Sir: The inhabitants of the upper and lower regions of Sindh are reportedly dying at a much younger age than previously and in greater numbers than before. The outbreak of lethal diseases, coupled with socioeconomic factors such as a sense of insecurity, lawlessness, inflation, pollution, contaminated water, fake medicines, etc, are to blame, says one health expert from Larkana. Average life expectancy declined from 60 years in 1990 to 50 years in 2008; it has fallen now to 48 years for men and 50 for women. The districts in the northern region of Sindh, including Larkana, Sukkur, Shikarpur, Kambar-Shahdad Kot, Jacobabad, Kashmore-Kandh Kot and Ghotki are showing a steep decline in life expectancy. The leading causes of death are tuberculosis, influenza and pneumonia, as well as common infections associated with HIV/AIDS in these districts. Unfortunately, our callous rulers are doing nothing to improve the living standards of the people and enhance the life expectancy in the province. Healthcare has, for long, been a peripheral issue for different governments, largely because health relief does not have a glossy appearance, such as transport systems, which can cause an increase in the vote bank. Hashim Abro Islamabad