This slide is all about the effect of population growth with poverty and infectious diseases.

1. POPULATION GROWTH AND
LINKAGE WITH POVERTY
AND INFECTIOUS DISEASES
PRAKASH DHAKAL
Public Health Microbiology
Tribhuvan University

2. OUTLINE OF PRESENTATION
 Population growth in World and Nepal
 Poverty in World and Nepal
 Hungry people of world
 Population growth and its linkage to poverty
 Population growth and its linkage to Infectious diseases
 Infectious diseases related to poverty

3. POPULATION GROWTH IN WORLD AND NEPAL
 Population is defined as the number of people living
or inhabiting in a particular place.
 The worlds population is currently 7.2 billion where
approximately 351 thousand new babies are born
and 144 thousand peoples die.
 The rate of population growth in world is 1.14 per
year.
 The population of China and India (Chindia)
together comprises about 40 % of the total world
population.

4.  Top 20 Largest Countries by Population :
1) China 2) India 3) USA 4) Indonesia 5) Brazil 6)
Pakistan 7) Nigeria 8) Bangladesh 9) Russia 10)
Japan 11) Mexico 12) Philippines 13) Ethiopia 14)
Vietnam 15) Egypt 16 ) Germany 17 ) Iran 18 ) Turkey
19) Congo 20 ) Thailand
 The population of Nepal is 26,494,504 and the rate of
population growth is 1.35 per annum.
 The increase in population creates problems like
Socio-economic discrimination, scarcity of food and
shelter, increasing instability and unemployment if not
properly managed.

6. POVERTY IN WORLD AND NEPAL
 Poverty is defined as the condition of being poor ,
due to which daily needs are difficult to fulfill and
have lower socio-economic condition than riches.
 Nearly half of the world‘s population — more than 3
billion people — live on less than $2.50 a day. More
than 1.3 billion live in extreme poverty (less than
$1.25 a day).
 1 billion children worldwide are living in poverty.
According to UNICEF, 22,000 children die each
day due to poverty.

7.  More than 1 billion people lack adequate access to
clean drinking water and an estimated 400 million of
these are children. Since, unclean water yields illness,
roughly 443 million school days are missed every year.
 In 2011, 165 million children under the age 5 were
stunted (reduced rate of growth and development) due
to chronic malnutrition.
 870 million people worldwide do not have enough food
to eat.
 Preventable diseases like diarrhea and pneumonia take
the lives of 2 million children a year who are too poor to
afford proper treatment.
 As of 2011, 19 million children worldwide remain
unvaccinated.
 A quarter of all humans live without electricity —
approximately 1.6 billion people.

8.  80 percent of the world population lives on less than
$10 a day.
 It would cost approximately $40 billion to offer basic
education, clean water and sanitation, reproductive
health for women, and basic health and nutrition to
every person in every developing country.
 The World Food Program says, “The poor are
hungry and their hunger traps them in poverty.”
Hunger is the number one cause of death in the
world, killing more than HIV/AIDS, malaria, and
tuberculosis combined.

12.  South Asia is home to over 40 percent of the world‘s
poor. Of the eight countries in the region, four fall in the
category of the UN-defined least developed countries.
Three of them are landlocked. The share of distribution
of GDP among the South Asian countries indicates that
there is a lack of symmetrical distribution.
 The Human Development Report of 2013 confirms that
in most South Asian countries, the score in terms of the
HDI is very low. Of the 187 countries, Norway ranks first
while Niger ranks last. Although Sri Lanka and the
Maldives are comparatively better, South Asia as a
region is still in an ―inhumane‖ state in terms of access
to income, health and education which is essential for a
decent living as per the international standards.

14.  Nepal is ranked as the twelfth poorest countries in the
world. However, over the last decade the country has
made considerable progress reducing poverty but is still
falling behind. Urban poverty declined from 22% to 10%
and rural poverty declined from 43% to 35%.
 About four fifths of the working population live in rural
areas and depend on subsistence farming for their
livelihoods. In these areas the majority of households have
little or no access to primary health care, education, clean
drinking water and sanitation services. Life is a constant
struggle for survival.
 In Nepal, only less than half of the population has
access to safe drinking water and about half the
children below five years of age are underweight. The
average age that people live in Nepal is about 54 years
while countries like Canada have achieved life expectancy
of about 80 years. This is mainly due to the lack of clean
water, poverty and unavailability of basic health care.

15.  United Nations has done extensive studies on the
level of poverty in Nepal. Kathmandu and
surrounding area and the East Nepal have lesser
poverty and the West generally suffers from
grinding poverty.

18.  Millennium development goals
 Goal 1: Eradicate extreme poverty and hunger
Target 1a. Halve, between 1990 and 2015, the proportion of
people whose income is less than one dollar a day.
Target 1b. Achieve full and productive employment and decent
work for all, including women and young people.
Target 1c. Halve, between 1990 and 2015, the proportion of
people who suffer from hunger.
 Goal 2: Achieve universal primary education
Target 2a. Ensure that, by 2015, children everywhere, boys and
girls alike, will be able to complete a full course of primary
schooling.
 Goal 3: Promote gender equality and empower women
Target 3a. Eliminate gender disparity in primary and secondary
education preferably by 2005 and in all levels of education no
later than 2015.

