WHO Says India Leads the World in TB Cases

India led the world with an estimated one quarter (26%, up from about 20% in previous years) of all TB cases, and China and India combined accounted for 38% of the global cases in 2010, according to the World Health Organization 2011 report titled "Global Tuberculosis Control 2011". The top five countries with the largest number of reported cases in 2010 were India (2.0 million–2.5 million), China (0.9 million–1.2 million), South Africa (0.40 million–0.59 million), Indonesia (0.37 million–0.54 million) and Pakistan (0.33 million–0.48 million).

The good news the WHO report offers is that TB rates are dropping for the first time. The number of TB cases fell from a high of 9 million in 2005 to 8.8 million in 2010. TB deaths dropped from 1.8 million in 2003 to 1.4 million in 2010, and the death rate plummeted 40% from 1990 to 2010. Cure rates are high -- in 2009, 87% of people who had TB were cured, but the report also found that a third of likely TB cases are never notified, so it's not known if those people were diagnosed and treated.

A number of countries have shown that the extra focus on fighting the disease pays off. Kenya, Tanzania and Brazil have all seen TB rates decline in the last 10 to 20 years. China's progress has been substantial, with death rates dropping by almost 80% from 1990 to 2010. The frequency of TB was also cut in half in that time.

Beyond TB, infectious diseases like malaria and dengue fever continue to take a heavy toll in developing nations. Over the past two months, dengue fever has killed 202 people in Pakistan and another 12,000 have been infected, according to Pakistani health officials. India has reported about 28,500 cases of malaria and at least 10 deaths in New Delhi, Andhra Pradesh, Haryana and Mumbai cumulatively this year. In India's Gujarat State 8228 cases have been confirmed in the last few weeks.

Poverty, hunger, unsanitary or unsafe conditions and inadequate health care in South Asia's developing nations are exposing their citizens to high risk of a variety of diseases which may impact their intelligence. Every year, World Health Organization reports what it calls "Environmental Burden of Disease" in each country of the world in terms of disability adjusted life years (DALYs) per 1000 people and total number of deaths from diseases ranging from diarrhea and other infectious diseases to heart disease, road traffic injuries and different forms of cancer.



In the range of DALYs/1000 capita from 13 (lowest) to 289 (highest), WHO's latest data indicates that India is at 65 while Pakistan is slightly better at 58. In terms of total number of deaths per year from disease, India stands at 2.7 million deaths while Pakistani death toll is 318, 400 people. Among other South Asian nations, Afghanistan's DALYs/1000 is 255, Bangladesh 64 and Sri Lanka 61. By contrast, the DALYs/1000 figures are 14 for Singapore and 32 for China.

Recent research shows that there are potentially far reaching negative consequences for nations carrying high levels of disease burdens causing lower average intelligence among their current and future generations.

Published by the University of New Mexico and reported by Newsweek, new research shows that there is a link between lower IQs and prevalence of infectious diseases. Comparing data on national “disease burdens” (life years lost due to infectious diseases or DALYs) with average intelligence scores, the authors found a striking inverse correlation—around 67 percent. They also found that the cognitive ability is rising in some countries than in others, and IQ scores have risen as nations develop—a phenomenon known as the “Flynn effect.”



According to the UNM study's author Christopher Eppig and his colleagues, the human brain is the “most costly organ in the human body.” The Newsweek article adds that the "brainpower gobbles up close to 90 percent of a newborn’s energy. It stands to reason, then, that if something interferes with energy intake while the brain is growing, the impact could be serious and longlasting. And for vast swaths of the globe, the biggest threat to a child’s body—and hence brain—is parasitic infection. These illnesses threaten brain development in several ways. They can directly attack live tissue, which the body must then strain to replace. They can invade the digestive tract and block nutritional uptake. They can hijack the body’s cells for their own reproduction. And then there’s the energy diverted to the immune system to fight the infection. Out of all the parasites, the diarrheal ones may be the gravest threat—they can prevent the body from getting any nutrients at all".

Looking at the situation in South Asia, it appears from the WHO data that Pakistan is doing a bit better than India in 12 out of 14 disease groups ranging from diarrhea to heart disease to intentional injuries, and it is equal for the remaining two (Malaria and Asthma).

A detailed WHO report on World Health Statistics for 2010 assesses and compares its member nations on the basis of nine criteria including mortality and burden of disease, cause-specific mortality, selected infectious diseases, health service coverage, risk factors, health workforce-infrastructure, health expenditures and demographic and socioeconomic statistics. It shows that both India and Pakistan have some serious challenges to overcome to have any chance of meeting health-related Millennium Development Goals (MDGs 4, 5 and 6).

