In Jordan, the WHO World Health Report (2003) indicates an adult mortality⁵⁶ rate per 1000 population of 191 for males and 121 for females (crude death rate 2.62 deaths/1,000 population and life expectancy at birth (total population) 78.06 years (2004 est.).⁵⁷ Life expectancy for males is 68.6; for females 73.3. Healthy life expectancy is 59.7 for males; 62.3 for females⁵⁸ (Table 7).

Table 7: Country death rates and life expectancy at birth (total population)

A study conducted in 1996 reported an overall crude death rate of 5/1000, which was lower in women (4.5/1000) than in men (5.5/1000). Although women have a lower death rate and a better life expectancy, it is commonly found that they have higher rates of morbidity.

Cardiovascular diseases were the leading cause of mortality (42%) followed by cancer (13%) and accidents (10.5%) .^59,60,61

Jordan has been operating a cancer registry since 1996, (the registry was set up before joining MECC). The Ministry of Health maintains a regular statistical return for cancer rates. In 2002 there were a total of 4,187 new cases of cancer registered; around 51% in men and 48% in women. Of these 82% were Jordanian and 18% were non-residents who were referred from neighbouring countries for treatment. The median age at diagnosis was 58 years. The commonest cancers in men were lung, bladder and colo-rectal.⁶² In women the commonest cancer is breast cancer. In children and young people <19 years old the commonest cancer is leukaemia .⁶³ Around 30% of cancer deaths are in patients aged >60 years old. Of the estimated total 1 7,011 deaths reported in 2004⁶⁴ an estimated 8,400 were cancer related patients who needed palliative care and pain relief using opioids.⁶⁵

Jordan has a very low prevalence of HIV/AIDS (<0.2%).⁶⁶ Estimates suggest that between 500 to 1000 people were living with HIV/AIDS at the end of 2003. In the same year, fewer than 200 adults and children are thought to have died from the disease (Table 8).⁶⁷

Table 8: Country HIV and AIDS estimates, end 2003

Source: 2004 Report of the global AIDS epidemic

UNAIDS reports:⁶⁸

In 2003 and during the first quarter of 2004, UNAIDS and WHO worked closely with national governments and research institutions to recalculate current estimates on people living with HIV/AIDS.⁶⁹ These calculations are based on the previously published estimates for 1999 and 2001 and recent trends in HIV/AIDS surveillance in various populations.^70,71A methodology developed in collaboration with an international group of experts was used to calculate the new estimates on prevalence and incidence of HIV and AIDS deaths, as well as the number of children infected through mother-to-child transmission of HIV. Different approaches were used to estimate HIV prevalence in countries with low-level, concentrated or generalised epidemics. The current estimates do not claim to be an exact count of infections. Rather, they use a methodology that has thus far proved accurate in producing estimates that give a good indication of the magnitude of the epidemic in individual countries. However, these estimates are constantly being revised as countries improve their surveillance systems and collect more information.

Assessment of the epidemiological situation 2004

There is no systematic HIV surveillance in Jordan.⁷² Available data consists mainly of compiled testing results among blood donors and foreign workers residing in Jordan. HIV seroprevalence among blood donors still remains below 0.03% in Jordan. Pregnant women have been examined intermittently, and HIV was not detected among antenatal mothers tested in 1992, 1994, and 1999. However, out of a total of 146,211 cases screened for HIV in 1996, 0.03% were seropositive.

The mode of transmission among AIDS cases reported between 1997 and 2001 was: 40% heterosexual, 3.2% men who have sex with men (MSM), 3.2% injection drug use (IDU), 38.9% via blood products (cases between 1997 and 2000), 1.1% mother to child transmission (MTCT), and 13.7% due to unknown causes.