Health conditions in Honduras are among the worst in the Western Hemisphere. There are an estimated 0.8 physicians and 1.1 hospital beds per 1,000 people. The Inter-American Cooperative Public Health Service, created in 1942 under the joint sponsorship of Honduras and the United States, has contributed to public health through malaria control, construction of water systems and sewage disposal plants, personnel training, and the establishment of a national tuberculosis sanatorium. US Peace Corps volunteers help train personnel for urban and rural clinics. Nearly 39% of children under five years of age were considered malnourished as of 2000. Honduras started fortifying sugar with vitamin A in 1996. As of 1999, total health care expenditure was estimated at 8.6% of GDP.
Major causes of illness and death are diseases of the digestive tract, intestinal parasites, accidents, suicides, influenza, pneumonia, cancer, and infant diseases. Malnutrition, impure water, poor sewage disposal, and inadequate housing are the major health problems. In 2000, 90% of the population had access to safe drinking water and 77% had adequate sanitation. In 1995, there were 4,717 cases of cholera, of which 77 turned fatal. In 1995, there were 1,022 malaria cases per 100,000 people. Honduras has been hard hit by AIDS. As of 1999, the number of people living with HIV/AIDS was estimated at 63,000, and deaths from AIDS that year were estimated at 4,200. HIV prevalence was 1.9 per 100 adults. Immunization rates for children up to one year old in 1997 were as follows: tuberculosis, 99%; diphtheria, pertussis, and tetanus, 94%; polio, 93%; and measles, 89%. The government pays 79% of routine immunization bills (1996). As of 2002, the birth rate was estimated at 31 per 1,000 people and the general mortality rate at 5 per 1,000 people. About 50% of married women (ages 15 to 49) were using contraception as of 2000. In 2000 the total fertility rate was 3.9 children per mother during her childbearing years. The infant mortality rate in 2000 was 35 per 1,000 live births. Life expectancy in the same year was an average of 66 years.