Global Burden of Disease

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Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD) Study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY). This article describes key features of the Global Burden of Disease analytic approach, the evolution of the GBD starting from the first study for the year 1990, and summarizes the methodological improvements incorporated into GBD revisions carried out by the World Health Organization. It also reviews controversies and criticisms, and examines priorities and issues for future GBD updates.

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Colin Mathers is Coordinator of the Country Health Information Unit in the Information, Evidence, and Research Cluster at the World Health Organization (WHO) in Geneva, Switzerland. From 2002 to 2005, he managed the WHO's Epidemiology and Burden of Disease Unit. Prior to joining the World Health Organization in 2000, he worked for the Australian Institute of Health and Welfare for 13 years in technical and senior managerial posts. He has published widely on population health and mortality analysis, on inequalities in health, health expectancies, and burden of disease, and on health system costs and performance. He developed the first set of Australian health accounts mapping health expenditures by age, sex, and disease and injury causes (1998) and carried out an influential national burden of disease and risk factors study (1999). He subsequently played a key role at the WHO in the development of comparable estimates of healthy life expectancy for 192 countries, in the reassessment of the Global Burden of Disease Study for the years 2000 and following, and in the development of software tools to support burden of disease analysis at the country level.

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