Objective  To compare life expectancy and mortality among populations in main countries along "Belt and Road" between 2009 and 2019 for providing evidences to promote sustained health cooperation with the countries and active participation in global health governance.

  Methods  Data on life expectancy and mortality of residents in 13 major countries along the “Belt and Road” were collected from the Global Burden of Disease Study 2019 (GBD 2019). Life expectancy and mortality of infectious diseases, maternal and infant diseases, nutritional deficiencies, chronic diseases, and injury in 2009 and 2019 were compared among these countries.

  Results  The life expectancy of residents in all the 13 major countries along the “Belt and Road” in 2019 increased compared with those in 2009, with the highest increment in Myanmar (5.5 years), and the lowest in Vietnam and the Philippines (both 1.4 years). Compared with those in 2009, the age standardized mortality rate of infectious diseases, maternal and infant diseases, nutritional deficiencies, chronic diseases, and injury among residents of 13 major countries along the “Belt and Road” have decreased in 2019, and the highest decline in the age standardized mortality rate of infectious diseases, maternal and infant diseases and nutritional deficiencies was seen in Myanmar (47.1%) and the lowest decline was seen in Thailand (10.5%). The highest decline in the age standardized mortality rate of chronic diseases was in Russia (21.5%), and the lowest decline was in Indonesia (2.9%). Russia had the highest decrease (33.0%) in age standardized mortality rate for injury, and the lowest decrease was seen in Turkey (4.7%). Compared with those in 2009, among the 13 major countries along the “Belt and Road” in 2019, Iran had the highest increase in the mortality rate of residents aged 70 and older (5.5%), and Bangladesh had the highest decrease (13.4%). In 2009 and 2019, the proportion of causes of death from infectious diseases, maternal and infant diseases, and nutritional deficiencies were the lowest in Russia (4.3%) and in China (3.3%), and the highest were both in Pakistan (47.5% and 39.0%); for chronic diseases, the proportion was the lowest in Pakistan (46.8% and 55.3%), and the highest was in Turkey (88.1%) and in China (90.1%); the lowest proportion of deaths caused by injury was seen in Turkey (5.0% and 4.9%), and the highest was in Iran (14.9% and 10.5%). There were differences in the ranking of causes of death among different populations and countries. Stroke and ischemic heart disease were the leading two causes in 10 major countries along the “Belt and Road” in 2009 and 2019 except for in Egypt, India, and Pakistan.

  Conclusion  The life expectancy and mortality varied substantially for residents in 13 major countries along the “Belt and Road”. Health cooperation should be strengthened among the countries.