Life expectancy
In Ethiopian the average life expectancy will increase from 66.0 years (64.0-68.5) in 2017 to 73.8 years (70.3-77.3) in 2040. Average life expectancy for males increases from 65.4 years (62.3-68.4) in 2017 to 72.2 years (68.1-76.3) in 2040 and for female from 67.2 (64.3-69.9) in 2017 to 75.5 years (71.6-79) in 2040 (Figure 1).
Crude death rates and percentage changes
Crude death rates for broad groups of causes and the crude all-cause mortality rate are presented in Table 1. In 2017, Communicable, Maternal, Neonatal and Nutritional Diseases (CMNND) accounted for 47.9% (95% UI 43.2–53.4), NCDs accounted for 43.6% (95% UI:38.6–47.9) and injuries accounted for 8.5% (95% UI:7.4–9.8) of the total 686,800 deaths. In 2040, deaths due to NCDs accounts for 60.8% (95% UI:53.3–66.7), CMMND causes accounts for 28.1% (95% UI 22.2–36.0) and injuries accounts for 11.0% (95% UI:9.17%–13.2) of 784,400 deaths.
In 2017, 311.7 deaths per 100,000 were due to CMMNN disease while 283.1 deaths per 100,000 were due to NCDs, and 55.5 deaths per 100,000 were due to injuries. In 2040, non-communicable disease accounted 277.9 deaths per 100,000, 129.6 deaths per 100,000 were due to CMNN disease and injuries accounted 50.4 deaths per 100,000.
All-cause death will decline by 30%; from 650.3 death per 100,000 in 2017 to 457.9 deaths per 100,000 in 2040. The transition from high CMNN disease burden to high NCDs burden occurs in 2020. From 2038, deaths due to NCDs will be two times higher than CMNN disease. Mortality due to CMNN causes will show a 58.4% significant decline, while NCDs have a 1.8% decline and injuries a 9% decline between 2017 and 2040.
In 2017, diarrhea, lower respiratory infections and other common infectious disease collectively caused 149.0 (95% UI; 104.0-205.0) deaths per 100,000 people. HIV/AIDs and tuberculosis collectively caused 60.1 (95% UI; (48.3-73.4) deaths per 100,000 people. Neonatal disorders caused 57.9 (95% UI; 45.0-75) deaths per 100,000 people (Table 1). Cardiovascular diseases and neoplasms caused 118.6 (95% UI; 93.1-145.8), 63.1(95% UI; 50.3-75.8) per 100,000 people respectively and diabetes caused 27.8 (95% UI; 21.7-37.6) per 100,000 people. Transport injury, unintentional injuries, self-harm and interpersonal violence causes 29.3 (95% UI; 21.5-39.9), 31 (95% UI; 26.6-36) and 25.8 (95% UI; 18.2-36.9) deaths per 100,000 people respectively. Between 2017 and 2040, diarrhea, lower respiratory infections and other common infectious disease causes collectively decline by 47%, HIV/AIDS and tuberculosis collectively decline by 56%, neonatal disorder causes decrease by 80% while cardiovascular disease fall only 15%, unintentional injuries 28% and self-harm and interpersonal violence decrease 6%. Whereas mortality due to neoplasm and diabetes causes increase by 22% and 14% respectively and transport injury increased by 21%, between 2017 and 2040.
Age-standardized death rates and the Epidemiologic transition
The CMNNDs were leading causes of age-standardized death rate since 1990, whereas non-communicable disease become leading causes of age-standardized death rate after 2007 through 2040 (Table 2). The epidemiologic transition from CMNNDs to NCDs and the burden of injuries in terms of age-standardized death rates for both sexes and all age groups, has shown in Figure 3. Overall, total mortality and age-standardized death rates for each of the broad groups of causes decreases between 2017 and 2040. In 2040, the all-cause age-standardized death rate is 854 (95% UI; 635.3-1168.7) per 100,000 people of which NCDs caused 567.1 (95% UI; 429.4-753.3) and CMNNDs caused 211.2 (95% UI; 132.8-331.9) of the deaths. NCDs and injuries show a smaller reduction of 26% and 23% respectively between 2017 and 2040 compared to the 53% decrease for CMNNDs (Table 2).
