Recent shifts in infectious-disease mortality across BRICS, 1990-2023: a GBD 2023 analysis.

OBJECTIVES: BRICS countries carry a substantial infectious-disease burden, but evidence spanning the pandemic and early post-pandemic period remains limited. METHODS: Data were obtained from the Global Burden of Disease 2023 Results Tool. Infectious diseases were classified into five categories: HIV/AIDS and sexually transmitted infections (HIV/STIs); respiratory infections and tuberculosis (RITB); enteric infections; neglected tropical diseases and malaria (NTDs/malaria); and other infectious diseases. Deaths, age-standardized mortality rates, and age-specific mortality rates were analysed for BRICS countries from 1990 to 2023. Temporal trends were quantified using the estimated annual percentage change. RESULTS: Infectious-disease deaths in BRICS declined from 5.014 million in 1990 to 2.574 million in 2023, and the BRICS share of global infectious-disease deaths decreased from 40% to 31%. Patterns differed by disease and country. HIV/AIDS and sexually transmitted infection deaths increased by 564.65%, with adverse age-standardized trends in South Africa, Russia, China, and India. Respiratory infections and tuberculosis increased in Brazil, Russia, and South Africa, whereas China and India maintained long-term declines. Enteric infections decreased in all five countries. Except for HIV/AIDS and sexually transmitted infections, mortality became increasingly concentrated at older ages by 2023. CONCLUSION: BRICS achieved major reductions in infectious-disease mortality, but progress was uneven. Post-pandemic control should prioritize HIV-related mortality, respiratory infection and tuberculosis recovery, and age-sensitive prevention.