Regional Demographic and Epidemiologic Transitions(cont...)

Figure 1.1 Dependency ratios in developed and developing countries

Developed Developing

Source: UN 2007.

Many implications from these transitions are evident. First, the burden will grow in the future, overwhelming the health sector and making it less responsive. If unaddressed, the impact of NCDs on individuals in terms of short- and long-term disability and premature death and forgone wages will be significant and worsen dependency ratios.

In Second, with most health care financed with private out-ofpocket resources, some people may never escape poverty or be driven into poverty, some will forgo treatment and suffer excessively, and some will skew their expenditure patterns from other human evelopment investments. Finally, at the country level, while empirical data are scant, it is expected that productivity will decline, impacting economic growth.

South Asia’s mainly rural (71 percent) population is young, but already less so than in Sub- Saharan Africa. Life expectancy at birth, at 64 years, has been rising but remains below the levels observed in other regions (except Sub-Saharan Africa). Aging is occurring rapidly but often without the social changes such as improved living conditions, better nutrition, gains in wealth and access to health services that accompanied aging in developed countries decades ago. This can result in unhealthy aging.

Demographic, Economic, and Health Profiles South Asia has experienced average annual 6 percent GDP growth in the last 20 years, despite conflict and instability. This performance has pushed down poverty rates, but growth has not been inclusive or fast enough to reduce the number of poor.

Indeed, South Asia has the largest concentration of poor people in the world, with over 1 billion—some two-thirds— living on less than US$2 a day. More than two-fifths of the population live in extreme poverty, on less than US$1.25 a day.