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WHO Library Cataloguing-in-Publication Data

World health statistics 2012.

1.Health status indicators. 2.World health. 3.Health services - statistics. 4.Mortality. 5.Morbidity. 6.Life expectancy. 7.Demography.

8.Millennium development goals statistics. 9.Statistics. I.World Health Organization.

ISBN 978 92 4 156444 1 (NLM classification: WA 900.1)

World Health Organization 2012

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purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264;

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responsibil ity for the interpretation and use of the material lies with the reader. In no event shall the World Health Organizationbe liable for damages arising from its use.

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Table of Contents

Abbreviations 7Introduction 8

Part I. Health-related Millennium Development Goals 11

Summary of status and trends 12

Regional and country charts 171. AARD (%) in under-five mortality rate, 19902010 19

2. Measles immunization coverage among 1-year-olds (%) 20

3. AARD (%) in maternal mortality ratio, 19902010 21

4. Births attended by skilled health personnel (%) 22

5. Antenatal care coverage (%): at least one visit and at least four visits 23

6. Unmet need for family planning (%) 24

7. AARD (%) in HIV prevalence, 20002009 25

8. Antiretroviral therapy coverage among people with advanced HIV infection (%) 26

9. Children aged

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2. Cause-specific mortality and morbidity 63Mortality

Age-standardized mortality rates by cause (per 100 000 population)

Number of deaths among children aged

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5. Risk factors 109Population using improved drinking-water sources (%)

Population using improved sanitation (%)

Population using solid fuels (%)

Low-birth-weight newborns (%)Infants exclusively breastfed for the first 6 months of life (%)

Children aged

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8. Health inequities 145Contraceptive prevalence (%)

Antenatal care coverage: at least four visits (%)

Births attended by skilled health personnel (%)

DTP3 immunization coverage among 1-year-olds (%)Children aged

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Abbreviations

AARD average annual rate of decline

AIDS acquired immunodeficiency syndrome

AFR WHO African Region

AMR WHO Region of the Americas

ARI acute respiratory infection

DBP diastolic blood pressure

DHS Demographic and Health Survey

DTP3 3 doses of diphtheria-tetanus-pertussis vaccine

EML essential medicines list

EMR WHO Eastern Mediterranean Region

EUR WHO European Region

GDP gross domestic product

HAI Health Action International

HepB3 3 doses of hepatitis B vaccine

Hib3 3 doses ofHaemophilus influenzae type B vaccine

HIV human immunodeficiency virus

ICD International Statistical Classification of Diseases and Related Health Problems

MCV measles-containing vaccine

MDG Millennium Development Goal

MICS Multiple Indicator Cluster Survey

MSH Management Sciences for Health

MTCT mother-to-child transmission

NCD noncommunicable disease

NHA national health account

ORS oral rehydration salts

ORT oral rehydration therapy

PPP Purchasing Power Parity

RHF recommended home fluid

SBP systolic blood pressure

SEAR WHO South-East Asia Region

WHA World Health Assembly

WPR WHO Western Pacific Region

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Introduction

The World Health Statistics series is WHOs annual

compilation of health-related data for its 194 Member

States1 and includes a summary of the progress made

towards achieving the health-related Millennium De-

velopment Goals (MDGs) and associated targets. This

year, it also includes highlight summaries on the topics

of noncommunicable diseases, universal health cover-

age and civil registration coverage.

The series is produced by the WHO Department of

Health Statistics and Information Systems of the In-novation, Information, Evidence and Research Cluster.

As in previous years, World Health Statistics 2012 has

been compiled using publications and databases pro-

duced and maintained by WHO technical programmes

and regional offices. A number of demographic and

socioeconomic statistics have also been derived from

databases maintained by a range of other organiza-

tions. These include the United Nations International

Telecommunication Union (ITU), the United Nations

Department of Economic and Social Affairs (UNDESA),

the United Nations Educational, Scientific and CulturalOrganization (UNESCO), the United Nations Childrens

Fund (UNICEF) and the World Bank.

Indicators have been included on the basis of their

relevance to global public health; the availability and

quality of the data; and the reliability and compara-

bility of the resulting estimates. Taken together, these

indicators provide a comprehensive summary of the

current status of national health and health systems in

the following ten areas:

Q life expectancy and mortality

Q cause-specific mortality and morbidity

Q selected infectious diseases

Q health service coverage

1. South Sudan became an independent state in July 2011 and a

WHO Member State in September 2011. As the reported data

shown here only concern the time before July 2011, the term

Sudan as used here only refers to the state as it existed prior

to July 2011.

Q risk factors

Q health workforce, infrastructure and essential medi-

cines

Q health expenditure

Q health inequities

Q demographic and socioeconomic statistics

Q health information systems and data availability.

The estimates given in this report are derived from mul-

tiple sources, depending on each indicator and on theavailability and quality of data. In many countries, statis-

tical and health information systems are weak and the

underlying empirical data may not be available or may

be of poor quality. Every effort has been made to ensure

the best use of country-reported data adjusted where

necessary to deal with missing values, to correct for

known biases, and to maximize the comparability of the

statistics across countries and over time. In addition,

statistical modelling and other techniques have been

used to fill data gaps.

Because of the weakness of the underlying empirical

data in many countries, a number of the indicators pre-

sented here are associated with significant uncertainty.

It is WHO policy to ensure statistical transparency, and

to make available to users the methods of estimation

and the margins of uncertainty for relevant indicators.

However, to ensure readability while covering such a

comprehensive range of health topics, printed versions

of the World Health Statistics series do not include mar-

gins of uncertainty; these are available from online WHO

databases such as the Global Health Observatory.2

While every effort has been made to maximize the com-

parability of the statistics across countries and over

time, users are advised that country data may differ in

terms of the definitions, data-collection methods, pop-

ulation coverage and estimation methods used. More

2. The Global Health Observatory (GHO) is WHOs portal pro-

viding access to data and analyses for monitoring the global

health situation (see: http://www.who.int/gho).

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detailed information on indicator metadata is available

in the WHO Indicator and Measurement Registry.3

WHO presents World Health Statistics 2012 as an in-

tegral part of its ongoing efforts to provide enhanced

access to comparable high-quality statistics on core

measures of population health and national health sys-

tems. Unless otherwise stated, all estimates have been

cleared following consultation with Member States and

are published here as official WHO figures. However,

these best estimates have been derived using stan-dard categories and methods to enhance their cross-

national comparability. As a result, they should not be

regarded as the nationally endorsed statistics of Mem-

ber States which may have been derived using alterna-

tive methodologies.

3. http://www.who.int/gho/indicatorregistry

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Part I

Health-related MillenniumDevelopment Goals

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Summary of status and trends

It is now more than a decade since world leaders ad-

opted the Millennium Development Goals (MDGs) and

their associated targets. In that time, substantial prog-

ress has been made in reducing child and maternal

mortality, improving nutrition, reducing morbidity and

mortality due to HIV infection, tuberculosis and malar-

ia, and increasing access to improved drinking-water

sources. These current trends provide a firm basis for

the intensified collective actions and expansion of suc-

cessful approaches now needed to overcome the chal-

lenges posed by multiple crises and large inequalities.Although progress in settings with the highest rates of

mortality has been accelerated in recent years, large

variations in health status persist both between and

within countries.

Childhood malnutrition is the underlying cause of an

estimated 35% of all deaths among children under five

years of age. The proportion of such children in devel-

oping countries who were underweight is estimated to

have declined from 29% to 18% between 1990 and

2010. Although this rate of progress is close to the rate

required to meet the relevant MDG target,4 improve-

ments have been unevenly distributed between and

within different regions.

Globally, significant progress has been made in reduc-

ing mortality rates among children under five years old.

Between 1990 and 2010, the under-five mortality rate

declined by 35% from an estimated 88 deaths per

1000 live births to 57. The global rate of decline has

also accelerated in recent years from 2.1% per an-num during 19902010 to 2.6% during 20052010

(Figure 1). The annual rate of decline in the WHO African

Region where almost half of all child deaths occur

increased from 1.8% during 19902010 to 2.8% during

20052010. Despite this improvement, most countries

in the Region are unlikely to achieve the MDG target of

a two-thirds reduction in 1990 mortality levels by the

4. MDG 1; Target 1.C: Halve, between 1990 and 2015, the pro-

portion of people who suffer from hunger.

0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5

(%)

AFR

AMR

SEAR

EUR

EMR

WPR

Global

1990201020052010MDG target

Figure 1. Average annual rate of decline (%) in under-five mortality levels, 19902010 and 20052010

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year 2015. Globally, 37 out of 143 low- and middle-

income countries will reach that target by 2015 if the

pace of progress achieved during the period 2005

2010 is maintained.

