Published on March 11, 2014
POPULATION GROWTH AND LINKAGE WITH POVERTY AND INFECTIOUS DISEASES PRAKASH DHAKAL Public Health Microbiology Tribhuvan University
OUTLINE OF PRESENTATION Population growth in World and Nepal Poverty in World and Nepal Hungry people of world Population growth and its linkage to poverty Population growth and its linkage to Infectious diseases Infectious diseases related to poverty
POPULATION GROWTH IN WORLD AND NEPAL Population is defined as the number of people living or inhabiting in a particular place. The worlds population is currently 7.2 billion where approximately 351 thousand new babies are born and 144 thousand peoples die. The rate of population growth in world is 1.14 per year. The population of China and India (Chindia) together comprises about 40 % of the total world population.
Top 20 Largest Countries by Population : 1) China 2) India 3) USA 4) Indonesia 5) Brazil 6) Pakistan 7) Nigeria 8) Bangladesh 9) Russia 10) Japan 11) Mexico 12) Philippines 13) Ethiopia 14) Vietnam 15) Egypt 16 ) Germany 17 ) Iran 18 ) Turkey 19) Congo 20 ) Thailand The population of Nepal is 26,494,504 and the rate of population growth is 1.35 per annum. The increase in population creates problems like Socio-economic discrimination, scarcity of food and shelter, increasing instability and unemployment if not properly managed.
POVERTY IN WORLD AND NEPAL Poverty is defined as the condition of being poor , due to which daily needs are difficult to fulfill and have lower socio-economic condition than riches. Nearly half of the world‘s population — more than 3 billion people — live on less than $2.50 a day. More than 1.3 billion live in extreme poverty (less than $1.25 a day). 1 billion children worldwide are living in poverty. According to UNICEF, 22,000 children die each day due to poverty.
More than 1 billion people lack adequate access to clean drinking water and an estimated 400 million of these are children. Since, unclean water yields illness, roughly 443 million school days are missed every year. In 2011, 165 million children under the age 5 were stunted (reduced rate of growth and development) due to chronic malnutrition. 870 million people worldwide do not have enough food to eat. Preventable diseases like diarrhea and pneumonia take the lives of 2 million children a year who are too poor to afford proper treatment. As of 2011, 19 million children worldwide remain unvaccinated. A quarter of all humans live without electricity — approximately 1.6 billion people.
80 percent of the world population lives on less than $10 a day. It would cost approximately $40 billion to offer basic education, clean water and sanitation, reproductive health for women, and basic health and nutrition to every person in every developing country. The World Food Program says, “The poor are hungry and their hunger traps them in poverty.” Hunger is the number one cause of death in the world, killing more than HIV/AIDS, malaria, and tuberculosis combined.
South Asia is home to over 40 percent of the world‘s poor. Of the eight countries in the region, four fall in the category of the UN-defined least developed countries. Three of them are landlocked. The share of distribution of GDP among the South Asian countries indicates that there is a lack of symmetrical distribution. The Human Development Report of 2013 confirms that in most South Asian countries, the score in terms of the HDI is very low. Of the 187 countries, Norway ranks first while Niger ranks last. Although Sri Lanka and the Maldives are comparatively better, South Asia as a region is still in an ―inhumane‖ state in terms of access to income, health and education which is essential for a decent living as per the international standards.
Nepal is ranked as the twelfth poorest countries in the world. However, over the last decade the country has made considerable progress reducing poverty but is still falling behind. Urban poverty declined from 22% to 10% and rural poverty declined from 43% to 35%. About four fifths of the working population live in rural areas and depend on subsistence farming for their livelihoods. In these areas the majority of households have little or no access to primary health care, education, clean drinking water and sanitation services. Life is a constant struggle for survival. In Nepal, only less than half of the population has access to safe drinking water and about half the children below five years of age are underweight. The average age that people live in Nepal is about 54 years while countries like Canada have achieved life expectancy of about 80 years. This is mainly due to the lack of clean water, poverty and unavailability of basic health care.
United Nations has done extensive studies on the level of poverty in Nepal. Kathmandu and surrounding area and the East Nepal have lesser poverty and the West generally suffers from grinding poverty.
