Communicable Disease Services
Epidemiological Shifts and Outpatient Care
The developing world as a whole is in the process of an epidemiological shift, where longer lives, better nutrition, and a host of other factors have led to a shift in mortality causes from infectious diseases - what are sometimes called ‘tropical diseases’ - to chronic diseases.
Although this shift is real and significant, outpatient care in developing countries remains largely driven by communicable diseases and for this reason the private sector, which is the predominant source of ambulatory care, remains a significant provider of diagnosis and treatment for most communicable diseases.
For some illnesses, such as TB, there is good evidence that even free government care cannot reach the full population in need and engagement with private providers for monitoring, referrals, and supported treatment has become part of the accepted policy response in most countries. For many other illnesses this degree of collaborative engagement has not yet been achieved. We provider more information on the diseases with broadest effect and highest global mortality and morbidity below.