I use to wonder why there was such opposition to globalization policies that enriched poor countries. Now I know -- it increases their access to cigars, booze, and MacDonald's.

The World Health Organization just released its annual report on global health. It found that the leading causes of death shifted dramatically once countries achieved middle-income status. The "killer" graf:

In low-income countries, the three most common causes of death were lack of food, unsafe sex and unsafe water. However, in middle-income countries the biggest three health risks were the same as for developed countries: alcohol, blood pressure and tobacco.

At least rock & roll wasn't on the list.

The WHO report is filled with the earnest bureaucratese that only well-meaning people with post-graduate degrees can write, but has that unrealistic feel so common to UN documents. Their press release lists various possible "interventions" to address different regional health problems. The recommendations to promote safe sex sound eminently sensible in an advanced industrialized state, but ignore the myriad cultural roadblocks that exist in the countries hardest hit by AIDS.

As for the ills of affluence:

The World Health Report 2002 urges countries to adopt policies and programs to promote population-wide interventions like reducing salt in processed foods, cutting dietary fat, encouraging exercise and higher consumption of fruits and vegetables and lowering smoking.

After 20 years of the U.S. trying to carry out this advice, the results aren't encouraging.

I don't mean to belittle the health risks posed by high cholesterol; it's merely that diseases of affluence are largely a product of individual choice, whereas the diseases of poverty by and large take place regardless of individual choice. I'd rather the WHO's focus be directed at the lattter.