Health standards have improved greatly since the 1950s, but malaria is still prevalent in areas up to 1,100 m (3,500 ft) in altitude and many Colombians suffer from intestinal parasites. Malnutrition, formerly a very serious problem, with nutritional goiter, anemia, scurvy, and pellagra frequent, had become less severe by the early 1980s, when the per capita calorie supply was estimated at 102% of requirements. As of 2000, an estimated 15% of children under five years old were considered to be malnourished. In 2000, 91% of the population had access to safe drinking water and 85% had adequate sanitation. In 1990, the government began an initiative to improve the national health system at every level. Health care provisions (doctors and beds) do not compare favorably with other countries of the region. As of 1999, total health care expenditure was estimated at 9.4% of GDP.
In 1993, Colombia departed from its older health care system to one of payment by capitation and structured competition among integrated health care service delivery systems; 5 million people in the poorest groups, previously excluded from the medical system, now have access to health services. According to a study made in 1995, 87% of the population (34 million people in 1993) had access to health care services. As of 1999, Colombia had 43,166 physicians, of which 57% are primary care physicians. There were an estimated 1.2 physicians and 1.5 hospital beds per 1,000 people.
Average life expectancy in 2000 was 72 years. The infant mortality rate decreased from 99.8 per 1,000 live births in 1960 to 20 in 2000. As of 2002, there were an estimated 22 births per 1,000, with 77% of married women (ages 15 to 49) using contraception in 2000. In 1999, children up to one year of age were immunized against the following: diphtheria, pertussis, and tetanus, 74%, and measles, 74%. Colombia's estimated death rate as of 2002 was 5.66 per 1,000 inhabitants. Between 1986 and 1992, there were approximately 22,000 civil war-related deaths. In the mid-1990s, malaria was at epidemic numbers with nearly 130,000 cases reported. In 1999, there were 51 cases of tuberculosis per 100,000 people.
As of 1999 the number of people living with HIV/AIDS was estimated at 71,000 and deaths from AIDS that year were estimated at 1,700. HIV prevalence was 0.31 per 100 adults. The disease is mostly spread by sexual activity. The first case of perinatal transmission occurred in 1987 and there have been 195 cases reported since then.