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August 19, 2009

Avoidable Deaths Worldwide -Scope of issues and What can and is being done


WHO estimates that better use of existing preventive measures could reduce the global burden of disease by as much as 70%.

2008 World Health Report.

Accelerating the improvement in lowering deaths from infectious disease. The top chart shows that acute respiratory infections, diarrhoeal disease, Malaria, HIV/Aids and Tubercolis kill about 9 million people in 2009. Progress in developing vaccines to treat Malaria is helping. Infectious disease is an area where a lot of deaths could be avoided.

In the year 2000, indoor air pollution from solid fuel use was responsible for more than 1.6 million annual deaths and 2.7% of the global burden of disease (in Disability-Adjusted Life Years or DALYs). This makes this risk factor the second biggest environmental contributor to ill health, behind unsafe water and sanitation.Every year, indoor air pollution is responsible for nearly 800 000 deaths due to pneumonia among children under five years of age. The solution is to make burning solid fuel indoors less deadly or to avoid it all together.

Outdoor air pollution was found to account for approximately 1.4% of total mortality, 0.5% of all disability-adjusted life years (DALYs) and 2% of all cardiopulmonary disease (World Health Report 2002). This is mainly from 2.5 to 10 micron particulates from the burning of coal and oil.

Newly Identified Persistent Free Radicals
Scientists have long known that free radicals exist in the atmosphere. These atoms, molecules, and fragments of molecules are highly reactive and damage cells in the body. Free radicals form during the burning of fuels or in photochemical processes like those that form ozone. Most of these previously identified atmospheric free radicals form as gases, exist for less than one second, and disappear. In contrast, the newly detected molecules — which Dellinger terms persistent free radicals (PFRs) — form on airborne nanoparticles and other fine particle residues as gases cool in smokestacks, automotive exhaust pipes and household chimneys. Particles that contain metals, such as copper and iron, are the most likely to persist, he said. Unlike other atmospheric free radicals, PFRs can linger in the air and travel great distances.

Once PFRs are inhaled, Dellinger suspects they are absorbed into the lungs and other tissues where they contribute to DNA and other cellular damage. Epidemiological studies suggest that more than 500,000 Americans die each year from cardiopulmonary disease linked to breathing fine particle air pollution, he says. About 10 to 15 percent of lung cancers are diagnosed in nonsmokers, according to the American Cancer Society. However, Dellinger stresses additional research is necessary before scientists can definitely link airborne PFRs to these diseases.

If the connection is made between airborne PFRs and disease, the solution is still to stop burning coal and oil.


Poor water quality continues to pose a major threat to human health. Diarrhoeal disease alone amounts to an estimated 4.1 % of the total DALY global burden of disease and is responsible for the deaths of 1.8 million people every year (WHO, 2004). It was estimated that 88% of that burden is attributable to unsafe water supply, sanitation and hygiene and is mostly concentrated on children in developing countries.

The millenium goals for 2015:

* halving the proportion of people without sustainable access to improved water supply;
* halving the proportion of people without sustainable access to both improved water supply and improved sanitation.

The results of this analysis point out that achieving the target for both water supply and sanitation would bring economic benefits; US$1 invested would give an economic return of between US$3 and US$34, depending on the region. Achieving this target would require an estimated additional investment of around US$11.3 billion per year over and above current investments. The benefits would include an average global reduction of diarrhoeal episodes of 10% and a total annual economic benefit of US$84 billion

* Access for all to improved water and sanitation services would cost around US$22.6 billion per year.
* Household water treatment using chlorine and safe storage would cost an additional US$2 billion on top of improved water and sanitation costs, taking the global cost to US$24.6 billion.
* Access for all to regulated in-house piped water supply with quality monitoring and in-house sewerage connection with partial treatment of sewage would require a total investment of US$136.5 billion per year


Politics and the situation where there is not enough money to implement plans using traditional technology is a feature that will be unlikely and slow to change. That is why more technology or new plans that can circumvent those factors is important to make more progress. We could have prevented polio deaths and did some with iron lungs, but it was not until vaccines were developed that big progress against polio was made.

