December 16, 1974

Health in a Developing World

Author Affiliations

La Jolla, Calif
From the Scripps Clinic and Research Foundation, La Jolla, Calif.

JAMA. 1974;230(11):1527-1529. doi:10.1001/jama.1974.03240110019011

Man in underdeveloped countries, or the disinherited in all parts of the world, perceives life not as a flowering or a development of an essential productiveness but as a permanent struggle against an omnipresent death.1

Frantz Fanon

THIS grim perception is reflected in several recent studies2,3 that have disclosed two astounding trends.

Two Trends 

Trend of Health Indices.—  During the first half of this century, modest progress was made towards improving world health. In the third quarter, progress halted or, worse, regressed. Virtually every measure of health care has remained static. Even more disturbing, the rates of improvement are worse in poor countries than in the rich.There is room for improvement that has not come about. For instance, the death rate from tuberculosis has remained static both in Chile and in the United States. But in Chile it is still five times higher than in the United