When Bill Gates laid out his foundation’s priorities for the coming year, better measurement of health trends around the world was at the top of the list.
On Tuesday, Gates and researchers at the University of Washington will announce ambitious plans to help achieve that goal with more-frequent updates to global death and disease statistics that used to take a decade or more to compile and analyze.
New results will be issued at least annually, covering 187 countries from Afghanistan to Zambia. Having up-to-date figures will enable nations to track progress and detect emerging problems more quickly, said Chris Murray, director of the UW’s Institute for Health Metrics and Evaluation (IHME).
On Tuesday, Murray and his colleagues will also unveil detailed findings from their most recent survey, a massive, country-by-country analysis that documents everything from a steep drop in child mortality in India to the rising epidemic of violence that is now the leading killer of young men in Colombia.
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In the United States, the study found Alzheimer’s disease now ranks as the fourth-leading cause of death, up from 19th two decades ago. AIDS deaths fell from 18 on the list to 39.
But the U.S. lags behind more than 30 countries, including Costa Rica, New Zealand and Portugal, in the number of healthy years of life residents enjoy.
Called the Global Burden of Disease (GBD) report, the UW study estimates deaths and disability from 291 diseases and types of injury around the world in 1990 and 2010. It is the most comprehensive review of the state of humanity’s health ever undertaken.
Findings on the global and regional scale were released in December, but what nations care about most are their own statistics and standings, Murray said.
Pulling the data together was a five-year task. Now that the methods are in place, though, it should be possible to quickly factor in new information, he said.
But some critics remain leery of the complex statistical methods Murray and his team use to fill in data gaps for the developing world, where reliable statistics are scarce.
And IHME’s reluctance to share its methods and some of its data have rekindled resentment against the Seattle institute, founded in 2007 with $105 million from the Seattle-based Bill & Melinda Gates Foundation.
“If the GBD report is really going to shape global policy, which is what it is meant to do, there is going to be a real need for transparency,” said Thomas Bollyky, a Gates Foundation adviser and senior fellow at the Council on Foreign Relations..
Many of the findings in the Gates-funded survey aren’t new, Bollyky pointed out. The World Health Organization conducted similar surveys in 1996 and 2004.
Both were based on Murray’s pioneering efforts to quantify not just deaths, but the health toll of chronic conditions, such as back pain and mental illness.
With Gates funding, Murray and his colleagues have expanded on that work, analyzing the data to tease out the role of risk factors like alcoholism, air pollution and poor diet that underlie many health problems.
“It was definitely a gigantic task,” said Peter Speyer, director of data development at IHME. Nearly 500 researchers at more than 300 institutions collaborated on the project.
Just finding the data was often a challenge. Speyer tracked down valuable household health surveys in Iraq, but a government official said the results had to be picked up in person. War was raging and it took three years to find an emissary headed for Baghdad and willing to collect the computer discs.
More than 100 nations don’t maintain basic birth and death records, which is why the researchers often had to extrapolate with statistical methods, Speyer said. They also relied on “verbal autopsies,” where family members were quizzed about their loved ones’ symptoms before death.
Critics say that approach could lead to mistakes, because many diseases have similar symptoms.
As they begin to update the statistics more often, Murray said he and his team will collaborate with experts working in countries around the globe.
Not only will the locals have access to additional data, but their expertise will help validate the results.
Murray said IHME will also share more of its data and make it available more quickly than in the past, though some countries, like China, insist that their raw data remain confidential.
More frequent updates will probably prove most valuable to individual countries, said Bollyky.
Wealthy nations and donors like the Gates Foundation focus mostly on infectious diseases, such as AIDS and malaria, and aren’t likely to shift their priorities even though statistics show that infectious disease is becoming less important in much of the world, he said.
But now ministries of health can quickly see if their policies are making a difference, and the public can hold their governments accountable for improvements.
Gates is expected to announce millions more in additional funding for the effort on Tuesday.