The Global Burden of Disease Study (GBD) is a comprehensive regional and global research program of

disease burden Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity, or other indicators. It is often quantified in terms of quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Bot ...

that assesses

mortality Mortality is the state of being mortal, or susceptible to death; the opposite of immortality. Mortality may also refer to: * Fish mortality, a parameter used in fisheries population dynamics to account for the loss of fish in a fish stock throug ...

and

disability Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be Cognitive disability, cognitive, Developmental disability, dev ...

from major diseases, injuries, and

risk factor In epidemiology, a risk factor or determinant is a variable associated with an increased risk of disease or infection. Due to a lack of harmonization across disciplines, determinant, in its more widely accepted scientific meaning, is often use ...

s. GBD is a collaboration of over 3600 researchers from 145 countries. Under principal investigator Christopher J.L. Murray, GBD is based out of the

Institute for Health Metrics and Evaluation The Institute for Health Metrics and Evaluation (IHME) is a research institute working in the area of global health statistics and impact evaluation at the University of Washington in Seattle. The Institute is headed by Christopher J.L. Murray ...

(IHME) at the

University of Washington The University of Washington (UW, simply Washington, or informally U-Dub) is a public research university in Seattle, Washington. Founded in 1861, Washington is one of the oldest universities on the West Coast; it was established in Seattle a ...

and funded by the

Bill and Melinda Gates Foundation The Bill & Melinda Gates Foundation (BMGF), a merging of the William H. Gates Foundation and the Gates Learning Foundation, is an American private foundation founded by Bill Gates and Melinda French Gates. Based in Seattle, Washington, it was ...

History

The Global Burden of Disease Study began in 1990 as a single

World Bank The World Bank is an international financial institution that provides loans and grants to the governments of low- and middle-income countries for the purpose of pursuing capital projects. The World Bank is the collective name for the Interna ...

-commissioned study that quantified the health effects of more than 100 diseases and injuries for eight regions of the world, giving estimates of

morbidity A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...

and

by age, sex, and region. It also introduced the

disability-adjusted life year The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life ex ...

(DALY) as a new metric to quantify the burden of diseases, injuries, and

s, to aid comparisons. GBD 1990 was "institutionalized" at the

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

(WHO) and the research was "conducted mainly by researchers at

Harvard Harvard University is a private Ivy League research university in Cambridge, Massachusetts. Founded in 1636 as Harvard College and named for its first benefactor, the Puritan clergyman John Harvard, it is the oldest institution of higher le ...

and WHO". In 2000–2002, the 1990 study was updated by WHO to include a more extensive analysis using a framework known as ''comparative risk factor assessment''. The WHO estimates were again updated for 2004 in ''The global burden of disease: 2004 update'' (published in 2008) and in ''Global health risks'' (published in 2009). Official DALY estimates had not been updated by WHO since 2004Global Burden of Disease (GBD)
at WHO, 2012 until the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), also known as the Global Burden of Disease Study 2010, was published in December 2012. The work quantified the burdens of 291 major causes of death and disability and 67 risk factors disaggregated by 21 geographic regions and various age–sex groups. GBD 2010 had the Institute for Health Metrics and Evaluation as its coordinating center, but was a collaboration between several institutions including WHO and the

Harvard School of Public Health The Harvard T.H. Chan School of Public Health is the public health school of Harvard University, located in the Longwood Medical Area of Boston, Massachusetts. The school grew out of the Harvard-MIT School for Health Officers, the nation's first ...

. The work was funded by the Gates Foundation. The GBD 2010 estimates contributed to WHO's own estimates published in 2013, although WHO did not acknowledge the GBD 2010 estimates. The Global Burden of Disease Study 2013 (GBD 2013) was published in 2014. The first installment, "Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980–2012", was published in the ''

Journal of the American Medical Association ''The Journal of the American Medical Association'' (''JAMA'') is a peer-reviewed medical journal published 48 times a year by the American Medical Association. It publishes original research, reviews, and editorials covering all aspects of bio ...

'' in January, and further installments were published throughout the year. IHME continued to act as the coordinating center for the work. The Global Burden of Disease Study 2017 (GBD 2017) was published in October 2018. The work was still coordinated at IHME. The life of Christopher Murray and the Global Burden of Disease Study is told in ''Epic Measures: One Doctor. Seven Billion Patients'' by Jeremey N. Smith. GBD 2019 was published in ''

The Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823. The journal publishes original research articles, ...

'' in October 2020.

Growth

The following table summarizes GBD's growth over the years.