19.  Goal 4: Reduce child mortality
Target 4a. Reduce by two-thirds, between 1990 and 2015,
the under-five mortality rate.
 Goal 5: Improve maternal health
Target 5a. Reduce by three-quarters, between 1990 and
2015, the maternal mortality ratio.
Target 5b. Achieve, by 2015, universal access to
reproductive health.
 Goal 6: Combat HIV/AIDS, malaria and other
diseases
Target 6a. Have halted by 2015 and begun to reverse the
spread of HIV/AIDS.
Target 6b. Achieve, by 2010, universal access to treatment
for HIV/AIDS for all those who need it.
Target 6c. Have halted by 2015 and begun to reverse the
incidence of malaria and other major diseases.

20.  Goal 7: Ensure environmental sustainability
Target 7a. Integrate the principles of sustainable
development into country policies and programs
and reverse the loss of environmental resources.
Target 7b. Reduce biodiversity loss, achieving, by
2010, a significant reduction in the rate of loss.
Target 7c. Halve, by 2015, the proportion of people
without sustainable access to safe drinking water
and basic sanitation.
Target 7d. By 2020, to have achieved a significant
improvement in the lives of at least 100 million slum
dwellers.

21.  Goal 8 : Develop a global partnership among
development
 These eight MDGs break down into 21 quantifiable
targets that are measured by 60 indicators .
 The developing world has already attained the first
Millennium Development Goal target to cut the
1990 poverty rate in half by 2015. The 1990
extreme poverty rate – $1.25 a day in 2005 prices –
was halved in 2010, according to new preliminary
estimates.
 Infectious diseases -- clustering in impoverished
communities and ignored, undertreated and under
researched– remain a substantial hurdle to MDG
attainment.

22. HUNGRY PEOPLE OF WORLD
 The United Nations Food and Agriculture Organization estimates
that nearly 870 million people of the 7.2 billion people in the world,
or one in eight, are suffering from chronic undernourishment in
2010-2012. Almost all the hungry people, 852 million, live in
developing countries, representing 15 percent of the population of
developing counties. There are 16 million people undernourished in
developed countries (FAO 2012).
 The number of undernourished people decreased nearly 30 percent
in Asia and the Pacific, from 739 million to 563 million, largely due to
socio-economic progress in many countries in the region. The
prevalence of undernourishment in the region decreased from 23.7
percent to 13.9 percent.
 Latin America and the Caribbean also made progress, falling from
65 million hungry in 1990-1992 to 49 million in 2010-2012, while the
prevalence of undernourishment dipped from 14.6 percent to 8.3
percent. But the rate of progress has slowed recently.

23.  The number of hungry grew in Africa over the
period, from 175 million to 239 million, with nearly
20 million added in the last few years. Nearly one
in four are hungry. And in sub-Saharan Africa, the
modest progress achieved in recent years up to
2007 was reversed, with hunger rising 2 percent
per year since then.
 Developed regions also saw the number of hungry
rise, from 13 million in 2004-2006 to 16 million in
2010-2012, reversing a steady decrease in
previous years from 20 million in 1990-1992
(FAO 2012).

24.  Children are the most visible victims of under
nutrition. Children who are poorly nourished suffer up to
160 days of illness each year. Poor nutrition plays a role
in at least half of the 10.9 million child deaths each year-
-five million deaths.
 Under nutrition magnifies the effect of every
disease, including measles and malaria. The estimated
proportions of deaths in which under nutrition is an
underlying cause are roughly similar for diarrhea
(61%), malaria (57%), pneumonia (52%), and measles
(45%) (Black 2003, Bryce 2005).
 Malnutrition can also be caused by diseases, such as
the diseases that cause diarrhea, by reducing the body's
ability to convert food into usable nutrients.
 Malnutrition, as measured by stunting, affects 32.5
percent of children in developing countries--one of three
(de Onis 2000).

25.  Geographically, more than 70 percent of malnourished children
live in Asia, 26 percent in Africa and 4 percent in Latin America
and the Caribbean. In many cases, their plight began even before
birth with a malnourished mother.
 Under-nutrition among pregnant women in developing countries
leads to 1 out of 6 infants born with low birth weight. This is not
only a risk factor for neonatal deaths, but also causes learning
disabilities, mental, retardation, poor health, blindness and
premature death.
 Causes of hunger :
Poverty is the principal cause of hunger.
Harmful economic systems are the principal cause of poverty and
hunger.
Conflict as a cause of hunger and poverty.
Hunger is also a cause of poverty, and thus of hunger.
Climate change

26. POPULATION GROWTH AND ITS LINKAGE TO
POVERTY
 The relationship between population growth and poverty
is a vicious circle. Rapid population growth is an
obstacle to economic progress in some of the poorest
countries, depriving those societies of funds for investment to
develop. At the same time, poverty fuels overpopulation
by depriving women of both the incentive and the
means to have fewer children.
High population growth contributes to poverty. High fertility
rates affect the health of mothers and families, increasing
the risk of maternal, infant and child mortality, all of which
combine to entrench poverty.

