The use of Western medicine has improved health generally and reduced the incidence of malaria and smallpox specifically, but high infant mortality and a variety of health problems remain. Most urban areas, including Vientiane, lack pure water and sanitary disposal systems. In 2000, 90% of the population had access to safe drinking water and 46% had adequate sanitation. In parts of Laos, malaria—the most serious health threat—is known to affect the majority of children. In 1995, there were 1,365 new cases of cholera. Other health problems are acute upper respiratory infections (including pneumonia and influenza), diarrhea and dysentery, parasites, yaws, skin ailments, various childhood diseases, hepatitis, venereal disease, and tuberculosis. Common diseases in recent years have been malaria (41,787 cases in 1993), measles (3,174 cases in 1995), and leprosy (967 cases in 1995). In 1999, there were 171 reported cases of tuberculosis per 100,000 inhabitants. In the mid-1990s, a UNICEF survey found iodine deficiencies and goiter to be common problems in rural areas of Laos. Programs to increase iodine levels via salt intake were being instituted. An estimated 25% of school-age children were reported to have goiter. Children up to one year of age were vaccinated in 1990–94 against tuberculosis, 69%; diphtheria, pertussis, and tetanus, 48%; polio, 57%; and measles, 73%. Vaccination rates in 1999 were 56% for DPT and 71% for measles. The prevalence of underweight children in 1995 was 44%, greater than the average of developing countries in South East Asia.
As of 1999, there were an estimated 0.2 physicians and 2.6 hospital beds per 1,000 people. As of 1999 total health care expenditure was estimated at 2.5% of GDP. Average life expectancy in 2000 was estimated at 54 years for men and women; infant mortality was estimated at 92 per 1,000 live births. The total fertility rate has remained nearly constant over the last years. The fertility rate in 2000 was five children per woman during her childbearing years. The overall mortality rate in 2002 was estimated at 12.7 per 1,000 people; the maternal mortality rate in 1998 was 650 per 100,000 live births.