British and American researchers found countries in sub-Saharan Africa and Eastern Europe with the highest rates of HIV and chronic diseases like diabetes and heart disease are also failing to meet goals on reducing child death rates and the spread of tuberculosis.

Lesotho, for example, has seen a 25 percent rise in infant death rates over the past few decades and has one of the highest rates of HIV in the world, they wrote.

In 2000, world leaders from 189 countries signed up to the Millennium Development Goals to reduce child mortality by two-thirds and to halt and reverse the spread of tuberculosis, malaria and HIV by 2015.

But the researchers said tackling both chronic problems like heart disease and infectious diseases like tuberculosis at the same time could be far more effective than pursuing a narrow focus against a few diseases named in globally-agreed targets.

Reducing HIV -- the virus that causes AIDS -- by 1 percent, or chronic diseases by 10 percent could help boost progress toward child health and tuberculosis targets by the equivalent of more than a decade of economic development, they said.

It is important to look at the entire health experience of individuals and families and not focus on just one or a few diseases, said Martin McKee of the London School of Hygiene and Tropical Medicine, who worked on the study with colleagues from the universities of Oxford and California San Francisco.

Success in global health means tackling the daily, interconnected risks people living in poor countries face, whether those risks are chronic or infectious.

Tackling joint epidemics of chronic and infectious diseases could especially help countries in sub-Saharan Africa, the researchers said, where progress toward goals had been slowest.

They also said Eastern Europe was far behind on tuberculosis goals, a failure they said was partly because of an explosive and uncontained chronic disease epidemic in the 1990s.

The study found it was not simply lack of money or infrastructure that hampered health progress, but that long-term diseases like HIV, heart disease and diabetes could trap households in vicious cycles of illness and poverty.

Traditional reasons for slow progress, such as economic development or health spending, are only a small part of the story about why poorer countries are falling behind, David Suckler of Oxford University wrote in the study in the Public Library of Science (PLoS) Medicine journal.

Future progress will crucially depend on finding a way to break the cycle of illness and poverty caused by HIV and chronic illnesses.

(Editing by Janet Lawrence)

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