The last two decades of the 20th century recorded a slowdown in the pace of progress of life expectancy at birth in most developing and transitional regions. The paper explores the causes of such trend on the basis of existing mortality theories. The results obtained through an eclectic econometric model confirm the negative impact of the 1980–2000 trends in the main determinants of health, such as rising inequality and volatility, declining health expenditure, lower vaccination coverage, slowly improving female literacy and so on. Finally, the paper simulates the level of LEB that would have been achieved in 10 regions of the world if the above determinants of health had continued developing over 1980–2000 as they did over 1960–1980. The results indicate that in seven of such regions (including China and India) in 2000 LEB would have been higher than actually observed. In this regard, the paper raises some doubts about the way globalisation has taken place and the way public policy oriented it. Copyright © 2009 John Wiley & Sons, Ltd.