What Do the Numbers Say About Global Health?

The state of global health is never static. The past century has seen some of the greatest advances in life expectancy and overall health in human history. And yet huge disparities exist between rich and poor nations in measures such as infant mortality and life expectancy. Richard Skolnik, a global health expert, talks about how to use the data to inform better decision-making—and to save lives.

In March, India was finally declared polio free, a major achievement for a country with nearly half the world's cases just five years ago. Polio eradication efforts are one of the success stories of global public health. Now there are only three countries considered endemic for polio—Afghanistan, Nigeria, and Pakistan—down from 125 in 1988.

But even the successes only tell part of the story. While health for wealthy and rising countries has been on a consistent upward trajectory for decades, other sectors of the globe continue to struggle under the burden of poverty and a host of persistent diseases, including HIV, dysentery, and tuberculosis.

In an excerpt from the Global Health course in the MBA for Executives program, Richard Skolnik, lecturer in public health at the School of Public Health, runs through some of the numbers to elucidate how the developing world continues to lag. He cites a figure to drive the point home: 7 million children under five die each year. "That's the equivalent of 2,000 777 [airplanes], or nearly six per day," he says. "If six 777s a day fell out of the sky filled with under-five children, I presume you'd be concerned."

Not only are child mortality numbers higher in poor areas, such as sub-Saharan Africa, but a larger proportion of deaths occur after the first year, due to mostly preventable causes. Skolnik prods students to think about how policy makers in developing countries should think about these numbers.

While developing countries tend to lag developed ones in terms of health, the gap can narrow rapidly under the right circumstances. During the last two decades of the 20th century, several East Asian countries experienced the largest increase in health in the shortest period of time in human history. The reason, Skolnik says, can be attributed to the East Asian economic miracle. This experience, he said, provides a kind of blueprint for those seeking to improve global health: "How you spend your money, in my view, is more important than how much you spend," he says. "If you develop rapidly and invest wisely, life expectancy can improve a lot."

Lecturer in Public Health, Yale School of Public Health