Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

GBD 2016 DALYs and HALE Collaborators

Abstract

Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI).

Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate.

Findings: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally.

Interpretation: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support.

Funding: Bill & Melinda Gates Foundation.

Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Figures

Figure 1
Figure 1
Trends of total DALYs (A) and age-standardised DALY rates (B) from 1990 to 2016 for GBD Level 1 cause groups by SDI quintile Shaded areas show 95% uncertainty intervals. DALYs=disability-adjusted life-years. GBD=Global Burden of Disease. SDI=Socio-demographic Index.
Figure 2
Figure 2
Leading 30 Level 3 causes of total DALYs for 1990, 2006, and 2016, with percentage change in number of DALYs and all-age and age-standardised DALY rates, overall and by SDI quintile Overall (A). Low SDI (B). Low-middle SDI (C). Middle SDI (D). High-middle SDI (E). High SDI (F). Causes are connected by lines between time periods; solid lines are increases and dashed lines are decreases. For the time period of 1990–2006 and 2006–16, three measures of change are shown: percentage change in the number of DALYs, percentage change in the all-age DALY rate, and percentage change in the age-standardised DALY rate. Statistically significant changes are shown in bold. COPD=chronic obstructive pulmonary disease. DALYs=disability-adjusted life-years. STDs=sexually transmitted diseases.
Figure 2
Figure 2
Leading 30 Level 3 causes of total DALYs for 1990, 2006, and 2016, with percentage change in number of DALYs and all-age and age-standardised DALY rates, overall and by SDI quintile Overall (A). Low SDI (B). Low-middle SDI (C). Middle SDI (D). High-middle SDI (E). High SDI (F). Causes are connected by lines between time periods; solid lines are increases and dashed lines are decreases. For the time period of 1990–2006 and 2006–16, three measures of change are shown: percentage change in the number of DALYs, percentage change in the all-age DALY rate, and percentage change in the age-standardised DALY rate. Statistically significant changes are shown in bold. COPD=chronic obstructive pulmonary disease. DALYs=disability-adjusted life-years. STDs=sexually transmitted diseases.
Figure 2
Figure 2
Leading 30 Level 3 causes of total DALYs for 1990, 2006, and 2016, with percentage change in number of DALYs and all-age and age-standardised DALY rates, overall and by SDI quintile Overall (A). Low SDI (B). Low-middle SDI (C). Middle SDI (D). High-middle SDI (E). High SDI (F). Causes are connected by lines between time periods; solid lines are increases and dashed lines are decreases. For the time period of 1990–2006 and 2006–16, three measures of change are shown: percentage change in the number of DALYs, percentage change in the all-age DALY rate, and percentage change in the age-standardised DALY rate. Statistically significant changes are shown in bold. COPD=chronic obstructive pulmonary disease. DALYs=disability-adjusted life-years. STDs=sexually transmitted diseases.
Figure 3
Figure 3
Leading Level 3 causes of all-age DALY rates by location for females (A) and males (B) in 2016 ATG=Antigua and Barbuda. DALY=disability-adjusted life-year. FSM=Federated States of Micronesia. LCA=Saint Lucia. TLS=Timor-Leste. TTO=Trinidad and Tobago. VCT=Saint Vincent and the Grenadines. VUT=Vanuatu. WSM=Samoa.
Figure 4
Figure 4
Ratios of all-age DALY counts from NCDs to those from CMNN diseases by SDI quintile, GBD super-region, and region, for males and females separately, for 1990, 1995, 2000, 2006, 2010, and 2016 Each point represents the ratio of DALYs from NCDs to those from CMNN diseases for each GBD region in a given year by sex. Ratios of more than 1·00 represent a greater number of DALYs from NCDs than from CMNN diseases. CMNN=communicable, maternal, neonatal, and nutritional. DALY=disability-adjusted life-year. GBD=Global Burden of Disease. NCDs=non-communicable diseases. SDI=Socio-demographic Index.
Figure 5
Figure 5
