3.1 Global Overview
Globally, the six major vIDPs—rabies, dengue, acute hepatitis, HIV/AIDS, Ebola, and COVID-19—resulted in significant health burdens. In 2021, the total deaths due to vIDPs were approximately 8.7 million, and the DALYs were approximately 259.2 million, accounting for 12.8% and 9.0% of the global all-cause totals, respectively. Table 1 summarizes the deaths, DALYs, incidence, and prevalence associated with each vIDP. In 2021, COVID-19 was the most impactful disease among those listed, with approximately 7.9 million (95% UI 7.5-8.4) deaths and 212.0 million (95% UI 197.9-234.7) DALYs. This stark contrast with other diseases underscores the unprecedented global impact of the pandemic. Additionally, acute hepatitis had the second highest age-standardized incidence rate at 3,411.5 (95% UI 3,201.8-3,631.3) per 100,000 polulation, and HIV/AIDS had the second highest age-standardized prevalence rate at 483.1 (95% UI 459.0-511.4) per 100,000 polulation. Compared to 1990, the deaths and DALYs of acute hepatitis in 2021 decreased, while the deaths and DALYs of HIV/AIDS increased. Moreover, the deaths, incidence and prevalence of dengue has increased, with deaths rising from 14,315 (95% UI 11,103-18,652) in 1990 to 29,076 (95% UI 17,628-38,981) in 2021. This increase highlights ongoing challenges in controlling dengue. Remarkably, the burden of rabies has significantly reduced, with DALYs in 2021 decreasing by 58.4% (95%UI 44.8%-71.9%) compared to 1990. Although the incidence and prevalence rates of rabies are relatively low, its high mortality rate continues to have a significant impact on the global disease burden. In comparison, the burden of Ebola remains relatively low, with 48 (95% UI 39-56) deaths and 2,602 (95% UI 2,130-3,062) DALYs in 2021. The low incidence and prevalence rates reflect effective containment of outbreaks but also underscore the necessity for vigilance and rapid response. Figure 1 illustrates the global distribution of age-standardized DALYs rate for these diseases in 2021.
Table 1. Global Burden of Six vIDPs in 2021 and 1990, with Percentage Change
vIDPs
|
All ages number (95% UI)
|
Age-standardized rate (95% UI)
|
2021
|
1990
|
% change
|
2021
|
1990
|
% change
|
Rabies
|
Deaths
|
10084(6016-14172)
|
21806(15577-28435)
|
-53.8(-66.5--40.5)
|
0.1(0.1-0.2)
|
0.4(0.3-0.5)
|
-69.4(-77.6--61.0)
|
DALYs
|
569550(323362-828522)
|
1368780(978542-1786737)
|
-58.4(-71.9--44.8)
|
7.5(4.2-11.0)
|
24.5(17.5-31.9)
|
-69.4(-79.3--59.5)
|
Incidence
|
10181(6081-14293)
|
22035(15732-28729)
|
-53.8(-66.5--40.4)
|
0.1(0.1-0.2)
|
0.4(0.3-0.5)
|
-69.4(-77.6--61.0)
|
Prevalence
|
391(234-549)
|
847(605-1104)
|
-53.8(-66.5--40.4)
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
-69.4(-77.6--61.0)
|
Dengue
|
Deaths
|
29076(17628-38981)
|
14315(11103-18652)
|
103.1(0.9-225.6)
|
0.4(0.2-0.5)
|
0.3(0.2-0.3)
|
40.5(-26.6-114.4)
|
DALYs
|
2076525(1056228-3130718)
|
1248669(876050-1552997)
|
66.3(-22.5-153.3)
|
27.8(14.2-41.7)
|
21.6(15.1-26.9)
|
28.3(-38.0-91.7)
|
Incidence
|
58964185(15473439-106885036)
|
26447129(3933186-51891942)
|
123.0(75.3-378.1)
|
752.0(196.3-1363.4)
|
481.8(70.8-946.3)
|
56.1(22.6-237.9)
|
Prevalence
|
3517384(928244-6430040)
|
1577834(234723-3169007)
|
122.9(76.2-374.5)
|
44.9(11.8-82.1)
|
28.7(4.2-57.8)
|
56.1(23.4-236.2)
|
Acute hepatitis
|
Deaths
|
71846(58045-92908)
|
160352(139545-180112)
|
-55.2(-63.0--44.2)
|
0.9(0.7-1.2)
