The term "developing countries" encompasses widely divergent situations. Although enormous gains have been made in reducing mortality in many regions of the world, there are still a number of countries that are in the pre-transitional phase, in terms of mortality trends, which is characterised by the predominance of communicable and early-childhood - diseases and by a lack of reliable information. On the other hand, as a result of the changes mentioned, in other developing countries the situation is closer to that of the developed world, with low mortality rates, a predominance of chronic and degenerative adult diseases among the causes of death and a greater availability of information, particularly vital statistics.

For practical purposes, adult mortality is defined here as that for persons from 15 to 64 years of age, while old-age mortality, which will be dealt with in another session, is defined as that pertaining for persons aged 65 years and over. Insofar as old-age mortality and child mortality may be relevant to the points being raised, they may be taken into consideration, although with less emphasis.

More specifically, the papers to be presented at this meeting are expected to focus on one or more of the issues outlined below:

For those countries that are in a early stage of the transition in mortality trends, the sources and methods currently used to estimate levels of adult mortality by sex and age should be evaluated and consideration given to means of improving them. Other relevant issues include experiences, preferably successful ones, with surveys and non-traditional methods for determining cause of death. It would be useful to have more information on the incidence of communicable diseases that affect adults and which have proven difficult to eradicate, such as tuberculosis, malaria and other emerging diseases (e.g. HIV/AIDS) as well as certain non-communicable but avoidable phenomena which could also have a significant impact on death rates, such as maternal mortality and violence.

With respect to countries in the intermediate and advanced stages of epidemiological and demographic transition, the availability and quality of vital statistics should be examined, in order to gain a better understanding of mortality levels and trends and, to analyse changes in mortality patterns by sex, age and cause. It would be of interest to seek answers to such questions as: Are there differences between developing countries and between different social strata in terms of the pattern of decline in mortality rates? How do trends in these countries differ from those observed in the past in the industrialised countries? To what extent have communicable diseases been eradicated as a cause of death or are there still large pockets of such diseases in less developed regions or areas? How significant are the emergence of chronic diseases and the incidence of external causes?

Lastly, it would be worthwhile to have studies devoted to improving analytical methods and providing further information on changes in mortality by major cause of death; in this respect, the risk factors involved, whether immediate or contextual, are extremely important for the formulation of preventive policies and programmes. Thus, on the one hand, proposals may be put forward regarding the identification of factors hindering the eradication of diseases such as malaria, dengue or Chagas’ disease, or approaches to the problems that lead to an increase in the number of deaths by violence in urban environments. On the other hand, for lower-mortality countries which have already brought communicable diseases under control, proposals might be made for measures to be taken to cope with the challenges of emerging diseases, such as cardiovascular diseases, certain types of tumour, etc. in situations of lower relative development.