Millennium development goals Goal 1: Eradicate extreme poverty and hunger Target 1a. Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day. Target 1b. Achieve full and productive employment and decent work for all, including women and young people. Target 1c. Halve, between 1990 and 2015, the proportion of people who suffer from hunger. Goal 2: Achieve universal primary education Target 2a. Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling. Goal 3: Promote gender equality and empower women Target 3a. Eliminate gender disparity in primary and secondary education preferably by 2005 and in all levels of education no later than 2015.
Goal 4: Reduce child mortality Target 4a. Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate. Goal 5: Improve maternal health Target 5a. Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio. Target 5b. Achieve, by 2015, universal access to reproductive health. Goal 6: Combat HIV/AIDS, malaria and other diseases Target 6a. Have halted by 2015 and begun to reverse the spread of HIV/AIDS. Target 6b. Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. Target 6c. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases.
Goal 7: Ensure environmental sustainability Target 7a. Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources. Target 7b. Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss. Target 7c. Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. Target 7d. By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers.
Goal 8 : Develop a global partnership among development These eight MDGs break down into 21 quantifiable targets that are measured by 60 indicators . The developing world has already attained the first Millennium Development Goal target to cut the 1990 poverty rate in half by 2015. The 1990 extreme poverty rate – $1.25 a day in 2005 prices – was halved in 2010, according to new preliminary estimates. Infectious diseases -- clustering in impoverished communities and ignored, undertreated and under researched– remain a substantial hurdle to MDG attainment.
HUNGRY PEOPLE OF WORLD The United Nations Food and Agriculture Organization estimates that nearly 870 million people of the 7.2 billion people in the world, or one in eight, are suffering from chronic undernourishment in 2010-2012. Almost all the hungry people, 852 million, live in developing countries, representing 15 percent of the population of developing counties. There are 16 million people undernourished in developed countries (FAO 2012). The number of undernourished people decreased nearly 30 percent in Asia and the Pacific, from 739 million to 563 million, largely due to socio-economic progress in many countries in the region. The prevalence of undernourishment in the region decreased from 23.7 percent to 13.9 percent. Latin America and the Caribbean also made progress, falling from 65 million hungry in 1990-1992 to 49 million in 2010-2012, while the prevalence of undernourishment dipped from 14.6 percent to 8.3 percent. But the rate of progress has slowed recently.
The number of hungry grew in Africa over the period, from 175 million to 239 million, with nearly 20 million added in the last few years. Nearly one in four are hungry. And in sub-Saharan Africa, the modest progress achieved in recent years up to 2007 was reversed, with hunger rising 2 percent per year since then. Developed regions also saw the number of hungry rise, from 13 million in 2004-2006 to 16 million in 2010-2012, reversing a steady decrease in previous years from 20 million in 1990-1992 (FAO 2012).
Children are the most visible victims of under nutrition. Children who are poorly nourished suffer up to 160 days of illness each year. Poor nutrition plays a role in at least half of the 10.9 million child deaths each year- -five million deaths. Under nutrition magnifies the effect of every disease, including measles and malaria. The estimated proportions of deaths in which under nutrition is an underlying cause are roughly similar for diarrhea (61%), malaria (57%), pneumonia (52%), and measles (45%) (Black 2003, Bryce 2005). Malnutrition can also be caused by diseases, such as the diseases that cause diarrhea, by reducing the body's ability to convert food into usable nutrients. Malnutrition, as measured by stunting, affects 32.5 percent of children in developing countries--one of three (de Onis 2000).
Geographically, more than 70 percent of malnourished children live in Asia, 26 percent in Africa and 4 percent in Latin America and the Caribbean. In many cases, their plight began even before birth with a malnourished mother. Under-nutrition among pregnant women in developing countries leads to 1 out of 6 infants born with low birth weight. This is not only a risk factor for neonatal deaths, but also causes learning disabilities, mental, retardation, poor health, blindness and premature death. Causes of hunger : Poverty is the principal cause of hunger. Harmful economic systems are the principal cause of poverty and hunger. Conflict as a cause of hunger and poverty. Hunger is also a cause of poverty, and thus of hunger. Climate change
POPULATION GROWTH AND ITS LINKAGE TO POVERTY The relationship between population growth and poverty is a vicious circle. Rapid population growth is an obstacle to economic progress in some of the poorest countries, depriving those societies of funds for investment to develop. At the same time, poverty fuels overpopulation by depriving women of both the incentive and the means to have fewer children. High population growth contributes to poverty. High fertility rates affect the health of mothers and families, increasing the risk of maternal, infant and child mortality, all of which combine to entrench poverty.
