In some nations, the rise of 'shortgevity'

It's an article of faith among most 21st-century humans that life is getting longer. In the last three decades, the average life span at birth has increased from about 60 years to 67 years worldwide, a remarkable achievement.

But in two dozen countries, human life spans are shortening for one of the few times since the bubonic plague swept through Europe and elsewhere in the 14th century. One expert calls the situation a "shortgevity" crisis.

The greatest setback has been in sub-Saharan Africa, swept by the HIV/AIDS epidemic. In all, 10 African countries have seen projections for their average life span fall below 40 years of age. The good news is that in Russia and in some of its close neighbors, the decline seems to have been reversed. Such trends are key to future prosperity.

"We talk a lot about the inequality of wealth [between the developed and developing worlds], and it seems to me we don't talk enough about the inequality in length of life, because connected with that of course is education, vigor, productivity," says Robert Butler, founder and chief executive of the International Longevity Center in New York and professor of geriatrics at Mount Sinai Medical Center there.

The world should care about what he calls shortgevity for self-interested reasons, he adds. "If we really are serious about the concept of global trade, then we'll realize that those other nations have to be given a fighting chance to be productive as well. And if they're not, they are not going to have the money to buy all our wonderful products and exchange goods with us."

For Russians and other members of the former Soviet bloc, the situation looked bleak a few years ago. The fall of the Soviet state in 1991 left "a degree of disorder that was disadvantageous to health," says Kenneth Hill, a demographer and director of the population center at the school of public health at Johns Hopkins University in Baltimore.

While infant mortality didn't rise significantly, self-destructive behaviors by adults did, including alcoholism. A clear social structure, based on party loyalty, had collapsed, and nothing had replaced it.

"It wasn't so much that the healthcare system worsened, but that the people's general spirit worsened," Dr. Hill says. That feeling of helplessness was associated with high mortality. "There's some evidence that being depressed isn't just bad for your mental health, it's bad for your physical health as well," he says.

Today illicit drugs and alcoholism are still major social ills in the region. But the outlook has begun to improve as those countries stabilize socially and economically, though longevity rates have still not returned to their peak levels of the 1980s.

In sub-Saharan Africa, the picture remains alarming. Experts attribute much of the problem to the HIV/AIDS epidemic there, which accounts for 25 million of the 40 million cases of HIV/AIDS in the world. According to the latest United Nations Human Development Report, life expectancy in Zimbabwe plummeted from 56 years in 1970-75 to just 33.1 today. Zambia went from 49.7 years to 32.4 in the same period, Lesotho from 49.5 to 35.1, and Botswana from 56.1 to 39.7.

"With the onset of HIV/AIDS we have seen a lot of the work we have done, and the gains we have achieved, being eroded," says Wilfred Mlay, who directs African operations for World Vision, a privately funded Christian relief and development organization at work in 25 sub-Saharan countries. Consequently, Dr. Mlay says by phone from Nairobi, Kenya, World Vision now is working hard to help African governments provide AIDS education and assist the most vulnerable, teaching both sexual abstinence outside marriage and the use of condoms. Some 99 percent of HIV infections in Africa in 2001 were caused by unsafe sex practices, according to a study by the World Health Organization (WHO) released in 2002. That leaves hope that lifestyle changes can lower infection rates.

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