updated 12/18/2003 9:06:48 PM ET 2003-12-19T02:06:48

Global efforts to battle HIV/AIDS and slash infant mortality rates will flounder unless the international community boosts basic medical care in poor countries, the U.N. health agency said Thursday.

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Campaigns against individual diseases are essential, but policy-makers also must focus on overall health services because neglecting them increases the risk that epidemics will spread across national borders, the World Health Organization said in its annual report.

Around 30 million people in African nations are infected with HIV/AIDS, about 70 percent of all cases in the world. AIDS kills 5,000 adults and 1,000 children every day in Africa. Adult life expectancy there has plunged as much as 20 years because of the disease.

But even without the impact of AIDS, millions of children born in Africa and other poor regions are at greater risk of dying before their fifth birthday than they were a decade ago, said the World Health Report.

International health programs _ like WHO-spearheaded attempts to increase access to anti-HIV drugs _ face "obstacles that have slowed and in some cases reversed progress toward meeting the health needs of all people," said the 193-page study.

Already struggling health services have been overwhelmed in the fight against AIDS, hampering efforts to defeat older killers like malaria and widening the health divide between rich and poor nations.

"These global health gaps are unacceptable," WHO chief Dr. Lee Jong-wook told reporters as he launched the report. "At the present rate of progress, it will take not 15 years but 150 years to reach the target of reducing child mortality in Africa by two-thirds."

Lee contrasted the prospects of baby girls born in 2002 in Japan and Sierra Leone.

Massive gaps in care
While the Japanese baby can expect to live for about 85 years, life expectancy for the child in one of Africa's poorest countries is now just 36 years. In the United States, women can expect to live to 80 years, and men, 75.

The Japanese girl will likely receive some of the world's best health care whenever she needs it, but the girl in Sierra Leone may never see a doctor, nurse or health worker, said Lee.

Some 10.5 million children in poor nations die every year before they turn five, 70 percent from infectious diseases. Leading child killers in 2002 included respiratory infections, which caused 1.9 million deaths. Diarrhea killed 1.6 million and malaria 1.1 million.

Around 9.5 million of the deaths easily could be prevented, said WHO expert Dr. Robert Beaglehole. "We can make a difference, right now," with things like oral rehydration treatment for diarrhea and anti-mosquito bed nets to fight malaria, he said.

"But very poor countries which only have the ability to spend $10 per person a year can't do this alone," Beaglehole said. "It's very hard to deal with health emergencies with the existing work force."

The report said donors can counter some of the weaknesses by funding more training for health workers, while governments should boost partnerships between health officials and affected communities. "It's going to take 10-15 years to build up, so we must start now," Beaglehole told reporters.

Poor children who do make it past childhood are confronted with adult death rates that exceed those of 30 years ago, said the report.

The gap between industrialized and developing countries is stark in the statistics on maternal mortality, said WHO. The risk for women of dying in childbirth is 250 times higher in poor countries than in rich ones. More than 500,000 women die each year as a result of complications during pregnancy.

The leading killers in 2002 were: HIV/AIDS, with 2.3 million deaths; heart disease, 1.3 million; tuberculosis, 1 million; stroke, 800,000. Road accidents killed 800,000 people, mostly in developing countries.

Copyright 2003 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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