|
3.2(2.8-3.6)
|
-71.1(-76.3--63.8)
|
DALYs
|
4228048(3342182-5559113)
|
9841371(8674224-11047444)
|
-57.0(-66.2--44.2)
|
56.7(44.1-75.6)
|
177.4(156.2-199.3)
|
-68.0(-74.9--58.5)
|
Incidence
|
250774458(234361297-268115472)
|
266388078(243212898-289980844)
|
-5.9(-12.1-0.4)
|
3411.5(3201.8-3631.3)
|
4660.0(4213.0-5125.1)
|
-26.8(-31.8--21.5)
|
Prevalence
|
21553992(19890335-23361736)
|
20248085(18524954-22021321)
|
6.4(-0.8-13.8)
|
290.6(269.5-312.7)
|
352.3(320.5-383.7)
|
-17.5(-23.2--12.2)
|
HIV/AIDS
|
Deaths
|
718079(669271-785447)
|
305945(234538-404774)
|
134.7(88.6-204.7)
|
8.7(8.1-9.6)
|
5.9(4.5-7.8)
|
47.5(18.6-91.2)
|
DALYs
|
40266792(37138092-44796387)
|
18673403(14782537-24225400)
|
115.6(78.1-168.5)
|
496.4(456.1-554.2)
|
346.9(273.1-451.8)
|
43.1(19.1-77.8)
|
Incidence
|
1645333(1484721-1822432)
|
2008916(1843346-2181339)
|
-18.1(-27.1--7.3)
|
20.8(18.8-23.0)
|
36.5(33.5-39.8)
|
-43.2(-49.7--35.4)
|
Prevalence
|
40036936(38036249-42372669)
|
7934077(7417414-8495410)
|
404.6(368.4-446.5)
|
483.1(459.0-511.4)
|
149.2(139.6-159.6)
|
223.8(200.5-251.3)
|
Ebola
|
Deaths
|
48(39-56)
|
NA
|
NA
|
0.0(0.0-0.0)
|
NA
|
NA
|
DALYs
|
2602(2130-3062)
|
NA
|
NA
|
0.0(0.0-0.0)
|
NA
|
NA
|
Incidence
|
94(82-106)
|
NA
|
NA
|
0.0(0.0-0.0)
|
NA
|
NA
|
Prevalence
|
62(18-163)
|
NA
|
NA
|
0.0(0.0-0.0)
|
NA
|
NA
|
COVID-19
|
Deaths
|
7887554(7507141-8403575)
|
NA
|
NA
|
94.0(89.5-100.0)
|
NA
|
NA
|
DALYs
|
212009596(197942419-234674235)
|
NA
|
NA
|
2500.7(2330.2-2778.2)
|
NA
|
NA
|
Incidence
|
2279717768(2181359056-2372460275)
|
NA
|
NA
|
28955.3(27708.3-30143.2)
|
NA
|
NA
|
Prevalence
|
152308807(117582720-214647715)
|
NA
|
NA
|
1911.7(1479.0-2688.6)
|
NA
|
NA
|
*The rate is per 100,000 population.
3.2 Trends by Global and Different SDI Levels
The trends depicted in Figure 2 emphasize the dynamic and diverse impact of vIDPs globally and across different SDI contexts. From 1990 to 2021, the age-standardized DALY rate for HIV/AIDS peaked around 2003 at 1,387.9 (95%UI 1,156.5-1,650.2) per 100,000 population globally, followed by a downward trend. However, in low SDI regions, HIV/AIDS continues to impose a significant burden, with DALY rate remaining considerably higher than in other regions. COVID-19, which emerged at the end of 2019, rapidly escalated to become the leading cause of DALYs among the six diseases by 2021, demonstrating widespread impact irrespective of economic status. The age-standardized DALY rate for dengue initially increased, peaking in 2014 at 32.5 (95%UI 20.5-46.3) per 100,000 population. However, by 2021, it had only decreased to levels comparable to those around 2007, at 27.8 (95%UI 14.2-41.7) per 100,000 population. This indicates that significant progress is still needed to reduce the burden of dengue. Particularly in low-middle and middle SDI regions, the disease continues to pose substantial challenges, with a considerable burden remaining as of 2021. Acute hepatitis and rabies exhibited relatively stable declining trends globally and across different SDI levels, with global reductions of approximately 68.0% (95%UI 58.5%-74.9%) for acute hepatitis and 69.4% (95%UI 59.5%-79.3%) for rabies in 2021 compared to 1990. Despite contributing to lower overall DALY rates compared to other diseases, Ebola showed notable spikes during specific outbreaks, particularly in low SDI regions, highlighting the episodic yet severe nature of these infections.