Aims

The GBD has three specific aims: # To systematically incorporate information on non-fatal outcomes into the assessment of the health status (using a time-based measure of healthy years of life lost due either to premature mortality or to years lived with a disability, weighted by the severity of that disability) # To ensure that all estimates and projections were derived on the basis of objective epidemiological and demographic methods, which were not influenced by advocates. # To measure the burden of disease using a metric that could also be used to assess the cost-effectiveness of interventions. The metric chosen was the DALY. The burden of disease can be viewed as the gap between current health status and an ideal situation in which everyone lives into old age free of disease and disability. Causes of the gap are premature mortality, disability and exposure to certain risk factors that contribute to illness.

Results

The 2013 report showed that global

life expectancy Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, current age, and other demographic factors like sex. The most commonly used measure is life expectancy at birth ...

for both sexes increased from 65.3 years in 1990, to 71.5 years in 2013, while the number of deaths increased from 47.5 million to 54.9 million over the same interval. Progress varied widely across

demographic Demography () is the statistical study of populations, especially human beings. Demographic analysis examines and measures the dimensions and dynamics of populations; it can cover whole societies or groups defined by criteria such as edu ...

and national groups. Reductions in age-standardised death rates for

cardiovascular diseases Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, ...

and

cancers Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Poss ...

in high-income regions, and reductions in child deaths from

diarrhoea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin wi ...

lower respiratory infections Lower respiratory tract infection (LRTI) is a term often used as a synonym for pneumonia but can also be applied to other types of infection including lung abscess and acute bronchitis. Symptoms include shortness of breath, weakness, fever, cough ...

and neonatal causes in low-income regions drove the changes.

HIV/AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...

reduced life expectancy in southern

sub-Saharan Africa Sub-Saharan Africa is, geographically, the area and regions of the continent of Africa that lies south of the Sahara. These include West Africa, East Africa, Central Africa, and Southern Africa. Geopolitically, in addition to the List of sov ...

. For most communicable causes of death both numbers of deaths and age-standardised death rates fell, while for most non-communicable causes, demographic shifts increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100,000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS,

pancreatic cancer Pancreatic cancer arises when cell (biology), cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a Neoplasm, mass. These cancerous cells have the malignant, ability to invade other parts of t ...

, atrial fibrillation and flutter, drug use disorders,

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...

chronic kidney disease Chronic kidney disease (CKD) is a type of kidney disease in which a gradual loss of kidney function occurs over a period of months to years. Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, vo ...

and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes and malaria remain in the top five causes of death in children younger than 5 years. The most important

pathogens In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...

are

rotavirus ''Rotavirus'' is a genus of double-stranded RNA viruses in the family ''Reoviridae''. Rotaviruses are the most common cause of diarrhoeal disease among infants and young children. Nearly every child in the world is infected with a rotavirus a ...

for diarrhoea and

pneumococcus ''Streptococcus pneumoniae'', or pneumococcus, is a Gram-positive, spherical bacteria, alpha-hemolytic (under aerobic conditions) or beta-hemolytic (under anaerobic conditions), aerotolerant anaerobic member of the genus Streptococcus. They are ...

for lower respiratory infections. GBD 2015 found that for the first time, annual deaths from

measles Measles is a highly contagious infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than , cough, ...

had fallen below 100,000 in 2013 and 2015. It also found that the global annual rate of new HIV infections has largely stayed the same during the past 10 years. GBD 2015 also introduced the Socio-demographic Index (SDI) as a measure of a location's socio-demographic development that takes into account average income per person, educational attainment, and

total fertility rate The total fertility rate (TFR) of a population is the average number of children that would be born to a woman over her lifetime if: # she were to experience the exact current age-specific fertility rates (ASFRs) through her lifetime # she were t ...

Reception

The results of the Global Burden of Disease Study have been cited by ''

The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid ...

'', ''

The Washington Post ''The Washington Post'' (also known as the ''Post'' and, informally, ''WaPo'') is an American daily newspaper published in Washington, D.C. It is the most widely circulated newspaper within the Washington metropolitan area and has a large nati ...

'', Vox, and ''

The Atlantic ''The Atlantic'' is an American magazine and multi-platform publisher. It features articles in the fields of politics, foreign affairs, business and the economy, culture and the arts, technology, and science. It was founded in 1857 in Boston, ...

''. The World Health Organization did not acknowledge the GBD 2010 estimates.

Publications

The following is a table of GBD publications . "GBD 2010" proper means the paper was published as part of the original triple issue in ''

''.

References

{{reflist, 30em

External links

GBD project page on the IHME website

Global Burden of Disease Study page on ''The Lancet'' website

Global burden of disease at WHO website

GBD Publications from Harvard School of Public Health

Global Burden of Disease Mental Disorders and Illicit Drug Use Expert Group at National Drug and Alcohol Research Centre (University of New South Wales, Australia)
International medical and health organizations Public health research