HPH NOW, Oct 27, 2006, Groundbreaking Global Burden of Disease Study Marks Anniversary

From left to right, Steven Hyman, Christopher Murray, and Alan Lopez

Ten years ago, a revolutionary study called the Global Burden of Disease was published by Harvard University Press, quantifying causes of death and disability around the world and projecting those patterns to the year 2020. Sponsored by WHO and the World Bank, the study involved more than 100 researchers and was based at HSPH.

On October 12, the study's researchers met with global and national policymakers at the Charles Hotel in Cambridge through an event organized by the Harvard Center for Population and Development Studies. The occasion marked the study's anniversary. HSPH Dean Barry Bloom and Provost Steven Hyman opened the daylong symposium, which featured sessions on the history of the study, methodological challenges and developments, how the Global Burden of Disease has made a difference within countries, and future directions and challenges.

By looking at the combined toll of death and disability within populations and by offering a means to compare those patterns between populations, the Global Burden of Disease study pulled back the curtain on the entire landscape of human suffering and its burden on individuals, countries, and economies.

Christopher Murray and Alan Lopez edited the original Global Burden of Disease book. Murray is now Richard Saltonstall Professor of Population Policy in the HSPH Department of Population and International Health and head of the Harvard Initiative for Global Health. Lopez is now professor of medical statistics and population health and head of the School of Population Health at the University of Queensland.

The study used a new tool called the disability-adjusted life year (DALY), which measured the toll taken by premature deaths and disabilities. The study revealed several remarkable findings, including the tremendous burden of mental health disorders, particularly depression, around the world, as well as the growing threat of chronic diseases and the ongoing threat of infectious diseases. And, unexpectedly, the study showed how automobile accidents around the globe cause a considerable amount of death and disability.

At the symposium, Dean Jamison, T & G Angelopoulos Visiting Professor of Public Health and International Development at HSPH and at KSG, provided an overview of the origins of the study. Jamison was a lead author of the World Development Report 1993: Investing in Health, a predecessor to the Global Burden of Disease study that drew attention to the relationships between health, policymaking, and economic development.

In the 1980s, the World Bank sought to prioritize the needs for disease control. By 1990, an instrument to collect, analyze, and compare information not only on how people around the world were dying, but also on how they were becoming disabled, had been developed. The instrument also assessed the cost-effectiveness of interventions. In 1996, the first two volumes of what has become a series were published. The current series in total quantifies the burdens of 486 sequelae of 108 major causes of death and disability, broken down into eight geographic regions and ten age-sex groups. The series also includes risk factors, intervention assessments, and projections.

Lawrence Summers, former chief economist of the World Bank and former president of Harvard, helped to close the symposium. He observed: "It seems to me that these efforts to calculate the global burden of disease are of the utmost importance." He said that these efforts have changed the way people think about health problems and make salient the afflictions that burden the globe. The findings affect the allocation of resources and make the case for the sheer magnitude of health problems experienced globally.