Global Burden of Disease 2010 Council on Foreign Relations Feb. 6, 2013, Washington, D.C. Christopher JL Murray Institute Director Findings and implications

2 Global Burden of Disease A systematic scientific effort to quantify the comparative magnitude of health loss for 187 countries from 1990 to Covering 291 diseases and injuries, 1,160 sequelae of these diseases and injuries, and 67 risk factors or clusters of risk factors. 3. GBD 2010 study initiated in 2007 funded by Bill and Melinda Gates Foundation 4. Summary papers published in a dedicated triple issue of the Lancet December 15 th, 2012

3 GBD 2010 Team 486 authors from 302 institutions in 50 countries.

4 Four Key Drivers of Rapid Changes in Global Health Patterns 1) Demographic transition – increasing population size, substantial increase in the average age in most regions and falling death rates. 2) Cause of death transition – fraction of deaths or years of life lost shifting from communicable, maternal, neonatal and nutritional to non-communicable diseases and injuries despite the HIV epidemic. 3) Disability transition – steady shift to burden of disease from diseases that cause disability but not substantial mortality. 4) Risk transition – shift from risks related to poverty to behavioral risks.

Percent of DALYs from Non-Communicable Diseases in 2010: Over 60% in Nearly All Countries Outside of Sub-Saharan Africa

6 What Ails You is Not Necessarily What Kills You: Years Lived with Disability by Cause and Age, 2010

Risk Factor Transition: Global DALYs Attributable to Leading Risk Factors

Despite Progress in Sub-Saharan Africa: Health Priorities Still Dominated by MDG 4, 5, and 6 8

9 Country Results Public Launch 1) Bill Gates will launch the public access to the data visualizations at the country level on March 5 th. 2) BMGF will also announce their funding for a continuous updating of the GBD database. 3) Data visualizations will be expanded and maintained. Providing a platform for broad engagement of society in understanding their own health problems and the opportunities for change.

10 Some Policy Implications 1) Scale-up of development assistance for health appears to have been a driver for progress in reducing child mortality, large declines in HIV since 2005, large declines in malaria since 2004, declines in measles, … 2) For funders focused on the worst-off, despite progress the MDG agenda remains critical. 3) Funders/actors interested in upper low-income and middle income countries should help these countries manage health system transformation required to address rapid changes in their burden profile. 4) Rising tide of chronic disability from mental disorders, substance abuse, musculo-skeletal disorders, vision loss, hearing loss needs a more R&D and policy innovation.

11 Some More Policy Implications 1) Untapped potential to address causes of premature mortality through risk factor modification: diet, tobacco, blood pressure, alcohol. 2) Articulating health goals for the post-2015 agenda will be critical given the power of the MDGs in aiding declines in child and maternal mortality.