Health Needs of People in Tropical Countries, Growth of Malignant Diseases and Coexistence of Extremes




(1)
Department of Geography, Paris Est Créteil University (UPEC), Paris, France

 



Keywords
LDCsEmerging countriesSocio-economic contextMalignant diseases


The tropical area is the hot and humid part of the world. It does not extend in latitude beyond the tropics (L. 23°27), but this does not mean that the tropical area is everything between the tropics, because a huge part of this space is occupied by hot deserts.

The region is home to nearly 80 % of the world’s population, a figure likely to reach 90 % by the end of the century.


1 The Fragmentation of the Third World


Tropical countries were classified in the Third World group defined by Alfred Sauvy in 1952, but today, the tropical area contains the entire spectrum of forms of socialisation of space, from the simple dependence on nature’s provision by the last hunter-gatherers to crowded cities with populations in the millions. The Third World has exploded, as illustrated by the contrasting health levels of its populations. Although some countries have made as much headway in the last 30 or 40 years as the industrialised countries made in a century, others have lagged behind [1].

Simple population health indicators such as mortality rates and life expectancy reveal this explosion, neatly summarising the condition and efficiency of states and throwing a spotlight on socio-economic conditions, social and public health policies and the effectiveness of development programmes (Tables 1 and 2).


Table 1
Changes in life expectancy at birth, by international region































 
Sub-saharan Africa

Middle East and Northern Africa

South Asia

East and Southeast Asia

Latin America and the Caribbean

1960a

40

47

44

47

56

2011b

53

72

65

73

74


aUNDP, 1990 World Report On Human Development

bPRB, World Population Data Sheet, 2011 [5]



Table 2
Comparison of mortality indicators for four regions in 2011



























 
Sub-saharan Africa

Northern Africa

Central and South Asia

South America

General mortality rate ‰

14

6

7

6

Infant mortality rate ‰

77

33

53

18


PRB, World Population Data Sheet, 2011

World ranking on the Human Development Index (a statistical index created in 1990 by the UN Development Programme) gives a useful insight into the countries’ development based on three criteria: life expectancy at birth, level of education, and standard of living. Out of 187 countries ranked by the UN, tropical countries now appear in all categories of the ranking. In 2014, Singapore is 7th, Cuba 44th, Malaysia 62nd, Sri Lanka 73rd, Brazil 79th and Thailand 89th. The countries of sub-Saharan Africa are disproportionately represented among the countries with the lowest indices—35 of the 43 [14].

The contrast in the evolution of the Third World has prompted international organisations to create categories of countries. To avoid the usual dichotomy whereby the world is divided into ‘developing/developed countries’, ‘north/south’ and ‘rich countries/poor countries’, it would be better at the beginning of the twenty-first century to speak of ‘LDCs’ (least developed countries), ‘emerging countries’ and ‘formerly industrialised countries’. Talk of ‘poor countries’ is ambiguous because wealth does not necessarily produce development. Countries rich in natural resources – sources of economic wealth for human development – are ranked bottom in the UN’s indices. Their populations are poor and vulnerable. Examples are Guinea and the Democratic Republic of Congo, which were listed 177th and 186th out of the 187 states on the United Nations’ Human Development Index in 2014 [13].


1.1 The Least Developed Countries (LDCs)


The least developed countries (LDCs) are the least developed in socio-economic terms. They are ranked according to three kinds of criteria:



  • Low standard of living, based on income per head over 3 years; this must be less than US$ 900 (2003 definition).


  • Delayed human development based on a composite index made up of infant mortality rate, life expectancy, malnutrition and schooling.


  • Economic vulnerability, also based on a composite index including population size (not more than 75 million inhabitants), remoteness (e.g. think Kiribati or Tuvalu in Oceania), the percentage share of each economic sector and the export concentration index.

There were 25 countries in this category when it was created in 1971. In 2014, they number 48, and of these 34 are in Africa, 9 in Asia, 4 in Oceania and 1 in the Antilles (Haiti). Their contribution to world output is marginal (less than 0.9 %).


1.2 Emerging Countries


The concept appeared in the 1980s based on the macroeconomic performance of developing countries that were no longer LDCs. These countries are stable and have a favourable business climate. Their GDP is less than that of a developed country, but their rapid economic growth means that their human development indicators are catching up with those of developed countries. Their contribution to the world economy is growing. According to the IMF, their share of world GDP rose from 27.4 % in 1992 to more than 40 % in 2011. Membership of the group is neither immutable nor unanimous (each international organisation has its own list). Some countries, such as the ‘Asian tigers’, have moved out of it; others, like Peru and the Philippines, are not regarded as emerging economies by all development experts, and still other countries are classified as ‘high-potential countries’, such as Nigeria, or ‘future emerging’ like Mexico.

Living standards in these countries are rising fast, producing an emerging middle class. The OECD [2] forecasts the worldwide middle class will expand from 1.8 billion people in 2009 to 3.2 billion in 2020 and 4.9 billion by 2030. This growth is driven by Asia (which by 2030 will have 66 % of the worldwide middle class), but there is a middle class emerging in Africa too. Hundreds of millions of people have come out of extreme poverty in the last three decades, but inequalities are growing. According to the 2014 UNDP Report, 1.2 billion people live on the equivalent of 1.25 dollars (the threshold of extreme poverty defined by the World Bank) or less a day, and 1.5 billion people in 91 countries live ‘in a state of poverty marked by mutually aggravating inadequacies in terms of health, education and standard of living’.

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Sep 20, 2016 | Posted by in HEMATOLOGY | Comments Off on Health Needs of People in Tropical Countries, Growth of Malignant Diseases and Coexistence of Extremes

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