Related Links:

Haq's Musings

India and Pakistan Compared in 2011

Indians and Pakistanis Suffer Heavy Disease Burdens

India Leads the World in Open Defecation

Infectious Diseases Kill Millions in South Asia

Infectious Diseases Cause Low IQ

Malnutrition Challenge in India and Pakistan

Hunger: India's Growth Story

WHO Report 2010 Blogger Analysis

Syeda Hamida of Indian Planning Commission Says India Worse Than Pakistan and Bangladesh

Global Hunger Index Report 2009

Grinding Poverty in Resurgent India

WRI Report on BOP Housing Market

Food, Clothing and Shelter For All

India's Family Health Survey

Is India a Nutritional Weakling?

Asian Gains in World's Top Universities

South Asia Slipping in Human Development

Indians and Pakistanis Suffer Heavy Disease Burdens

Poverty, hunger, unsanitary or unsafe conditions and inadequate health care in South Asia's developing nations are exposing their citizens to high risk of a variety of diseases which may impact their intelligence. Every year, World Health Organization reports what it calls "Environmental Burden of Disease" in each country of the world in terms of disability adjusted life years (DALYs) per 1000 people and total number of deaths from diseases ranging from diarrhea and other infectious diseases to heart disease, road traffic injuries and different forms of cancer.



In the range of DALYs/1000 capita from 13 (lowest) to 289 (highest), WHO's latest data indicates that India is at 65 while Pakistan is slightly better at 58. In terms of total number of deaths per year from disease, India stands at 2.7 million deaths while Pakistani death toll is 318, 400 people. Among other South Asian nations, Afghanistan's DALYs/1000 is 255, Bangladesh 64 and Sri Lanka 61. By contrast, the DALYs/1000 figures are 14 for Singapore and 32 for China.

Recent research shows that there are potentially far reaching negative consequences for nations carrying high levels of disease burdens causing lower average intelligence among their current and future generations.



Published by the University of New Mexico and reported by Newsweek, new research shows that there is a link between lower IQs and prevalence of infectious diseases. Comparing data on national “disease burdens” (life years lost due to infectious diseases or DALYs) with average intelligence scores, the authors found a striking inverse correlation—around 67 percent. They also found that the cognitive ability is rising in some countries than in others, and IQ scores have risen as nations develop—a phenomenon known as the “Flynn effect.”



According to the UNM study's author Christopher Eppig and his colleagues, the human brain is the “most costly organ in the human body.” The Newsweek article adds that the "brainpower gobbles up close to 90 percent of a newborn’s energy. It stands to reason, then, that if something interferes with energy intake while the brain is growing, the impact could be serious and longlasting. And for vast swaths of the globe, the biggest threat to a child’s body—and hence brain—is parasitic infection. These illnesses threaten brain development in several ways. They can directly attack live tissue, which the body must then strain to replace. They can invade the digestive tract and block nutritional uptake. They can hijack the body’s cells for their own reproduction. And then there’s the energy diverted to the immune system to fight the infection. Out of all the parasites, the diarrheal ones may be the gravest threat—they can prevent the body from getting any nutrients at all".

Looking at the situation in South Asia, it appears from the WHO data that Pakistan is doing a bit better than India in 12 out of 14 disease groups ranging from diarrhea to heart disease to intentional injuries, and it is equal for the remaining two (Malaria and Asthma).

Source: Health Metrics and Valuation

 A detailed WHO report on World Health Statistics for 2010 assesses and compares its member nations on the basis of nine criteria including mortality and burden of disease, cause-specific mortality, selected infectious diseases, health service coverage, risk factors, health workforce-infrastructure, health expenditures and demographic and socioeconomic statistics. It shows that both India and Pakistan have some serious challenges to overcome to have any chance of meeting health-related Millennium Development Goals (MDGs 4, 5 and 6).

Related Links:

Haq's Musings

Infectious Diseases Kill Millions in South Asia
Infectious Diseases Cause Low IQ

Malnutrition Challenge in India and Pakistan
Hunger: India's Growth Story

WHO Report 2010 Blogger Analysis
Syeda Hamida of Indian Planning Commission Says India Worse Than Pakistan and Bangladesh

Global Hunger Index Report 2009

Grinding Poverty in Resurgent India
WRI Report on BOP Housing Market

Food, Clothing and Shelter For All

India's Family Health Survey
Is India a Nutritional Weakling?
Asian Gains in World's Top Universities

South Asia Slipping in Human Development

Dengue, Malaria and Other Infectious Diseases Killing Millions in South Asia

There have been 1200 confirmed cases of dengue fever and 12 deaths in Pakistan after the recent heavy monsoon rains and massive floods, according to media reports.

