How many people worldwide die of diabetes? How many are injured in motor vehicle crashes? How many suffer from depression? What impact does air pollution have on health?
Until the 1990s, global health data focused on mortality, particularly from infectious diseases like measles and tuberculosis, and there were a lot of guesstimates. There was no hard data to answer broader questions about the causes and non-fatal impacts of health challenges that affected billions of people.
That changed when the World Bank commissioned two researchers to paint a picture of the world’s health for their annual report.
It was, in many ways, a fool’s errand because the data were patchy at best.
“The fact that we even tried is amazing. It was dramatically harder than rational people would suspect,” said Dr. Christopher Murray, one of the researchers.
His colleague, Dr. Alan Lopez, had a similar reaction: “I shook my head and said, ‘No, it can’t be done.’”
Nevertheless they persisted and created a method they called the Global Burden of Disease (GBD), a way of systematically calculating death, disability and loss of life expectancy caused by diseases, injuries and other health threats.
In the 25 years since that initial effort, the GBD has become a standard way for interpreting health data and the definitive source of information especially in neglected areas of global health such as mental health, non-communicable diseases and nutritional risk factors.
As a result, the GBD has had a profound impact on public health policy-making and agenda-setting around the world.
For their groundbreaking work, Drs. Murray and Lopez have been chosen as the recipients of the 2018 John Dirks Canada Gairdner Global Health Award.
Dr. Zulfiqar Bhutta, co-director of the Centre for Global Child Health at Toronto’s Hospital for Sick Children, said, “Their work is extraordinary. They have produced some of the most policy-relevant data in the world in the past decades.”
Just as importantly, he said, they have persuaded many countries to collect better data which, in turn, has led to smarter funding decisions.
Dr. Lopez, who is now the Rowden-White chair in global health and burden of disease measurement at the University of Melbourne in Australia, said he was surprised and flattered to see “backroom work” like the development of GBD measures being honoured with such a prestigious award, and humbled by the impact of the work.
“These data tell a story of how the health of the planet is changing – it’s a story of improvement and setbacks but, overall, the public health gains have been impressive,” he said.
“We’ve broadened the conversation beyond death to disability, premature mortality and quality of life,” Dr. Lopez added.
Dr. Murray, who is now a professor of global health at the University of Washington and director of the Institute for Health Metrics and Evaluation (IMHE), both in Seattle, said that as difficult as it was to produce the data, “having information in front of people has changed the way we look at the world,” and has had untold influence on decision-makers.
Bill and Melinda Gates – both avowed data geeks – have said the GBD has fundamentally shaped how they think about global health, and how they invest their philanthropic dollars. (The Bill and Melinda Gates Foundation has invested billions in health programs since its inception and now funds the IMHE to continue to expand the breadth of Global Burden of Disease data collection.)
The GBD, which started as a two-person effort, now involves more than 2,400 collaborators in 132 countries. The study has also grown to analyze the health impacts of more than 300 types of diseases and injuries, 80 disease risk factors and 2,600 sequelae (non-fatal health consequences related to a disease – for example, kidney disease is a common sequela of diabetes).