10 research outputs found
Ethics and science in brazilian legal discourse
The Brazilian Constitution of 1988 declares Brazil as a Democratic State of Law. This formally democratic legal status has been facing difficulties when it comes to its material implementation. Brazilian legal procedures are still greatly influenced by the catholic heritage from Portugal in the times of colonization, translated in the present times into a strong moral set of dogmas that still reflects upon the legal production and interpretation in the country. Recently in Brazil, a debate brought to the Supremo Tribunal Federal, the Brazilian Federal Supreme Court, has evidenced the struggle between Ethics and Morality in the country’s legal scenario. The focus of the discussion was the possibility of abortion of anencephalic fetuses (in Brazil, abortion in considered a crime against life). In order to properly ground its decision, the Court invited scientists, doctors, members of feminist movements and representatives of certain religions to a public dialogue, in which both scientific-technical and purely moral-religious arguments were presented. Although these procedures encouraged and promoted a democratic and pluralistic legal debate, it seems like the crucial point of the discussion were not taken into account: the scientific character of Law. This is the object of the present manuscript: in order to ensure an intersubjective construction and application of Law, this must be perceived as an Applied Social Science and judges, lawyers, legislators and all other legal actors must proceed in a scientific way. To illustrate the theme, the specific case of abortion of anencephalic fetuses will be mentioned through the text
Methods of Comparative Law: Developments in the 20th century and contemporary perspectives
Enquanto disciplina jurídica, o Direito Comparado apresenta enorme potencial teórico e prático para fazer progredir a Ciência do Direito, especialmente através de sua vocação para superar pontos de vista internos na análise de questões apresentadas por ordenamentos jurídicos ao lidar com problemas normativamente relevantes. Apesar de sua importância, ele é, por vezes, apressadamente compreendido como mera aproximação fática de casos, normas ou soluções entre ordenamentos, cujos resultados são, muito mais, um recurso a ilustrar, colorandi causa, determinado posicionamento do que a efetivamente fundamentar, com base científico-metodológica, uma argumentação. Com o intuito de apresentar criticamente as bases metodológicas do Direito Comparado, possibilitando a reflexão acerca de seu papel dentro da teoria do Direito e das ferramentas hermenêuticas que este disponibiliza ao comparatista, é que este artigo é elaborado. Para tanto, percorre-se a trajetória que vai da contestação ao dogmatismo predominante no proceder comparatista até o final do século XIX até o surgimento de metodologias pós-modernas e neofuncionalistas na contemporaneidade. Nesse contexto, merecem especial destaque o método funcionalista de Direito Comparado, bem como as críticas a ele dirigidas e a formulação de alternativas metodológicas, como a tese da dimensão cultural do Direito Comparado, de Erik Jayme, e as perspectivas contemporâneas de releitura do método funcionalista de Jaakko Husa e Ralf Michaels. Ao final, serão tecidas considerações acerca dos critérios orientadores da escolha do pesquisador pelo método mais adequado para conduzir suas investigações na área do Direito Comparado.Palavras-chave: Direito Comparado, método, funcionalismo, dimensão cultural do Direito, funcionalismo moderado.As a legal discipline, Comparative Law presents a great theoretical and practical potential to make Jurisprudence progress, particularly through its ability to overcome internal points of view in the analysis of questions presented by legal orders when dealing with normatively relevant issues. In spite of its importance, it is, at times, prematurely grasped as a mere factual approximation between cases, norms or solutions, whose results are, much more, a resource to illustrate, colorandi causa, certain positions than to actually justify, on a scientifi c-methodological basis, an argumentation. This article is elaborated with the objective of critically introducing the methodological grounds of Comparative Law, allowing for reflection upon its role within legal theory and upon the hermeneutic tools it makes available to the comparatist. For this purpose, it analyses the journey through the objection to the dogmatism present in the comparatist approach from the end of the nineteenth century until contemporary times, with the rise of post-modern and neo-functionalist theories. In this context, the functionalist method of Comparative Law, as well as the criticism of it and the formulation of methodological alternatives, such as the thesis of the cultural dimension of Comparative Law by Erik Jayme and the contemporary perspectives of reconception of the functionalist method by Jaakko Husa and Ralf Michaels, will deserve special attention. At the end, final considerations about the criteria guiding the researcher in the choice of the most adequate method to conduce her investigations will be made.Keywords: Comparative Law, method, functionalism, cultural dimension of Law, moderate functionalism
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Métodos de Direito Comparado: desenvolvimento ao longo do século XX e perspectivas contemporâneas