Expected relationship between age-standardised YLL and YLD rates (per 100 000 people) and SDI (A) and all-age YLL and YLD rates (per 100 000 people) and SDI (B) for 21 Level 2 causes These stacked curves represent the average relationship between SDI and YLL and YLD rates for each cause observed across all geographies over the time period 1990–2016. In each figure, the y axis goes from lowest SDI to highest SDI. The left side shows rates for YLLs on a reflected axis and the right side shows rates for YLDs; higher rates are further from the midline in each direction. Differences in patterns between (A) and (B) is the effect of shifts in population age structure in relation to SDI. DALY=disability-adjusted life-year. SDI=Socio-demographic Index. YLDs=years lived with disability. YLLs=years of life lost.
Figure 6
Figure 6
Proportion of all-age DALY counts due to years lived with disability for all ages and both sexes combined for 1990 (A) and 2016 (B) Locations are colour-coded in terms of the magnitude of the ratio. ATG=Antigua and Barbuda. DALY=disability-adjusted life-year. FSM=Federated States of Micronesia. LCA=Saint Lucia. TLS=Timor-Leste. TTO=Trinidad and Tobago. VCT=Saint Vincent and the Grenadines.
Figure 7
Figure 7
Ratio of observed to expected age-standardised DALY rates (per 100 000) on the basis of SDI alone for both sexes combined in 2016 Ratios are colour-coded in terms of the magnitude of differences between observed and expected age-standardised DALY rates. Blues indicate much lower observed DALY levels than expected on the basis of SDI, whereas reds reflect observed DALYs that far exceed expected levels given SDI. ATG=Antigua and Barbuda. DALY=disability-adjusted life-year. FSM=Federated States of Micronesia. LCA=Saint Lucia. SDI=Socio-demographic Index. TLS=Timor-Leste. TTO=Trinidad and Tobago. VCT=Saint Vincent and the Grenadines.
Figure 8
Figure 8
Leading ten causes of all-age DALYs with the ratio of observed to expected DALYs on the basis of Socio-demographic Index in 2016, by location The ratio of observed to expected DALYs on the basis of Socio-demographic Index is provided in brackets for each cause and cells are colour-coded by ratio ranges (calculated to place a roughly equal number of cells into each bin). Shades of blue represent much lower observed DALY levels than expected on the basis of Socio-demographic Index, whereas red shows observed DALYs that exceed expected levels. Alcohol=alcohol use disorders. Alzheimer's=Alzheimer's disease and other dementias. Anxiety=anxiety disorders. Back+Neck=low back and neck pain. Cirr alc=cirrhosis due to alcohol use. Cirr HepC=cirrhosis due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict Terror=conflict and terrorism. Congenital=congenital anomalies. COPD=chronic obstructive pulmonary disease. Depression=depressive disorders. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. DR Congo=Democratic Republic of the Congo. Drugs=drug use disorders. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Iron=iron-deficiency anaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=lung, bronchus, and trachea cancers. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oth MSK=other musculoskeletal disorders. Oth NN=Other neonatal disorders. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. Sense=sense organ diseases. Skin=skin and subcutaneous diseases. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=Cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence.
Figure 8
Figure 8
Leading ten causes of all-age DALYs with the ratio of observed to expected DALYs on the basis of Socio-demographic Index in 2016, by location The ratio of observed to expected DALYs on the basis of Socio-demographic Index is provided in brackets for each cause and cells are colour-coded by ratio ranges (calculated to place a roughly equal number of cells into each bin). Shades of blue represent much lower observed DALY levels than expected on the basis of Socio-demographic Index, whereas red shows observed DALYs that exceed expected levels. Alcohol=alcohol use disorders. Alzheimer's=Alzheimer's disease and other dementias. Anxiety=anxiety disorders. Back+Neck=low back and neck pain. Cirr alc=cirrhosis due to alcohol use. Cirr HepC=cirrhosis due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict Terror=conflict and terrorism. Congenital=congenital anomalies. COPD=chronic obstructive pulmonary disease. Depression=depressive disorders. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. DR Congo=Democratic Republic of the Congo. Drugs=drug use disorders. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Iron=iron-deficiency anaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=lung, bronchus, and trachea cancers. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oth MSK=other musculoskeletal disorders. Oth NN=Other neonatal disorders. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. Sense=sense organ diseases. Skin=skin and subcutaneous diseases. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=Cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence.