3.3 Age and Gender Differences
The incidence rates of vIDPs show significant differences across various age groups and genders. Figure 3 displays the incidence rates and number of cases of six vIDPs across different age groups and genders in 2021.
For rabies, both the incidence rates and number of cases are relatively high among children and adolescents. The incidence rate is also notably high among the elderly, especially those aged 95 and above, with an incidence rate of 0.3 (95% UI 0.2-0.5) per 100,000 population. There is no statistically significant difference in the incidence rates and number of cases between males and females, with the total number of male cases being 6,381 (95% UI 3,528-8,964) compared to 3,800 (95% UI 2,202-6,184) in females.
For dengue, the incidence reaches its peak in the 10-14 years age group, with 6.3 million cases (95% UI 1.5-11.7). The incidence rate is also very high among those aged 95 and above, at 2,768.8 (95% UI 1,012.7-4,885.7) per 100,000 population. Also, there is no statistically significant difference between males and females, with the total number of male cases being 27.3 million (95% UI 6.0-50.3) and 31.6 million (95% UI 8.5-56.6) in females.
Acute hepatitis shows a significantly higher risk of incidence among children and adolescents, particularly in children under 5 years old, with 77.8 million cases (95% UI 70.4-85.4) and an incidence rate of 11,815.5 (95% UI 10,696.9-12,969.7) per 100,000 population. Overall, the incidence rate among males in 2021 was significantly higher than among females, with males accounting for 3,408.0 (95% UI 3,165.8-3,673.0) per 100,000 population and females accounting for 2,946.1 (95% UI 2,754.0-3,153.8) per 100,000 population.
Young adults are the most affected by HIV/AIDS, with the incidence rate peaking in females at ages 25-29 years at 59.1 (95% UI 51.6-68.2) per 100,000 population, while the incidence rate for males peaks slightly later at ages 30-34 years at 59.8 (95% UI 52.6-67.5) per 100,000 population. Additionally, children under 5 years are another significant group affected by HIV/AIDS, with an incidence rate of 15.4 (95% UI 12.8-19.2) per 100,000 population. Among those aged 15-24, the incidence rate is significantly higher in females than in males. However, in the age groups 30-39 and 65-79, the incidence rate is significantly higher in males than in females.
The incidence of Ebola is relatively low across all age groups, with a minor peak in children under 10 years and a more significant peak at ages 35-39 years, reaching an incidence rate of 2.0 (95% UI 1.7-2.2) per 100,000,000 population. The incidence rate decreases after age 40 but shows a slight increase again among those aged 75 and above, indicating that older adults still face some risk during Ebola outbreaks. Overall, the incidence rate among females in 2021 was significantly higher than among males, with females accounting for 1.0 (95% UI 0.9-1.2) per 100,000,000 population and females accounting for 1.3 (95% UI 1.2-1.5) per 100,000,000 population.