As a legal discipline, Comparative Law presents a great theoretical and practical potential to make Jurisprudence progress, particularly through its ability to overcome internal points of view in the analysis of questions presented by legal orders when dealing with normatively relevant issues. In spite of its importance, it is, at times, prematurely grasped as a mere factual approximation between cases, norms or solutions, whose results are, much more, a resource to illustrate, colorandi causa, certain positions than to actually justify, on a scientifi c-methodological basis, an argumentation. This article is elaborated with the objective of critically introducing the methodological grounds of Comparative Law, allowing for reflection upon its role within legal theory and upon the hermeneutic tools it makes available to the comparatist. For this purpose, it analyses the journey through the objection to the dogmatism present in the comparatist approach from the end of the nineteenth century until contemporary times, with the rise of post-modern and neo-functionalist theories. In this context, the functionalist method of Comparative Law, as well as the criticism of it and the formulation of methodological alternatives, such as the thesis of the cultural dimension of Comparative Law by Erik Jayme and the contemporary perspectives of reconception of the functionalist method by Jaakko Husa and Ralf Michaels, will deserve special attention. At the end, final considerations about the criteria guiding the researcher in the choice of the most adequate method to conduce her investigations will be made.Keywords: Comparative Law, method, functionalism, cultural dimension of Law, moderate functionalism.Enquanto disciplina jurídica, o Direito Comparado apresenta enorme potencial teórico e prático para fazer progredir a Ciência do Direito, especialmente através de sua vocação para superar pontos de vista internos na análise de questões apresentadas por ordenamentos jurídicos ao lidar com problemas normativamente relevantes. Apesar de sua importância, ele é, por vezes, apressadamente compreendido como mera aproximação fática de casos, normas ou soluções entre ordenamentos, cujos resultados são, muito mais, um recurso a ilustrar, colorandi causa, determinado posicionamento do que a efetivamente fundamentar, com base científico-metodológica, uma argumentação. Com o intuito de apresentar criticamente as bases metodológicas do Direito Comparado, possibilitando a reflexão acerca de seu papel dentro da teoria do Direito e das ferramentas hermenêuticas que este disponibiliza ao comparatista, é que este artigo é elaborado. Para tanto, percorre-se a trajetória que vai da contestação ao dogmatismo predominante no proceder comparatista até o final do século XIX até o surgimento de metodologias pós-modernas e neofuncionalistas na contemporaneidade. Nesse contexto, merecem especial destaque o método funcionalista de Direito Comparado, bem como as críticas a ele dirigidas e a formulação de alternativas metodológicas, como a tese da dimensão cultural do Direito Comparado, de Erik Jayme, e as perspectivas contemporâneas de releitura do método funcionalista de Jaakko Husa e Ralf Michaels. Ao final, serão tecidas considerações acerca dos critérios orientadores da escolha do pesquisador pelo método mais adequado para conduzir suas investigações na área do Direito Comparado.Palavras-chave: Direito Comparado, método, funcionalismo, dimensão cultural do Direito, funcionalismo moderado
The pragmatic turn
Review:Bernstein, Richard J. The Pragmatic Turn. Cambridge: Polity Press, 2012
Métodos de Direito Comparado: desenvolvimento ao longo do século XX e perspectivas contemporâneas
Os princípios jurídicos e a efetividade das sentenças da Corte Interamericana de Direitos Humanos no Brasil.
Lately, principles have received attention in the legal
system. However, both the formalization of legal practices and
procedures and their theorization have been delayed and
incomplete. Recent legal debates have attributed to the norms
the division in principles and rules by arguing that the principles
guide the legal system, defending in many cases that specific
legislation to protect such rights is unnecessary. In this line of
thought, what is not taken into consideration is that, despite
the fact that they are used to inform the legal system as a
whole, the principles, without appropriate regulation, could
grant full freedom to specific sectors of decision-makers to
take the measures that should be within the reach of all of
those to which they apply to. That is what occurs with the
judgments of the Inter-American Court of Human Rights �
(IACRH). The competence of the IACHR gave to that court
the opportunity to judge the country for actions it had committed
and that may involve disrespect for human rights, but it is up
to the country itself to determine how to implement the
sentences. However, the absence of national legislation
accordingly leaves broad discretionary power to the state, which,
on behalf of principles that consider priorities, may not apply
the sentence in its entirety or excuse such application by the
absence of appropriate domestic legislation.Nas últimas décadas, os princípios vêm recebendo
destaque no ordenamento jurídico por serem o resultado de
generalizações que reúnem e organizam conhecimentos
anteriores, permitindo, assim, a compreensão e a explicitação
correlacionada entre ciência acumulada e realidade conhecida.
