- Commonwealth initiatives
The health sector in Commonwealth countries
Life expectancy in Commonwealth countries ranges from 82 in Australia and Singapore, down to just 42 in Sierra Leone (2013).
The Commonwealth countries with the highest birth rate per 1,000 are Uganda and Zambia at 43, with the lowest being Malta with nine (UNICEF, 2013).
The country with the highest population growth between 1990 and 2014 is Uganda at 3.3%, while the country with the lowest population growth is St Vincent and the Grenadines with 0.07% (World Bank).
In 2014, 11 countries were reported to have 100% access to clean water, while 16 countries fell below 90%. In 22 Commonwealth countries, less than 90% of the population have access to adequate sanitation facilities and in at least 16 countries, this figure is less than 50%.
Non-communicable diseases such as diabetes, cancer, chronic respiratory diseases and cardiovascular diseases impact all regions of the Commonwealth. Diabetes alone affects 65 million Commonwealth citizens. The worst affected member state is Nauru, with 31% of the adult population affected by the disease. The impact of cancerous diseases in the Commonwealth is proportionately less than for the rest of the world. The Commonwealth has around 30% of the world’s population but accounts for just 19% of worldwide cancer deaths. Detection mechanisms for cancers are much more advanced in the developed part of the Commonwealth, with developing countries carrying the greater burden of cancer-related mortality.
HIV prevalence among adults of 15–49 years is highest in Swaziland, 27.7%, and reportedly lowest in Bangladesh, Fiji, Pakistan, and Sri Lanka (World Bank, 2014). AIDS is a leading cause of death, taking the lives of 1.2 million Commonwealth citizens a year (2009). Commonwealth countries represent just under a third of the world’s population, but carry a disproportionate 60% of the world’s HIV/AIDS current burden of more than 40 million infected people.
Vector-borne diseases are major health issues in Commonwealth Africa and South Asia. Malaria, particularly, continues to threaten the lives of mainly pregnant women and children under five years of age. In the poorest countries, where malaria takes its highest toll, this is due to lack of finance and prevention mechanisms.
Malta has the highest number of medical doctors per capita at around 350 for every 100,000 people. India, however, has the highest number overall, with more than 936,488 (2014) operating in the country.
Mauritius has the highest concentration of pharmaceutical personnel in the Commonwealth at 116 for every 100,000 people.
The country with the largest public spending on health, according to the World Bank, is Tuvalu at 20% of GDP, while Bangladesh, India, Nigeria, Pakistan and Sri Lanka are the Commonwealth countries with the lowest, all at 1% (2013).
Pharmaceuticals in the Commonwealth
The UK is the only Commonwealth country, and one of a few select countries worldwide, with a sophisticated pharmaceutical industry comprised of significant research initiatives, transnational corporations (such as Glaxosmithkline and AstraZeneca), innovators and reproducer firms which manufacture medicines which are not protected by patent. Commonwealth countries such as India, Canada and Australia have noteworthy industries with innovative capability, having already discovered and marketed their own drugs. India particularly has a rapidly growing market and an industry led mainly by Ranbaxy Pharmaceuticals and Dr Reddy’s Laboratories which have hundred million dollar research and development capacities. Although they remain major net importers virtually all member states in the rest of Asia and Africa and additionally Trinidad and Tobago, New Zealand, Papa New Guinea and Jamaica have a domestic medicine manufacturing industry based on reproducer firms and companies which concentrate on finishing products from imported ingredients. Pharmaceutical manufacturing facilities are non-existent in the vast majority of small island developing states.
Commonwealth initiatives: the Commonwealth Secretariat and other organisations
The Commonwealth Secretariat implements programmes in five areas throughout the association: e-Health, health worker migration, HIV/AIDS, maternal and child health and non-communicable diseases. Health ministers and senior officials of the Commonwealth meet annually in Geneva, Switzerland, to discuss and find solutions to prevailing health issues in the Commonwealth. The event is organised by the Social Transformation Programmes Division of the Commonwealth Secretariat.
Health sector organisations in the Commonwealth include the: