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Estimated preventable deaths since 1900

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A longer view — the cumulative cost of global health inequality

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The Longer View

Our main counter focuses on 1990-present — a period where we have high-quality data and all the medical solutions already exist.

For those who want to see the bigger picture, here's what the numbers look like if we go further back to 1900.

The scale is staggering — but we present this with important caveats. The pre-1990 figures are model-based estimates with significant uncertainty.

Three Eras

1900–1949
The Colonial Era
~500M

Life expectancy in colonized nations was 25–30 years, compared to 45–55 in Europe. Limited modern medicine, no antibiotics until the 1940s. Basic sanitation and public health measures were already understood but rarely deployed.

1950–1989
The Development Era
~400M

Antibiotics, vaccines, and modern medicine existed but weren't distributed globally. The life expectancy gap remained 20–30 years. Development occurred, but the benefits were uneven.

1990–2025
The Modern Era
~350M

All solutions exist. The gap is purely about deployment. This is our primary claim — the period with the highest data confidence.

See full analysis

What Was Possible

These are the life expectancies achieved by the world's best-performing countries in each era — demonstrating what was technically possible.

Era Best Country Life Expectancy vs. Developing World
1900 Sweden ~46 years +15–20 years
1950 Sweden ~72 years +30–40 years
2000 Japan ~81 years +20–25 years
2025 Japan ~85 years +15–20 years

Important Caveats

This longer view requires significant caveats. The 1990-present figure on our main page is far more defensible.

  • Pre-1950 data is model-based and less reliable. We rely on estimates from Gapminder and Riley (2005), which themselves note "very poor" data quality for many regions.
  • This is an estimate with a wide range — roughly 700 million to 1.5 billion. Our central estimate of ~1.1 billion is plausible but speculative.
  • We've excluded war deaths, specific policy famines (like China's Great Famine), and pandemics that affected all nations equally (like Spanish Flu). This is about infrastructure and healthcare gaps, not all mortality.
  • The 1990-present figure has much higher confidence. That's why it's our primary claim — the data is robust and the argument is clear.
"Could rich countries have deployed their technology globally in 1900? Probably not fully. But basic public health measures — clean water, sanitation, quarantine practices — were well understood and could have saved millions."

The strength of our argument is the 1990-present timeline — where every death is unambiguously preventable with existing technology.

See the modern era (1990-present)