27. At a societal level, rapid population growth increases the
number of people in need of health care, education and
livelihoods. This in turn requires more financial, material and
natural resources.
A further link between poverty, overpopulation and
sustainability is that communities which are poor and
overpopulated are generally those which suffer most as a result
of rapid environmental change or ‗natural‘ disasters, as illustrated
by the 2010 flooding of large parts of Pakistan.
 Being poor makes it impossible to pay for measures to mitigate
the effects of climate change, and the more people there are the
more difficult it is for them to move or to migrate to areas less
affected by the changes.

28.  In some developing countries, there is a wide gap – or in
some cases – widening gap between rich and poor, and
between those who can and cannot access opportunities. It
means that access to good schools, healthcare, electricity,
safe water and other critical services remains elusive for many
people who live in growing economies.
 In many developing countries, widespread poverty has
persisted because of three main reasons: slow rate of growth,
biased growth pattern, and failure of government policies. A
slow rate of growth has dual effect: it decreases income and
employment and increases the rent-seeking behavior of the
politicians in favor of non-poor like businessmen, large
farmers, bureaucrats, trade unions, and the security
personnel.
 Many of the determinants of health lie outside the control of
the health sector. Social, economic ,political and
environmental factors all influence risk ,exposure and the
effects of infectious disease .

29. POPULATION GROWTH AND ITS LINKAGE
TO INFECTIOUS DISEASES
 Population growth drives infectious disease rate upward.
 Demand-driven agriculture and livestock production predicted
to increase spread and dangers of zoonotic diseases.
 As the world population grows, the rise of mega agriculture to
meet increased demand for food could aid the spread and
virulence of infectious diseases worldwide. Developing
nations, where most of the population growth is expected to
occur, will race to meet the demands, but poor public health
infrastructures could put the global food supply at risk.
 The agriculture is the first contributor to the problem. When
humans started to grow their own food, they remained stable
and built communities. Infectious diseases are able to spread
and grow in these stable human populations .

30.  Population growth puts more people in closer proximity to
each other, which facilitates the spread of contagious
infectious diseases.
 The planet is in the midst of a warming trend. Certain
infectious diseases, such as those borne by mosquitoes,
increase when the climate is more hospitable to their carriers.
More such species can thrive in warmer weather.
 New medical technologies, such as blood transfusions and
organ transplants, when not very tightly controlled and
regulated, provide new paths for the spread of pathogens.

31.  In an increasingly globalized world, rapid population
mobility and migration is reducing the differences in
infectious disease epidemiology between regions of
the world.
 The movement and relocation of populations
between locations where the prevalence and
incidence of infections are markedly different poses
current and future challenges to those involved in
clinical infectious diseases and public health
program management.

32. INFECTIOUS DISEASES RELATED TO
POVERTY
 ―Infectious diseases of poverty‖ is an umbrella term used to describe a
number of diseases which are known to be more prevalent among
poorer populations, These are more prevalent among the poor than
among wealthier people rather than a definitive group of diseases .
 Diseases of poverty are often co-morbid and ubiquitous with
malnutrition.
 Crowded living and working conditions, inadequate sanitation, and
disproportionate occupation as sex workers, the poor are more likely to
be exposed to infectious diseases.
 The interrelationships between health, infectious diseases and poverty
are dynamic and complex. Timely, targeted research will prevent these
diseases from driving more people into poverty

33.  Malnutrition is associated with 54% of childhood
deaths from diseases of poverty, and lack of skilled
attendants during childbirth is primarily responsible
for the high maternal and infant death rates among
the poor
 Many such diseases are also considered
―neglected tropical diseases‖, as defined by WHO.
Infectious diseases of poverty are not restricted to
low and middle-income countries, but manifest in
poor populations globally. Apart from TB, Malaria
and HIV/AIDS, many other infectious diseases have
not been high on the global agenda. However, an
increasing number of organizations and
partnerships are now engaged in their control.

34.  According to the Global Report for Research on
Infectious Diseases of Poverty, poverty-related
circumstances such as ―lack of
food, shelter, security and social protection make
people more vulnerable to infections, while affected
populations are often unable to obtain even the
most basic means of prevention and care.‖
 Poverty and disease are stuck in an
ongoing, vicious relationship. One goes a long way
towards intensifying the other with studies
demonstrating that infection rates of certain
diseases are highest in regions where poverty is
high.

37. Diseases of Poverty
 Tuberculosis
 AIDS
 Asthma
 Cardiovascular disease
 Dental Decay or Dental caries
 African trypanosomiasis
 Chagas disease
 Leishmaniasis
 Lymphatic filariasis
 Onchocerciasis
 Schistosomiasis
 Trichomoniasis

38. THANK YOU