Institute for Health Metrics and Evaluation Archives - Humanosphere

Institute for Health Metrics and Evaluation

Call for global health geeks to join forces with human rights activists |

Editor of The Lancet, Richard Horton, wants human rights activists and global health geeks to come together in common cause.

More than 500 public health experts, policy makers and academics from 50 different countries have gathered in Seattle this week to dig deeper into what one of the leaders in the field characterized as having done for global health what the Human Genome Project has done for biomedical science and medicine.

“This is the golden era for global health,” said Julio Frenk, dean of the Harvard School of Public Health, on the opening day of the conference.

Part of what makes it golden, Frenk said, is the new Global Burden of Disease Study – a massive worldwide assessment of what’s killing, injuring and disabling people around the planet. The GBD, as its known, was created by some 500 researchers in 187 countries looking through hundreds of millions of reports on nearly 300 causes of death and disability.

It’s the global health community equivalent of sequencing all human DNA, Frenk said, and a sign that this field has entered its ‘Big Data’ stage. But data alone is not enough, Frenk said, adding that what’s needed is to use this data to create a truly global and ‘pluralistic’ community aimed at improving health.

And just as the human genome project did not proceed without controversy, neither has the Global Burden of Disease. As Lancet editor Richard Horton noted in his comments at the opening session of the Seattle meeting (and in the video above), contained within all these GBD measurements of death and disease are dicey political issues of justice, power and equity.

“Human rights and health metrics is not the most obvious marriage,” Horton said. In fact, he added, the human rights community often tends to look upon the health data community with suspicion, and vice versa. But numbers are not facts, he said, and disease charts do not naturally translate into policy decisions.

The next step for making the best use of this powerful new tool, he said, is to focus on translating the data into meaningful policy decisions and political action.

“We can use these new data, with the combined forces of the human rights and global health community, to make the uncounted count, to make the invisible more visible and to bring more attention to those now marginalized,” said Horton.

FILED UNDER: Health, Science, Chris Murray, Global Burden of Disease, Institute for Health Metrics and Evaluation, Julio Frenk, Richard Horton

June 14, 2013 | 11:20 AM | By Guest |

Vizualize Malnutrition |

: DFIDAt a recent summit in London, more than $4 billion to end hunger and malnutrition.

At a recent summit in London, donors pledged more than $4 billion to end hunger and malnutrition.

Hunger is one thing. Malnutrition is another. To begin with, hunger sounds like a problem that’s fairly easy to solve, in concept anyway. If hungry people are given food, problem solved. Malnutrition is more insidious. Young children who are chronically malnourished, even if later given food and kept from hunger, suffer long-term mental and physical damage.

And it exacts a massive financial toll as well: Read our post from last week on Malnutrition’s Global Cost: $3.5 Trillion.

Online data visualization tools created as part of the Institute for Health Metrics and Evaluation’s Global Burden of Disease Study can be used to better understand why malnutrition is such a major health threat globally. These tools can also be used to track progress the world has made fighting this scourge.

Katie Leach-Kemon, a policy translation specialist at IHME, part of the University of Washington, walks us through some of these tools below. Check out the links to access the interactive version of the tool hosted at the Institute:

Continue reading →

FILED UNDER: Basics, Science, Global Burden of Disease, Institute for Health Metrics and Evaluation, malnutrition, visual information

June 7, 2013 | 10:00 AM | By Tom Paulson |

Scientists identify China’s mysteriously massive cancer burden |

Flickr, PTorrodellas

Tai Chi in the park

Scientists in Seattle, Australia and China report in The Lancet today on the leading causes of death and disability – as well as the many positive health trends – in a rapidly modernizing China.

Perhaps unsurprisingly, the study, based on Global Burden of Disease data compiled at the University of Washington’s Institute for Health Metrics and Evaluation (IHME), found that China’s rapid economic development over the past few decades has been accompanied by a decline in ‘diseases of poverty’ like malaria, vaccine-preventable infectious diseases and child malnutrition.

The world’s largest nation and new emerging superpower also has seen remarkable progress at lowering childhood and maternal mortality, along with an equally unsurprising rise in the burden of diseases and disorders familiar to wealthier countries such as heart disease, stroke and dementia. Air pollution gets special attention as well.

NPR reported As China Gets Richer, First World Diseases Take Hold, which was the primary theme of the The Lancet special report on China. Similarly, Forbes reported that China’s health problems mirror wealthy nations.

Not quite.

One surprising – and not completely understood or explained – finding out of the study is that China appears to be the undisputed world leader for certain cancers: Liver, stomach and esophageal.

