Bitter Pills:Medicines & The Third World Poor | Page 12
CHAPTER 1
A PILL FOR ALL ILLS?
Medicines and health
FIFTY YEARS ago in the world's poorest countries average life expectancy was
only 30 years. At that time the first modern drugs were only just being developed
in Europe and America. In the poor world today average life expectancy is 50
years. '"The poor may live longer now but the evidence suggests that during their
lifetime, they are likely both to experience as much ill-health as their greatgrandparents, and to suffer from essentially the same health problems. In fact,
for the vast majority of the Third World poor, the quality of life has barely
improved. For some it has almost certainly worsened. <21
Do modern drugs offer a solution? Could their use radically improve the quality
of life of the Third World poor? Before looking at the potential of modern drugs,
we need to take stock of the health problems in poor countries and examine their
underlying causes.
DIAGNOSIS OF ILL-HEALTH
Even the most 'reliable' statistics on ill-health in poor countries can be little more
than 'guesstimates'. Localised studies can often give a more accurate picture than
national statistics. In many countries official figures on causes of death are based
entirely on hospital records. But hardly any of the dead end up in hospital, for
example, less than 4% in Tanzania. (3) Official statistics also tend to mask the
major health problems of the poor. After all, they can only cover patients treated
by the health services, whereas WHO estimates that in many Third World countries
as many as 70% of the population has no access to organised health care. |4)
So official statistics are almost invariably underestimates of the true incidence
of premature death and disease. But there is little doubt about the major health
problems in poor countries, or the fact that the poorest are most severely affected.
The single most widespread cause of ill-health is malnutrition.