For COVID-19, the highest risk of infection is observed among adolescents and young adults, particularly in the 15-19 years age group, where the incidence rate peaks at 36,557.6 (95% UI 34,763.1-38,238.8) per 100,000 population, likely due to more frequent social interactions and contacts in this age group. The incidence rate decreases with age but shows an increase again among those aged 55 and above. This indicates that older adults face a higher risk of infection during the COVID-19 pandemic, possibly due to declining immunity and underlying health issues. Also, there is no statistically significant difference between males and females
3.4 Regional Differences
In 2021, in most regions, the global burden was highest for COVID-19, followed by HIV/AIDS, acute hepatitis, dengue, rabies, and lowest for Ebola, as shown in Figure 4. COVID-19 caused the highest DALYs in nearly all regions worldwide, underscoring its extensive impact. However, in East Asia, it ranked third with a DALY rate of 2.8 (95% UI 0.8-9.2) per 100,000 population. Sub-Saharan Africa bears the heaviest burden of HIV/AIDS, with DALY rates reaching 9,615.8 (95% UI 9,003.0-10,270.0) per 100,000 population, highlighting severe public health challenges. South Asia and Eastern Sub-Saharan Africa show high DALY rates for acute hepatitis, with 140.3 (95% UI 103.2-197.4) and 129.0 (95% UI 104.3-163.0) per 100,000 population respectively. Southeast Asia exhibits a high DALY rate for dengue at 147.0 (95% UI 95.3-201.0) per 100,000 population. Rabies imposes a substantial burden in Eastern and Western Sub-Saharan Africa, with DALY rates of 26.7 (95% UI 10.3-59.7) and 19.8 (95% UI 7.9-31.4) per 100,000 population, respectively. Central Sub-Saharan Africa faces a significant impact from Ebola, with a DALY rate of 1.1 (95% UI 0.9-1.3) per 100,000 population.
Table 2 presents the progress and ongoing challenges in managing the burden of major vIDPs across different regions over the past three decades. In both 1990 and 2021, Africa remained the region most severely affected by HIV/AIDS. Notably, while the burden in Eastern Sub-Saharan Africa has decreased, it has significantly increased in Southern and Western Sub-Saharan Africa. Additionally, the burden of HIV/AIDS has also markedly increased in Asia and Oceania, indicating persistent challenges in controlling this epidemic in these regions. In contrast, the burden of acute hepatitis in 2021 showed a significant decline across all 21 regions globally compared to 1990. Meanwhile, regions such as Southeast Asia, South Asia, and Tropical Latin America have consistently been hotspots for dengue, continuing to exhibit high DALY rates in both 1990 and 2021. This persistence indicates the ongoing transmission challenges of dengue. Moreover, in high-income North America, while the overall burden of dengue remains relatively low, the DALY rate in 2021 showed a significant increase compared to 1990, with a percentage change of 427.1 (102.1-1029.3). This rise suggests emerging threats and the need for vigilant public health measures to prevent outbreaks. Finally, globally, the DALY rate for rabies decreased by 69.4% (59.5%-79.3%). However, in regions such as high-income North America, Western Europe, and Australasia, the burden of rabies increased significantly compared to 1990. This upward trend highlights the necessity for continued and enhanced rabies prevention efforts.
