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Improving the health of the world's poor

BMJ 1997; 315 doi: (Published 30 August 1997) Cite this as: BMJ 1997;315:497

Communicable diseases among young people remain central

  1. Davidson R Gwatkin, Directora,
  2. Patrick Heuveline, Research associateb
  1. a International Health Policy Program, Washington, DC 20433, USA
  2. b Population Studies Center, University of Pennsylvania, Philadelphia PA 19104, USA

    Several prominent reports have recently called attention to the world's health transition,1 2 3 4 5 a process associated with reductions in fertility and improvements in overall health. As the transition progresses death and disability among infants and children from communicable diseases tend to decline in importance relative to problems resulting from non-communicable conditions at older ages.

    The transition has proceeded furthest in the developed countries, but it has also occurred in the developing world. Recognising this, many observers have begun thinking in terms of a double burden of disease in developing countries.6 7 The first is the “unfinished agenda” of communicable diseases in the young, which dominated professional thought in the decade after the World Health Organisation's 1978 Alma-Ata conference on primary health care. The second is the “emerging agenda” of non-communicable …

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