Checkup on World Health: Many Deaths Preventable : Medicine: WHO reports mortality rate could drop 40% with improved health systems, drugs, vaccines, education and lifestyles.

At least 40% of the estimated 50 million annual deaths worldwide could be prevented by improved health systems, drugs and vaccines and “a healthier lifestyle and education,” according to a report Sunday by the World Health Organization.

More than 1 billion people--or one-fifth of the world’s population--are suffering from disease at any one time, and 46.5 million of the total deaths are directly related to illness, the organization said.

Although the global death rate has decreased from 10.8 per 1,000 people in 1980 to 9.5 in 1990, there is no evidence of a significant improvement in world health, WHO said. The number of sick and disabled may have even increased, particularly among the elderly, the group added.

“The tragedy is that there are at least 20 million deaths each year that could be prevented,” said Dr. Hiroshi Nakajima, director general of the Geneva-based U.N. agency.

The report, which is scheduled to be presented to a meeting of the World Health Assembly, WHO’s policy-making body, this week in Geneva, was compiled by WHO epidemiologists who examined incidence and death rates for more than 50 diseases.

The number of childhood deaths has been dropping by 120,000 a year in the last five years, largely due to increased vaccination and oral rehydration therapy programs, WHO said. Immunization levels for the six vaccine-preventable childhood diseases recently reached a global average of 80%, and access to oral rehydration therapy--the most effective treatment for life-threatening diarrheal diseases--has increased to about 70%.

Nevertheless, 12.9 million children under the age of 5 die each year in developing countries, which is one-third the total of those who died in 1990 in the developing world, according to WHO.

This “chilling statistic” compares with 284,000 children under 5--or 2.4%--who died in industrialized nations, the report said.

AIDS also remains “a huge threat” to the public health. An estimated 30 million to 40 million people will be infected with the human immunodeficiency virus by the year 2000.

Infectious and parasitic diseases take the largest single toll, resulting in about 17.5 million deaths annually. These include an estimated 7 million deaths due to acute respiratory infections, of which 4.3 million are children younger than 5. These infections are the leading cause of death in this age group, with 80% of the mortality due to pneumonia, WHO said.

Pneumonia deaths could be reduced by one-third through the prompt use of simple oral antibiotics, which cost less than 50 cents a dose, WHO said.

The infectious/parasitic category also includes 4.2 million deaths from diarrheal diseases, 3.3 million from tuberculosis and 1 million to 2 million each from malaria and hepatitis B.

Cardiovascular diseases kill nearly 12 million and cancer 5.1 million. About 9 million developed cancer worldwide in 1990 and a total of 20 million suffer from the disease. Cancer is becoming “more common globally as a cause of death,” the report said.

An estimated 2 billion people are infected with the hepatitis B virus and 2.4 billion are infected with intestinal worms. Furthermore, 1.8 billion suffer from a vaccine-preventable illness, 2.1 billion are anemic and 600 million have tropical diseases. Also, there are 250 million new cases of sexually transmitted diseases every year.

WHO said that many individuals are afflicted with more than one disease. However, being infected does not always mean an individual is ill, the organization stressed. For example, 1.7 billion people are infected with the bacillus that causes tuberculosis, but only 20 million are actually ill.

With improvements in childhood survivability, life expectancy has risen to 65 years for the world as a whole, WHO said. For the least developed countries, however, the life expectancy is about 50. For the developed world, it is 76. The report predicted an increase globally of about four months per year during the next five years.

“However, gains in life expectancy have not been matched by comparable gains in freedom from disability or chronic illness,” Nakajima said.