Table 2. Age-Standardized DALY Rates and Percentage Change for Major vIDPs in 1990 and 2021
vIDPs
|
2021
|
1990
|
% Change
|
HIV/AIDS
|
Global
|
496.4(456.1-554.2)
|
346.9(273.1-451.8)
|
43.1(19.1-77.8)
|
High-income Asia Pacific
|
7.6(6.8-8.7)
|
3.1(2.8-3.4)
|
149.5(131.4-174.6)
|
High-income North America
|
88.5(72.9-108.6)
|
491.6(478.6-508.6)
|
-82.0(-84.8--78.7)
|
Western Europe
|
37.6(33.0-43.6)
|
138.8(135.7-142.3)
|
-72.9(-75.7--69.1)
|
Australasia
|
13.3(11.3-16.2)
|
103.5(101.3-106.6)
|
-87.1(-88.8--84.7)
|
Andean Latin America
|
236.3(222.1-253.4)
|
67.0(64.5-71.3)
|
252.7(224.5-279.3)
|
Tropical Latin America
|
300.9(290.0-315.1)
|
300.9(296.3-307.5)
|
0.0(-2.4-2.7)
|
Central Latin America
|
243.0(236.5-251.4)
|
167.1(165.2-169.6)
|
45.4(42.9-48.6)
|
Southern Latin America
|
177.4(168.4-190.6)
|
87.5(84.1-91.4)
|
102.7(96.7-110.5)
|
Caribbean
|
831.0(677.7-1042.1)
|
1325.4(941.5-1886.4)
|
-37.3(-53.3--16.7)
|
Central Europe
|
23.3(22.3-24.7)
|
25.2(24.8-25.6)
|
-7.3(-10.4--2.9)
|
Eastern Europe
|
628.4(605.8-656.9)
|
115.0(113.1-118.3)
|
446.3(433.7-461.6)
|
Central Asia
|
78.4(76.2-81.2)
|
35.9(35.6-36.4)
|
118.0(113.3-124.5)
|
North Africa and Middle East
|
87.5(56.0-175.2)
|
13.1(9.4-24.3)
|
565.5(175.6-1553.4)
|
South Asia
|
129.9(97.3-200.7)
|
1.9(1.0-3.4)
|
6759.2(3479.0-13428.2)
|
Southeast Asia
|
233.4(216.7-260.7)
|
138.4(135.7-141.4)
|
68.6(56.5-86.8)
|
East Asia
|
82.4(59.6-108.5)
|
6.6(1.3-10.5)
|
1151.7(547.6-7869.3)
|
Oceania
|
421.4(301.1-711.0)
|
21.0(19.6-23.0)
|
1910.9(1335.7-3242.4)
|
Western Sub-Saharan Africa
|
2103.4(1790.9-2539.7)
|
1326.0(887.1-1999.2)
|
58.6(18.5-117.7)
|
Eastern Sub-Saharan Africa
|
3372.1(3034.8-3767.8)
|
5426.6(3753.3-7793.1)
|
-37.9(-54.7--7.6)
|
Central Sub-Saharan Africa
|
1808.3(1472.5-2305.8)
|
2381.7(1638.2-3488.6)
|
-24.1(-47.6-9.2)
|
Southern Sub-Saharan Africa
|
9615.8(9003.0-10270.0)
|
2958.4(2190.3-4165.6)
|
225.0(133.4-343.9)
|
Acute hepatitis
|
Global
|
56.7(44.1-75.6)
|
177.4(156.2-199.3)
|
-68.0(-74.9--58.5)
|
High-income Asia Pacific
|
5.1(3.7-7.0)
|
10.0(8.2-12.2)
|
-49.2(-58.5--40.7)
|
High-income North America
|
4.0(3.0-5.3)
|
5.2(4.2-6.5)
|
-23.6(-29.9--17.8)
|
Western Europe
|
3.5(2.5-4.8)
|
4.5(3.4-6.0)
|
-22.0(-27.7--16.4)
|
Australasia
|
3.9(2.6-5.6)
|
4.5(3.2-6.2)
|
-12.6(-22.3--2.7)
|
Andean Latin America
|
7.0(5.3-9.1)
|
13.7(11.2-16.8)
|
-49.1(-60.6--37.3)
|
Tropical Latin America
|
6.8(5.3-8.8)
|
15.1(13.1-18.1)
|
-54.6(-62.3--47.7)
|
Central Latin America
|
8.6(6.9-10.8)
|
17.2(15.0-19.8)
|
-49.8(-57.2--40.8)
|
Southern Latin America
|
4.9(3.4-6.6)
|
9.3(7.2-13.5)
|
-47.9(-65.7--35.9)
|
Caribbean
|
13.7(9.5-18.8)
|
21.4(14.7-32.4)
|
-36.3(-54.5--10.0)
|
Central Europe
|
5.2(3.7-7.0)
|
8.5(6.8-10.7)
|
-39.3(-47.4--31.3)
|
Eastern Europe
|
6.7(5.3-8.7)
|
17.7(15.9-19.9)
|
-62.3(-68.7--55.8)
|
Central Asia
|
22.9(17.6-30.5)
|
186.3(166.7-210.3)
|
-87.7(-90.8--83.4)
|
North Africa and Middle East
|
57.1(42.9-77.8)
|
274.1(200.8-355.0)
|
-79.2(-84.5--72.4)
|
South Asia
|
