Lesotho, for example, has experienced a 25 per cent rise in infant death rates over the past several decades and continues to have one of the highest rates of HIV in the world, with about one in five persons infected. Similarly, Niger, a country which has improved its child health goals by 50 per cent and has had relative success in curbing the HIV epidemic, is still grappling with very high rates of NCDs (about 1030 deaths per 100,000 population), estimated to account for two-thirds of its unmet MDG progress.

Meanwhile Eastern Europe, like sub-Saharan Africa, was found to be far behind on tuberculosis goals (about 75 per cent unmet progress), partly because of an explosive and uncontained chronic disease epidemic in the 1990s.

'This paper demonstrates why it is important to look at the entire health experience of individuals and families, and not focus on just one or a few diseases. Success in global health means tackling the daily, interconnected risks people living in poor countries face, whether those risks are chronic or infectious,' added Professor Martin McKee, of London School of Hygiene and Tropical Medicine. Dr Sanjay Basu, from the University of California San Francisco, said: 'Alongside the biological risks, families face common household risks that prevent money from being spent on key health requirements. Tobacco and HIV substantially increase the biological risks of tuberculosis infection, but they also divert money from important daily living requirements like nutritious food or visits to the doctor.'

plosmedicine/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000241