Global Burden of Disease

Question 1

What are the origins of GBD efforts?

Answer 1

Word Bank commissioned the first GBD study and featured it in the World Development Report 1993: Investing in Health
-Most comprehensive effort so far to measure the world’s health problems, provides estimates for 107 diseases and 484 sequelae (nonfatal health consequences related to a disease
-8 regions and 5 age groups with estimates through 1990
-Profound impact on health policy and agenda-setting
-GBD work institutionalized as WHO
WHO Disease Burden Unit
-Generated GBD estimates for 2000, 2001, and 2002 publishing the estimates in the annual World Health Reports
-In 2008 the WHO updated the GBD estimates for 2004
GBD 2010 (now funded by BMGF)
-Published new estimates for the complete time series from 1990 to 2010 with methods explained in Lancet in December in 2012
-Brought together a community of experts from around the world to derive estimates based on new/refined methods
-291 diseases and injuries, 67 risk factors, 1160 sequelae, 21 regions, 20 age groups and 187 countries

Question 2

Definition of a DALY

Answer 2

Disability-Adjusted Life Year: Measure of overall disease burden, expressed as number of years lost due to disability, ill-health and death

Question 3

Data Needed for DALY calculation

Answer 3

Cause of death patterns by age and gender
To calculate time lived with disability need
-age and gender specific information on the incidence of disease
-The proportion of disease incidence leading to a disabling outcome
-the average age of disability onset, the duration of disability
-the distribution of disability across the six disability classes

Question 4

Benefits of GBD Data

Answer 4

• Help decision-makers obtain a more objective overall assessment of the magnitude of difference diseases, injuries, and risk factors
• Enhance informed debate on the social values that influence resource allocation in health systems
• Identify health problems that may be neglected
• Point to strengths and weaknesses of the existing HIS

Question 5

Leading Causes of Death in 2010

Answer 5

1: Ischemic Heart Disease
2: Cerebrovascular disease
3: COPD
4: Lower respiratory infections
5: Lung cancer
6: HIV/AIDS
7: Diarrheal diseases
8: Road injury
9: Diabetes mellitus
10: Tuberculosis
11: Malaria
12: Cirrhosis