Figure 8
Figure 8
Leading ten causes of all-age DALYs with the ratio of observed to expected DALYs on the basis of Socio-demographic Index in 2016, by location The ratio of observed to expected DALYs on the basis of Socio-demographic Index is provided in brackets for each cause and cells are colour-coded by ratio ranges (calculated to place a roughly equal number of cells into each bin). Shades of blue represent much lower observed DALY levels than expected on the basis of Socio-demographic Index, whereas red shows observed DALYs that exceed expected levels. Alcohol=alcohol use disorders. Alzheimer's=Alzheimer's disease and other dementias. Anxiety=anxiety disorders. Back+Neck=low back and neck pain. Cirr alc=cirrhosis due to alcohol use. Cirr HepC=cirrhosis due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict Terror=conflict and terrorism. Congenital=congenital anomalies. COPD=chronic obstructive pulmonary disease. Depression=depressive disorders. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. DR Congo=Democratic Republic of the Congo. Drugs=drug use disorders. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Iron=iron-deficiency anaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=lung, bronchus, and trachea cancers. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oth MSK=other musculoskeletal disorders. Oth NN=Other neonatal disorders. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. Sense=sense organ diseases. Skin=skin and subcutaneous diseases. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=Cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence.
Figure 8
Figure 8
Leading ten causes of all-age DALYs with the ratio of observed to expected DALYs on the basis of Socio-demographic Index in 2016, by location The ratio of observed to expected DALYs on the basis of Socio-demographic Index is provided in brackets for each cause and cells are colour-coded by ratio ranges (calculated to place a roughly equal number of cells into each bin). Shades of blue represent much lower observed DALY levels than expected on the basis of Socio-demographic Index, whereas red shows observed DALYs that exceed expected levels. Alcohol=alcohol use disorders. Alzheimer's=Alzheimer's disease and other dementias. Anxiety=anxiety disorders. Back+Neck=low back and neck pain. Cirr alc=cirrhosis due to alcohol use. Cirr HepC=cirrhosis due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict Terror=conflict and terrorism. Congenital=congenital anomalies. COPD=chronic obstructive pulmonary disease. Depression=depressive disorders. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. DR Congo=Democratic Republic of the Congo. Drugs=drug use disorders. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Iron=iron-deficiency anaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=lung, bronchus, and trachea cancers. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oth MSK=other musculoskeletal disorders. Oth NN=Other neonatal disorders. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. Sense=sense organ diseases. Skin=skin and subcutaneous diseases. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=Cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence.
Figure 8
Figure 8
