Life expectancy increased as the world tackled the big killers, although poor management of the pandemic slowed progress

According to a new study published in 1990, global life expectancy has increased by 6.2 years since 1990 The Lancet. Over the past three decades, declines in deaths from the leading causes of death have fueled these advances, including diarrhea and lower respiratory infections, as well as stroke and ischemic heart disease.

When the COVID-19 pandemic emerged in 2020, progress was derailed in many locations. This is the first study to compare deaths from COVID-19 with deaths from other causes worldwide.

Despite the challenges posed by the COVID-19 pandemic, the researchers found that the Southeast Asia, East Asia and Oceania superregion saw the largest net gain in life expectancy (8.3 years) between 1990 and 2021, largely due to the decline in life expectancy. mortality from chronic respiratory diseases, stroke, lower respiratory tract infections and cancer.

The super-region’s strong management of the COVID-19 pandemic has helped sustain these gains. South Asia experienced the second largest net increase in life expectancy among super-regions (7.8 years) between 1990 and 2021, mainly due to the sharp decline in deaths from diarrheal diseases.

“Our study provides a nuanced picture of global health,” said Dr. Liane Ong, co-first author of the study and principal investigator at the Institute for Health Metrics and Evaluation (IHME). “On the one hand, we see the monumental achievements of countries in preventing deaths from diarrhea and stroke,” she said. “At the same time, we see how much the COVID-19 pandemic has held us back.”

The research also highlights how COVID-19 radically changed the top five causes of death for the first time in thirty years. COVID-19 is replacing long-dominant fatal stroke – and has become the second leading cause of death worldwide. The study presents updated estimates from the Global Burden of Disease Study (GBD) 2021.

The authors found that the super-regions hit hardest by the COVID-19 pandemic were Latin America and the Caribbean and Sub-Saharan Africa, where the most years of life were lost in 2021 due to COVID-19. life caused by the COVID-19 pandemic, the researchers also identified the reasons behind the improvements in life expectancy in each super region.

Looking at the different causes of death, the research shows a sharp decline in the number of deaths from intestinal diseases – a class of diseases that also includes diarrhea and typhoid. These improvements have increased life expectancy by 1.1 years worldwide between 1990 and 2021.

A reduction in deaths from lower respiratory tract infections increased global life expectancy by 0.9 years over this period. Progress in preventing deaths from other causes also increased life expectancy around the world, including stroke, neonatal disease, ischemic heart disease and cancer. For each disease, the decline in deaths was most pronounced between 1990 and 2019.

At a regional level, Eastern Sub-Saharan Africa experienced the largest increase in life expectancy, increasing by 10.7 years between 1990 and 2021. Control of diarrheal diseases has been the leading force behind improvements in this region. East Asia recorded the second largest increase in life expectancy; The region’s success in reducing deaths from chronic obstructive pulmonary disease played a key role.

The GBD 2021 study measures mortality by cause of death and years of life lost at global, regional, national and subnational levels. The analysis links specific causes of death to changes in life expectancy.

The study not only highlights the diseases that have led to increases and decreases in life expectancy, but also looks at how disease patterns have shifted over time across different locations, which, as the authors write, offers an “opportunity to advance our understanding of mortality reduction’. strategies…[which] could reveal areas where successful public health interventions have been implemented.”

GBD 2021 highlights places that have made huge progress in preventing deaths from serious illness and injuries. It also highlights how some of the most burdensome diseases are now concentrated in certain locations, underscoring the opportunities for intervention. For example, in 2021, deaths from intestinal diseases were largely concentrated in sub-Saharan Africa and South Asia.

For another disease, malaria, researchers found that 90% of deaths occurred in an area inhabited by just 12% of the world’s population, in an area stretching from western Africa south of the Sahara through Central Africa to Mozambique.

“We already know how to save children from dying from intestinal infections, including diarrheal diseases, and progress in the fight against this disease has been enormous,” said Professor Mohsen Naghavi, co-first author of the study and director of Subnational Burden of Disease Estimation at IHME. .

“Now we must focus on preventing and treating these diseases, strengthening and expanding immunization programs and developing brand new vaccines against E. coli, norovirus and Shigella,” he added.

The study not only provides new insights into COVID-19, but also reveals the growing threats of non-communicable diseases, such as diabetes and kidney disease, which are increasing in every country. The researchers also point to uneven progress in conditions such as ischemic heart disease, stroke and cancer. High-income countries have reduced deaths from many types of non-communicable diseases, but many low-income countries have not.

“The global community must ensure that the life-saving resources that have reduced deaths from ischemic heart disease, stroke and other non-communicable diseases in most high-income countries are available to people in all countries, even where resources are limited are,” says Eve. Wool, senior author of the study and Senior Research Manager at IHME.