3. The Burden of Disease and Mortality by Condition: Data, Methods, and Results for 2001

Abstract

An analysis of the Disease Control Priorities in Developing Countries (DCP2) global and regional results confirms the original Global Burden of Disease (GBD) study conclusions on the need to include nonfatal outcomes in assessing global health and the importance of noncommunicable diseases in low– and middle–income countries.

Some dramatic changes have occurred in population health since 1990. These include the rise of HIV/AIDS to become the fourth leading cause of burden of disease globally (and the leading cause in Sub–Saharan Africa), and a 40 percent increase in the per capita disease burden in Europe and Central Asia, chiefly due to increases in alcohol abuse, suicide, and violence.

The 15–year–old burden of disease framework still offers the best, and only, approach for comprehensively assessing the impact of adverse conditions and exposures. Much comment on the original GBD study focused on social value choices incorporated into the disability–adjusted life year (DALY) measure. However, the lack of information on disease epidemiology has much greater consequences for policy. Substantial uncertainty remains about the comparative burden of diseases and injury in many parts of the world as well as the true levels of burden from major chronic diseases, mental disorders, and other causes.

For the burden of disease framework to be even more useful in the future, there must be a more concerted effort to obtain and critically assess data sets on the health of populations in all countries.