Health – a human right

The health situation in developing countries

Drinking water dispenser in a school in Burkina Faso

The good news: human life expectancy worldwide has risen from 63 years to approximately 72 years since 1980. The global rate for maternal mortality fell between 1990 and 2015 by 43 per cent, while the same period saw a reduction in the child mortality rate for the under-fives of well over 50 per cent. The number of new HIV infections fell from 2000 to 2018 by about 40 per cent.

Over the last twenty years, primary health care has improved in much of the world. And German development cooperation alone succeeded in improving health care for more than 300 million people worldwide between 2010 and 2015. What is more, far greater numbers of people now have opportunities to insure themselves against the impact of illness.


But there is bad news, too: Despite all this progress, around one billion people have no access to adequate and affordable health cover. This applies above all to poor and disadvantaged sections of society. Women and children are at particular risk. Life expectancy in African countries south of the Sahara stands at just 60 years, well below the global average.

Mothers with their children in the waiting room of a health station in Goma (Democratic Republic of Congo)

Illnesses like tuberculosis and malaria are still widespread in developing countries, where they claim more than two million lives every year. The 2018 data show that approximately 37.9 million people were infected with HIV worldwide, of whom over 25 million live in sub-Saharan Africa. Infections caused by parasites, including worm diseases like schistosomiasis (bilharzia) and river blindness (onchocerciasis), also continue to present a major health threat to both children and adults.

Causes of ill-health in developing countries

Provisional hospital in a refugee camp in the Central African Republic

One of the most common causes of disease is poverty. It is considered to be a contributory factor in the majority of all deaths. Poverty prevents the sick receiving medical care. It often leads to hunger and malnutrition. People who cannot afford safe drinking water or a toilet tend to fall sick more frequently and take longer to recover.

Factors such as unemployment, lack of formal education and an absence of family planning options can also have a negative impact on health.

Poor people often find it impossible to take out health insurance or find some other form of social protection. According to estimates by the World Health Organization (WHO) and the World Bank, around 100 million people a year fall below the poverty line because they are financially ruined by the costs of the medical services they need.

Many poor people also are pushed to the edges of society. Marginalisation can result in prostitution, violence, crime and drug abuse, all of which are associated with very high risks to health. Further risk factors to health are armed conflict and natural disasters. Again, it is the poor who are particularly vulnerable in the face of these crises.

Inadequate health systems

A doctor in Goma (Democratic Republic of Congo) fills an injection syringe with a vaccine.

Health systems are seriously underfunded in many countries, where it is not possible to provide even basic health care for all sectors of the population. Moreover, important medical services, whether state-run or private, are often available only in the cities and mainly to the more affluent in society.

What is more, these weak health systems are ill-prepared for the task of dealing with an increasing number of communicable diseases.

Even where there is the political will to restructure health systems, most developing countries lack both the financial and human resources needed to build a properly functioning health system offering universal coverage. It is estimated that Africa alone currently lacks around three million health professionals.

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