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In the face of growing health demands, policy-makers
are facing difficult decisions regarding the allocation of limited
resources. Informed and strategic decision-making relies on an accurate
picture of the relative impact of diseases and conditions so that policies
result in the greatest health gains for the population.
Measuring the burden of disease and conditions in
the country and understanding which sub-populations are most effected is a
critical component of targeted policy-making. In response to the lack of
basic, accurate data for informed priority setting, WHO and others have
undertaken work on estimating the global burden of disease (BoD). The Global Burden of Disease project undertaken by
WHO and others has attempted to bring together the available data on disease
incidence, prevalence, severity, duration, and mortality for a more accurate
summary of population health status that can be used for monitoring and
comparative purposes.
In 1992, the World Bank commissioned researchers at WHO, Harvard
University and others
to conduct the initial Global BoD study based on
1990 data. This initial study was significant in that it established a methodology
not only reflecting the disease mortality rates but also quantifying the
effect of premature death and disability and integrates these components into
a common “measure of the overall burden of disease on the population”. The
metric developed is a disability-adjusted life year or DALY. The DALY
expresses years of life lost to premature death and years lived with a
disability of specified severity and duration. In other words, one DALY is
equivalent to one lost year of healthy life.
Importantly, the work takes into account the burden
of non-communicable diseases, including mental illness and injury, which are
not only growing in terms of magnitude of burden but also in terms of the
resources need to control and treat. In fact, by 2020, non-communicable diseases
are projected to account for 70% of deaths in developing countries.
Furthermore, the BoD methodology allowed the
quantification of the impact of risk factors on population health and provided policy-makers a basis to compare the relative
cost-effectiveness of different interventions
Since the 1990 study, the WHO Global BoD project has refined the methodology and updated the BoD estimations for years 2000-2002, reporting revisions
in the annual World Health Reports. The results of the 2001 Global Burden of
Disease study improved the framework for the assessment of the disease and
injury burden from major risk factors and the quantification of uncertainties
in estimation. The global, regional and country level data can be found on
the WHO headquarters website.
The WHO is now undertaking a new assessment of the
Global Burden of Disease for the year 2004 and, recently, WHO has refined BoD projections for the years 2002-2030 based on 2002
estimates. The global burden of disease work has also spawned several
national and subnational level BoD
estimations including by the states of Andhra Pradesh and Himachal Pradesh.
Reports
Other Publications
Global Burden of Disease and Risk Factors
State-level BOD Studies
Himachal Burden of Disease– Department
of Health and Family Welfare Himachal Pradesh
Workshop
National Workshop on Developing Protocols for
Morbidity Field Surveys, 23-24 Nov. 2006
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