In 2010, global measles immunization coverage was

85% among children aged 1223 months. More coun-

tries are achieving high levels of measles immunization

coverage, with 65% of all countries either reaching or

maintaining at least 90% coverage in 2010. Between

2000 and 2010, the estimated number of measlesdeaths decreased by 74%, accounting for about one

fifth of the overall reduction in child mortality.

Almost 20% of deaths in children under the age of five

mostly those due to pneumonia and diarrhoeal dis-

eases are also preventable by vaccines. Efforts are

therefore being made to expand interventions. For ex-

ample, a rapidly increasing number of countries in the

WHO African Region, the WHO Region of the Americas

and the WHO Eastern Mediterranean Region have in-

troduced pneumococcal conjugate vaccines in the pastyear with support from the GAVI Alliance.

Despite a significant reduction in the number of ma-

ternal deaths from an estimated 543 000 in 1990 to

287 000 in 2010 the rate of decline is just over half

that needed to achieve the relevant MDG target.5 Be-

tween 1990 and 2010, the global rate of decline was

3.1% per annum, with lower rates in the WHO African

Region, WHO Region of the Americas and WHO East-

ern Mediterranean Region (Table 1). Approximately one

quarter of the countries with the highest maternal mor-tality ratio in 1990 (100 maternal deaths per 100 000

live births) have made insufficient or no progress.

5. MDG 5; Target 5.A: Reduce by three quarters, between 1990

and 2015, the maternal mortality ratio.

Table 1.Average annual rate of decline (%) in

maternal mortality, 19902010

WHO region 19902010

AFR 2.7

AMR 2.5

SEAR 5.2

EUR 3.8

EMR 2.6

WPR 5.2

Global 3.1

To reduce the number of maternal deaths, women

need access to good-quality reproductive-health care

and effective interventions. In 2008, 63% of women

aged 1549 years who were married or in a consen-

sual union were using some form of contraception,

while 11% wanted to stop or postpone childbearing

but were not using contraception. The proportion of

women receiving antenatal care at least once duringpregnancy was about 81% for the period 20052011,

but for the recommended minimum of four visits or

more the corresponding figure drops to around 55%.

The proportion of births attended by skilled personnel

crucial for reducing perinatal, neonatal and maternal

deaths is above 90% in three of the six WHO re-

gions. However, increased coverage is needed in cer-

tain regions, such as Africa where the figure remains

less than 50% (Figure 2).

About half the worlds population is at risk of malaria,and an estimated 216 million cases in 2010 led to ap-

proximately 655 000 deaths 86% of these in children

under the age of five. In a total of eight countries and

one territory in the WHO African Region there was a

more than 50% reduction in either confirmed malaria

cases or malaria admissions and deaths. In other WHO

regions, the number of reported cases of confirmed

malaria decreased by more than 50% in 35 of the 53

countries with ongoing transmission between 2000 and

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AFR

AMR

SEAR

EUR

EMR

WPR

Global

(%)

Figure 2. Coverage of reproductive-health services

2010, while downward trends of 2550% were seen infour other countries. The estimated incidence of ma-

laria fell globally by 1.8% per annum between 2000 and

2009 (Figure 3). The coverage of interventions such as

the distribution of insecticide-treated nets and indoor

residual spraying has greatly increased, and will need

to be sustained in order to prevent the resurgence of

disease and deaths caused by malaria.

Globally, the annual number of new cases of tubercu-losis has been slowly falling since 2006. In 2010, there

were an estimated 8.8 million new cases approximate-

ly 13% of which occurred in people living with HIV. In

2010, an estimated 1.1 million HIV-negative people died

from tuberculosis, while an additional 0.35 million died

from HIV-associated tuberculosis. Since 1990, mortality

due to tuberculosis has fallen by just over one third

though regional variations persist (Figure 4). In 2009, the

treatment-success rate reached 87% worldwide, repre-

senting the third successive year that the target of 85%

(first set by the World Health Assembly in 1991) wasexceeded. Although all six WHO regions are on course

to achieve the relevant MDG target,6 multidrug-resistant

tuberculosis continues to present significant problems.

In 2010, an estimated total of 2.7 million people were

newly infected with HIV 15% less than the 3.1 million

6. MDG 6; Target 6.C: Have halted by 2015 and begun to reverse

the incidence of malaria and other major diseases.

100

80

60

40

20

0

AFR

AMR

SEAR

EUR

EMR

WPR

0

(%)

10 20 30 40 50

Figure 3. Annual decline (%) in malaria incidence,20002009

Global

Unmet need forfamily planning,

2008

Contraceptive prevalence(any method),

2008

Antenatal care coverage:at least one visit,

20052011

Births attended byskilled health personnel,

20052011

AFR

AMR

SEAR

EUR

EMR

WPR

Global

AFR

AMR

SEAR

EUR

EMR

WPR

Global

AFR

AMR

SEAR

EUR

EMR

WPR

Global

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people newly infected in 2001. In 22 countries in sub-Saharan Africa, a similar rate of decline has been ob-

served over the past decade, but the number of cases in

this region still accounts for 70% of all those who acquire

HIV infection globally. At the end of 2010, there were an

estimated 34 million people living with HIV an increase

on previous years. As access to antiretroviral therapy in

low- and middle-income countries expands (16 times

more people were treated in 2010 than in 2003), the

population living with HIV will continue to climb as fewer

individuals die from AIDS-related causes (Figure 5).7

Neglected tropical diseases are a group of 17 diseases8

endemic in 149 countries and which affect more than

1000 million people. With the exception of dengue and

leishmaniasis, these diseases rarely cause outbreaks,

7. Estimated tuberculosis mortality excludes tuberculosis deaths

among HIV-positive people. Shaded areas represent margins

of uncertainty.

8. For a list of the 17 neglected tropical diseases please see:

http://www.who.int/neglected_diseases/diseases/en/

AFR AMR SEAR

EUR EMR WPR

50

40

30

20

10

0

50

40

30

20

10

0

per100000population

per100000populat

ion

Figure 4. Trends in estimated tuberculosis mortality rates, 199020107

2002 2003 2004 2005 2006 2007 2008 2009 2010

8

7

6

5

4

3

2

1

0

Millionsofp

eople

People dying from AIDS-related causes

People receiving antiretroviral therapy

Figure 5. Number of people with access to antiretroviraltherapy and the number of people dying from

AIDS-related causes in low- and middle-

income countries, 20022010

1995 2000 20051990 2010 1995 2000 20051990 2010 1995 2000 20051990 2010

1995 2000 20051990 2010 1995 2000 20051990 2010 1995 2000 20051990 2010

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and thrive in the poorest, most marginalized commu-

nities, causing severe pain, permanent disability and

death. Since 2007, a coordinated and integrated ap-

proach has enabled WHO to reach a turning point inits efforts to overcome these diseases through the si-

multaneous use of multiple safe and high-quality do-

nated medicines. In the case of dracunculiasis, fewer

than 1100 cases were reported in 2011 which would

indicate that this disease is on the verge of eradication

without the use of any medication or vaccine.

The world has now met the MDG target relating to ac-

cess to safe drinking-water.9 In 2010, 89% of the popu-

lation used an improved source of drinking-water com-

pared to 76% in 1990 (Figure 6). Progress has howeverbeen uneven in different regions. While coverage is at

least 90% in four of the six WHO regions, it remains low

in the WHO African Region and WHO Eastern Mediter-

ranean Region.

9. MDG 7; Target 7.C: Halve, by 2015, the proportion of the pop-

ulation without sustainable access to safe drinking-water and

basic sanitation.

With regard to basic sanitation, current rates of prog-

ress are too slow for the MDG target to be met, both

globally (Figure 6) and within WHO regions with the

exception of the WHO Western Pacific Region. In 2010,2500 million people did not have access to improved

sanitation facilities, with 72% of these people living in

rural areas. The number of people living in urban areas

without access to improved sanitation is increasing be-

cause of rapid growth in the size of urban populations.

Although almost all countries publish an essential medi-

cines list, the availability of medicines at public health

facilities is often poor. Surveys conducted in more than

70 mainly low- and middle-income countries indicate

that the average availability of selected generic medi-cines at health facilities was only 42% in the public

sector and 64% in the private sector. The availability of

medicines for the treatment of chronic noncommuni-

cable diseases (NCDs) is particularly poor when com-

pared with the availability of medicines for acute condi-

tions. In a study of 40 countries, the mean public sector

availability of generic chronic NCD medicines was 36%,

while in the same facilities the availability of medicines

for acute conditions was 53.5%.10 A lack of medicines

in the public sector forces patients to purchase medi-

cines from the private sector, where generic medicinescost on average 610% more than their international

reference price. Such low public sector availability and

high private sector prices drive many families into cata-

strophic poverty, particularly those with a family mem-

ber suffering from a chronic NCD.