Spend 136 billion/year on sanitation and clean water or create a cheap and effective diahrrea vaccines so that people can tolerate dirty water. Still work on clean sanitation but vaccinations could be 20 times cheaper and save 80-90% of the lives.



6 million deaths could be avoided by stopping the use of Tobacco.






Technology for helping Reduce Deaths

A set of 15 proteins found in urine can distinguish healthy individuals from those who have coronary artery disease (CAD), a new study has found. Coronary artery disease is the most common type of cardiovascular disease, occurring in about 5 to 9% (depending on sex and race) of people aged 20 and older.


Researchers from Imperial College in London, England, isolated the receptor in the lungs that triggers the immune overreaction to flu.

With the receptor identified, a therapy can be developed that will bind to the receptor, preventing the deadly immune response. Also, by targeting a receptor in humans rather than a particular strain of flu, therapies developed to exploit this discovery would work regardless of the rapid mutations that beguile flu vaccine producers every year.

The flu kills 250,000 to 500,000 people in an average year with epidemics reaching 1 to 2 million deaths (other than the spanish flu which was more severe


Cost effective disease prevention

Iron deficiency: Iron fortification is very cost-effective in areas of iron deficiency. It involves the addition of iron usually combined with folic acid, to the appropriate food vehicle made available to the population as a whole. Cereal flours are the most common food vehicle, but there is also some experience with introducing iron to other vehicles such as noodles,rice, and various sauces.

The most cost effective strategy to reduce under-nutrition and its consequences combines a mix of preventive and curative interventions. Micronutrient supplementation and fortification - Vitamin A, zinc and iron – is very cost-effective. It should be combined with maternal counselling to continue breast feeding, and targeted provision of complimentary food as necessary. In addition, routine treatment of diarrhoea and pneumonia, major consequences of under-nutrition, should be part of any health improvement strategy for children. Childhood and maternal underweight was estimated to cause 3.4 million deaths in 2000, about 1.8 million in Africa. This accounted for about one in 14 deaths globally.


1.3 million people die each year from traffic accidents. Automation (robotic driving) even partial automation could help a great deal in reducing these deaths and injuries. Partial Automation: detection of imminient crash and auto-avoidance or reduction of crash severity (auto-brake), automation at intersections where disproportionate accidents occur.

Near term possibilities
Changes in driver behaviors are key, Degutis said. In many countries, truck, bus and other transport employees drive recklessly due to economic pressures, with little policing to restrain them. "The quicker they can do a route, the faster they can get there, the more money they make," she said. "There's just not that incentive to be safe. We have to create those incentives for safety."

Certain measures have successfully reduced traffic deaths in the United States and should work elsewhere, experts said.

According to Rosenberg, these interventions include simple, low-cost steps such as installing barriers along the median to prevent head-on collisions; converting four-way intersections into safer traffic circles; and installing speed bumps.

Encouraging governments to beef up policing of reckless or drunk drivers, as well as improving driver training, can also help decrease the carnage


Make roads safe is an action plan being promoted now

Road injury is conspicuous by its absence from the international development agenda. That is – quite literally - a fatal failure of political leadership. Measured on a narrow economic calculus, the costs of business-as-usual are enormous. Road injuries are costing many of the world’s poorest countries 1-3 per cent of the GDP, acting as a brake on economic growth. Simple cost-benefit analysis makes its own case for action. As this report documents, every $1 invested in road safety can save as much as $20 in lost earnings, reduced productivity, and health costs. Instead of asking themselves whether their country can afford to invest in road safety, finance ministers might ask themselves whether it can afford not to.


48 page world Health Organization study on current technology interventions to reduce road deaths and injury

A 19 page UK report looks at issues with increasing automation of driving

Nextbigfuture has proposed plans for electric powered all robotic driving

A parallel path to robotic transportation which could be deployed faster is to use robotic flying (shown with UAVs) to create safer and faster robotic commuter flying.

Mass robotic driving is closer than many people think with pod cars in Masdar city and in super warehouses and adjustable GPS aware cruise control for automatic energy efficient driving.



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