Christopher JL Murray, Director, Institute for Health Metrics and Evaluation at the University of Washington The Royal Society, 14 December 2012

1. DALYs for 291 Diseases and Injuries
1990-2010
Christopher JL Murray, Institute Director
The Royal Society, 14 December 2012

2. 2

3. Outline
Four Key Patterns
Leading Causes of Burden
Regional and National Variations on the Themes
Future Directions
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4. Three Ds Explain Rapid Changes in Global
Health Patterns
1) Demographic transition is shifting burden from
children to young adults.
2) Disease transition is leading to a larger fraction of
deaths from non-communicable diseases.
3) Disability transition is shifting the burden of
disease to conditions that cause disability but not
substantial mortality.
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5. 5

6. Change in Percent of DALYs Due to NCDs
1990-2010
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7. Disability Transition: Share of DALYS Due to
YLLs and YLDs by Region, 1990 and 2010
1990 2010
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8. Fourth Pattern: the Majority of Burden in sub-Saharan
Africa is Still from MDGs 4, 5 and 6
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9. Outline
Four Key Patterns
Leading Causes of Burden -- DV
Regional and National Variations on the Themes
Future Directions
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10. Uncertainty Varies by Cause
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11. Decomposing Change in DALYs Into Population
Growth, Population Aging and Changes in Age-Specific
Rates
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12. Outline
Four Key Patterns
Leading Causes of Burden
Regional and National Variations on the Themes -DV
Future Directions
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13. Leading Causes of DALYs by Country, 2010

14. Outline
Key Global Findings
Three Drivers of Rapid Transition
Regional and National Variations
Future Directions
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15. Sustaining and Expanding the GBD as a Global
Public Good
1) Vision: provide the world access to continuously
updated country level assessments of the burden of
disease over time for all major diseases, injuries and
risk factors using the latest available evidence.
2) As new evidence on descriptive epidemiology is
published, collected through surveillance systems or
released in reports, this evidence should be rapidly
incorporated in the GBD country, regional and global
estimates and made widely available.
3) Methodological innovations or studies that provide new
insights into etiology or causation should also be
adopted when the evidence is compelling.
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16. Expanding the Scope of the GBD
1) Including forecasts for disease burden
(mortality, causes of
death, prevalence, YLDs, YLLs, DALYs) by country for
the next 15-25 years.
2) Track health expenditure at the national level by
disease and injury categories.
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17. Relating Burden to What Health Systems Do
1) Estimate the DALYs averted through current health
service provision. How many DALYs are averted
through the 12.7 million US outpatient visits and 3
million bed-days for cellulitis?
2) What are opportunities for public health, primary care
and referral care for averting DALYs that are not
occurring.
3) Provide an integrated framework for understanding at a
detailed level changes in health and the role of public
health and medical care in contributing to these
changes.
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