Leading ten causes of all-age DALYs with the ratio of observed to expected DALYs on the basis of Socio-demographic Index in 2016, by location The ratio of observed to expected DALYs on the basis of Socio-demographic Index is provided in brackets for each cause and cells are colour-coded by ratio ranges (calculated to place a roughly equal number of cells into each bin). Shades of blue represent much lower observed DALY levels than expected on the basis of Socio-demographic Index, whereas red shows observed DALYs that exceed expected levels. Alcohol=alcohol use disorders. Alzheimer's=Alzheimer's disease and other dementias. Anxiety=anxiety disorders. Back+Neck=low back and neck pain. Cirr alc=cirrhosis due to alcohol use. Cirr HepC=cirrhosis due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict Terror=conflict and terrorism. Congenital=congenital anomalies. COPD=chronic obstructive pulmonary disease. Depression=depressive disorders. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. DR Congo=Democratic Republic of the Congo. Drugs=drug use disorders. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Iron=iron-deficiency anaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=lung, bronchus, and trachea cancers. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oth MSK=other musculoskeletal disorders. Oth NN=Other neonatal disorders. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. Sense=sense organ diseases. Skin=skin and subcutaneous diseases. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=Cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence.
Figure 8
Figure 8
Leading ten causes of all-age DALYs with the ratio of observed to expected DALYs on the basis of Socio-demographic Index in 2016, by location The ratio of observed to expected DALYs on the basis of Socio-demographic Index is provided in brackets for each cause and cells are colour-coded by ratio ranges (calculated to place a roughly equal number of cells into each bin). Shades of blue represent much lower observed DALY levels than expected on the basis of Socio-demographic Index, whereas red shows observed DALYs that exceed expected levels. Alcohol=alcohol use disorders. Alzheimer's=Alzheimer's disease and other dementias. Anxiety=anxiety disorders. Back+Neck=low back and neck pain. Cirr alc=cirrhosis due to alcohol use. Cirr HepC=cirrhosis due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict Terror=conflict and terrorism. Congenital=congenital anomalies. COPD=chronic obstructive pulmonary disease. Depression=depressive disorders. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. DR Congo=Democratic Republic of the Congo. Drugs=drug use disorders. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Iron=iron-deficiency anaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=lung, bronchus, and trachea cancers. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oth MSK=other musculoskeletal disorders. Oth NN=Other neonatal disorders. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. Sense=sense organ diseases. Skin=skin and subcutaneous diseases. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=Cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence.
Figure 8
Figure 8
Leading ten causes of all-age DALYs with the ratio of observed to expected DALYs on the basis of Socio-demographic Index in 2016, by location The ratio of observed to expected DALYs on the basis of Socio-demographic Index is provided in brackets for each cause and cells are colour-coded by ratio ranges (calculated to place a roughly equal number of cells into each bin). Shades of blue represent much lower observed DALY levels than expected on the basis of Socio-demographic Index, whereas red shows observed DALYs that exceed expected levels. Alcohol=alcohol use disorders. Alzheimer's=Alzheimer's disease and other dementias. Anxiety=anxiety disorders. Back+Neck=low back and neck pain. Cirr alc=cirrhosis due to alcohol use. Cirr HepC=cirrhosis due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict Terror=conflict and terrorism. Congenital=congenital anomalies. COPD=chronic obstructive pulmonary disease. Depression=depressive disorders. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. DR Congo=Democratic Republic of the Congo. Drugs=drug use disorders. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Iron=iron-deficiency anaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=lung, bronchus, and trachea cancers. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oth MSK=other musculoskeletal disorders. Oth NN=Other neonatal disorders. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. Sense=sense organ diseases. Skin=skin and subcutaneous diseases. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=Cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence.

