South-East Asia Regional Conference on Epidemiology

72 | <strong>South</strong>-<strong>East</strong> <strong>Asia</strong> <strong>Regional</strong> <strong>Conference</strong> on Epidemiology
Fig. 1: Maternal mortality ratio (MMR) per 100 000 live births, by selected <strong>Asia</strong>n countries, 2005
Source: World Health Statistics 2010, Interagency Estimates for 2005
The trends of the estimated TB incidence rates with reference to the 1990 baseline indicate that
the Region as a whole has already achieved a reversal in TB incidence. Similarly, the estimated
tuberculosis prevalence and mortality rates reflect a decrease in most Member countries, indicating
that the expected reductions in prevalence and mortality would also be achieved by 2015. This is also
supported by the current trends in treatment success and case-detection rates.
An estimated 1.2 billion people or 83% of the total population of the Region lives in malariarisk
areas. All countries, except Maldives, have indigenous malaria transmission, predominantly
Plasmodium falciparum and Plasmodium vivax. Sri Lanka is targeting eradication of local transmission
of malaria by 2012, which will surpass MDG targets.
Social determinants
The Region consists of a number of countries which are not only poor but they also shoulder
a significant proportion of the global disease burden. People who are economically or socially
disadvantaged suffer from worse health conditions than their better-off counterparts. There is no
great mystery as to why this happens. Poor people encounter high rates of illness due to infectious
diseases and malnutrition because of lack of food, unclean water, low levels of sanitation and shelter,
failure to deal with environments that lead to high exposure to infectious disease agents and lack of
appropriate medical care. An increasing burden of noncommunicable diseases among the poor is an
emerging concern. This raises the question of what action can be taken at different levels – individual,
community, government – to tackle these inequities. Operationally, the important question would
be how and through what mechanisms can governments and civil society work together to reduce
health inequities. While addressing major health problems of children under five years with medical
interventions, it has to be realized that social determinants of health have played a major role in
tackling the issue of infant and child deaths (Fig. 2).