With less than four years to go before the end of 2015,

it is clear that much remains to be done if the health-

related MDGs set out in 2000 are to be achieved. At

the same time, the world faces new challenges that will

need to be reflected in the ways in which progress ismeasured after 2015.

10. Cameron A et al. (2011). Differences in the availability of medi-

cines for chronic and acute conditions in the public and private

sectors of developing countries. Bulletin of the World Health

Organization, 89:412421. Doi: 10.2471/BLT.10.084327

(http://www.who.int/bulletin/volumes/89/6/10-084327/en/in-

dex.html).1990

100

Proportionofpo

pulation(%)

Improved drinking-water source

Improved sanitation

1995 2000 2005 2010

80

60

40

20

0

Global water target

Global sanitation target

Figure 6. Global trends in the proportion of population

using safe drinking-water sources andimproved sanitation

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Regional and country charts

The following charts provide country-by-country summaries of progress and current regional averages for key MDG

indicators for which data are available. Depending on the availability of data for each indicator, there are two types

of chart:

Chart type I

For six indicators under-five mortality rate; maternal mortality ratio; HIV prevalence; tuberculosis incidence rate;

population without access to improved drinking-water sources; and population without access to improved sanita-

tion the charts show the average annual rate of decline (AARD) since 1990 up to the latest available year (or for

the year range indicated), and the overall AARD required for the country to achieve the relevant MDG by 2015. Thecountry figures show data for the latest available year.

Chart type II

For seven indicators measles immunization coverage among 1-year-olds; births attended by skilled health person-

nel; antenatal care coverage; unmet need for family planning; antiretroviral therapy coverage among people with

advanced HIV infection; children aged

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The under-five mortality rate is defined as the probability of dying by age 5 expressed as the total number of such deaths per 1000 live births. Within each WHO region, countries are

sorted in descending order based on the AARD in this rate.

In order to reach the MDG target of reducing by two thirds the under-five mortality rate between 1990 and 2015, an AARD of 4.3% is needed and this is denoted by the vertical line. The

numerical values show the estimated under-five mortality rate in each country in 2010. For countries with low levels of under-five mortality, the target AARD may not be applicable.

Further details may be found in Part III, Table 1.

Mongolia 32

Singapore 3

Malaysia 6

Vanuatu 14

Lao People's Democratic Republic 54

China 18

Cambodia 51

Viet Nam 23

Cook Islands 9

Philippines 29

Japan 3

Marshall Islands 26

Australia 5

New Zealand 6

Kiribati 49

Tuvalu 33

Palau 19

Fiji 17

Solomon Islands 27

Brunei Darussalam 7

Tonga 16

Republic of Korea 5

Papua New Guinea 61

Samoa 20

Micronesia (Federated States of) 42

Nauru 40

Niue 22

Oman 9

Egypt 22

Tunisia 16

United Arab Emirates 7

Libya 17

Saudi Arabia 18

Qatar 8

Iran (Islamic Republic of) 26

Morocco 36

Syrian Arab Republic 16

Jordan 22

Lebanon 22

Bahrain 10

Yemen 77

Pakistan 87

Afghanistan 149

Kuwait 11

Djibouti 91

Sudan 103

Iraq 39

Somalia 180

San Marino 2

Turkey 13

Estonia 5

Serbia 7

Portugal 4

Slovenia 3

Czech Republic 4The former Yugoslav Republic of Macedonia 12

Greece 4

Hungary 6

Cyprus 4

Poland 6

Belarus 6

Armenia 20

Romania 14

Luxembourg 3

Lithuania 7

Iceland 2

Italy 4

Israel 5

Norway 3

Croatia 6

Andorra 4

Ireland 4

Russian Federation 12

Belgium 4

Spain 5

Austria 4

Bosnia and Herzegovina 8

Albania 18

Finland 3

Sweden 3

Denmark 4

Montenegro 8

France 4

Slovakia 8

Latvia 10

Georgia 22

Germany 4

Azerbaijan 46

Monaco 4

Republic of Moldova 19

Netherlands 4

Kyrgyzstan 38

Malta 6

Tajikistan 63

Turkmenistan 56

Switzerland 5

Bulgaria 13

Kazakhstan 33

United Kingdom 5

Ukraine 13

Uzbekistan 52

Maldives 15

Timor-Leste 55

Bangladesh 48

Nepal 50

Bhutan 56

Thailand 13

Indonesia 35

Sri Lanka 17

India 63

Myanmar 66

Democratic People's Republic of Korea 33

Peru 19

El Salvador 16

Saint Kitts and Nevis 8

Antigua and Barbuda 8

Brazil 19

Mexico 17

Belize 17

Ecuador 20

Nicaragua 27

Guatemala 32

Honduras 24

Dominican Republic 27

Cuba 6

Bolivia (Plurinational State of) 54

Guyana 30

Uruguay 11

Chile 9

Paraguay 25

Argentina 14

Colombia 19

Grenada 11

Venezuela (Boli varian Republic o f) 18

Costa Rica 10

Suriname 31

Panama 20

Jamaica 24

United States of America 8

Saint Lucia 16

Canada 6

Dominica12

Bahamas 16

Trinidad and Tobago 27

Saint Vincent and the Grenadines 21

Barbados 20

Haiti 165

Madagascar 62

Rwanda 64

Malawi 92

Eritrea 61

Liberia 103

Niger 143

United Republic of Tanzania 76

Algeria 36

Senegal 75

Namibia 40

Uganda 99

Guinea 130

Ethiopia 106

Gambia 98

Cape Verde 36

Zambia 111

Ghana 74

Mozambique 135

Sierra Leone 174

Mauritius 15

Equatorial Guinea 121

Benin 115

Angola 161

Nigeria 143

Comoros 86

Mali 178

Togo 103

Guinea-Bissau 150

Burundi 142

Gabon 74

Congo 93

Swaziland 78

Cte d'Ivoire 123

Botswana 48

Seychelles 14

Chad 173

Sao Tome and Principe 80

Kenya 85

Burkina Faso 176

Mauritania 111

Democratic Republic of the Congo 170

South Africa 57

Lesotho 85

Central African Republic 159

Cameroon 136

Zimbabwe 80

AFR EMRAMR EUR

SEAR

WPR

REGIONAL AVERAGE: 119






19902010

19902010

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Argentina

Brazil

Cuba

Dominica

Honduras

Nicaragua

Saint Kitts and Nevis

Saint Vincent and the Grenadines

Antigua and Barbuda

Belize

Ecuador

Grenada

Guyana

Mexico

Panama

Saint Lucia

Uruguay

Bahamas

Paraguay

Peru

Canada

Chile

Guatemala

El Salvador

Trinidad and Tobago

United States of America

Suriname

Colombia

Jamaica

Barbados

Costa Rica

Bolivia (Plurinational State of)

Dominican Republic

Venezuela (Boliva rian Republic of)

Haiti

China

Cook Islands

Nauru

Niue

Tonga

Republic of Korea

Viet Nam

Marshall Islands

Mongolia

Malaysia

Singapore

Australia

Brunei Darussalam

Fiji

Japan

Cambodia

New Zealand

Kiribati

Philippines

Tuvalu

Micronesia (Federated States of)

Palau

Solomon Islands

Lao People's Democratic Republic

Samoa

Papua New Guinea

Vanuatu

Albania

Andorra

Belarus

Greece

Hungary

Kazakhstan

Kyrgyzstan

Monaco

Turkmenistan

Czech Republic

Finland

Israel

Poland

Russian Federation

Slovakia

The former Yugoslav Republic of Macedonia

Uzbekistan

Armenia

Bulgaria

Republic of Moldova

Turkey

Germany

Lithuania

Luxembourg

Netherlands

Portugal

Sweden

Croatia

Estonia

Romania

Serbia

Slovenia

Spain

Belgium

Georgia

Tajikistan

Ukraine

Bosnia and Herzegovina

Iceland

Latvia

Norway

San Marino

United Kingdom

France

Ireland

Italy

Montenegro

Switzerland

Cyprus

Denmark

Austria

Malta

Azerbaijan

Eritrea

Mauritius

Seychelles

Gambia

Cape Verde

Algeria

Botswana

Burkina Faso

Swaziland

Angola

Ghana

Malawi

Burundi

Sao Tome and Principe

United Republic of Tanzania

Zambia

Kenya

Lesotho

Togo

Zimbabwe

Rwanda

Sierra Leone

Ethiopia

Cameroon

Congo

Namibia

Comoros

Niger

Nigeria

Cte d'Ivoire

Mozambique

Benin

Democratic Republic of the Congo

Madagascar

Mauritania

South Africa

Liberia

Mali

Central African Republic

Guinea-Bissau

Senegal

Gabon

Uganda

Equatorial Guinea

Guinea

Chad

Democratic People's Republic of Korea

Sri Lanka

Thailand

Maldives

Bhutan

Bangladesh

Indonesia

Myanmar

Nepal

India

Timor-Leste

Bahrain

Iran (Islamic Republic of)

Qatar

Jordan

Kuwait

Libya

Morocco

Saudi Arabia

Oman

Tunisia

Egypt

United Arab Emirates

Sudan

Pakistan

Djibouti

Syrian Arab Republic

Iraq

Yemen

Afghanistan

Lebanon

Somalia

This chart shows the percentage of 1-year-olds fully immunized against measles. Within each WHO region, countries are sorted by the 2010 level.

