The epidemiological transition is not a ratchet and can run backwards. Wahdan: health and disease patterns evolve in diverse ways through demographic, socioeconomic, technological, cultural, environmental and biological change, making it a continuous transformation process with some diseases disappearing and others appearing or reemerging. Reversals are common and follow changes in a society's underlying dynamics. This matters for the healthcare chapter: the transition is a direction of travel maintained by conditions, not a stage a country reaches and keeps.

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a continuous transformation process, with some diseases disappearing and others appearing or reemerging.” Since the trend is not a unidirectional process, reversals often occur and are a result of changes in the underlying dynamics of a soc

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