Professor Richard Feachem, dean of the London School of Hygiene and Tropical Medicine and chairman of a World Bank advisory committee, warns that 'there is a huge epidemic of (smoking-related) illness which will occur whatever we do today and whatever we do tomorrow'.
Three million premature deaths from smoking occur each year, but if the pattern continues and tobacco companies extend their grip on the Third World, the figure will be 12 million by early in the next century.
The report says tobacco consumption is falling slowly in industrial countries, and has remained unchanged in the formerly socialist economies. But it is rising among both men and women in almost all developing countries, and is expected to increase by about 12 per cent between 1990 and 2000.
In China, one of the fastest developing countries, consumption has increased from 500 billion cigarettes in 1978 to 1,700 billion in 1992. If such patterns persist in the Third World, 10 per cent of the 120 million who reach adult life each year will die prematurely because of tobacco. 'The chief uncertainty is not whether mortality from tobacco will reach 12 million a year in the second quarter of the next century but exactly when it will do so,' the report says.
The 'new health agenda' - tobacco, HIV and drug resistant micro- organisms - overshadows the recent dramatic gains in health throughout the world, Professor Feachem said. But child deaths in poor countries are still 10 times greater than those in wealthier nations, and pregnancy and childbirth claim the lives of 400,000 women annually.
As little dollars 12 per person anually in low-income countries could reduce the burden of disease by about 25 per cent. Low-cost public health measures, such as immunisation, infectious disease control and better health education, especially for schoolgirls, rather than hi-tech specialised care should be a priority.
* World Development Report 1993: Investing in Health.Reuse content