A.C. Dhariwal, director of India's National Vector-Borne Disease Control Program, told AFP recently that dengue cases in India were at a 20-year high with 50 people dead and 12,000 reported infections. The number of actual infections is likely to be far higher.

A recent global Hygiene Home Truths Study says India is among the worst when it comes to hygiene, according to a report published in Times of India.

Two-thirds of India's population lacks basic sanitation facilities. They are exposed to a variety of infectious diseases claiming 1.3 million lives a year, accounting for the largest number of victims of infections any where in the world. Studies indicate the prevalence of infections may be contributing to lower IQ of Indians.

In addition to malaria, dengue fever, and cysticercosis, India also has a huge disease burden of rabies, caused by dog bites. In India, 20,000 rabies deaths (that is about 2/100,000 population) are estimated to occur annually, according to Times of India. According to the World Health Organization (WHO) which describes the dog population in India as "getting out of hand", roughly 36% of rabies deaths in the world occur in India.

India might be an emerging economic power, but it is way behind Pakistan, Bangladesh and even Afghanistan in providing basic sanitation facilities, a key reason behind the death of 2.1 million children under five in the country.

Lizette Burgers, chief of water and environment sanitation of the Unicef, says India is making progress in providing sanitation but it lags behind most of the other countries in South Asia. A former Indian minister Mr Raghuvansh Prasad Singh told the BBC that more than 65% of India's rural population defecated in the open, along roadsides, railway tracks and fields, generating huge amounts of excrement every day, and causing disease.

A recent meeting of experts hosted by the National Institute of Health in Islamabad has warned that although dengue was a risk, another mosquito-borne disease malaria, posed a much more serious threat especially in the flood-affected areas. World Health Organization-Pakistan representative Guido Sabatinelli said that even at the start of the malaria season there were “300,000 suspected cases” nationwide.

A US NIH funded study published in Lancet says over 200,000 Indians die of Malaria among 1.3 million infectious disease deaths reported in the country, according to a report by the BBC:

"The number of people dying from malaria in India has been hugely underestimated, according to new research.

The data, published in the Lancet, suggests there are 13 times more malaria deaths in India than the World Health Organization (WHO) estimates.

The authors conclude that more than 200,000 deaths per year are caused by malaria.

The WHO said the estimate produced by this study appears too high.

The research was funded by the US National Institutes of Health, the Canadian Institute of Health Research and the Li Ka Shing Knowledge Institute.

The new figures raise doubts over the total number of malaria deaths worldwide.
Difficult diagnosis

Calculating how many people die from malaria is extremely difficult. Most cases that are diagnosed and treated do not result in fatalities.

People who die of extremely high fevers in the community can be misdiagnosed and the cause of death can be attributed to other diseases and vice versa.

As most deaths in India occur at home, without medical intervention, cause of death is seldom medically certified.

There are about 1.3 million deaths from infectious diseases, where acute fever is the main symptom in rural areas in India.

In this study, trained field workers interviewed families, asking them to describe how their relative died. Two doctors then reviewed each description and decided if the death was caused by malaria. This method is called verbal autopsy.

Some 122,000 premature deaths between 2001 and 2003 were investigated.

The data suggests that 205,000 deaths before the age of 70, mainly in rural areas, are caused by malaria each year."

While a mere 14 percent of people in rural India - that account for 65 percent of its 1.1 billion population - had access to toilets in 1990, the number had gone up to 28 percent in 2006. In comparison, 33 percent rural Pakistanis had access to toilets in 1990 and it went up to an impressive 58 percent in 2006, according to UNICEF.

Why is it that Pakistan has had more success than India in improving sanitation?

Both India and Pakistan have Community-Led Total Sanitation (CLTS) campaigns supported by UNICEF, with the aim of creating open defecation free villages through education and funding. For reasons which are not obvious, it seems that the strategy has produced better results in Pakistan than in India so far. One possible reason may be that CLTS India is state driven while CLTS Pakistan is driven by community champions, according to a paper by Lyla Mehta that sheds light on how the CLTS campaigns work in India and Pakistan.

Given the high risk of dengue and malaria in the aftermath of unusually heavy monsoon rains and massive floods, it is important for CLTS campaign in Pakistan to extend its mandate to include anti-malaria efforts by draining puddles of water, or at least spraying stagnant water with disinfectants to eradicate mosquitoes and other disease-carrying insects.

