Over recent years, without much media fanfare, something fascinating occurred, a reminder that for all the ways in which we seem to be sliding backward, we’re lurching forward, too.
The developing world turned a corner — thanks to medical advances, rising wealth and more — and communicable diseases like malaria and AIDS now kill fewer of its people than noncommunicable ones like heart disease, strokes, respiratory ailments and diabetes do.
But awareness of this progress lags far behind it. According to the Institute for Health Metrics and Evaluation, noncommunicable diseases were responsible for 67 percent of deaths in low- and middle-income countries in 2015, but only about 1 percent of the foreign aid and donations dedicated to health care was aimed at preventing and treating them.
That discrepancy is showcased in an open letter that Mike Bloomberg publishes every year to explain the direction of Bloomberg Philanthropies, which gives away hundreds of millions of dollars annually, much of it to promote health.
He provided me with an advance copy and sat down with me to underscore its plea that nonprofits and governments work harder to fight noncommunicable diseases.
Viewed one way, he’s trying to globalize priorities from his time as mayor of New York, where he waged wars against smoking and trans fats and coaxed people to eat smarter and exercise more.
‘‘In 12 years in City Hall, life expectancy increased by three years,’’ he said, referring to New York during his mayoralty, which ended in 2013. As he spoke, he nibbled from several bowls of snacks — blackberries, grapes, carrots — arrayed colorfully before us like props in a movie devoted to an obvious theme.
I asked him if his public crusades had made him a private health nut.
Yes and no, he said, copping to too much bread and conceding that he means to exercise daily but often manages only four times a week. He hasn’t smoked in many decades, though.
‘‘A friend of mine once said the way to stop smoking is to close your eyes, think about the person you dislike the most,’’ Bloomberg, 75, told me. ‘‘Now, do you want to be at their funeral or you want them to be at yours?’’
He was making a point about how difficult it can be for people to change their behaviors. It’s also one reason those diseases don’t always generate the concern that something like Zika or Ebola does. They’re regarded as the sufferer’s fault.
There are other reasons, too. A communicable disease can spread fast and far and kill indiscriminate of age.
But heart disease, respiratory ailments and diabetes — all among the world’s top 10 causes of death — also end the lives of many people still in their prime. And they’re often abetted by environmental factors within government’s influence.
We’ve used taxes to lessen the appeal of cigarettes and can take a similar approach with sugary beverages. We can construct parks and bike lanes.
We can clean the air. We can improve road safety; traffic injuries were the 10th leading cause of death globally in 2015, according to the World Health Organization.
Bloomberg is advocating all of this in a new role as the WHO’s global ambassador for noncommunicable diseases. And his charitable organization’s Partnership for Healthy Cities provides money and other support to local governments around the world that implement policies to prevent noncommunicable diseases, road injuries or both. A decade ago, his organization funded two programs along these lines; now it funds nine. He has committed more than $800 million over the next six years to these efforts.
He noted that while many countries have cut smoking rates, none has made significant inroads against obesity, maybe because people don’t deem someone else’s extreme overweightness to be a concern of theirs, the way secondhand smoke is.
‘‘You have 80 percent that want you to stop smoking,’’ he said. ‘‘Zero percent want you to stop being obese.’’ People need to understand better the wages of obesity, but such education isn’t easy.
‘‘What percentage of the public would know the name of the vice president of the United States?’’ he said, noting that many Americans don’t. ‘‘It’s hard to get a message out.’’
Bloomberg, an independent who opposed Donald Trump, said that Democrats never found the right message. ‘‘Hillary said, ‘Vote for me because I’m a woman and the other guy’s bad,’’’ he said.
They’re still searching for the right issues and words, he said, and too many have visions of 2020 dancing in their heads.
‘‘They’ll step on each other and re-elect Donald Trump,’’ he told me, estimating ‘‘a 55 percent chance he gets re-elected.’’
Fifty-five percent? Whether good for my longevity or not, I need a cookie.
Frank Bruni writes for The New York Times.