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MORTALITY IN LESS DEVELOPED COUNTRIES 227

during 1950–1955 to 65.3 years during 1950–55 to 69.3 years during 1965–70, very
1975–80, although the pace of progress has close to that of Europe and North America.
become slower since then (UN, 2007). Much Since then, it has continued to decline and
of the mortality decline in developing coun- has reached a level as low as 64.8 years
tries occurred as a result of improved and during 2000–2005, below the levels in Asia
imported medical technologies, particularly (67.5) and Latin America and the Caribbean
those related to the use of vaccines and antibi- (72.0). This was largely a result of an
otics for controlling infectious diseases, which increase in adult mortality rather than infant
were introduced in the early 1940s (Bloom mortality, which has continued to decline,
and Williamson, 1997). In Europe, it took albeit at a slower pace (UN, 2000: 33–34).
almost one and half centuries for life Increased stress from the transition to a
expectancy to rise from 33.3 years in 1800 to market economy, abrupt economic transition,
64.7 years in 1950. China made a similar gain large recessions, and uncertainty may have
in less than 25 years. Sri Lanka is a classic been partially responsible for this uneven
example, where medical technology played an pattern, although reasons for this phenome-
important role in reducing mortality within a non are still unclear (Brainerd and Cutler,
short period. In this country, life expectancy at 2005; Murrell, 1996).
birth rose slowly and steadily from about 32 Slowdowns and reversals in mortality pat-
years during 1920–22 to 46 years during terns are most apparent in sub-Saharan
1945–47, with a gain of 14 years in about 25 Africa, where a number of countries are still
years. With the introduction of DDT against in the first and second stages of epidemio-
malaria, life expectancy rose to 60 years in logic transition. In this region, life
1954, with a gain of an additional 14 years expectancy rose from 37.6 years during
within just 7 years (Livi-Bacci, 1992; UN, 1950–55 to 49.9 years during 1985–90,
1963). In sum, less-developed countries were but has declined since then and reached
able to control their level of mortality just by 48.8 years by 2000–2005 (UN, 2007). Once
importing a wide range of cost-effective med- again, the stagnation and reversal in mortal-
ical technologies, without much social and ity in this region have to do primarily with a
economic development. rise in adult mortality, particularly that
These observations are suggestive of the resulting from the emergence of HIV/AIDS
convergence hypothesis. However, there are (UN, 2003b: 11–16). The infant mortality
some important exceptions where the mortal- rate has continued to decline, although at a
ity level stagnated or showed signs of rever- slower pace than in early periods. Africa,
sal. In the 1950s and 1960s, mortality levels China, and India were almost at the same
in Eastern Europe and the former communist level in the 1950s. China, however, has made
states of the Soviet Union used to be closer to enormous progress since the 1960s and has
those in the industrialized world. However, in reached a mortality level close to that of
recent years the patterns changed dramati- Latin America and the Caribbean. India’s
cally. In Eastern Europe, life expectancy rose progress was slower until the early 1980s.
from 64.2 years for the period of 1950–55 to Only recently, has its mortality started to
69.6 years during 1965–70, but fluctuated decline at a rather fast pace, although still at
around the same level until 1985–90 before a much slower pace than China’s. Africa’s
declining to 67.8 years during 2000–2005 mortality level was not only very high to
(UN, 2007). The experience of the Russian begin with, but also its improvement has
Federation is striking. Its life expectancy been very slow. Tropical geography, slug-
used to be among the world’s highest, but gish economic development, widespread
now it is no better than that of many develop- malnutrition, the emergence of new epi-
ing countries. The Russian life expectancy demics like AIDS, and other infectious dis-
rose from 64.5 years during the period of eases such as endemic malaria and