Like Keating at FP, I am unwilling to make any causal claims linking dictatorship to disease or vice versa but suffice it to say that most people who live under dictatorships – in Chad, Zimbabwe, Myanmar, North Korea, etc – do live despite great odds occasioned by their respective governments’ incompetence and runaway lack of accountability.
It is not obvious that democracy necessarily leads to good outcomes. In this regard I agree with Huntington that it is not the type of government that matters but the degree of government. China and Rwanda, for instance, are competent autocracies with high degrees of government. They also register much better outcomes than many nominal democracies out there
(Just for the record, this is not to say that we should not promote democracy. Despite the sobering reality of this world, I believe that everyone should do all in their capacity to help disperse power whenever they see it being concentrated in one individual or institution — paraphrasing my officemate Tomer).