140.3(103.2-197.3)
|
374.8(320.6-435.0)
|
-62.6(-75.4--42.7)
|
Southeast Asia
|
41.0(34.8-49.4)
|
155.9(116.5-206.7)
|
-73.7(-80.8--62.0)
|
East Asia
|
11.8(9.3-15.0)
|
148.8(127.0-173.8)
|
-92.0(-94.1--89.7)
|
Oceania
|
36.0(18.9-58.2)
|
130.1(68.9-204.6)
|
-72.3(-80.6--56.1)
|
Western Sub-Saharan Africa
|
71.1(48.1-96.5)
|
459.0(236.0-701.4)
|
-84.5(-88.9--76.3)
|
Eastern Sub-Saharan Africa
|
129.0(104.3-163.0)
|
292.6(240.0-371.5)
|
-55.9(-65.1--43.7)
|
Central Sub-Saharan Africa
|
37.3(23.5-52.3)
|
199.5(118.2-316.7)
|
-81.3(-87.3--70.4)
|
Southern Sub-Saharan Africa
|
34.4(23.5-50.4)
|
65.7(36.6-96.9)
|
-47.7(-61.3--25.5)
|
Dengue
|
Global
|
27.8(14.2-41.7)
|
21.6(15.1-26.9)
|
28.3(-38.0-91.7)
|
High-income Asia Pacific
|
2.9(0.5-7.4)
|
1.3(0.2-3.5)
|
122.6(-21.0-1012.3)
|
High-income North America
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
427.1(102.1-1029.3)
|
Western Europe
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
-99.0(-99.7--97.3)
|
Australasia
|
0.6(0.2-1.6)
|
0.3(0.0-1.0)
|
107.8(-59.5-4136.7)
|
Andean Latin America
|
6.6(2.8-12.3)
|
3.6(0.7-8.9)
|
83.0(-15.4-909.9)
|
Tropical Latin America
|
63.8(22.4-136.0)
|
43.6(3.3-113.6)
|
46.4(-17.1-834.2)
|
Central Latin America
|
17.5(9.9-27.6)
|
8.3(2.4-17.7)
|
112.3(31.1-515.1)
|
Southern Latin America
|
1.2(0.2-3.3)
|
0.8(0.0-3.0)
|
50.6(-50.9-3544.6)
|
Caribbean
|
5.8(1.2-15.5)
|
5.0(0.8-14.8)
|
16.0(-41.6-206.9)
|
Central Europe
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
NA
|
Eastern Europe
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
NA
|
Central Asia
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
NA
|
North Africa and Middle East
|
0.2(0.1-0.4)
|
0.3(0.2-0.4)
|
-26.8(-67.5-85.6)
|
South Asia
|
53.5(19.5-91.9)
|
35.8(18.0-57.4)
|
49.4(-14.5-103.3)
|
Southeast Asia
|
147.0(95.3-201.0)
|
135.0(88.8-204.7)
|
8.9(-49.5-91.0)
|
East Asia
|
0.1(0.0-0.2)
|
0.3(0.2-0.5)
|
-72.2(-84.3--53.4)
|
Oceania
|
6.0(2.7-11.9)
|
13.4(8.6-20.8)
|
-55.0(-73.2--23.7)
|
Western Sub-Saharan Africa
|
4.9(0.2-17.0)
|
3.7(0.0-14.3)
|
33.9(-45.5-3259.1)
|
Eastern Sub-Saharan Africa
|
1.3(0.2-4.1)
|
8.2(0.7-21.5)
|
-84.4(-98.6-245.6)
|
Central Sub-Saharan Africa
|
1.9(0.1-10.3)
|
1.4(0.0-8.4)
|
40.2(-84.1-1135.1)
|
Southern Sub-Saharan Africa
|
0.0(0.0-0.1)
|
0.0(0.0-0.1)
|
-2.4(-90.8-923.1)
|
Rabies
|
Global
|
7.5(4.2-11.0)
|
24.5(17.5-31.9)
|
-69.4(-79.3--59.5)
|
High-income Asia Pacific
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
-92.7(-93.7--91.6)
|
High-income North America
|
0.1(0.1-0.1)
|
0.0(0.0-0.0)
|
162.3(131.5-195.6)
|
Western Europe
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
113.0(84.3-145.0)
|
Australasia
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
76.1(9.6-191.2)
|
Andean Latin America
|
0.0(0.0-0.0)
|
2.6(2.0-3.1)
|
-99.9(-99.9--99.8)
|
Tropical Latin America
|
0.0(0.0-0.0)
|
3.1(2.1-4.3)
|
-99.7(-99.8--99.6)
|
Central Latin America
|
0.0(0.0-0.0)
|
2.3(2.1-2.5)
|
-99.9(-99.9--99.9)
|
Southern Latin America
|
0.0(0.0-0.0)
|
0.0(0.0-0.0)
|
-49.3(-58.9--36.8)
|
Caribbean
|
0.0(0.0-0.1)
|
0.0(0.0-0.1)
|
-6.6(-54.7-93.3)
|
Central Europe
|
0.0(0.0-0.0)
|
0.1(0.1-0.1)
|
-98.3(-98.8--97.6)
|
Eastern Europe
|
0.1(0.1-0.1)
|
0.3(0.3-0.3)
|
