© The International Society for Neglected Tropical Diseases 2014
Figure 1 shows the ten countries which have secured the biggest reduction in the number of under-5s deaths since 2000 (under-5 mortality rate in 2011 as a % of the under-5 mortality rate in 2000).
Under-5 mortality rates improved the most in the Maldives from 53 per 1,000 live births in 2000 to 11 per 1,000 by 2011. This figure was 105 per 1,000 live births in 1990. In Rwanda, a much larger country with a population in excess of 10 million, under-5 mortality also dropped dramatically by over 70% over the last decade, reaching 54 per 1,000 live births by 2011.
In Barbados, however, under-5 mortality increased over this period. The greatest number of children who die under the age of 5 each year is by far in India (1.7 million children in 2011) and Sierra Leone has the highest rate of child mortality at 185 deaths per 1,000 live births in 2011.
In Canada and Somalia it remained unchanged, albeit at dramatically different levels - 6 per 1,000 live births in Canada and 180 per 1,000 live births in Somalia.
Worldwide, the number of children who die under the age of 5 has fallen by more than 40% — from 12 million in 1990 to 6.9 million in 2011. 27 countries have reached the MDG target related to reducing child mortality by two-thirds of 1990 levels but this target is unlikely to be met globally by 2015.
Child under-nutrition continues to account for more than a third of under-5 deaths worldwide.
Figure 2 lists the ten countries which have received the most official development assistance for health per person in 2011. For Swaziland, this respresents a total of some US$71 million for 2011 (at 2010 prices). Despite falls in overall figures by donor OECD-reporting countries in their commitment to development assistance for health, this may be significantly offset by funding from foundations and non-traditional donors including Brazil, China, India and the Gulf States.
Health funding continues to accrue mostly to address the Millenium Development Goal 6 (combating HIV/AIDS, malaria and other diseases) - from 2002 to 2011 ODA disbursements for MDG 6 increased more than five-fold to US$10.6 billion in 2011.
Despite immense investments in safe water, sanitation and infrastructure in resource-poor settings worldwide, a large proportion of the planet remains without access to improved sanitation and this trend will continue beyond 2015. Figure 3 lists the countries with the lowest rates in use of improved sanitation for 2011. In South Sudan, only 9% of the population used improved sanitation in 2011 but 57% of the population used improved drinking-water sources.
Improved sanitation was used by 100% of the population in 39 countries which, aside from high-income countries, include Uzbekistan, the Republic of Korea, Kuwait, Bulgaria and Iran.
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"World Health Statistics 2013" & "Progress on Drinking Water & Sanitation 2013"
This year, World Health Statistics compiled by the World Health Organisation about its 194 member states show significant progress towards the Millenium Development Goals and reduction in health gaps between & within countries, including falls in maternal and child mortality [Figure 1] worldwide. This progress has been achieved despite the increasing concern that economic circumstances of high-income countries and traditional bilateral donors are worsening and leading to a decline in official development assistance (ODA) [Figure 2].
Coupled with updates on the provision of safe drinking water & sanitation worldwide, as provided by the UNICEF/WHO report "Progress on Drinking Water & Sanitation 2013", the veiw strongly emerges that despite the vast improvements in health provision and disparities worldwide, spurred on by the Millenium Development Goals, attention is already turning to the post-2015 challenges particularly in drinking-water and basic sanitation. The Millenium Development Goal regarding drinking water has been met and surpassed since 2010, but 2.4 billion people will still lack sufficient sanitation in 2015.