Where you live shouldn’t determine whether you live. But too often, it does. The average child born in a rich country today will live 17 years longer than a child born in a poor country.

This is not a coincidence. Poor health and poverty are inextricably linked.

Increasing access to health services and life-saving tools, like vaccines and medicine, in low-income countries has the potential to improve lives and help disrupt this cycle of poverty.

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Key Numbers

  • In 2020, an estimated 627 thousand people died from malaria. 96% were in Africa, totaling 602 thousand deaths.
  • In 2021 75% of people living with HIV received ART. AIDS related deaths fell by 5% globally to 650 thousand.
  • As of 05 December 2022, the global COVID-19 vaccination rate (2 doses) is63%. Only 25.6% of Africans have been fully vaccinated, below the 70% target.

Causes of death in low-income countries

Globally, about 60 million people die each year. But why people die and what risk factors lead to early death vary dramatically between countries. Non-communicable diseases, like chronic or cardiovascular conditions account for the majority of deaths in higher-income countries while infectious diseases are still among the leading causes of death in the world’s poorest countries. These diseases are also more likely to be associated with early death despite being completely preventable and treatable. Expanding access to primary health care and scaling interventions for the biggest diseases killers in low- and lower-middle income countries would save lives now and increase life expectancy over time.

Leading causes of death by income group

Six of the top 10 causes of death in low-income countries are preventable infectious diseases.

These deaths are concentrated in the world’s poorest countries. Only one of these conditions (lower respiratory infections) appears in the top 10 for higher-income groups.

These deaths are completely preventable and treatable with better access to health services and health technologies like vaccines and medicine.



The global response to AIDS has been heralded a relative success — a model for what’s possible when political will and funding are consistently directed toward a global health crisis. Two decades ago, HIV/AIDS was killing almost 4,000 people every day and new infections doubled each year. Today, 27.5 million people are accessing lifesaving treatment and AIDS deaths have dropped by more than half since their peak. 

But that well earned progress is at risk of backsliding. The global AIDS epidemic is still growing at an alarming pace. In 2021, 1.5 million contracted HIV. While new infections have been dropping steadily over the last two decades, the pace of progress is well short of where it needs to be to end AIDS as a public health threat by 2030. New HIV infections are increasingly concentrated among poorer people and countries, and more vulnerable populations such as women, men who have sex with men, and sex workers. Reaching these populations with fit-for-purpose prevention services is key to ending the threat of AIDS.


For millions of people around the world, a mosquito bite can have deadly consequences. Malaria is a tropical disease caused by parasites and transmitted through the bite of an infected Anopheles mosquito.  About 95% of malaria cases and deaths globally occur in sub-Saharan Africa; just four African countries accounted for half of all malaria deaths worldwide (Nigeria, DRC, Tanzania, Mozambique). Control measures such as indoor residual spraying with insecticides, insecticide-treated bed nets, and antimalarial drugs have successfully reduced malaria cases and deaths. However, insecticide- and drug-resistance is a growing threat as these interventions continue to be scaled up. A promising new malaria vaccine recommended by WHO in 2021 could dramatically increase protection if successfully scaled up. 

Deaths from malaria

Over 600,000 people died from malaria in 2020.
In 2020, 95% percent of malaria cases and 96% of malaria deaths occurred in Africa.
Children under 5 accounted for about 80% of all malaria deaths in the region.



Vaccines are one of the most cost-effective investments in health and development in history. They safely prevent sickness and death associated with infectious diseases and contribute to broader gains in education and economic development. But 1.5 million people are still dying from vaccine-preventable diseases. And climate change, conflict and urbanisation are together making it easier for infectious disease outbreaks to spread. In 2022, for the first time in three decades, global vaccination coverage among children declined. The backslide is being driven by disruptions caused by COVID-19, conflict, displacement and increasing vaccine misinformation. As a result, 25 million children are missing out on life-saving vaccines every year, placing them at risk from preventable diseases like measles and polio. The most poor and marginalised children – often most in need of vaccines – continue to be the least likely to get them.

Diphtheria tetanus toxoid and pertussis (DTP3) immunization

Coverage of the diphtheria tetanus toxoid and pertussis (DTP3) vaccine is considered a proxy for routine childhood immunisation. A child who receives all three doses before turning one likely has regular access to health services.

Globally, coverage of DTP3 has improved dramatically in the last 20 years. In 2020, over 50% more children were immunised with DTP3 in lowest-income countries than in 2000.

But for the first time in three decades, global vaccination coverage among children declined in 2021.


Health expenditure

Financing for health in low-income countries has increased steadily over the past 20 years, but a closer look at the major sources of financing reveals some concerning trends: international support from donor countries is stagnant, domestic resources are not keeping pace with need, and people in the poorest countries, many of which are in sub-Saharan Africa, are far too often forced to pay for essential health services out of their own pockets.

Health spending in Sub-Saharan Africa by source

Domestic health spending in sub-Saharan Africa more than doubled, in absolute terms, between 2000 and 2018. But development assistance for health (DAH) has significantly outpaced the growth of domestic health financing.

This surge in development assistance for health was driven largely by donor investments in HIV/AIDS, TB, malaria and maternal and child health, but since 2018 has been largely stagnated.

Use the dropdown to see total or per person figures.


Few low and lower-middle income countries in Africa reach the $86 target

Estimates suggest that low income countries should spend at least 5% of their GDP and $86 per capita to ensure that all citizens have access to primary healthcare services.

17 countries in Africa met the $86 per capita target.

But only 13 African countries met both targets.