References

    1. Mathers CD, Sadana R, Salomon JA, Murray CJ, Lopez AD. Healthy life expectancy in 191 countries, 1999. Lancet. 2001;357:1685–1691.
    1. Murray CJ, Vos T, Lozano R. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197–2223.
    1. Murray CJ, Barber RM, Foreman KJ. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet. 2015;386:2145–2191.
    1. Kassebaum NJ, Arora M, Barber RM. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1603–1658.
    1. Murray CJ, Salomon JA, Mathers CD, Lopez AD. Summary measures of population health. Concepts, ethics, measurement and applications. World Health Organization; Geneva: 2002.
    1. Murray CJ. Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ. 1994;72:429–445.
    1. GBD 2016 Mortality Collaborators Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1084–1150.
    1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211–1259.
    1. Sullivan DF. A single index of mortality and morbidity. HSMHA Health Rep. 1971;86:347–354.
    1. GBD 2016 Causes of Death Collaborators Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1151–1210.
    1. GBD 2016 Risk Factors Collaborators Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1343–1420.
    1. Murray CJ, Ezzati M, Flaxman AD. GBD 2010: design, definitions, and metrics. Lancet. 2012;380:2063–2066.
    1. Stevens GA, Alkema L, Black RE. Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement. Lancet. 2016;388:e19–e23.
    1. Stevens GA, Alkema L, Black RE. Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement. PLoS Med. 2016;13:e1002056.
    1. Wang H, Naghavi M, Allen C. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459–1544.
    1. Flaxman AD, Vos T, Murray CJ, editors. An integrative metaregression framework for descriptive epidemiology. first edn. University of Washington Press; Seattle: 2015.
    1. Stanaway JD, Shepard DS, Undurraga EA. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis. 2016;16:712–723.
    1. Gething PW, Casey DC, Weiss DJ. Mapping Plasmodium falciparum mortality in Africa between 1990 and 2015. N Engl J Med. 2016;375:2435–2445.
    1. Salomon JA, Vos T, Hogan DR. Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet. 2012;380:2129–2143.
    1. Salomon JA, Haagsma JA, Davis A. Disability weights for the Global Burden of Disease 2013 study. Lancet Glob Health. 2015;3:e712–e723.
    1. Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. Milbank Q. 2005;83:731–757.
    1. WHO . The world health report 2000. Health systems: improving performance. World Health Organization; Geneva: 2000.
    1. Bloom DE, Cafiero ET, Jané-Llopis E, Abrahams-Gessel S, Bloom LR. The global economic burden of noncommunicable diseases. World Economic Forum; Geneva: 2011.
    1. Fries JF. Aging, natural death, and the compression of morbidity. N Engl J Med. 1980;303:130–135.
    1. Mundel T. Honing the priorities and making the investment case for global health. PLoS Biol. 2016;14:e1002376.
    1. Institute for Health Metrics and Evaluation . A hand up: global progress towards universal education. Institute for Health Metrics and Evaluation; Seattle: 2015.
    1. Jamison DT, Summers LH, Alleyne G. Global health 2035: a world converging within a generation. Lancet. 2013;382:1898–1955.
    1. Bhatt S, Weiss DJ, Cameron E. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526:207–211.
    1. Gakidou E, Cowling K, Lozano R, Murray CJ. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis. Lancet. 2010;376:959–974.
    1. Wang H, Wolock TM, Carter A. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015. Lancet HIV. 2016;3:e361–e387.
    1. Murray CJ, Lopez AD, editors. Global Burden of Disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. 1st edn. Harvard School of Public Health; Cambridge: 1996.
    1. Stuckler D, King L, Robinson H, McKee M. WHO's budgetary allocations and burden of disease: a comparative analysis. Lancet. 2008;372:1563–1569.
    1. Catalá-López F, García-Altés A, Álvarez-Martín E, Gènova-Maleras R, Morant-Ginestar C. Does the development of new medicinal products in the European Union address global and regional health concerns? Popul Health Metr. 2010;8:34.
    1. Chalmers I, Bracken MB, Djulbegovic B. How to increase value and reduce waste when research priorities are set. Lancet. 2014;383:156–165.
    1. Emdin CA, Odutayo A, Hsiao AJ. Association between randomised trial evidence and global burden of disease: cross sectional study (Epidemiological Study of Randomized Trials—ESORT) BMJ. 2015;350:h117.
    1. Lam J, Lord SJ, Hunter KE, Simes RJ, Vu T, Askie LM. Australian clinical trial activity and burden of disease: an analysis of registered trials in National Health Priority Areas. Med J Australia. 2015;203:97–101.
    1. Mitchell RJ, McClure RJ, Olivier J, Watson WL. Rational allocation of Australia's research dollars: does the distribution of NHMRC funding by National Health Priority Area reflect actual disease burden? Med J Australia. 2009;191:648–652.
    1. Aoun S, Pennebaker D, Pascal R. To what extent is health and medical research funding associated with the burden of disease in Australia? Aust N Z J Public Health. 2004;28:80–86.
