Global burden of disease

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The global burden of disease (GBD) is a comprehensive regional and global assessment of mortality and disability from 107 diseases and injuries and ten risk factors. The GBD is assessed using the GBD study by the World Health Organization, and is an example of an evidence-based input to public health policy debate. The aim of the study was to provide information and projections about disease burden on a global scale.

The GBD project was initiated in 1992 and is a collaborative effort between the Harvard School of Public Health, the World Health Organization (WHO) and the World Bank. The original project estimated health gaps using disability-adjusted life years (DALYs) for eight regions of the world in 1990. It is a worldwide collaboration of over 100 researchers based at the Harvard School of Public Health. It provides a standardised approach to epidemiological assessment and uses a standard unit, the disability-adjusted life year (DALY), to aid comparisons.

The GBD has three specific aims:

To systematically incorporate information on non-fatal outcomes into the assessment of 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 Disability-Adjusted Life Years, or DALYs

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.

The GBD is now in its fifth round. The series quantifies the burdens of 483 sequelae of 109 major causes of death and disability disaggregated by eight geographic regions and ten age-sex groups. Risk factors are evaluated and projections to the year 2020 are made.