Todavia, dado o caráter predominantemente aplicado do Direito,
tanto a formalização de práticas e procedimentos jurídicos como
sua teorização têm sido tardias e fragmentárias. Discussões jurídicas
mais recentes atribuíram às normas a divisão em princípios e regras.
No cerne da divisão está o entendimento de que princípios são
enunciados com alto grau de abstração, cujo conteúdo atinge todo
o ordenamento e que podem ser aplicados de diversas maneiras,
dependendo do caso concreto, e que regras têm função secundária.
No que tange à garantia dos Direitos Humanos, essa diferenciação
é especialmente relevante. Argumentando que princípios orientam
todo o ordenamento jurídico, defende-se, em muitos casos, a
desnecessidade de legislação específica para proteção de tais direitos,
como se o fato de haver princípios que versam abstratamente
sobre esse tema bastasse para assegurar sua efetivação. Esquecese
de que, por serem abstratos, os princípios, sem que sejam
devidamente regulamentados, podem também acabar conferindo
plena liberdade a setores específicos de decisões para a tomada de
medidas que deveriam estar ao alcance de todos aqueles aos quais
elas se aplicam. É o que ocorre com as sentenças da Corte
Interamericana de Direitos Humanos (CIDH). Como efetivá-las
ante a ausência de regras sobre sua aplicação? Essa lacuna legislativa
não dá segurança jurídica à garantia dos direitos especificados na
tutela concernente à CIDH. A competência da CIDH, recentemente
reconhecida pelo Brasil, atribuiu àquele órgão a possibilidade de
julgar o país por ações que tenha cometido e que podem envolver
desrespeito a Direitos Humanos, mas cabe ao próprio país
determinar o modo de aplicar as sentenças. Contudo, a ausência
de legislação nacional nesse sentido deixa ampla margem de
discricionariedade ao Estado, que pode, em nome de princípios
que considerar prioritários, deixar de aplicar a sentença na sua
inteireza ou se escusar de tal aplicação pela ausência de legislação
doméstica apropriada, ficando o tutelado à mercê da boa vontade
de governantes, sem as devidas e apropriadas garantias
OS PRINCÍPIOS JURÍDICOS E A EFETIVIDADE DAS SENTENÇAS DA CORTE INTERAMERICANA DE DIREITOS HUMANOS NO BRASIL
Nas últimas décadas, os princípios vêm recebendo destaque no ordenamento jurídico por serem o resultado de generalizações que reúnem e organizam conhecimentos anteriores, permitindo, assim, a compreensão e a explicitação correlacionada entre ciência acumulada e realidade conhecida. Todavia, dado o caráter predominantemente aplicado do Direito, tanto a formalização de práticas e procedimentos jurídicos como sua teorização têm sido tardias e fragmentárias. Discussões jurídicas mais recentes atribuíram às normas a divisão em princípios e regras. No cerne da divisão está o entendimento de que princípios são enunciados com alto grau de abstração, cujo conteúdo atinge todo o ordenamento e que podem ser aplicados de diversas maneiras, dependendo do caso concreto, e que regras têm função secundária. No que tange à garantia dos Direitos Humanos, essa diferenciação é especialmente relevante. Argumentando que princípios orientam todo o ordenamento jurídico, defende-se, em muitos casos, a desnecessidade de legislação específica para proteção de tais direitos, como se o fato de haver princípios que versam abstratamente sobre esse tema bastasse para assegurar sua efetivação. Esquecese de que, por serem abstratos, os princípios, sem que sejam devidamente regulamentados, podem também acabar conferindo plena liberdade a setores específicos de decisões para a tomada de medidas que deveriam estar ao alcance de todos aqueles aos quais elas se aplicam. É o que ocorre com as sentenças da Corte Interamericana de Direitos Humanos (CIDH). Como efetivá-las ante a ausência de regras sobre sua aplicação? Essa lacuna legislativa não dá segurança jurídica à garantia dos direitos especificados na tutela concernente à CIDH. A competência da CIDH, recentemente reconhecida pelo Brasil, atribuiu àquele órgão a possibilidade de julgar o país por ações que tenha cometido e que podem envolver desrespeito a Direitos Humanos, mas cabe ao próprio país determinar o modo de aplicar as sentenças. Contudo, a ausência de legislação nacional nesse sentido deixa ampla margem de discricionariedade ao Estado, que pode, em nome de princípios que considerar prioritários, deixar de aplicar a sentença na sua inteireza ou se escusar de tal aplicação pela ausência de legislação doméstica apropriada, ficando o tutelado à mercê da boa vontade de governantes, sem as devidas e apropriadas garantias
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
BackgroundEstimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.Methods22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.FindingsGlobal all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.InterpretationGlobal adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic