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Health Without Wealth

The Worrying Paradox of Modern Medical Miracles

Against medical advice: a miner smoking in Heilongjiang Province, China, October 2015. jason lee / reuters

For the first time in recorded history, bacteria, viruses, and other infectious agents do not cause the majority of deaths or disabilities in any region of the world. Since 2003, the number of people who die each year from HIV/AIDS has fallen by more than 40 percent. Deaths from malaria, tuberculosis, and diarrheal diseases have fallen by more than 25 percent each. In 1950, there were nearly 100 countries, including almost every one in sub-Saharan Africa, South Asia, and Southeast Asia, where at least one out of five children died before his or her fifth birthday, most of them from infectious diseases. Today, there are none. The average life expectancy in developing countries has risen to 70.

But the news is not all good. In the past, gains in longevity went hand in hand with broader improvements in health-care systems, governance, and infrastructure. That meant the byproducts of better health—a growing young work force,

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