The Global Burden of Disease (GBD) approach endeavors to measure disability and death from a multitude of causes worldwide. It has grown over the past two decades into an international consortium of nearly 5,500 researchers, and its estimates are being updated annually.
The GBD enterprise dates to the early 1990s, when the World Bank commissioned the original GBD study and featured it in the landmark World Development Report 1993: Investing in Health. Co-authored by Dr. Christopher Murray, who went on to become Director of IHME, this GBD study served as the most comprehensive effort up to that point to systematically measure the world’s health problems, generating estimates for 107 diseases and 483 sequelae (nonfatal health consequences related to a disease). It covered eight regions and five age groups with estimates through 1990.
The GBD 1990 study had a profound impact on health policy and agenda-setting throughout the world, especially as it brought global attention to otherwise hidden or neglected health challenges, such as mental illness and the burden of road injuries. Academic papers from GBD 1990 have been cited more than 11,000 times since they were published.
GBD work was institutionalized at the World Health Organization (WHO), and the organization continued to update GBD findings.
In 1998, the WHO created a Disease Burden Unit, which generated GBD estimates for 2000, 2001, and 2002, publishing the estimates in WHO’s annual World Health Reports. In 2008, WHO updated the GBD estimates for 2004. By the time of the GBD 2004 study, the causes of death and disability being studied had grown to 136.
The next comprehensive GBD update, the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) published new estimates for the complete time series from 1990 to 2010 and an explanation of its methods in The Lancet in December 2012 in seven papers, commentaries, and accompanying comprehensive web appendices totaling more than 2,300 pages.
While the earlier work had been conducted mainly by researchers at Harvard and the World Health Organization, GBD 2010 brought together a community of nearly 500 experts from around the world in epidemiology, statistics, and other disciplines.
Funded by the Bill & Melinda Gates Foundation, GBD 2010 significantly broadened the scope of previous versions of GBD. Using improved methods for estimating disability weights, GBD 2010 produced estimates for 291 diseases and injuries, 67 risk factors, 1,160 sequelae, 21 regions, 20 age groups, and 187 countries.
The policy report The Global Burden of Disease: Generating Evidence, Guiding Policy summarizes the GBD 2010 methods and results.
In 2013, the World Bank and GBD researchers renewed the fruitful collaboration they began two decades earlier by launching a series of six regional reports based on findings from GBD 2010.
With IHME as the coordinating center for an international network of GBD contributors, GBD 2013 expanded the methodology, datasets, and tools used in GBD 2010 and presented estimates for more than 300 diseases and injuries, 79 risk factors, and over 2,300 sequelae for 188 countries. It reflected the work of more than 1,000 researchers in more than 100 countries. GBD 2013 findings were published in a series of papers on smoking; maternal mortality; child mortality; overweight and obesity; HIV/AIDS, malaria, and tuberculosis; causes of death, nonfatal outcomes, disability-adjusted life years, and risk factors.
GBD 2015 marked the first year of production of annual updates of the entire time series of GBD estimates. These more frequent updates provide policymakers, donors, and other decision-makers with the most timely and useful picture of population health. The 2015 update expanded the methodology, datasets, and tools used in GBD 2013 and introduced the Socio-demographic Index (SDI), a summary measure that identifies where countries or other geographies sit on the spectrum of development. Expressed on a scale of 0 to 1, SDI is a composite average of the rankings of the incomes per capita, average educational attainment, and fertility rates of all areas in the GBD study. Estimates were generated for 315 diseases and injuries and 79 risk factors for 195 countries. The study reflected the work of more than 1,800 researchers in more than 120 countries. GBD 2015 findings were published in a series of papers which can be found here. GBD 2015 also complied with recommendations set forth by Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).
GBD 2016, was published in a special issue of The Lancet in September 2017 and included the second annual report on the Sustainable Development Goal (SDG) indicators. The study included 333 diseases and injuries, 84 risk factors, 23 age groups, estimated for a total of 774 locations, and was produced with the participation of 2,518 collaborators from 133 countries and three territories. Articles using GBD 2016 results to focus on specific topics followed, including studies of death and disability related to alcohol use, US disease burden at the state level, and global mortality from firearms.
Published in November 2018, GBD 2017 provides for the first time an independent estimation of population, for each of 195 countries and territories and the globe, using a standardized, replicable approach, as well as a comprehensive update on fertility. GBD 2017 incorporates major data additions and improvements, and methodological refinements. Mortality and life expectancy estimates have been extended back to 1950, and new causes have been added to the fatal and non-fatal cause lists, for a total of 359 diseases and injuries. One new risk factor, bullying victimization, and 80 new risk-outcome pairs have also been added. More SDG indicators are now examined, and forecasting methods are used to generate projections through 2030 and assess the pace of change needed to attain the SDGs. Produced with the input of 3,676 collaborators from 146 countries and territories, GBD 2017 also includes estimates at the subnational level for Russia, in addition to the countries for which subnational estimates have been published in previous editions of the GBD study (Brazil, China, India, Indonesia, Japan, Kenya, Mexico, South Africa, Sweden, the UK, and the US).
Published in The Lancet in October 2020, GBD 2019 provides for the first time an independent estimation of population, for each of 204 countries and territories and the globe, using a standardized, replicable approach, as well as a comprehensive update on fertility and migration. GBD 2019 incorporates major data additions and improvements, and methodological refinements. Mortality and life expectancy estimates have expanded to a total of 990 locations at the most detailed level, and new causes have been added to the fatal and non-fatal cause lists, for a total of 369 diseases and injuries. Two new risk factors (high and low non-optimal temperatures) and 54 new risk-outcome pairs have also been added. Produced with the input of over 5,000 collaborators from 152 countries and territories, GBD 2019 also includes estimates at the subnational level for five new countries (Italy, Nigeria, Pakistan, the Philippines, and Poland) in addition to the countries for which subnational estimates have been published in previous editions of the GBD study (Russia, Brazil, China, India, Indonesia, Japan, Kenya, Mexico, South Africa, Sweden, the UK, and the US).