Infectious diseases cause 48 percent of deaths worldwide of people under the age of 45, and as such are a huge impediment to economic development in poor countries. Surprisingly, most of the infections can be easily treated or prevented.

Those are the main conclusions of a report produced by the World Health Organization (WHO) and released here yesterday.

Reducing the burden of infectious diseases will require two things -- more money from wealthy countries, and more willingness by poor ones to use the money wisely.

"What's most disturbing is that the governments [of many developing nations] are not committing to interventions known to be effective today," said David Heymann, the head of communicable disease programs at WHO, who discussed the report at a news conference.

The organization, based in Geneva, has released many previous reports on the state of the world's health. This is the first to sketch the global economic consequences of infections and to propose specific solutions. It's part of an effort by Gro Harlem Brundtland, the former prime minister of Norway who became WHO's director general a year ago, to focus and delineate the organization's priorities.

Six illnesses cause about 90 percent of infectious disease deaths. Respiratory infections (mostly bacterial pneumonia and influenza) kill about 3.5 million people a year, followed by AIDS (2.3 million), various diarrheal infections (2.2 million), tuberculosis (1.5 million), malaria (1.1 million) and measles (900,000).

There are a number of reasons for this high mortality, according to the report.

Twenty percent of children are not fully immunized against measles and five other major childhood infections. Only one-half of WHO's 191 member states follow the organization's recommendations to treat tuberculosis with a specific combination of drugs for at least six months, and to have a health care worker observe the patient take the medicines every day. Consequently, drug-resistant TB -- which is vastly more expensive to treat -- is becoming more common.

Only 63 of 120 developing nations use a system called "integrated management of childhood illnesses," in which non-physicians are taught to diagnose and treat common illnesses (such as malaria, diarrhea or pneumonia) by recognizing a few cardinal symptoms.

About one-quarter of childhood malaria deaths could be prevented if children in affected areas slept under mosquito netting that had been treated with insecticide. The bed nets and a year's supply of insecticide cost about $11, "less than one hour's parking in New York, Paris or Tokyo," the report noted.

Although AIDS is incurable and "triple therapy" with antiviral drugs is beyond the financial reach of poor countries, the burden of AIDS can still be lessened, the report said. Aggressive and correct treatment of venereal diseases, AIDS education in schools (endorsed by only half of WHO's member countries) and free distribution of condoms will help decrease the spread of the virus.

The report noted that less than 10 percent of foreign aid and charitable donations to developing countries is used for health-related purposes. The money earmarked for treating or preventing infectious diseases is "a neglected concern within this neglected sector."

The Global Health Council, a Washington-based organization that lobbies on international health issues, released at the news conference yesterday the results of a telephone survey of 1,200 Americans. It found that, by a ratio of five to one, people support increased spending by the United States to combat infectious diseases worldwide.

Dying Young

Here are the main causes of premature death worldwide for people age 0 to 44.

Infectious diseases 48%

Injuries 19%

Noncommunicable conditions 18%

Birth complications (child) 10%

Birth complications (mother) 3%

Malnutrition 2%

SOURCE: World Health Organization