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How Important Are The Big Three Infections – Really?

poverty.jpgQuick, what is the leading acute cause of death in world’s poorest nations? How about the second most common acute cause of death? The truth may startle you. Pneumonia as the leading acute cause of death is no surprise. But number two is coronary artery disease. No, not HIV, not tuberculosis, not even malaria. It is simply arterial athersclerosis. And least you believe this an outlier, consider the fact that stroke – another manifestation of athersclerosis – is the fifth leading acute cause of death in the poorest nations. Such straightforward epidemiology challenges one of the most popular misconceptions in the field of global health: the notion that infectious diseases – particularly the Big Three: tuberculosis, malaria and HIV – are the greatest plagues afflicting the world’s most vulnerable peoples. The fact of the matter, conversely, is that non-infectious, chronic maladies severely burden those living in extreme poverty, and that such maladies worsen their poverty through both health care costs and lost wages connected with lost work. What effective steps are we taking against chronic diseases?

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