My suggestions for approaching an answer Generally speaking, countries with the highest under-five mortality rates are in what is conventionally thought of as the South. Of the nine countries with the lowest under-five mortality rates (less than 25 child deaths per 1000 live births), five are developed countries, and three (Cuba, Jamaica and Sri Lanka) are usually thought of as belonging to the South. But what about the remaining country in this group of nine - Poland? Is this in the South - a developing country, or not? (I leave you to think about that question.)

It seems to me that we can draw two general points from this exercise: *Disease appears to be more prevalent in the South than in developed countries. The under-five mortality rate is generally higher for the developing countries listed.

*There is a large variation between the developing countries listed. This should make us wary of sweeping generalizations, such as 'all of the South is disease-ridden'. The under-five mortality rates for some developing countries in the table (Cuba, Jamaica and Sri Lanka) are not so different from those for developed countries. Why do these countries fare better? We shall return to this question later.

By doing this acitivity we have established a broad pattern in which the South is more disease-prone than developed countries. But several countries don't fit the pattern and when that happens it immediately raises the question: Why don't they fit? What else is happening?

The table tells us nothing about the types of disease in different parts of the world, either. In fact, the tendency is for infectious diseases to predominate in the South and chronic diseases, such as cancers and heart disease, to predominate in the developed countries. Again, however, there are many variations, and certainly cancer and heart disease are problems in many parts of the South.

AIDS is one disease that is recognized as being a global problem. Back in 1993 it was estimated that, by the year 2000, around 1.8 million people would be dying in the world because of AIDS each year. In some communities the disease is already starting to reverse long-term declines in child mortality (World Bank, 1993, p.99). Later you will see that AIDS initiatives form part of the World Bank's public health package. However, although many countries are very open about the AIDS problem, others are quieter.

For a variety of practical, moral and political reasons, a few countries are still reluctant to acknowledge they have an AIDS problem.

On the next page, I'll ask you to consider your home country, and patterns of disease there.

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