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State of the Tropics
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The Tropics is at the nexus of biodiversity loss, climate change, emerging and persistent disease, rising prevalence of non-communicable diseases, urbanisation and globalization.
Health outcomes in the Tropics have improved dramatically in the 21st century. In the middle of the 20th century, the majority of tropical countries had a life expectancy at birth of less than 50 years. By 2017, despite still lagging behind the rest of the world. Most tropical countries , with only a few exceptions now have a life expectancy of greater than 60 years of age.
The Tropics carries a higher burden of infectious diseases than the rest of the world. There are many interacting reasons for this encompassing social, economic, historical and environmental factors related to climate, poverty, inequality and infrastructure.
HIV/AIDS has spread around the world since it was first identified in the 1980s, affecting people from all socio-economic and ethnic backgrounds. However the majority of new infections are now within tropical nations where life saving treatments are not as readily available.
The number of people between the ages of 15 and 49 living with HIV in the Tropics is much higher than in the rest of the world. In 2018, an estimated 16.8 million 15-49 year olds in the Tropics were living with HIV, compared to 7.3 million the rest of the world.
Malaria has affected humans for thousands of years. At the height of its global distribution, 90% of the global population was exposed to malaria, with the disease extending almost as far as the Arctic Circle in the northern hemisphere. Since the discovery that mosquitoes transmit the disease in 1897, control efforts have dramatically reduced the disease’s global distribution. While in 1900, around 77% of the global population was at risk of malaria, today this figure sits at around 50%, with the vast majority of those directly exposed to the disease living in the Tropics.
Malaria incidence rates fell by 25% globally between 2000 and 2017, with the number of cases dropping from an estimated 241 million to 223 million. An estimated 97% of malaria cases occurred in the Tropics in 2017.
Global efforts to reduce malaria have been comprehensive, and in many cases, very successful. Nevertheless, many tropical nations are not on track to meet 2030 Agenda targets. Inadequate funding, inefficient implementation of interventions, anomalous climate patterns and conflict and other crises continue to slow, and in some cases, reverse progress.
Nutrition is the basis of good health and wellbeing. Undernourishment, which occurs when a person’s diet does not provide sufficient energy and nutrients to perform daily tasks can compromise the immune system, increase the risk of acquiring illness and diminish the body’s ability to absorb food and nutrients.
After several decades of progress in improving rates of undernourishment, there has been a reversal of trends in recent years, particularly in the Tropics. The total number of people affected by undernourishment around the world is estimated to have increased from around 804 million in 2016 to nearly 821 million in 2017.
In the Tropics, the proportion of the population experiencing undernourishment decreased from 20.35 in 2000 to 13.6% in 2016. However, between 2014 and 2016, the prevalence of undernourishment increased in the region.
Although these data are only available to 2016, evidence suggests undernourishment has continued to increase to 2020. There is also a very strong possibility that the COVID-19 pandemic will have a significant impact of food security and undernourishment. Communities already suffering from undernourishment will have little capacity to cope with the health and socio-economic impact of the pandemic and experts have warned to expect far more people suffering from food crises due to the virus.
Progress has been made across most major health indicators in the Tropics including tuberculosis, neglected tropical diseases and maternal and child health. However, there are concerning indications that even prior to the pandemic, progress across many health indicators had slowed.
- An estimated 62% of all new TB cases in 2018 (more than 6 million) occurred in the Tropics, and the incidence of TB in the Tropics is more than double that for the rest of the world.
- The emergence of drug-resistant TB is an ongoing challenge in some tropical countries.
- Neglected tropical diseases (NTDs) are a group of 20 diseases and other health conditions that affect more than one billion people each year, predominantly in tropical nations. While not fatal in most incidences, they cause widespread disability and a substantial burden of disease.
- Some tropical countries are still undergoing epidemiological transition, such that rates of Non-communicable diseases (NCDs) are continuing to increase alongside persistently high rates of infectious diseases and undernourishment.
- Maternal, newborn and child deaths have continued to decline globally and in the Tropics; however, far too few women, children and adolescents have access to essential, good-quality healthcare and education in the Tropics.