The vertical line denotes the target of 90% coverage by 2015 set at the World Health Assembly (WHA) 2010.


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among 1-year-olds (%)

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Estonia 2

Belarus 4

Romania 27

Lithuania 8

Poland 5

Turkey 20

Italy 4

Czech Republic 5

Austria 4

Slovakia 6


Greece 3


Bulgaria 11

Uzbekistan 28

Portugal 8

Serbia 12

Kazakhstan 51

Netherlands 6

Albania 27

Israel 7

Germany 7

Cyprus 10

Malta 8

Latvia 34

The former Yugoslav Republic of Macedonia 10

Armenia 30

France 8

Ukraine 32


Sweden 4

Tajikistan 65

Iceland 5

Finland 5

Belgium 8

Norway 7

Azerbaijan 43

Turkmenistan 67

Spain 6

Ireland 6

Montenegro 8

Hungary 21

Kyrgyzstan 71

Denmark 12

Georgia 67

Slovenia 12

Switzerland 8

United Kingdom 12

Croatia 17

Luxembourg 20

Andorra ...

Monaco ...

San Marino ...

The maternal mortality ratio is defined as the number of maternal deaths per 100 000 live births. Within each WHO region, countries are sorted in descending order based on the AARD in

this ratio. Unrounded values have been used to calculate the AARD.

In order to reach the MDG target of reducing the maternal mortality ratio by three quarters between 1990 and 2015, an AARD of 5.5% is needed and this is denoted by the vertical line.

The numerical values show the estimated maternal mortality ratio for 2010. For countries with low levels of maternal mortality, the target AARD may not be applicable.



Eritrea 240

Ethiopia 350

Rwanda 340

Madagascar 240

Angola 450

Cape Verde 79

Malawi 460

Burkina Faso 300

Algeria 97

Benin 350


Niger 590

Togo 300

Mali 540

Guinea 610

Gambia 360

Uganda 310


Mozambique 490

Senegal 370

Cte d'Ivoire 400


Nigeria 630

Ghana 350

Liberia 770

Comoros 280

Mauritania 510

Sierra Leone 890

Guinea-Bissau 790

Burundi 800

Gabon 230

Mauritius 60

Kenya 360

Zambia 440


Namibia 200

Cameroon 690

Swaziland 320

Botswana 160

Chad 1100

Lesotho 620

South Africa 300

Zimbabwe 570

Congo 560

Seychelles ...

Peru 67


Barbados 51

Chile 25

Honduras 100

Brazil 56


El Salvador 81

Saint Lucia 35

Mexico 50

Colombia 92

Nicaragua 95

Haiti 350

Ecuador 110


Grenada 24

Guatemala 120

Uruguay 29

Belize 53Saint Vincent and the Grenadines 48

Paraguay 99

Panama 92

Bahamas 47


Costa Rica 40

Argentina 77

Cuba 73

Guyana 280

Suriname 130


Jamaica 110

Canada 12

Antigua and Barbuda ...

Dominica ...

Saint Kitts and Nevis ...


Oman 32

Egypt 66


Yemen 200

Morocco 100

Afghanistan 460

Tunisia 56

Qatar 7

Lebanon 25

United Arab Emirates 12

Pakistan 260

Saudi Arabia 24

Jordan 63

Libya 58

Djibouti 200

Iraq 63

Sudan 730

Bahrain 20

Somalia 1000

Kuwait 14

Viet Nam 59


China 37

Cambodia 250

Japan 5

Vanuatu 110

Mongolia 63

Malaysia 29

Philippines 99

Papua New Guinea 230

Singapore 3

Solomon Islands 93


Australia 7

Fiji 26

Brunei Darussalam 24

New Zealand 15

Republic of Korea 16

Tonga 110

Cook Islands ...

Kiribati ...

Marshall Islands ...

Nauru ...

Niue ...

Palau ...

Samoa ...

Tuvalu ...

Maldives 60

Bhutan 180

Nepal 170

Timor-Leste 300

Bangladesh 240

India 200

Indonesia 220

Myanmar 200

Sri Lanka 35


Thailand 48

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19902010

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Antigua and Barbuda

Barbados

Grenada

Saint Lucia

Chile

Cuba

Uruguay


Bahamas

Brazil

Canada


Jamaica

Argentina

Trinidad and Tobago

Costa Rica

Mexico

Colombia

Dominica

Dominican Republic

Ecuador

Panama

Belize

Guyana

Suriname

El Salvador

Paraguay

Peru

Nicaragua


Honduras

Guatemala

Haiti


Venezuela (Boli varian Republic o f)

Cook Islands


Niue

Palau

Republic of Korea

Brunei Darussalam

Japan

Fiji

Singapore

Australia

Mongolia

Malaysia

Kiribati

Tonga

Nauru

China

New Zealand

Tuvalu

Marshall Islands

Viet Nam

Samoa

Vanuatu

Cambodia

Solomon Islands

Philippines

Papua New Guinea


Lithuania

San Marino

Switzerland

Turkmenistan

Belarus

Slovenia

Ireland

Italy

Malta

Poland

Serbia

Georgia

Russian Federation


Croatia

Czech Republic

Hungary

Uzbekistan

Armenia

Montenegro

Republic of Moldova

Slovakia


Bulgaria

Kazakhstan

Albania

Estonia

Norway

Latvia

Ukraine

Austria

Finland

Germany

Romania

Cyprus

Denmark

France

Kyrgyzstan

Turkey

Tajikistan

Azerbaijan

Andorra

Belgium

Greece

Iceland

Israel

Luxembourg

Monaco

Netherlands

Portugal

Spain

Sweden

United Kingdom

Mauritius

Seychelles

Algeria

Botswana

Congo

Swaziland

Namibia



Cape Verde

Benin

Malawi

Rwanda

Burkina Faso

Zimbabwe

Senegal

Cameroon

Lesotho

Burundi

Togo

Mauritania

Cte d'Ivoire

Mozambique

Ghana

Gambia

Angola

Mali


Zambia

Liberia

Guinea

Guinea-Bissau

Madagascar

Kenya

Uganda


Nigeria

Sierra Leone

Niger

Ethiopia

Chad

Comoros

Equatorial Guinea

Eritrea

Gabon

South Africa


Thailand

Sri Lanka

Maldives

Indonesia

Myanmar

Bhutan

India

Nepal

Timor-Leste

Bangladesh

Qatar

Saudi Arabia


Libya

Jordan


Kuwait

Oman

Bahrain


Tunisia

Iraq

Egypt

Djibouti

Morocco

Pakistan

Yemen

Afghanistan

Sudan

Somalia

Lebanon

This chart shows the percentage of births attended by skilled health personnel. Within each WHO region, countries are sorted by the latest available data since 2005.

The vertical line denotes the global target of 90% coverage by 2015 set by the International Conference on Population and Development (ICPD+5).