I asked a policy translation specialist at IHME, Katie Leach-Kemon, to dig into this a little deeper using one of IHME’s data visualization tools known as a ’cause pattern’ analysis. Leach-Kemon compiled this graphic below showing age-standardized rates of years-of-life-lost due to different cancers around the world. Here’s a link to the active chart online. Notice my red highlights:

UW IHME

Continue reading →

FILED UNDER: Health, Science, cancer, China, Chris Murray, Global Burden of Disease, Institute for Health Metrics and Evaluation, University of Washington

March 5, 2013 | 4:00 PM | By Tom Paulson |

Visualize Global Health |

It’s a new dawn for global health data borne of necessity, mind-numbing numbers, Netflix and a desire to avoid insanity.

“For our own sanity, we needed to create a new way to look at this stuff,” said Peter Speyer.

Speyer, head of data development at Seattle’s Institute for Health Metrics and Evaluation, explained why he and his colleagues are transforming a massive collection of health data known as the Global Burden of Disease (GBD) into a stunning collection of powerful online and interactive visual tools. Go to the link; below is just a screen grab. Seriously, go there and try these out. You’ll have fun even if you don’t know yet what you’re doing.

Today, Bill Gates and Speyer’s boss, IHME director Chris Murray, officially unveiled some of those tools aimed at allowing anyone (even you) to dig deeper into these global estimates arrived at by some 500 researchers working in collaboration worldwide for five years on more than 200 million results tracking the impact of nearly 300 causes of death and disability in 187 countries.

Phew. It makes your head hurt just to read that sentence. Imagine trying to compile a complete report including all of the numbers, statistics and charts.

“That’s one of the most exciting things about this phase of the project,” said Murray, who with his long-time partner in death-and-disability number crunching, Alan Lopez of the University of Queensland in Australia, has been trying for decades to create a reliable yardstick for measuring what’s going on in global health.

: Chris Murray; IHME

“I think these visual tools represent a significant paradigm change for global health,” Murray said. “They engage even the most data-resistant people. It’s an incredible revelation to me how profoundly influential it can be to present the data in this way. I think data visualization will be revolutionary for global health.”

Continue reading →

FILED UNDER: Health, Science, Chris Murray, data visualization, Global Burden of Disease, Institute for Health Metrics and Evaluation, Peter Speyer

February 6, 2013 | 1:58 PM | By Tom Paulson |

Global health spending is stable, non-communicable diseases neglected |

Some of the world’s leading global health number-crunchers, at the Seattle-based Institute for Health Metrics and Evaluation, wanted to know if a perceived slowdown in what had been a rapidly increasing war chest for fighting diseases of poverty represented The End of the Global Age for global health.

Funding has flattened out, the study reports, but on a plateau that reveals one category of huge neglect – non-communicable diseases.

“From the late 1990s to 2010, we saw a period of rapidly increasing funding for global health,” said Michael Hanlon, one of the lead authors of the report released today entitled Financing Global Health 2012: The End of the Golden Age? The IHME report follows up several earlier, similar reports which revealed a plateau, and even a decline between 2010 and 2011, in new funding for global health activities.

“I think the good news here is that we’re not seeing a decline yet and are maintaining a high level of funding,” Hanlon said. “That could change, of course, but I think it’s fair to say we’ve ended the phase of rapid increases in funding and entered a new phase, a maintenance phase.”

Here’s an illustration from the IHME report showing, over the past 10 years or so, the overall increase in development assistance for health (DAH).

So it’s mostly good news, at least for those who believe spending on global health is good.

Whether this is good enough (relative to what we spend on dog food, cosmetics and bottled water – not to mention military adventures or bailing out struggling bankers) is another question, of course. And whether the money is going where it’s most needed is another question raised by this report. Following are some highlights: Continue reading →

FILED UNDER: Health, Amanda Glassman, Chris Murray, financing, global health, Institute for Health Metrics and Evaluation, Michael Hanlon

December 13, 2012 | 9:02 AM | By Tom Paulson |

The burden of a new global health agenda |

Flickr, Oliver Erdmann

A massive study of death, disability and disease on Earth, coordinated out of Seattle and to be officially published in The Lancet on Friday, could do for global health something like what Galileo did for the solar system.

It’s called the Global Burden of Disease (technically, the Global Burden of Disease, Injuries and Risk Factors Study 2010) and it is, like its earlier incarnations dating back to 1990, almost guaranteed to provoke and disrupt the international community’s approach to improving global health.

The good news is that people, in general, are living longer. The bad news is more of them seem to be fatter, still smoking too much and suffering from disabilities.

Just as the 16^th century astronomer Galileo – much to the dismay of the religious orthodoxy of the time – displaced Earth from its celestial prominence in favor of the Sun, the new Global Burden of Disease may displace infectious disease from its position as the categorical center of the global health universe.

Think the top three killers in the world are scourges like AIDS, tuberculosis and malaria? Think again, of heart disease, respiratory infections and stroke.