At a societal level, rapid population growth increases the number of people in need of health care, education and livelihoods. This in turn requires more financial, material and natural resources. A further link between poverty, overpopulation and sustainability is that communities which are poor and overpopulated are generally those which suffer most as a result of rapid environmental change or ‗natural‘ disasters, as illustrated by the 2010 flooding of large parts of Pakistan. Being poor makes it impossible to pay for measures to mitigate the effects of climate change, and the more people there are the more difficult it is for them to move or to migrate to areas less affected by the changes.
In some developing countries, there is a wide gap – or in some cases – widening gap between rich and poor, and between those who can and cannot access opportunities. It means that access to good schools, healthcare, electricity, safe water and other critical services remains elusive for many people who live in growing economies. In many developing countries, widespread poverty has persisted because of three main reasons: slow rate of growth, biased growth pattern, and failure of government policies. A slow rate of growth has dual effect: it decreases income and employment and increases the rent-seeking behavior of the politicians in favor of non-poor like businessmen, large farmers, bureaucrats, trade unions, and the security personnel. Many of the determinants of health lie outside the control of the health sector. Social, economic ,political and environmental factors all influence risk ,exposure and the effects of infectious disease .
POPULATION GROWTH AND ITS LINKAGE TO INFECTIOUS DISEASES Population growth drives infectious disease rate upward. Demand-driven agriculture and livestock production predicted to increase spread and dangers of zoonotic diseases. As the world population grows, the rise of mega agriculture to meet increased demand for food could aid the spread and virulence of infectious diseases worldwide. Developing nations, where most of the population growth is expected to occur, will race to meet the demands, but poor public health infrastructures could put the global food supply at risk. The agriculture is the first contributor to the problem. When humans started to grow their own food, they remained stable and built communities. Infectious diseases are able to spread and grow in these stable human populations .
Population growth puts more people in closer proximity to each other, which facilitates the spread of contagious infectious diseases. The planet is in the midst of a warming trend. Certain infectious diseases, such as those borne by mosquitoes, increase when the climate is more hospitable to their carriers. More such species can thrive in warmer weather. New medical technologies, such as blood transfusions and organ transplants, when not very tightly controlled and regulated, provide new paths for the spread of pathogens.
In an increasingly globalized world, rapid population mobility and migration is reducing the differences in infectious disease epidemiology between regions of the world. The movement and relocation of populations between locations where the prevalence and incidence of infections are markedly different poses current and future challenges to those involved in clinical infectious diseases and public health program management.
INFECTIOUS DISEASES RELATED TO POVERTY ―Infectious diseases of poverty‖ is an umbrella term used to describe a number of diseases which are known to be more prevalent among poorer populations, These are more prevalent among the poor than among wealthier people rather than a definitive group of diseases . Diseases of poverty are often co-morbid and ubiquitous with malnutrition. Crowded living and working conditions, inadequate sanitation, and disproportionate occupation as sex workers, the poor are more likely to be exposed to infectious diseases. The interrelationships between health, infectious diseases and poverty are dynamic and complex. Timely, targeted research will prevent these diseases from driving more people into poverty
Malnutrition is associated with 54% of childhood deaths from diseases of poverty, and lack of skilled attendants during childbirth is primarily responsible for the high maternal and infant death rates among the poor Many such diseases are also considered ―neglected tropical diseases‖, as defined by WHO. Infectious diseases of poverty are not restricted to low and middle-income countries, but manifest in poor populations globally. Apart from TB, Malaria and HIV/AIDS, many other infectious diseases have not been high on the global agenda. However, an increasing number of organizations and partnerships are now engaged in their control.
According to the Global Report for Research on Infectious Diseases of Poverty, poverty-related circumstances such as ―lack of food, shelter, security and social protection make people more vulnerable to infections, while affected populations are often unable to obtain even the most basic means of prevention and care.‖ Poverty and disease are stuck in an ongoing, vicious relationship. One goes a long way towards intensifying the other with studies demonstrating that infection rates of certain diseases are highest in regions where poverty is high.
Diseases of Poverty Tuberculosis AIDS Asthma Cardiovascular disease Dental Decay or Dental caries African trypanosomiasis Chagas disease Leishmaniasis Lymphatic filariasis Onchocerciasis Schistosomiasis Trichomoniasis
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