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skilled health personnel (%)

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France

Ireland

Belarus

Cyprus

Armenia

Turkmenistan


Uzbekistan

Ukraine

Italy

Kazakhstan

Republic of Moldova

Serbia

Czech Republic

Montenegro

Albania

Latvia

Kyrgyzstan

Georgia


Turkey

Tajikistan

Azerbaijan

Andorra

Austria

Belgium

Bulgaria

Croatia

Denmark

Estonia

Finland

Germany

Greece

Hungary

Iceland

Israel

Lithuania

Luxembourg

Malta

Monaco

Netherlands

Norway

Poland

Portugal

Romania

Russian Federation

San Marino

Slovakia

Slovenia

Spain

Sweden

Switzerland

United Kingdom

Burundi

Rwanda


Swaziland

Burkina Faso

Cape Verde

Malawi

Namibia

Zambia

Botswana

Uganda

Senegal

Guinea-Bissau

Lesotho

Kenya

Ghana

Zimbabwe

Algeria

Mozambique

Guinea



Togo

Madagascar

Congo

Gambia

Cte d'Ivoire

Cameroon

Benin

Liberia

Mauritania

Mali

Angola

Sierra Leone


Nigeria

Niger

Ethiopia

C had

Comoros

Equatorial Guinea

Eritrea

Gabon

Maurit ius

Seychelles

South Africa

Antigua and Barbuda

Barbados

Canada

Cuba

Dominica

Grenada



Dominican Republic

Saint Lucia

Costa Rica

Jamaica

Bahamas

Brazil

Colombia

Uruguay

Paraguay

Mexico

Panama

Trinidad and Tobago

Peru

El Salvador

Guatemala

Belize

Argentina

Nicaragua

Suriname


Guyana

Haiti

Honduras

Chi le

Ecuador


Venezuela (Boli varian Republi c of)

Bahrain

Qatar


Oman


Jordan

Saudi Arabia

Tunisia

Libya

Kuwait


Iraq

Djibouti

Morocco

Egypt

Pakistan

Afghanistan

Yemen

Somalia

Lebanon

Sudan

Brunei Darussalam

Cook Islands

Fiji

Kiribati

Niue

Republic of Korea

Singapore

Mongolia

Australia

Tonga

China

Nauru

Tuvalu

Samoa

Philippines

Palau

Cambodia

Viet Nam

Vanuatu

Malaysia

Marshall Islands

Solomon Islands

Papua New Guinea


Japan


New Zealand


Sri Lanka

Maldives

Thailand

Indonesia

Timor-Leste

Myanmar

India

Bhutan

Nepal

Bangladesh

This chart shows the percentage of women who received antenatal care from skilled health personnel at least once and at least four times during pregnancy.

Within each WHO region, countries are sorted by the latest available data since 2005 for at least one visit. The regional averages refer to at least one visit.

The vertical line denotes the global target of 100% coverage by 2015 set by the International Conference on Population and Development (ICPD+5).


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At least one visit

At least four visits

at least one visit and at least four visits

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Thailand

Sri Lanka

Indonesia

India

Bangladesh

Nepal

Maldives

Timor-Leste

Bhutan

Democratic People's Republicof Korea

Myanmar

Zimbabwe

Niger

Cape Verde

Madagascar

Congo

Nigeria

Namibia

Guinea


Lesotho

Swaziland

Kenya


Benin

Zambia

Mali

Sierra Leone

Senegal

Ethiopia

Ghana

Liberia


Uganda

Rwanda

Algeria

Angola

Botswana

Burkina Faso

Burundi

Cameroon


Chad

Comoros

Cte d'Ivoire

Equatorial Guinea

Eritrea

Gabon

Gambia

Guinea-Bissau

Malawi

Mauritania

Mauritius

Mozambique

Seychelles

South Africa

Togo

France

Turkey

Republic of Moldova

Ukraine

Albania

Armenia

Azerbaijan

Georgia

Andorra

Austria

Belarus

Belgium


Bulgaria

Croatia

Cyprus

Czech Republic

Denmark

Estonia

Finland

Germany

Greece

Hungary

Iceland

Ireland

Israel

Italy

Kazakhstan

Kyrgyzstan

Latvia

Lithuania

Luxembourg

Malta

Monaco

Montenegro

Netherlands

Norway

Poland

Portugal

Romania

Russian Federation

San Marino

Serbia

Slovakia

Slovenia

Spain

Sweden

Switzerland

Tajikistan


Turkmenistan

United Kingdom

Uzbekistan

Egypt

Jordan

Pakistan

Afghanistan

Bahrain

Djibouti


Iraq

Kuwait

Lebanon

Libya

Morocco

Oman

Qatar

Saudi Arabia

Somalia

Sudan


Tunisia


Yemen

Marshall Islands

Solomon Islands

Philippines

Tuvalu

Cambodia


Samoa

Australia

Brunei Darussalam

China

Cook Islands

Fij i

Japan

Kiribati

Malaysia


Mongolia

Nauru

New Zealand

Niue

Palau

Papua New Guinea

Republic of Korea

Singapore

Tonga

Vanuatu

Viet Nam

This chart shows the percentage of women who are fecund and sexually active but want to stop or delay childbearing and are not using any method of contraception. Within each WHO

region, countries are sorted by the latest available data since 2005.

Achieving the MDG target of universal access to reproductive health by 2015 can be interpreted as 0% unmet need. The vertical line corresponds to 0% with the percentage of unmet

need shown to the left of this line with a range of 50%.


Paraguay

Colombia

Brazil


Peru

Nicaragua

Dominican Republic

Mexico

Honduras


Haiti

Antigua and Barbuda

Argentina

Bahamas

Barbados

Belize

Canada

Chi le

Costa Rica

Cuba

Dominica

Ecuador

El Salvador

Grenada

Guatemala

Guyana

Jamaica

Panama


Saint Lucia


Suriname

Trinidad and Tobago

Uruguay


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family planning (%)

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Cambodia 425

Singapore 72

Japan 6.4

Malaysia 369

New Zealand 58

Australia 94


Viet Nam 316

Papua New Guinea 507

Fiji 67

Mongolia 17

Philippines 9.5


Brunei Darussalam

China

Cook Islands

Kiribati

Marshall Islands


Nauru

Niue

Palau

Samoa

Solomon Islands

Tonga

Tuvalu

Vanuatu

Lebanon 84

Djibouti 1 604

Qatar 8

Morocco 81


Pakistan 54

Oman 39Somalia 373

Egypt 13

Tunisia 24

Sudan 615

Afghanistan

Bahrain

Iraq

Jordan

Kuwait

Libya

Saudi Arabia



Yemen

Thailand 786

Maldives 11

India 200

Myanmar 477

Nepal 217

Sri Lanka 14

Bangladesh 3.9

Bhutan 142

Indonesia 133


Timor-Leste

Colombia 342

Panama 585

Guyana 771

Honduras 520

Haiti 1 226

Peru 256


Jamaica 1 161

Ecuador 275


Bahamas 1 921

Suriname 717

Mexico 201

Belize 1 554

Paraguay 199


Canada 200

Argentina 283

El Salvador 549

Trinidad and Tobago 1 085

Uruguay 296

Chile 238

Guatemala 445

Nicaragua 121

Costa Rica 215

Barbados 827

Cuba 64

Antigua and Barbuda

Brazil

Dominica

Grenada


Saint Lucia



Liberia 937

Burkina Faso 699

Central African Republic 2 861

Cte d'Ivoire 2 124

Mali 581

Zimbabwe 9 518

Eritrea 490

Kenya 3 664

Rwanda 1 664

Burundi 2 139

United Republic of Tanzania 3 199

Malawi 6 059

Guinea 789

Niger 400

Ghana 1 099

Uganda 3 645

Benin 674

Congo 2 078

Zambia 7 557

Nigeria 2 104

Togo 1 884

Namibia 8 163

Cameroon 3 107

Madagascar 123

Botswana 16 354

Lesotho 13 914

Angola 1 089

Gabon 3 118

Chad 1 846

South Africa 11 236

Mauritania 413

Swaziland 15 605

Guinea-Bissau 1 346

Mozambique 5 985

Senegal 472

Sierra Leone 860

Comoros 32

Algeria 50

Mauritius 684

Equatorial Guinea 2 945

Gambia 1 047

Cape Verde


Ethiopia


Seychelles

Spain 294

Hungary 30

Greece 79

Italy 240

Romania 74

Belgium 134


Netherlands 135

France 246

Sweden 88

Norway 83

Israel 105

Poland 70

Portugal 390

Switzerland 240

Ireland 152

Ukraine 766

Malta 71

Germany 81

Luxembourg 182

Armenia 62Iceland 172

Czech Republic 19

Denmark 97

Finland 49

Croatia 20

Lithuania 37

United Kingdom 137

Tajikistan 131

Latvia 385

Slovakia 6.6

Slovenia 26

Bulgaria 50

Turkey 6.1

Estonia 736

Serbia 50

Azerbaijan 41

Austria 183

Belarus 172

Georgia 81


Kazakhstan 84

Kyrgyzstan 178

Uzbekistan 103

Albania

Andorra


Cyprus

Monaco

Montenegro

San Marino


Turkmenistan

This chart shows the AARD in the estimated prevalence of HIV infections per 100 000 population per year for the period 20002009. Within each WHO region, countries are sorted in

descending order based on the AARD in this rate.

The MDG target to halt by 2015 and begin to reverse the spread of HIV/AIDS can be interpreted as any AARD greater than 0%. The vertical line corresponds to an AARD of 0% with cut-

off points of 10% on either side. Lightly shaded bars indicate countries in which the AARD was less than -10%. The numerical values show estimated HIV prevalence per 100 000

population for 2009.


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REGIONAL AVERAGE: 2 740






20002009

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Nicaragua

Cuba

Chile

Guyana

Argentina

Mexico

Dominican Republic

Uruguay

Brazil

Paraguay

Costa Rica

Ecuador

El Salvador

Jamaica

Peru

Venezuela (Bolivar ian Republic of)

Belize

Guatemala

Haiti

Honduras

Suriname

Panama

Colombia


Antigua and Barbuda

Bahamas

Barbados

Canada

Dominica

Grenada


Saint Lucia


Trinidad and Tobago


Thailand

Bangladesh

Bhutan

Sri Lanka

Indonesia

Myanmar

Nepal

Maldives

Democratic Peoples Republic of Korea

India

Timor-Leste

Comoros

Botswana

Namibia

Rwanda

Swaziland

Zambia

Kenya

Zimbabwe

Benin

Guinea

Lesotho

South Africa

Gabon

Senegal

Togo

Burkina Faso

Guinea-Bissau

Uganda

Mali

Cape Verde

Congo

Eritrea


Mozambique

Chad

Cameroon

Cte d'Ivoire

Gambia

Ghana

Burundi


Angola

Algeria

Sierra Leone

Niger

Liberia

Nigeria


Equatorial Guinea

Mauritania

Mauritius


Madagascar

Ethiopia

Malawi

Seychelles

Croatia

Slovakia

Romania

Georgia

Turkey

Belarus

Hungary

Poland

Serbia

Azerbaijan

Armenia

Kazakhstan

Uzbekistan

Lithuania

Republic of Moldova

Bulgaria

Latvia

Tajikistan

Ukraine

Kyrgyzstan

Russian Federation

Albania

Andorra

Austria

Belgium


Cyprus

Czech Republic

Denmark

Estonia

Finland

France

Germany

Greece

Iceland

Ireland

Israel

Italy

Luxembourg

Malta

Monaco

Montenegro

Netherlands

Norway

Portugal

San Marino

Slovenia

Spain

Sweden

Switzerland


Turkmenistan

United Kingdom

Oman

Lebanon

Morocco

Djibouti

Egypt

Tunisia

Pakistan


Sudan

Afghanistan

Somalia

Bahrain

Iraq

Jordan

Kuwait

Libya

Qatar

Saudi Arabia



Yemen

Cambodia

Papua New Guinea

Viet Nam


Philippines

Malaysia

Fiji

China

Mongolia

Australia

Brunei Darussalam

Cook Islands

Japan

Kiribati

Marshall Islands


Nauru

New Zealand

Niue

Palau

Republic of Korea

Samoa

Singapore

Solomon Islands

Tonga

Tuvalu

Vanuatu

This chart shows estimated antiretroviral therapy coverage in 2010 based on the standards for treatment set out in the 2010 guidelines of the Joint United Nations Programme on HIV/

AIDS. Within each WHO region, countries are sorted in descending order by the level of coverage achieved.

The vertical line denotes the target of universal access to antiretroviral therapy, defined as providing antiretroviral therapy to at least 80% of patients in need.


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REGIONAL AVERAGE: 8



with advanced HIV infection (%)

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Argentina

Bel ize


Brazi l

Colombia

Costa Rica

Dominican Republic

Ecuador

El Salvador

Guatemala

Guyana

Hai ti

Honduras

Jamaica

Mex ico

Nicaragua

Panama

Paraguay

Peru

Suriname

Venezuela (Boli varian Republic o f)

Non-endemic

Antigua and Barbuda

Bahamas

Barbados

Canada

Chile

Cuba

Dominica

Grenada


Saint Lucia


Trinidad and Tobago


Uruguay

Indonesia

Bangladesh

Bhutan


Ind ia

Myanmar

N epal

Sri Lanka

Thailand

Timor-Leste

Non-endemic

Maldives

Niger


Gambia

Kenya

Equatorial Guinea

Zambia

Guinea-Bissau

Togo

Ethiopia

Senegal

Ghana

Mali

Sierra Leone

Malawi

Rwanda

Benin

Angola



Cameroon

Burkina Faso

Uganda

Burundi

Mozambique

Congo

Cte d'Ivoire


Nigeria

Liberia

Zimbabwe

Guinea

Algeria

Botswana

Cape Verde

Chad

Comoros

Eritrea

Gabon

Madagascar

Mauritania

Mauritius

Namibia

South Africa

Swaziland

Non-endemic

Lesotho

Seychelles

Tajikistan

Armenia

Azerbaijan

Georgia

Kyrgyzstan

Russian Federation

Turkey

Turkmenistan

Uzbekistan

Non-endemic

Albania

Andorra

Austria

Belarus

Belgium


Bulgaria

Croatia

Cyprus

Czech Republic

Denmark

Estonia

Finland

France

Germany

Greece

Hungary

Iceland

Ireland

Israel

Italy

Kazakhstan

Latvia

Lithuania

Luxembourg

Malta

Monaco

Montenegro

Netherlands

Norway

Poland

Portugal

Republic of Moldova

Romania

San Marino

Serbia

Slovakia

Slovenia

Spain

Sweden

Switzerland


Ukraine

United Kingdom

Sudan

Somalia

Yemen

Afghanistan

Djibouti

Pakistan

Egypt


I ra q

Morocco

O man

Saudi Arabia


Non-endemic

Bahrain

Jordan

Kuwait

Lebanon

Libya

Qatar

Tunisia


Viet Nam

Cambodia

China


Malaysia

Papua New Guinea

Philippines

Republic of Korea

Solomon Islands

Vanuatu

Non-endemic

Australia

Brunei Darussalam

Cook Islands

Fiji

Japan

Kiribati

Marshall Islands


Mongolia

Nauru

New Zealand

Niue

Palau

Samoa

Singapore

Tonga

Tuvalu

This chart shows the percentage of children under 5 years old that slept under an insecticide-treated net the night prior to the survey. Within each WHO region, countries are sorted by the

latest available data since 2005.

The vertical line denotes the target of 80% coverage set by WHO and the Roll Back Malaria Partnership.


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REGIONAL AVERAGE: 5


insecticide-treated nets (%)

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Haiti

Honduras

Argentina

Belize


Brazil

Colombia

Costa Rica

Dominican Republic

Ecuador

El Salvador

Guatemala

Guyana

Jamaica

Mexico

Nicaragua

Panama

Paraguay

Peru

Suriname Venezuela (Boli varian Republic o f)

Non-endemic

Antigua and Barbuda

Bahamas

Barbados

Canada

Chile

Cuba

Dominica

Grenada


Saint Lucia


Trinidad and Tobago


Uruguay

India

Timor-Leste

Indonesia

Sri Lanka

Nepal

Bangladesh

Bhutan


Myanmar

Thailand

Non-endemic

Maldives

Guinea

Liberia

Gambia

Uganda


Cameroon


Benin

Guinea-Bissau

Nigeria

Burkina Faso

Congo

Togo

Malawi

Ghana


Mozambique

Cte d'Ivoire

Chad

Zambia

Niger

Mali

Sierra Leone

Angola

Zimbabwe

Kenya

Mauritania

Namibia

Madagascar

Burundi

Eritrea

Ethiopia

Senegal


Rwanda

Swaziland

Algeria

Botswana

Cape Verde

Comoros

Equatorial Guinea

Gabon

Mauritius

South Africa

Non-endemic

Lesotho

Seychelles

Tajikistan

Armenia

Azerbaijan

Georgia

Kyrgyzstan

Russian Federation

Turkey

Turkmenistan

Uzbekistan

Non-endemic

Albania

Andorra

Austria

Belarus

Belgium


Bulgaria

Croatia

Cyprus

Czech Republic

Denmark

Estonia

Finland

France

Germany

Greece

Hungary

Iceland

Ireland

Israel

Italy

Kazakhstan

Latvia

Lithuania

Luxembourg

Malta

Monaco

Montenegro

Netherlands

Norway

Poland

Portugal

Republic of Moldova

Romania

San Marino

Serbia

Slovakia

Slovenia

Spain

Sweden

Switzerland


Ukraine

United Kingdom

Sudan

Djibouti

Somalia

Pakistan

Afghanistan

Egypt


Iraq

Morocco

Oman

Saudi Arabia


Yemen

Non-endemic

Bahrain

Jordan

Kuwait

Lebanon

Libya

Qatar

Tunisia


Solomon Islands


Viet Nam

Cambodia

Philippines

China

Malaysia

Papua New Guinea

Republic of Korea

Vanuatu

Non-endemic

Australia

Brunei Darussalam

Cook Islands

Fiji

Japan

Kiribati

Marshall Islands


Mongolia

Nauru

New Zealand

Niue

Palau

Samoa

Singapore

Tonga

Tuvalu

This chart shows the percentage of children under 5 years old with fever in the two weeks prior to the survey who received any antimalarial medicine. Within each WHO region, countries

are sorted by the latest available data since 2005.