Think preventing death is the best way to tell if we’re winning the war on disease? You better think again about that as well since rates of obesity, chronic pain, injury and mental illness may say more….

Chris Murray

“We were surprised by many of the findings,” said Chris Murray, one of the founders of the study and director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

“The simple purpose of this study has always been to provide the best scientific evidence on patterns of disease and disability to help us make sense of what’s happening out there and set priorities,” Murray said.

Sounds simple enough. So why did it take some 500 researchers more than five years to do it? Continue reading →

FILED UNDER: Health, Science, Alan Lopez, Chris Murray, Global Burden of Disease, Institute for Health Metrics and Evaluation, University of Washington

May 18, 2012 | 2:56 PM | By Tom Paulson |

Stanford attack of UW/Seattle study on global health funding itself under attack |

Okay, this is a bit convoluted but see if you can follow.

The gist here is about how best to fund improvements in global health.

In 2010, Seattle researchers at the University of Washington’s Institute for Health Metrics and Evaluation published an analysis of global health spending and found a significant amount of ‘displacement’ – meaning foreign donations to fight HIV, malaria, TB or other scourges were allowing governments in poor countries to cut their own spending on health.

This is a problem because one of the primary goals in global health is to support local investment in health services and infrastructure.

Some used (arguably, misinterpreted) the UW study as evidence a lot of global health spending is misused or wasted. The Seattle number-crunchers weren’t actually saying that, of course. They were just pointing out that donors and aid organizations may need to build in better incentives to programs to avoid this counter-productive phenomenon.

But perhaps based on the concern that some were using the IHME study as evidence foreign health aid is a waste, some experts at Stanford University recently published their own analysis of the UW analysis and decided that there is “no evidence that international health is wasted.” Writing in PLoS Medicine, two experts with Stanford contend of the Seattle study:

(The) conclusions drawn from these data are unstable and driven by outliers…. While government spending may be displaced by development assistance for health in some settings, the evidence is not robust and is highly variable across countries. We recommend that current evidence about aid displacement cannot be used to guide policy.

Them’s fighting words for number crunchers. Continue reading →

FILED UNDER: Basics, Science, global health spending, Institute for Health Metrics and Evaluation

May 16, 2012 | 11:35 AM | By Tom Paulson |

WHO report highlights chronic diseases & lack of global health strategy |

Flickr, Erebos

Analysis

The World Health Organization has published its annual health report for 2012 and this year decided to “put the spotlight on the growing problem of non-communicable diseases.”

Here are some of the news stories spawned by the WHO report:

Reuters/MSNBC Heart disease, diabetes spreading to poor regions

AP/Washington Post Diseases of affluence are spreading worldwide

Voice of America Non-communicable diseases cause most deaths worldwide

UN Dispatch The Good, Bad and Mixed News in World Health Statistics

This focus on the NCDs, (non-communicable diseases) is certainly legitimate since they are, as a general category, major contributors to the global burden of disease. But another way to look at this, of course, is that the WHO report has turned the spotlight away from other diseases.

Why the focus this year on diabetes, heart disease and other chronic illnesses? Why has the attention been shifted away from the still-expanding HIV-AIDS pandemic, the threat of drug-resistant tuberculosis or malaria?

One easy answer is that the WHO annual statistics report always picks a theme and this year’s flavor is chronic disease.

Before, it was AIDS. Another year, it was TB or malaria. To WHO’s credit, one year the organization focused the attention on the much-neglected problem of mental illness worldwide. Another time, the spotlight was on deaths from accidents (which is a much bigger contributor to global mortality than you might think).

All of these are legitimate health concerns. But the nagging suspicion — or perhaps just inkling — you get from all this is that the shifting spotlight indicates no real strategy for global health.

I’ve long been disturbed by the lack of a clear, comprehensive strategy in global health — as well as the lack of a clear definition of what the hell we even mean by global health. Many tell me to lighten up, that the diversity of opinion and a de-centralized approach to the fight against disease is actually a good thing.

I’m not so sure, and I’m not alone in my uncertainty. See this post from the Center for Global Development’s Amanda Glassman and Kate McQueston Making Priority Setting a Priority for Global Health, which offers links to other related posts.

Update: Here is Amanda’s more recent perspective published in the British Medical Journal.

Kate Kelland of Reuters earlier this week also did a great report on the ‘squishiness’ of the WHO health statistics and the debate over how best to measure the burden of disease globally. It’s worth a read and mentions a group of Seattle number-crunchers, at the UW’s Institute for Health Metrics and Evaluation (e.g. a recent report on malaria) who are trying to bring more reliability and perhaps order to all this.

But, clearly, it’s not just a matter of improving the numbers. The international community has no consensus on what we mean by global health, let alone consensus on which problems deserve the most attention and resources.