Advances include the following:
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the globalization of knowledge and the increased mobility of the world's population
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the expansion of knowledge about disease problems in most of the developing world
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the remarkable progress achieved in the control of infectious diseases in most parts of the world
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the worldwide penetration of new forms of communication
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the promise of new technologies in biomedical research (for example, in the fields of genomics, transgenic organisms, informatics, robotics, and nanotechnology)
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the increasing flow of private resources devoted to understanding health problems related to development.
The following concerns are pertinent:
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The world's population continues to grow, numbering 6.3 billion people in 2004, with 200,000 added each day. In at least 68 countries, more than 40 percent of the population is younger than 15, whereas in wealthy countries, the proportion of elderly people in the population is expanding quickly.
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Despite falling global poverty rates, progress is uneven: 1.2 billion people still live on less than US$1 a day, and 2.8 billion live on less than US$2 a day. One in six children is chronically hungry.
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Disparities have increased. The richest 20 percent of the world's population now accounts for 150 times the income of the poorest 20 percent. The ratio of the income of the top 20 percent to that of the poorest 20 percent rose from 30 to 1 in 1960 to 61 to 1 in 1991 and to 78 to 1 in 1994. Evidence of global environmental degradation is apparent, especially in the developing world. For example, 45 percent of tropical rain forest has already been lost, at least 20 percent of current species will be extinct by 2030 and 50 percent by the end of the century, and half of China's and many other countries' cities already face water shortages.
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With global warming, temperatures will likely rise 1.0°C to 4.5°C this century, threatening coastal areas and changing patterns of vectorborne and epidemic disease.
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The pace of migration from rural to urban environments is speeding up, giving rise to more megacities.
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The period 1955-98 witnessed 31 civil and foreign wars, 35 million displaced people and refugees, and 127 instances of state failures—ethnic wars, revolutionary wars, and disruptive regime changes—in 96 states.
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Terrorism has become a global threat.
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Gender discrimination persists.
Sources: King and Zeng 2001, 2002; Wilson 2003; World Bank 2004; World Revolution (http://www.worldrevolution.org).