The vertical line denotes the target of 100% coverage set by WHO and the Roll Back Malaria Partnership.


AFR EMREURAMR

SEAR

WPR

treatment with any antimalarial (%)

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Bahamas 11

Honduras 51

Mexico 16

Costa Rica 13

Peru 106

Ecuador 65

Saint Lucia 7.9

United States of America 4.1

Nicaragua 42


Argentina 27

Barbados 1.7

Cuba 9.3

Brazil 43

Chile 19


Canada 4.7

El Salvador 28

Colombia 34

Haiti 230

Uruguay 21

Guatemala 62

Saint Vincent and the Grenadines 24

Dominica 13

Grenada 4.1

Paraguay 46

Saint Kitts and Nevis 7.6


Belize 40

Jamaica 6.6

Panama 48


Antigua and Barbuda 4.9

Guyana 111

Suriname 145

Maldives 36

Bhutan 151

India 185

Myanmar 384

Bangladesh 225

Indonesia 189

Nepal 163

Sri Lanka 66

Thailand 137

Timor-Leste 498


Rwanda 106

Malawi 219

Uganda 209

Botswana 503

Mali 68

Namibia 603

Ghana 86

Zambia 462

Comoros 37

Cte d'Ivoire 139

Burundi 129


Nigeria 133

Burkina Faso 55

Seychelles 31


Zimbabwe 633

Mauritius 22

Cape Verde 147


Algeria 90

Kenya 298

Chad 276

Cameroon 177

Congo 372


Mozambique 544

Benin 94

Ethiopia 261

Lesotho 633

Eritrea 100

Liberia 293

Gambia 273

Guinea-Bissau 233

Senegal 288

Angola 304

Togo 455

Mauritania 337

Niger 185

Madagascar 266


Swaziland 1287

Guinea 334

South Africa 981

Sierra Leone 682

Gabon 553

Serbia 18.0

Austria 5.0

Slovakia 8.0

Germany 4.8

Andorra 7.4

Estonia 25

Latvia 39

Czech Republic 6.8

Hungary 15.0

Montenegro 19

Denmark 6.0

Croatia 21

The former Yugoslav Republic of Macedonia 21

Israel 4.9

Slovenia 11

Italy 4.9

Finland 6.7

Greece 4.6

Albania 14

Turkey 28

Portugal 29

Belgium 8.7

Ireland 8.1

Romania 116

Spain 16

Poland 23

France 9.3

Turkmenistan 66

Netherlands 7.3

Kazakhstan 151


Lithuania 69

Switzerland 7.6


Bulgaria 40

Luxembourg 8.8

Belarus 70

Norway 6.0

Azerbaijan 110

Georgia 107

Uzbekistan 128

Cyprus 4.4

Armenia 73

Kyrgyzstan 159

United Kingdom 13.0

Iceland 5.0

Ukraine 101

Sweden 6.8


Tajikistan 206

Malta 12

Monaco ...

San Marino ...

Yemen 49


United Arab Emirates 3.1


Jordan 5.4

Bahrain 23

Egypt 18Qatar 38

Morocco 91

Oman 13

Saudi Arabia 18

Afghanistan 189

Iraq 64

Lebanon 17

Libya 40

Pakistan 231

Sudan 119

Djibouti 620

Somalia 286

Tunisia 25

Kuwait 41

Niue 6.5

Cook Islands 3.5

Samoa 11

Japan 21

Solomon Islands 108

Tonga 17

Vanuatu 69

Tuvalu 237

Brunei Darussalam 68

New Zealand 7.6

Singapore 35

China 78


Palau 124

Philippines 275

Malaysia 82

Mongolia 224

Cambodia 437

Nauru 40

Fiji 27

Viet Nam 199

Kiribati 370Papua New Guinea 303

Australia 6.3



Marshall Islands 502

This chart shows the AARD in the estimated incidence of tuberculosis per 100 000 population per year for the period 20002010. Within each WHO region, countries are sorted in

descending order based on the AARD in estimated tuberculosis incidence.

Achieving the MDG target of halt ing by 2015 and beginning to reverse the incidence of malaria and other major diseases such as tuberculosis can be interpreted as any AARD greater

than 0%. The vertical line corresponds to an AARD of 0% with a range of -10% to the left of the line and +15% to the right. The numerical values show the estimated incidence of new

tuberculosis cases per 100 000 population for 2010.


AFR EMRAMR EUR

SEAR

WPR



REGIONAL AVERAGE: 29REGIONAL AVERAGE: 109



20002010

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Barbados

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The AARD in the proportion of the population without access to basic sanitation was calculated using the complement of the estimated proportion using improved sanitation, for the period

19902010 (or any minimum period of five years since 1990). Within each WHO region, countries are sorted in descending order based on this rate of decline.

In order to reach the MDG target of halving, by 2015, the proportion of people without sustainable access to basic sanitation, an AARD of 2.7% will be required and is denoted by

the vertical line. Countries with sustained low levels of proportion of population without improved sanitation (

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Part II

Highlightedtopics

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Noncommunicable diseases: a majorhealth challenge of the 21st century

such trends, the total number of annual NCD deaths is

projected to reach 55 million by 2030 whereas annual

infectious disease deaths are projected to decline over

the next 20 years.

In 2008, around 80% of all NCD deaths (29 million) oc-

curred in low- and middle-income countries. In addi-tion, a higher proportion (48%) of all NCD deaths in low-

and middle-income countries are estimated to occur in

people under the age of 70 compared with an esti-

mated 26% in high-income countries and a global av-

erage of 44%. Such premature death rates from NCDs

are a major consideration in determining their impact.

The probability of dying from an NCD between the ages

of 30 and 70 is highest in sub-Saharan Africa, Eastern

Europe and parts of Asia. (Figure 7).

Of the estimated 57 million global deaths in 2008, 36

million (63%) were due to noncommunicable diseases

(NCDs).11,12 Population growth and increased longev-

ity are leading to a rapid increase in the total number

of middle-aged and older adults, with a corresponding

increase in the number of deaths caused by NCDs. It

is projected that the annual number of deaths due tocardiovascular disease will increase from 17 million in

2008 to 25 million in 2030, with annual cancer deaths

increasing from 7.6 million to 13 million. As a result of

11. Cause-specific mortality: regional estimates for 2008. Geneva,

World Health Organization, 2011 (http://www.who.int/healthin-

fo/global_burden_disease/estimates_regional/en/index.html).

12. Causes of death 2008: data sources and methods. Geneva,

World Health Organization, 2011 (http://www.who.int/healthin-

fo/global_burden_disease/cod_2008_sources_methods.pdf).

Figure 7. Probability of death from an NCD between ages 30 and 70 (%), 2008

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NCD risk factors are known

The largest proportion of NCD deaths is caused by car-

diovascular disease (48%), followed by cancers (21%)and chronic respiratory diseases (12%). Diabetes is di-

rectly responsible for 3.5% of NCD deaths. Behavioural

risk factors, including tobacco use, physical inactivity,

unhealthy diet and the harmful use of alcohol, are esti-

mated to be responsible for about 80% of coronary heart

disease and cerebrovascular disease.13

Behavioural risk factors are associated with four key

metabolic and/or physiological changes raised blood

pressure, increased weight leading to obesity, hypergly-

caemia and hyperlipidemia. These changes can havemultiple effects. For example, in addition to its direct role

in diabetes, raised fasting blood glucose also increases

the risk of cardiovascular deaths, and was estimated to

cause 22% of coronary heart disease deaths and 16%

of stroke deaths.13 In terms of attributable deaths, the

leading behavioural and physiological risk factors glob-

13. Global health risks: mortality and burden of disease attributable

to selected major risks. Geneva, World Health Organization,

2009 (http://www.who.int/healthinfo/global_burden_disease/

GlobalHealthRisks_report_full.pdf).

ally are raised blood pressure (to which 13% of global

deaths are attributed), followed by tobacco use (9%),

raised blood glucose (6%), physical inactivity (6%) and

being overweight or obese (5%).

