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May 16, 2012

Primary Health Care in Low-Income CountriesBuilding on Recent Achievements

Author Affiliations

Author Affiliations: The Earth Institute, Sustainable Development, Health Policy and Management, Columbia University, New York, New York.

JAMA. 2012;307(19):2031-2032. doi:10.1001/jama.2012.4438

Small investments in improved health of the poor have a remarkable return in reduced morbidity and mortality. While the developed economies grapple with health systems that cost several thousand dollars per person per year and often spend hundreds of thousands of dollars on a treatment to eke out an additional few months of life, outlays of just a few dozen dollars per person per year in impoverished countries can add several years to life expectancy. In the least developed countries, approximately 112 of every 1000 children die before their fifth birthday, as opposed to 8 per 1000 in the developed countries.1 With a concerted science-based effort, the under-5 mortality rate of the least developed countries could be reduced to less than 30 per 1000 by 2020. Such low under-5 mortality rates have already been achieved, for example, by the Dominican Republic (28 per 1000), Mexico (17 per 1000), and Thailand (13 per 1000).1

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