Diarrheal, lower respiratory infections, and other common infectious diseases combined caused 144.5 (95% UI; 72.4-253.2) age-standardized deaths per 100,000 populations in 2040. The combined age-standardized death rate for HIV/AIDs and tuberculosis is 35.2 (95% UI:22.2-53.5) deaths per 100,000 people (Table 2). Cardiovascular and neoplasm causes 224.7 (95% UI: 149.2-328.4), 137.8 (95% UI: 103.2-177.1) deaths per 100,000 people respectively. Transport and unintentional injuries causes 22.5 (95% UI: 16.3-30.8) and 34 (95% UI: 27.3-42.5) deaths per 100,000 people, respectively.
Between 2017 and 2040, except diarrheal, lower respiratory infections, and other common infectious diseases which decline by 42%, all CMNND level two categories of causes of death showed a 57% and above decline. The age-standardized death rates from cardiovascular diseases and neoplasms will have a 37% and 8% reduction, respectively, between 2017 and 2040. Age-standardized death rates due to unintentional injuries will also decline by 33% and due to transport injuries by 2% (Table 2).
The top 20 leading causes of deaths accounts for 72% of the total age-standardized deaths in 2040. Twelve of the 20 leading causes were NCDs and six of them were in the top 10 leading causes. The top five leading cause in 2040 are ischemic heart disease, lower respiratory infections, diarrheal disease, stroke and diabetes 96 (95% UI:47.3-167.6), 71.1 (95% UI:42.6-110.4), 57.5 (95% UI:12.1-148.1), 56.8 (95% UI:34.6-95, 39.9 (95% UI:23-69.8) deaths per 100,000 people, respectively (Table 2).
Transition in disease burden in the age-standardized death rate per 100,000 for the top 30 leading causes of death between 2017 and 2040 is shown in Figure 5. Significantly larger reductions, 50% and more occurs for diarrheal disease (50%), tuberculosis (76%), Meningitis (52%), protein-energy malnutrition (69%). Lower respiratory infection (28%) and HIV/AIDs (35%) also show declining. NCDs in the top 10 leading category show reductions; ischemic heart disease by 39%, stroke by 46%, diabetes by 3%, whereas prostate cancer increases by 18%.
Crude YLL rates and percentage changes
In 2040, the all-cause crude YLL rate was 14223.2 per 100,000 people (95% UI: 11000.3-18499.7) of which CMNNDs caused 28.1% (5524.9 per 100,000 people (95% UI: 3754-7866.6), NCDs caused 60.8% (6725.8
(95% UI: 5231.6-8461.8) per 100,000 people, injuries caused 11% (1972.5 per 100,000 people (95% UI: 1479.2-2568.1) (Table 3). The crude YLL per 100,000 people showed 70% reductions for CMNNDs, 12% and 23%, for NCD and injuries respectively. All CMNNDs level two causes showed 55 to 85% reduction in crude YLL rates. Cardiovascular disease and diabetes causes declines by 21 and 5%, respectively, while neoplasm increased by 12%, mental and substance use disorder by 17% and neurological disorders increases by 2% between 2017 and 2040. Unintentional injuries declines by 47%, however transport injury increased by 11% in the same period.
Age-standardized YLL rates and disease burden transitions
In 2040, the all-cause age-standardized YLL rate was 19023.2 (95% UI: 14223.8-25077.7), of which CMNNDs caused 6496.1 per 100,000 people (95% UI: 4322.6-9529.3), NCDs caused 10332.3 per 100,000 (95% UI: 7695-13683) and Injuries caused 2194.7 per 100,000 people (95% UI: 1647.3-2836.8) (Table 4). The age-standardize YLL percentage contribution of CMNNDs declined from 62.4% in 1990, 45% in 2018 and 34% in 2040, whereas NCDs contribution increased from 25.2% in 1990, 46% in 2019 and 54% in 2040 (Figure 4). NCDs are the leading causes of age-standardized YLL rates between 2019 and 2040, as indicated in Figure 6). The top 20 leading causes accounted 64% of the total age-standardized YLL rate in 2040 (Figure 5). In 2040, 10 of the 20 leading causes were NCDs. The top five leading causes were lower respiratory infections, Ischemic heart disease, diarrheal diseases, stroke, and road injuries causing 1665.6(95% UI: 921.9-2634.2), 1493.6(95% UI: 788-2482.6), 1211.5(95% UI: 334.3-2912.7), 951.3(95% UI: 560.8-1650.6), and 742.9(95% UI: 525-1032.7) per 100,000 people, respectively.