Islamabad - Today, fewer people are dying from tetanus and diarrheal diseases in Pakistan as mortality from tetanus dropped by 93 per cent between 1990 and 2013. At the same time, a number of diseases, including chronic kidney disease and diabetes claimed more lives in Pakistan in 2013 than in 1990. Life expectancy improved for both men and women in Pakistan at an average of 3.4 years gained since 1990, according to a new, comprehensive analysis of trend data from 188 countries.

The study “Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013” was conducted by an international consortium of researchers coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. The paper is about global mortality that compares data from 1990 to 2013 and analyses the shift in top causes for death across 188 countries.

The leading killers in Pakistan were ischemic heart disease, stroke, and pneumonia, accounting for 28 percent of all deaths in 2013. Ischemic heart disease and road injuries were the top two causes of death for people between the ages of 15 and 49, resulting in 40,379 lives lost in 2013. Among individuals 70 and older, ischemic heart disease claimed the most lives that year.

The top cause of child mortality was neonatal encephalopathy in 2013, killing 64,388 children under the age of 5.

Worldwide, too ischemic heart disease, stroke, and COPD claimed the most lives, accounting for nearly 32 per cent of all deaths. But much global progress has been made in reducing mortality from diseases such as measles and diarrhea, with 83 per cent and 51 per cent declines, respectively, from 1990 to 2013.

In Pakistan, chronic kidney disease and diabetes took more lives in 2013 than in 1990, with deaths increasing 182 per cent and 175 per cent, respectively. Mortality from ischemic heart disease also increased 135 per cent between 1990 and 2013.

Since 1990, Pakistan saw marked declines in mortality from a number of diseases that used to take a large toll on the country. For instance, by 2013, mortality from tetanus decreased 93 per cent and diarrheal diseases caused 50 per cent fewer deaths. In 1990, these diseases killed 161,309 people. Twenty three years later, they claimed 90,277 fewer lives.

The study also revealed how some diseases and injuries cause different mortality patterns for males and females. For example, in Pakistan, chronic obstructive pulmonary disease (COPD) took a greater toll on men, killing 32,469 males and 10,898 females in 2013. By contrast, stroke claimed 61,289 women’s lives and 57,256 men’s lives. “We have achieved great progress in reducing mortality from a number of diseases, reflecting our country’s investments in improving health for its citizens,” said Country Expert Dr Ejaz Ahmad Khan, an Assistant Professor at the Health Services Academy, Islamabad while talking to The Nation. “But we are still seeing children dying and deaths from other conditions are rising. The data are critical to understanding where we have been and then where we need to go in order to save more lives in future,” he added. “These findings underscore the need for continued investments in maternal and child health,” said Professor Zulfiqar A. Bhutta, Founding Director of the Centre of Excellence in Women and Child Health at the Aga Khan University.  “The overall gains in life expectancy and the high number of deaths related to ischemic heart disease and stroke also underscore the need for parallel investments in reducing the burden of non-communicable diseases, which should receive urgent policy attention at national and provincial level,” he added.

Globally, people live an average of 6.2 years longer than they did in 1990, with life expectancy rising to just under 72 years in 2013. Women showed a slightly larger average gain (an increase of 6.6 years) than men (a rise of 5.8 years).

Improvements in health, reduced fertility, and shifts in the world’s age patterns have driven these global gains in life expectancy.

In Pakistan, the average life expectancy for women was 67.3 years in 2013, with men living an average of 64.4 years. By contrast, women lived an average of 62.6 years, and men had a life expectancy of 62.2 years in 1990. Out of the 188 countries included in the study, Pakistan ranked 140th for women and 129th for men for longest life expectancies. In 2013, Andorra had the longest life expectancy for women (86.7 years) and Qatar had the longest for men (81.2 years). Lesotho had the shortest life expectancy for both women (51.2 years) and men (45.6 years).

Researchers found a widening gap between countries with the lowest and highest death rates from a given disease,  a potential sign of increasing inequalities in health. They also emphasised the importance of measuring local disease burdens, as the health challenges found in one corner of a country can widely vary from those experienced a few hours away.