Best among the worst

just 10 avoidable risk factors, including malnutrition, unsafe sex, smoking and poor sanitation, account for 40 per cent of global deaths each year. This was stated in the latest World Health Report of the World Health Organisation (who).

According to the organisation, cheap remedies exist for many ailments and governments of all countries can do more to prevent unnecessary and premature deaths. It concludes that such countermeasures could extend average life expectancy by five to 10 years.

"The report provides a road map on how societies can tackle a range of preventable conditions that kill millions of people prematurely and rob tens of millions of healthy life," says Gro Harlem Brundtland, who director-general.

The risks are starkly different between 'haves' and 'have-nots'. Whereas poor people typically die because of lack of food and clean water, the rich die due to diseases of overindulgence. These reasons may be obvious, but who describes them as "shocking". Of the 10 risk factors, the five that dominate in poor countries are: abnormally low body weight, unsafe sex, iron deficiency, unsafe water and exposure to indoor smoke from solid fuels. "Indoor air pollution was a complete surprise," says Christopher Murray, overall director of the report. The smoke causes pneumonia in children and lung disease in women.

In richer countries, the five key killers identified are tobacco smoking, alcohol drinking, high blood pressure, high blood cholesterol and obesity.