The Global Burden of Disease Study (GBD) is a comprehensive regional and global research program of disease burden that assesses mortality 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, d ...

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 12,000 researchers from more than 160 countries. Under principal investigator Christopher J.L. Murray, GBD is based in the

Institute for Health Metrics and Evaluation The Institute for Health Metrics and Evaluation (IHME) is a public health research institute of the University of Washington in Seattle. Its research fields are global health statistics and impact evaluation. IHME is headed by Christopher J.L. ...

(IHME) at the

University of Washington The University of Washington (UW and informally U-Dub or U Dub) is a public research university in Seattle, Washington, United States. Founded in 1861, the University of Washington is one of the oldest universities on the West Coast of the Uni ...

and funded by the

Bill and Melinda Gates Foundation The Gates Foundation is an American private foundation founded by Bill Gates and Melinda French Gates. Based in Seattle, Washington, it was launched in 2000 and is reported to be List of wealthiest charitable foundations, the third largest char ...

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 Grant (money), grants to the governments of Least developed countries, low- and Developing country, middle-income countries for the purposes of economic development ...

–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 adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical conditions that are asso ...

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

disability-adjusted life year A disability-adjusted life year (DALY) is a measure of overall disease burden, representing a year 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 expectancy of ...

(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 list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...

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

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

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 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 ''JAMA'' (''The Journal of the American Medical Association'') 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 ...

'' 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, founded in England in 1823. It is one of the world's highest-impact academic journals and also one of the oldest medical journals still in publication. The journal publishes ...

'' in October 2020. GBD 2021 was published in ''The Lancet'' in February to May 2024, including an impact assessment of the COVID-19 pandemic as well as projections by 2050. Fact sheets are provided for all topics. The estimates are also available through an online tool and data files, for which a registration is required.

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 (Disability Adjusted Life Years). 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 Human life expectancy is a statistical measure of the estimate of the average remaining years of life at a given age. The most commonly used measure is ''life expectancy at birth'' (LEB, or in demographic notation ''e''0, where '' ...

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 statistics, statistical study of human populations: their size, composition (e.g., ethnic group, age), and how they change through the interplay of fertility (births), mortality (deaths), and migration. Demographic analy ...

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

cardiovascular diseases Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheuma ...

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. Po ...

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

diarrhoea Diarrhea (American English), also spelled diarrhoea or diarrhœa (British English), is the condition of having at least three loose, liquid, or watery bowel movements in a day. It often lasts for a few days and can result in dehydration d ...

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, coug ...

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

HIV/AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...

reduced life expectancy in southern

sub-Saharan Africa Sub-Saharan Africa is the area and regions of the continent of Africa that lie south of the Sahara. These include Central Africa, East Africa, Southern Africa, and West Africa. Geopolitically, in addition to the list of sovereign states and ...

. 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 ...

atrial fibrillation Atrial fibrillation (AF, AFib or A-fib) is an Heart arrhythmia, abnormal heart rhythm (arrhythmia) characterized by fibrillation, rapid and irregular beating of the Atrium (heart), atrial chambers of the heart. It often begins as short periods ...

and flutter, drug use disorders,

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

chronic kidney disease Chronic kidney disease (CKD) is a type of long-term kidney disease, defined by the sustained presence of abnormal kidney function and/or abnormal kidney structure. To meet criteria for CKD, the abnormalities must be present for at least three mo ...

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 (, "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. The term ...

are

rotavirus Rotaviruses are the most common cause of diarrhea, diarrhoeal disease among infants and young children. Nearly every child in the world is infected with a rotavirus at least once by the age of five. Immunity (medical), Immunity develops with ...

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

measles Measles (probably from Middle Dutch or Middle High German ''masel(e)'', meaning "blemish, blood blister") is a highly contagious, Vaccine-preventable diseases, vaccine-preventable infectious disease caused by Measles morbillivirus, measles v ...

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 are born to a woman over her lifetime, if they were to experience the exact current age-specific fertility rates (ASFRs) through their lifetime, and they were t ...

Reception

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

The New York Times ''The New York Times'' (''NYT'') is an American daily newspaper based in New York City. ''The New York Times'' covers domestic, national, and international news, and publishes opinion pieces, investigative reports, and reviews. As one of ...

'', ''

The Washington Post ''The Washington Post'', locally known as ''The'' ''Post'' and, informally, ''WaPo'' or ''WP'', is an American daily newspaper published in Washington, D.C., the national capital. It is the most widely circulated newspaper in the Washington m ...

'', Vox, and ''

The Atlantic ''The Atlantic'' is an American magazine and multi-platform publisher based in Washington, D.C. It features articles on politics, foreign affairs, business and the economy, culture and the arts, technology, and science. It was founded in 185 ...

''. 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

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)
{{Webarchive, url=https://web.archive.org/web/20130618131243/http://www.gbd.unsw.edu.au/ , date=2013-06-18 International medical and health organizations Public health research