Global shift in health care burdens Aging populations: Reports show need for sharper focus in research investments.

IT IS ONE measure of improvement in conditions for the world's poorest people that public health experts are now looking ahead to a major shift in the nature of health problems facing countries around the world.

Once the focus of health concerns in developing countries was the scourge of communicable diseases that took an especially harsh toll on children. Now that immunization programs and other improvements in public health can prevent many of those needless deaths, more people are surviving to adulthood. As a result, in the three decades between 1990 and 2020, the proportion of the world's population aged 45 and over is expected to increase by 200 percent.

Consequently, poor countries will find themselves faced with a shift in the kinds of health problems they must cope with. Old threats like pneumonia, malaria and tuberculosis will still take a heavy toll in lives and productivity, but other problems are rapidly making themselves felt as well. In developed countries, health care systems are accustomed to treating cancer, heart disease, mental illnesses, accidents.

Traditionally, these afflictions have been a smaller share of the health care burden in poorer parts of the world, and the medical and public health systems are less equipped to deal with them. A prime example is tobacco-related health problems, which are growing more rapidly than the AIDS epidemic. In fact, tobacco-related deaths could almost triple in the next quarter-century, to a toll of nearly 8.4 million lives a year.

These trends are explored in a new assessment of global health problems, sponsored by the World Health Organization, the World Bank, as well as several governments and private foundations. By looking at the current and future health needs of various regions of the world, compared to the current investments in research on various diseases, the report highlights imbalances and provides the information necessary to international efforts to set a more effective agenda for health care resources.

Pub Date: 10/16/96