II. Global Health Disparities: Are Profound Health Inequalities Fair?

Perhaps it does not, or should not, matter if global health serves the interests of the richest countries. After all, there are powerful humanitarian reasons to help the world’s least healthy people. But even ethical arguments have failed to capture the full attention of political leaders and the public.

It is well known that the poor suffer, and suffer more than the rich. Unfortunately, this is also true with respect to global health. What is less often known is the degree to which the poor suffer unnecessarily. The global burden of disease is not just shouldered by the poor, but disproportionately so, such that health disparities across continents render a person’s likelihood of survival drastically different based on where she is born. These inequalities have become so extreme and the resultant effects on the poor so dire, that health disparities have become an issue no less important than global warming or the other defining problems of our time.

The current global distribution of disease has led to radically different health outcomes in developed and developing countries. Disparities in life expectancy among rich and poor countries are vast. Average life expectancy in Africa is nearly 30 years less than in the Americas or Europe. Life expectancy in Zimbabwe or Swaziland is less than half that in Japan; a child in born in Angola is 73 times more likely to die in the first few years of life than a child born in Norway; and a women giving birth in sub-Saharan Africa is 100 times more likely to die in labor than a women in an rich country. While life expectancy in the developed world increased throughout the twentieth century, it actually decreased in the least developed countries and in transitional States such as Russia. As little as one concrete example offers a sense of perspective on the global health gap. In one year alone, 14 million of the poorest people in the world died, while only four million would have died if this population had the same death rate as the global rich.