation to predict the top future causes of death
and disease.
"This is an important contribution that will help us determine the
priorities in public health," said Dr. Majid Ezzati, an associate
professor of international health at Harvard University, who was not
connected to the paper.
While it may be possible to avert some of the impending damage from
HIV/AIDS, Mathers says that other predictions are unlikely to vary
significantly.
As populations age, he explains, they are naturally more susceptible to
illnesses like cancer and heart disease than from infectious diseases _
even in the developing world. Life expectancy is expected to increase
worldwide, with the highest projected life expectancy in 2030 to be in
Japanese women, at 88.5 years.
Mathers and Loncar speculate that by 2030, cancer deaths will jump from
7.1 million in 2002 to 11.5 million. The number of deaths from
cardiovascular disease is expected to rise from 16.7 million in 2002 to
23.3 million in 2030. Overall, they expect non-communicable diseases to
account for 70 percent of all deaths globally, up from 59 percent in 2002.
Though economic development may bring better health care, it also has an
unfortunate side effect: more road accidents. Based on rates of
increasing car ownership, the World Bank estimates that traffic
fatalities will increase globally by 66 percent by 2020. This might be
avoided, Mathers says, if developing countries learn from the experience
of developed countries, where laws and improved safety practices have
sharply cut the numbers of road-related deaths.
Knowing the likely causes of future mortality allows policymakers to
attempt to improve the expected outcome. While Mathers and Loncar are
unable to account for unforeseen events such as the emergence of new
deadly diseases or major outbreaks like a flu pandemic, their
projections may help to set the agenda of global health.
"I hope this paper inspires change," said Mathers. "And I hope our
pessimistic projections turn out to be wrong."