13

It has been estimated that raised blood pressure causes

51% of stroke deaths and 45% of coronary heart dis-

ease deaths.13 Mean blood pressure has decreased

dramatically in nearly all high-income countries. For

example, mean age-standardized male systolic blood

pressure (SBP) in the United States decreased from

131 mm Hg (95% uncertainty interval 127135) in

1980 to 123 mm Hg (120127) in 2008, while mean

age-standardized female SBP decreased from 125

mm Hg (121130) to 118 mm Hg (115122) mm Hg.In contrast, mean blood pressure has been stable or

increasing in most African countries.14,15 Today, mean

blood pressure remains very high in many African and

14. Danaei G et al. (2011). National, regional, and global trends

in systolic blood pressure since 1980: Systematic analysis

of health examination surveys and epidemiological studies

with 786 country-years and 5.4 million participants. Lancet,

377:568577.

15. Global Health Observatory. Geneva, World Health Organiza-

tion, 2011 (http://www.who.int/gho).

50

45

40

35

30

25

20

15

10

5

0

(%)

1980 2008 1980 2008 1980 2008 1980 2008 1980 2008 1980 2008 1980 2008

Figure 8. Age-standardized prevalence (%) of raised blood pressure (SBP 140 mm Hg or DBP 90 mm Hg)

among adults aged 25 years and over by WHO region, 1980 and 2008

AFR AMR SEAR EUR EMR WPR Global

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some European countries. As shown in Figure 8, the

prevalence of raised blood pressure in 2008 (SBP 140

mm Hg or diastolic blood pressure (DBP) 90 mm

Hg) was highest in the WHO African Region at 36.8%(34.039.7). Applying the lessons learnt in high-income

countries to low- and middle-income settings has the

potential to significantly reduce the overall rate of adult

mortality from cardiovascular diseases.

More than two thirds of all cancer deaths occur in

low- and middle-income countries, with lung, breast,

colorectal, stomach and liver cancers causing the ma-

jority of such deaths. Risk factors for cancer include the

four main NCD risk factors. However, infections such as

hepatitis B and hepatitis C (both associated with livercancer), human papillomavirus (associated with cervi-

cal cancer) and Helicobacter pylori (associated with

stomach cancer) also cause 20% of cancer deaths in

low- and middle-income countries, and 9% of cancer

deaths in high-income countries.13

Predominant cancer types vary according to the prevail-

ing underlying risks. In sub-Saharan Africa, for example,

cervical cancer is the leading cause of cancer death

among women due to a high prevalence of infection

with human papillomavirus. In high-income countries,

the leading causes of cancer deaths are lung cancer

among men and breast cancer among women.

Worldwide, 2.8 million people die each year as a resultof being overweight or obese.13 Being overweight or

obese can lead to adverse metabolic effects on blood

pressure, cholesterol and triglyceride levels, and can

result in diabetes. Being overweight or obese thus in-

creases the risks of coronary heart disease, ischaemic

stroke, type 2 diabetes mellitus, and a number of com-

mon cancers.

Between 1980 and 2008, the worldwide prevalence of

obesity (body mass index 30 kg/m2) almost doubled

(Figure 9). By 2008, 10% of men and 14% of women inthe world were obese, compared with 5% of men and

8% of women in 1980. As a result, an estimated half

a billion men and women over the age of 20 were esti-

mated to be obese in 2008. In all WHO regions, women

were more likely to be obese than men.

The prevalence of overweight and obese individuals

was highest in the WHO Region of the Americas (62%

overweight in both sexes, and 26% obese) and lowest

in the WHO South-East Asia Region (14% overweight

in both sexes and 3% obese). In the WHO European

Figure 9. Age-standardized prevalence (%) of obesity (body mass index 30 kg/m2) among adults aged 20 years

and over by WHO region, 1980 and 2008

30

25

20

15

10

5

0

(%)

1980 2008 1980 2008 1980 2008 1980 2008 1980 2008 1980 2008 1980 2008

AFR AMR SEAR EUR EMR WPR Global

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Region, WHO Eastern Mediterranean Region and WHO

Region of the Americas, over 50% of women were

overweight. In all three regions, approximately half of

these overweight women were obese (23%, 24% and29% respectively).

The United Nations

is taking action

To address the prevention and control of NCDs, with

a particular focus on developing countries, the United

Nations General Assembly convened a High-Level

meeting on NCDs in September 2011. The Political

Declaration adopted by the General Assembly rep-resents a breakthrough in the global struggle against

NCDs. It acknowledges that NCDs constitute one of

the major challenges to development in the 21st cen-

tury, highlights the rapidly growing magnitude of NCDs

in developing countries, and recognizes NCDs as a

contributing factor to poverty and hunger in developing

countries. The declaration outlines ways to strengthen

national capacities to address NCDs, and to respond

to the challenge through the reduction of risk factors,

the strengthening of health systems, and improved

monitoring and evaluation. The declaration specificallyrequests WHO:

Q to develop a comprehensive global monitoring

framework and recommendations for a set of vol-

untary global targets for the prevention and control

of NCDs;

Q to provide guidance to Member States on the devel-

opment of national targets and indicators;

Q to collaborate with the Secretary-General of the

United Nations in submitting a report to the United

Nations General Assembly in 2012 on options for

strengthening and facilitating multisectoral action for

the prevention and control of NCDs through effec-

tive partnership.

The global monitoring framework, targets and indica-

tors are now being developed with the full participation

of WHO Member States and in collaboration with other

United Nations agencies, funds and programmes, and

with relevant international organizations.

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Health expenditures and universal coverage

Two recent World Health Assembly (WHA) resolutions

16,17

have highlighted the importance of health-financing

systems in helping countries attain and maintain univer-

sal coverage sometimes called universal health cov-

erage or social health protection. Universal coverage

has been defined as:

ensuring that all people have access to needed

health services prevention, promotion, treatment

and rehabilitation without facing financial ruin be-

cause of the need to pay for them.18

The two WHA resolutions requested that WHO support

countries seeking to modify their health-financing sys-

tems in order to achieve this aim partly through the

sharing of information on best practices and country ex-

periences. Drawing on the experiences of countries at all

income levels, TheWorld Health Report 201018 makes

the case that all countries could do at least one thing to

move closer to universal coverage or to protect the gains

already made. Options for immediate action include:

Q raising more funds for health domestically;

Q reducing financial barriers to services by increasingforms of prepayment and the pooling of funds, rath-

er than relying on direct out-of-pocket payments;

Q improving efficiency and equity in the way resources

are used.

The report urged that richer countries continue to sup-

port lower-income countries in all of these areas. In the

16. Fifty-Eighth World Health Assembly. Resolution WHA 58.33.

Sustainable health financing, universal coverage and socialhealth insurance. Geneva, World Health Organization, 2005

(http://apps.who.int/gb/ebwha/pdf_files/WHA58-REC1/eng-

lish/Resolutions.pdf accessed 8 February 2012).

17. Sixty-Fourth World Health Assembly. Resolution WHA 64.9.

Sustainable health financing structures and universal coverage.

Geneva, World Health Organization, 2011 (http://apps.who.

int/gb/ebwha/pdf_files/WHA64/A64_R9-en.pdf accessed 8

February 2012).

18. The World Health Report 2010. Health systems financing: the

path to universal coverage. Geneva, World Health Organiza-

tion, 2010 (http://www.who.int/whr/2010/en/index.html ac-

cessed 8 February 2012).

case of the first two options, national health accountsand other forms of expenditure tracking can provide

very useful information.

How much money is available

for health?

The overall level of funding allocated to health sets the

boundaries that determine which services will be avail-

able to the population. This overall level is determined

partly by a countrys wealth, the proportion of nation-al income devoted to health, and inflows of funds for

health from external partners.

Figure 10 shows total health expenditure (US$) per

capita for 2009. Data are unavailable for the Democratic

Republic of Korea, Somalia and Zimbabwe. Because of

the enormous variation in health expenditures between

different countries, the relative values shown by the

horizontal bars use a logarithmic scale, with the corre-

sponding absolute figures shown to the left of each bar.

Expenditures per capita from all sources public, pri-

vate and external partners ranged from US$ 11 in Er-

itrea to US$ 8262 in Luxembourg. Average (weighted)

per capita expenditures also varied substantially across

WHO region

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