Related Links:

Haq's Musings

Syeda Hamida of Indian Planning Commission Says India Worse Than Pakistan and Bangladesh

Global Hunger Index Report 2009

Grinding Poverty in Resurgent India

WRI Report on BOP Housing Market

Food, Clothing and Shelter For All

India's Family Health Survey

Hunger and Undernutrition Blog

Pakistan's Total Sanitation Campaign

Is India a Nutritional Weakling?

Asian Gains in World's Top Universities

South Asia Slipping in Human Development

What Does Democracy Deliver in Pakistan

Do South Asian Slums Offer Hope?

Infections Cause Low IQ in South Asia, Africa?

It has long been known that IQ scores vary by regions. The lowest average IQ scores in mid-60s have been measured in the African nations of Equatorial Guinea, Cameroon, Mozambique, Gabon, and highest scores of over 100 found in the nations of Singapore, South Korea, China, Japan, and Italy. South Asian and North African IQ scores are in mid 80s. However, the research surrounding intelligence assessment has been highly controversial and tainted by pseudosciences such as craniometry that was used by the Nazis to "prove" the white “race” as the most intelligent.

Here is some published data on average IQ scores of people from different races:

Richard Lynn, "Race Differences in Intelligence: An Evolutionary Analysis" 2006 Table 16.2 (indigenous populations)	Estimated average IQ
Arctic Peoples	91
East Asians	105
Europeans	100
Native Americans (north & south)	86
Southern Asian & Northern Africans	84
Bushmen (southern Africa)	54
Africans (subsaharan)	67
Native Australians (aboriginals)	62
Southeast Asians	87
Pacific Islanders	85

Apparently, this is a compilation of data from "credible sources" and published in respected journals such as American Journal of Psychology. The neutrality and factual accuracy of these studies and data have been questioned by many researchers and scientists. The most common criticisms are that these studies and tests are developed in the European context and they measure mainly problem-solving capability and skills, not innate intelligence.



For those who are curious, Pakistanis are included along with Indians in Southern Asia with an average IQ of 84, about 16 points below Europeans' average and almost 21 points behind East Asians' average. East Asians include Chinese, Japanese and Koreans. However, a quick look at the overlapping distribution curves above shows that the differences in intelligence scores within each race are much greater than the difference between races.


Recent data, published by the University of New Mexico and reported by Newsweek, shows that there is a link between lower IQs and prevalence of infectious diseases. Comparing data on national “disease burdens” (life years lost due to infectious diseases) with average intelligence scores, the authors found a striking inverse correlation—around 67 percent. They also found that the cognitive ability is rising in some countries than in others, and IQ scores have risen as nations develop—a phenomenon known as the “Flynn effect.”



According to the UNM study's author Christopher Eppig and his colleagues, the human brain is the “most costly organ in the human body.” The Newsweek article adds that the "brainpower gobbles up close to 90 percent of a newborn’s energy. It stands to reason, then, that if something interferes with energy intake while the brain is growing, the impact could be serious and longlasting. And for vast swaths of the globe, the biggest threat to a child’s body—and hence brain—is parasitic infection. These illnesses threaten brain development in several ways. They can directly attack live tissue, which the body must then strain to replace. They can invade the digestive tract and block nutritional uptake. They can hijack the body’s cells for their own reproduction. And then there’s the energy diverted to the immune system to fight the infection. Out of all the parasites, the diarrheal ones may be the gravest threat—they can prevent the body from getting any nutrients at all".

On the question of nature versus nurture, here are some data points on minorities tested in North America and Europe:


In the detailed data for South Asians, there is a distinct smaller cluster between 90 and 100, and another bigger cluster between 80 and 90, closer to 90. But then there are a bunch of scores that go as low as 75 which bring down the average to 84.



There are some who argue that there is an inverse correlation between IQ scores and religiosity as shown in the above graph. The big exception to this argument is the United States where about 60% people say religion is important to them, and the average IQ is fairly high at 98. The IQ scores are lower in India and Pakistan where, according to a Pew survey on religion, 92% and 91% respondents respectively say religion is important to them.



The results of the UNM research study point to the need for fighting infectious diseases in the developing world with greater urgency. Reduction in infectious diseases like diarrhea, malaria, pneumonia and tuberculosis can help improve the cognitive capabilities, and with it, the intelligence and the quality of life of billions in Africa and South Asia.

Related Links:

Haq's Musings

Mensa Pakistan

Are People of Color Less Intelligent?

Human Development Slipping in South Asia

IQ Challenge

Student Performance By Country and Race

India Shining and Bharat Drowning

South Asian IQs

IQ and Wealth of Nations by Richard Lynn and Tatu Vanhanen

IQ and Religion

Why Do IQ Scores Vary By Nation?

Flynn Effect

The Elementary DNA of Dr. Watson