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Death rates for many communicable diseases fell in past decade
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Over the past decade, significant declines were seen in total deaths and age-standardized death rates for many of the world’s communicable diseases, according to findings from the Global Burden of Disease 2015 Study.
“Amid these gains, less pronounced progress occurred for several communicable diseases, and fatalities climbed rapidly for others, such as the Ebola virus disease,” researchers wrote in a far-ranging report published in The Lancet.
According to the report, several factors drove a decrease in total deaths and age-standardized death rates between 2005 and 2015 for communicable, maternal, neonatal and nutritional diseases, including continued progress against HIV/AIDS and malaria.
HIV/AIDS deaths fell 33.4% (95% uncertainty interval [UI], 30-36.2) between 2005 and 2015, from 1.8 million (95% UI, 1.7 million to 1.9 million) to 1.2 million (95% UI, 1.1 million to 1.3 million), while age-standardized death rates dropped 42.1% (95% UI, 39.1-44.6), according to the researchers. Expansion of ART and reducing the rate of mother-to-child transmission were factors in the decrease in HIV/AIDS–related mortality, they said.
Malaria deaths declined 37.4% (95% UI, 27.8-47) in the same period to 730,500 (95% UI, 555,800-904,000), while age-standardized death rates fell 43.1% (95% UI, 34.7-51.8). The researchers said there have been “sustained” gains against malaria, which killed an estimated 1.2 million people in 2003.
Among other developments in the report, as noted by the researchers:
- Mortality rates declined for diarrheal disease, tetanus, measles and African trypanosomiasis.
- Slower progress was made among certain diseases such as tuberculosis, which killed an estimated 500,000 fewer people than HIV/AIDS in 2005, but was responsible for only approximately 100,000 fewer deaths than HIV/AIDS by 2015 (TB deaths decreased 17.4%).
- Total mortality rates due to lower respiratory infections and meningitis remained “fairly constant.”
- Significant reductions in deaths due to hepatitis A virus drove down hepatitis-related mortality rates.
- Deaths due to dengue, leishmaniasis and Ebola increased.
Overall global life expectancy from birth increased from 61.7 years (95% UI, 61.4-61.9) to 71.8 (95% UI, 71.5-72.2) years between 1980 and 2015, according to the report. Researchers said advancements in the fight against HIV/AIDS led to “very large gains” in life expectancy in several sub-Saharan African countries between 2005 and 2015. – by Gerard Gallagher
Disclosures: Please see the full study for a list of all authors’ relevant financial disclosures.
Perspective
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Kenneth H. Mayer
The recent report in the Lancet by the Global Burden of Disease 2015 Mortality and Causes of Death Collaborators presents many exciting findings and highlights areas in need of continued action. Overall, mortality has fallen significantly across the planet over the past 35 years. Global progress has been much less impressive for the probability of death among those aged 15 to 50 years than for children. In the younger adult age groups, temporal patterns were profoundly shaped by the unfolding of the HIV epidemic in Eastern and Southern sub-Saharan Africa and roll-out of ART and prevention of mother-to-child transmission. Yet despite major progress, especially amid the scale-up of HIV treatment and prevention in sub-Saharan Africa, HIV/AIDS remains the leading cause of death in youth in 16 countries and among top five causes of mortality in 38 countries. They also estimated that 17.8% of the HIV deaths in 2015 were due to tuberculosis in HIV-infected people. These findings underscore the need for expanded funding to optimize control of the HIV and TB epidemics. Drugs are available now to effectively address each of these synergistically interacting epidemics, but level or decreasing funding by some of the key international donors may lead to further deterioration in recent successes. Because HIV and TB are communicable infections, failure to ensure ongoing access to medication for those who have initiated treatment, and expanded screening for those who are infected with either pathogen but unaware of their infection could undermine many of the important successes highlighted in the Lancet report.
* Photo credit: The Fenway Institute
Disclosure: Mayer reports receiving support from the NIH for his NIH studies, and getting unrestricted research grants from Gilead Sciences and ViiV Healthcare for additional HIV prevention research.
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