In some nations, the rise of 'shortgevity'

World Vision also supports people with AIDS by giving them nutrition and medications. Keeping parents healthy and alive longer means fewer orphans who must be cared for. "We are beginning to see some minor changes" in behaviors, Mlay says.

"If you were to take AIDS away, I think you would see gains [in longevity] everywhere," says John Bongaarts, vice president for policy research at the Population Council in New York. "Overall, the developing world is a success story."

Based on current UN projections, HIV/AIDS is expected to be the source of so many fatalities that by 2025 these countries will have 14 percent fewer people than they would have otherwise. Projections of HIV/AIDS fatalities in China and India suggest a difficult battle ahead for those two countries as well.

The burden on families will be "staggering," the report says. But it adds: "The course of the HIV/AIDS epidemic is by no means predetermined. The eventual course of the disease depends on how individuals, communities, nations, and the world respond to the HIV/AIDS threat today and tomorrow."

Still, the cost of caring for those already sick and their families can be overwhelming. In the United States, it costs about $10,000 per year to treat a person who is diagnosed with HIV, Dr. Bongaarts says. "In many of these sub-Saharan countries, the governments spend less than $10 per year per capita on health. So there's not much you can do with that money to treat people." Generic versions of AIDS drugs can substantially cut the cost. "But even so, that is an enormous expense," he says.

Every year of life expectancy gained is estimated to raise per capita gross domestic product in a country by about 4 percent. That's prompted some researchers to question whether development aid to Africa, only about 10 percent of which is aimed at improving health, is being properly spent. It's in everyone's interest "to overcome what I call the 'longevity di- vide,' " Dr. Butler says.

While the per capita GDPs of sub- Saharan countries have not dipped as dramatically as their longevity rates, that measure can be deceiving, Hill says. The deaths of young adults have reduced the labor force, but that has allowed survivors to pick up extra work and boost their own earnings. Thus, the fall in per capita GDP doesn't look so bad.

Longevity is one of several measures the UN uses to determine a population's well-being, rather than simply tracking wealth per capita. Its Human Development Index also includes school enrollment, literacy, and income to produce a broader picture. "People are the real wealth of nations," concludes a report last July by the UN Development Program.

To attack Africa's health problems, not only money but new ideas are needed, Butler says, such as a vaccine to protect against malaria, which is linked to more than 1 million deaths a year worldwide. Some $2.5 billion a year - 10 times what is being spent now - is needed to combat malaria in Africa, the WHO said this week. Also needed is a way to get vaccines to remote villages without spoiling.

Though vaccines are seen as important, traditionally researchers cite rising incomes, better education, healthier lifestyles, and cleaner environments as the major keys to increasing longevity.

Residents of developed nations usually live longest, experts believe, because they have access to basic amenities such as clean drinking water and modern sanitation. Places with the longest life expectancy at birth are:

Country Life expectancy*

1. Japan 81.5 years

2. Sweden 80.0

3. Hong Kong 79.9

4. Iceland 79.7

5. Canada 79.3

6. Spain 79.2

7. Australia 79.1

(tie) Israel 79.1

(tie) Switzerland 79.1

10. France 78.9

*for a child born in 2002

Source: UN Development Program

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