Epidemics such as measles and poliomyelitis and the limited response by the health care system are worsening the situation. Health indicators even improved during the 1980s, the infant mortality declined from 80 per 1,000 live births in 1979 to 40 in 1989, and the under-5 mortality rate fell from 120 to 60 per 1,000 live births.21 International sanctions imposed during the 1980s and the consequent economic development rollback, however, took a toll on the health system and health outcomes. Life expectancy at birth and health-adjusted life expectancy did not improve among young people between 1990 and 2010.