Global Health and Extreme Poverty
Question 3 of 6: How does society turn those resources into what people need? · The whole story
In short: Over the last two centuries, and especially the last fifty years, health and incomes have improved more than at any time in history. But hundreds of millions of people still live in extreme poverty, and millions of children still die each year from causes that are cheap to prevent. This is where a society’s systems most visibly succeed or fail at meeting basic needs.
The Question
Section titled “The Question”The articles before this one describe how a society turns resources into what people need. This one looks at the results worldwide: how well are basic needs actually being met, and for whom?
How Far We Have Come
Section titled “How Far We Have Come”- Child deaths: the number of children who die before their fifth birthday fell from about 12.8 million in 1990 to under 5 million today, even though there are more children.
- Life expectancy: worldwide, people now live about 73 years on average, compared with around 30 to 40 years in 1900.
- Vaccines: a 2024 study led by the World Health Organization estimated that vaccination has saved about 154 million lives over the past fifty years.
- Poverty: in 1990, more than a third of the world lived in extreme poverty. Today it is about one in ten.
Who Is Still Left Behind
Section titled “Who Is Still Left Behind”- Extreme poverty: around 800 million people live on less than 3 dollars a day, the World Bank’s extreme poverty line since 2025 (adjusted for differences in prices between countries). More and more of them live in sub-Saharan Africa and in places hit by conflict.
- Preventable deaths: malaria still kills around 600,000 people a year, most of them young children in Africa. Diarrhoea, pneumonia and malnutrition kill many more.
- Progress has slowed: COVID-19, wars and higher food prices pushed many people back into poverty, and the fall in extreme poverty has almost stopped since 2020.
Why It Is Some of the Cheapest Good There Is
Section titled “Why It Is Some of the Cheapest Good There Is”Because the gap is so large, a little goes a long way. A bed net that protects a family from malaria costs a few dollars. A dose of vitamin A or a deworming tablet costs cents. Charity evaluators such as GiveWell estimate that the best programmes save a child’s life for a few thousand dollars. Few other uses of money do as much good per euro.
What Makes the Difference
Section titled “What Makes the Difference”Health and income grow together, but not automatically. The countries that improved fastest usually combined:
- basic health care close to home, with vaccines, clean water and sanitation;
- schooling, especially for girls;
- stable institutions and peace;
- jobs, often first in farming and then in industry.
Aid helps most when it supports these, rather than replacing them.
Examples
Section titled “Examples”- Smallpox: once killed millions every year. A worldwide vaccination effort wiped it out by 1980. It is the only human disease ever eradicated.
- Bangladesh: in 1971 it was among the poorest countries in the world. Through community health workers, family planning, girls’ education and garment jobs, child deaths fell sharply and life expectancy is now above India’s.
The Human Side
Section titled “The Human Side”Behind every figure is a family. Extreme poverty means not knowing whether there will be food tomorrow, and watching children fall ill from things that could easily be prevented. Meeting these needs comes first, because without health and safety, people cannot pursue anything else. See Human needs in the Personal Guide.
Open Questions
Section titled “Open Questions”- How much should rich countries give, and in what form: aid, fair trade rules, debt relief, or open migration?
- How can progress continue in countries hit by war and climate change at the same time?
- Who should decide how aid is spent: donors, governments, or the people it is meant for?
Where Next
Section titled “Where Next”- Previous: Democracy and Reliable Information
- Next: How Societies Change
- Related: Fair Globe Sharing, Social Redistribution
Sources
Section titled “Sources”- World Bank, Poverty, Prosperity, and Planet Report (2024)
- World Bank, June 2025 update of the international poverty line to $3.00 a day (Poverty and Inequality Platform)
- UN Inter-agency Group for Child Mortality Estimation, Levels and Trends in Child Mortality (2024 and 2025 reports)
- Shattock et al., “Contribution of vaccination to improved survival and health”, The Lancet (2024)
- WHO, World Malaria Report (2024)
- GiveWell, cost-effectiveness analyses (givewell.org)
- Hans Rosling, Factfulness (2018)