-72.6(-77.2--66.3)
|
Central Asia
|
0.5(0.3-0.9)
|
1.2(0.6-2.3)
|
-53.9(-75.5--14.7)
|
North Africa and Middle East
|
0.1(0.1-0.2)
|
1.6(0.8-2.4)
|
-91.4(-94.7--85.4)
|
South Asia
|
14.2(9.1-20.2)
|
79.9(59.2-99.4)
|
-82.2(-86.4--76.5)
|
Southeast Asia
|
5.4(3.1-8.2)
|
18.6(14.1-25.4)
|
-71.1(-82.0--57.7)
|
East Asia
|
1.8(1.0-2.8)
|
6.0(3.5-8.4)
|
-69.8(-79.9--57.0)
|
Oceania
|
0.6(0.1-1.6)
|
0.7(0.2-2.0)
|
-13.1(-54.3-66.8)
|
Western Sub-Saharan Africa
|
19.8(7.9-31.4)
|
35.8(16.3-62.7)
|
-44.8(-69.5--11.4)
|
Eastern Sub-Saharan Africa
|
26.7(10.3-59.7)
|
76.6(35.4-167.6)
|
-65.2(-81.0--41.8)
|
Central Sub-Saharan Africa
|
0.9(0.2-2.5)
|
1.7(0.3-5.2)
|
-46.6(-70.2--7.2)
|
Southern Sub-Saharan Africa
|
2.2(1.3-3.7)
|
3.2(1.8-5.0)
|
-30.6(-56.5-16.6)
|
*The rate is per 100,000 population. Ebola and COVID-19 are not included in the table due to the lack of data for the year 1990.
3.5 Relationship Between vIDPs and SDI
The analysis of the relationship between vIDPs and the SDI reveals significant patterns and disparities. Higher SDI is generally associated with lower DALY rates for diseases such as rabies, acute hepatitis, and HIV/AIDS. There is a strong negative correlation between SDI and DALYs for rabies. Regions with lower SDI, particularly Sub-Saharan Africa, have the highest DALY rates, highlighting the challenges in rabies control due to inadequate vaccination and limited access to post-exposure prophylaxis. In contrast, high-SDI regions like High-income North America, Western Europe, and Australasia exhibit DALY rates close to zero, reflecting successful public health measures and comprehensive vaccination programs. Similarly, acute hepatitis shows a clear negative correlation between SDI and DALYs. Low-SDI regions, such as Western Sub-Saharan Africa, experience higher DALY rates, while high-SDI regions demonstrate significantly lower DALY rates, indicating effective healthcare systems and public health interventions. For HIV/AIDS, there is a moderate negative correlation between SDI and DALYs, with Sub-Saharan Africa bearing the highest burden. However, many regions show a rise and subsequent decline in disease burden, underscoring the critical role of international efforts and sustained interventions in combating HIV/AIDS.
In contrast, the burden of dengue, Ebola, and COVID-19 does not follow a direct correlation with SDI. Regions such as Southeast Asia and Tropical Latin America, despite having moderate SDI levels, exhibit high DALY rates for dengue. This suggests that factors beyond socio-economic development, such as climate and vector prevalence, significantly influence the burden of dengue. The relationship between Ebola and SDI is also dispersed, indicating that outbreaks are more influenced by regional ecological and epidemiological factors than socio-economic status alone. Similarly, the relationship between COVID-19 and SDI is not clear-cut, as the pandemic's impact was widespread, affecting regions across the SDI spectrum. High-SDI regions experienced significant burdens due to healthcare system strain and socio-economic disruptions, while lower SDI regions faced challenges related to limited healthcare infrastructure and resource constraints.