    1. Lamarre-Cliche M, Castilloux AM, LeLorier J. Association between the burden of disease and research funding by the Medical Research Council of Canada and the National Institutes of Health. A cross-sectional study. Clin Invest Med. 2001;24:83–89.
    1. WHO . Global Health Estimates 2015: deaths by cause, age, sex, by country and by region, 2000–2015. World Health Organization; Geneva: 2016. (accessed March 14, 2017).
    1. WHO . WHO methods and data sources for global burden of disease estimates 2000–2015. World Health Organization; Geneva: 2017.
    1. WHO WHO Member State DALY estimates, 2000–2015. (accessed April 24, 2017).
    1. Kuznik A, Lamorde M, Nyabigambo A, Manabe YC. Antenatal syphilis screening using point-of-care testing in sub-Saharan African countries: a cost-effectiveness analysis. PLoS Med10: e1001545.
    1. Vogel JP, Habib NA, Souza JP. Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO Antenatal Care Trial. Reprod Health. 2013;10:19.
    1. Bhatt S, Weiss DJ, Cameron E. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526:207–211.
    1. Baird JK. Effectiveness of antimalarial drugs. N Engl J Med. 2005;352:1565–1577.
    1. Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis. 2005;5:42–52.
    1. Quinn TC. HIV epidemiology and the effects of antiviral therapy on long-term consequences. AIDS. 2008;22:S7–S12.
    1. Stover J, Johnson P, Hallett T, Marston M, Becquet R, Timaeus IM. The Spectrum projection package: improvements in estimating incidence by age and sex, mother-to-child transmission, HIV progression in children and double orphans. Sex Transm Infect. 2010;86:ii16–ii21.
    1. WHO . Towards a grand convergence for child survival and health. A strategic review of options for the future building on lessons learnt from IMNCI. World Health Organization; Geneva: 2016.
    1. GBD 2015 Healthcare Access and Quality Collaborators Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015. Lancet. 2017;390:231–266.
    1. National AIDS and STI Control Programme . Kenya AIDS Indicator Survey 2012: final report. National AIDS and STI Control Programme; Nairobi: 2014.
    1. Ministry of Health . Uganda AIDS Indicator Survey 2011. Ministry of Health; Kampala: 2012.
    1. Uniting to Combat Neglected Tropical Diseases The London Declaration on neglected tropical diseases. (accessed May 8, 2017).
    1. Hopkins DR. Disease eradication. N Engl J Med. 2013;368:54–63.
    1. Brun R, Blum J, Chappuis F, Burri C. Human African trypanosomiasis. Lancet. 2010;375:148–159.
    1. WHO Fifth meeting of the Emergency Committee under the International Health Regulations (2005) regarding microcephaly, other neurological disorders and Zika virus. Nov 18, 2016. (accessed May 8, 2017).
    1. Bogoch II, Brady OJ, Kraemer MU. Potential for Zika virus introduction and transmission in resource-limited countries in Africa and the Asia-Pacific region: a modelling study. Lancet Infect Dis. 2016;16:1237–1245.
    1. Wikan N, Smith DR. Zika virus: history of a newly emerging arbovirus. Lancet Infect Dis. 2016;16:e119–e126.
    1. Pan American Health Organization Zika cumulative cases. (accessed May 8, 2017).
    1. GBD 2015 Eastern Mediterranean Region Collaborators. Mokdad AH. Danger ahead: the burden of diseases, injuries, and risk factors in the eastern Mediterranean region, 1990–2015. Int J Public Health. 2017 published online Aug 3.
    1. Gómez-Dantés H, Fullman N, Lamadrid-Figueroa H. Dissonant health transition in the states of Mexico, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2016;388:2386–2402.
    1. O'Donnell MJ, Xavier D, Liu L. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376:112–123.
    1. Zhang LF, Yang J, Hong Z. Proportion of different subtypes of stroke in China. Stroke. 2003;34:2091–2096.
    1. Andrade LH, Alonso J, Mneimneh Z. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med. 2014;44:1303–1317.
    1. Degenhardt L, Glantz M, Evans-Lacko S, et al. Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health surveys. World Psychiatry (in press).
    1. Mathers BM, Degenhardt L, Ali H. HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet. 2010;375:1014–1028.
    1. Jorm AF, Patten SB, Brugha TS, Mojtabai R. Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries. World Psychiatry. 2017;16:90–99.
    1. Ng M, Fleming T, Robinson M. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–781.
    1. Global Burden of Disease Health Financing Collaborator Network. Evolution and patterns of global health financing 1995–2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet389: 1981–2004.s.
    1. Global Burden of Disease Health Financing Collaborator Network. Future and potential spending on health 2015–40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet389: 2005–30.
    1. Dowell SF, Blazes D, Desmond-Hellmann S. Four steps to precision public health. Nature. 2016;540:189–191.
    1. Golding N, Burstein R, Longbottom J. Mapping under-5 and neonatal mortality in Africa, 2000–15: a baseline analysis for the Sustainable Development Goals. Lancet. 2017 (in press).
    1. Roberts L. Hunger amplifies infectious diseases for millions fleeing the violence of Boko Haram. April 6, 2017. (accessed March 24, 2017).
    1. Hoff PD. A first course in Bayesian statistical methods. Springer; New York: 2009. New York.

Source: PubMed

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