Global burden of disease report shows gains made from HIV response, work that remains to respond to infectious disease

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cover-tifGlobal life expectancy has increased by 10.2 years since 1980, with the most marked increases occurring over the past decade in Sub-Saharan Africa, where the expansion of antiretroviral therapy and prevention of mother-to-child transmission of HIV activities have expanded life expectancy by more than ten years in countries with the highest HIV burdens.

Zimbabwe in particular saw the fastest progress, with life expectancy increasing by 11.7 years in men and 17 years in women since 2005, according to the Global Burden of Disease report published in The Lancet. South Africa, Ethiopia, Botswana, Zambia, Swaziland and Malawi also saw large increases in life expectancy since 2005 due to marked reductions in deaths from HIV, the report says.

Deaths from HIV have fallen by 33 percent since the peak of global HIV deaths in 2005, when 1.8 million people died from HIV, compared to 1.2 million who died from HIV in 2015. Eighteen percent of HIV deaths were due to tuberculosis, the study authors estimate. HIV deaths among children under five have fallen by 52 percent, to 88,900 deaths in 2015.

Deaths from other communicable diseases have also fallen since 2005, including deaths from malaria, hepatitis and tuberculosis. While deaths from tuberculosis have fallen by 17.4 percent since 2005, currently deaths from tuberculosis exceed deaths from HIV, with 1.8 million dying from tuberculosis in 2015.

The most marked increase in death comes from dengue, which has seen an increase in deaths by 49 percent since 2005. Increasing transmissions of dengue contributes to growing concerns about other viruses transmitted by the Aedes mosquito, the report notes, including Chikungunya and Zika virus. Deaths from other vector-borne diseases such as Chagas disease and leishmaniasis have marginally increased over the past decade as well.

While HIV has dropped from being the fourth highest cause of years of lives lost globally to being the seventh, HIV, along with malaria, is still responsible for the most years of lives lost in Sub-Saharan Africa, according to study authors. HIV remains among the top five causes of death in 38 countries.

“Continued high death rates in sub-Saharan Africa highlight the critical importance of improved quality of care and early initiation of therapy, irrespective of disease progression,” the report notes, adding, “Stagnating development assistance for health for HIV/AIDS programs amplifies the challenge of reducing HIV/AIDS mortality.”

In light of the Ebola and Zika outbreaks, the report also makes the case for improved surveillance and preparedness infrastructure to better respond to the next Public Health Emergency of International Concern when it happens.

“These findings come at a time when two very different views of the future of health can be envisioned,” the report says. “Rising threats such as climate change food insecurity, water shortages, pandemics, human security, continued increases in obesity, or antimicrobial resistance that could undermine past health gains; and the realization of the huge potential of new medical and public health breakthroughs driven by genomics, nanotechnology and other technical developments.”

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