IHME experts speak

On May 23, 2017, President Donald Trump released his FY 2018 budget request to Congress that includes approximately $2.5 billion in cuts to global health. In t

Americans are living longer than ever before, thanks in large part to NIH-supported research. But a new, heavily publicized study shows that recent gains in longevity aren’t being enjoyed equally in all corners of the United States.

Since John Graunt's analyses of the Bills of Mortality in London, UK, in 1662, observations of premature deaths have driven public health actions—from John Snow's apocryphal removal of the handle on the Broad Street pump during the 1854 cholera outbreak to the international response to the 2013–16 outbreak of Ebola virus disease in west Africa.

A new report in The Lancet using data from the Global Burden of Disease Study adds quantitative detail to an already extensive international literature on the health impact of the global tobacco epidemic by providing comprehensive estimates of death and disability caused by smoking at the country level.

Although knowledge about global health financing has expanded over the past two decades, major gaps remain. We know little, for example, about how much governments spend on major disease areas, how these amounts have evolved over time and how countries compare. A global health financing data revolution is sorely needed. The suite of papers that make up this special issue underline the importance of reliable information about financial resources for health.

In this issue of JAMA, IHME's Laura Dwyer-Lindgren and colleagues1 present advanced methods and applications of small area estimation techniques to produce county-level summary measures of cause-specific mortality rates across the United States and estimates of temporal trends in these rates.

The use of data to guide interventions that benefit populations more efficiently is a strategy we call precision public health. Large-scale collections of the world's health data are catalogued (such as by the Global Health Data Exchange) and have been used to compile an inventory of the global burden of disease. The 2015 report from the Institute for Health Metrics and Evaluation in Seattle enlisted more than 1,800 collaborators who analysed more than 14,000 data sets to estimate mortality for 249 causes in 195 countries across 35 years.

After more than a decade of immense growth, development assistance for health has flatlined. DAH fueled a scale up of antiretrovirals, insecticide-treated bed nets, vaccinations and a host of important global health interventions. Over the same period, the spread of a number of infectious diseases was reversed, reducing premature death and disability across the developing world. The plateau in international funding may threaten to slow progress or even roll back these gains.

Bill Gates explains in this Gates Notes post using Global Burden of Disease study results why, "Malaria is the key reason mosquitoes are the deadliest animal in the world."

In the past two decades, thanks to effective antiretroviral treatment (ART), enormous progress has been made in improving the health and life expectancy of HIV-infected individuals.1 The success of ART, combined with the benefits of treatment as prevention and pre-exposure prophylaxis on HIV transmission, have generated new hope to end the HIV/AIDS epidemics.2 Translation of this hope into universal reality will need accelerated efforts to ensure rapid access to ART and to extend HIV prevention services to reach the most affected populations and regions.

Christopher Murray, Director of the Institute for Health Metrics and Evaluation, discusses the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) statement and the importance of ensuring accurate and transparent reporting of public health research.

Unprecedented global forces are shaping the health and well-being of the largest generation of 10 to 24 year olds in human history. Population mobility, global communications, economic development, and the sustainability of ecosystems are setting the future course for this generation and, in turn, humankind. At the same time, we have come to new understandings of adolescence as a critical phase in life for achieving human potential.

Before leaving home for a trip to the market, you likely know how much you plan to spend and how much food you will get for your money. This basic understanding of how much food your money will buy allows you to budget effectively and makes your shopping experience much less stressful. For most purchases, it is critical to understand how much money you have and what that money will purchase,  Unfortunately, this basic concept is all too often absent in health systems, particularly in primary health care (PHC) systems.

Uganda has achieved large gains against malaria through improving intervention delivery. At the same time, this year’s outbreak in northern Uganda highlights a need for stronger, more focal monitoring of malaria needs. No magic bullet exists against malaria, nor will a one-size-fits-all solution work to end the disease. But by harnessing local evidence and devising multipronged, targeted programs, Uganda aims to accelerate toward its goal of reaching zero malaria.

We know what works to fight pneumonia in children. Improving access to prompt diagnosis and treatment of pneumonia and scaling up vaccines that protect children against particularly deadly strains has occurred in many countries. So why has progress against pneumonia fallen behind?

China’s emphasis on providing primary health care to even the most remote areas has paid off. Yet, despite impressive health progress, massive disparities persist within China.

Twenty-five years ago, the state of public health for large populations was like that of a doctor trying to treat a patient without a proper diagnosis. The diseases and injuries that cut lives short and caused widespread suffering were not rigorously tracked. To address this problem, Alan Lopez and Christopher Murray launched the Global Burden of Disease project (GBD) in 1990. Decision-makers need information about the world’s biggest health threats and how they have changed over time, across age groups, and by sex, so they can ensure that everyone has the opportunity to live the longest, healthiest life possible.

In the era of the Millennium Development Goals (MDGs), regular reporting of specific health indicators drew public and policy attention, and ultimately resources, to causes such as maternal and child health. On Sept 25–27, 2015, the UN Sustainable Development Summit was held in New York, NY, USA, leading to the adoption of the Sustainable Development Goals (SDGs) by the UN General Assembly. On the basis of the lessons learned from the MDGs, the indicators chosen for each SDG target will probably determine the amount of action and attention each target receives.

If you asked the average global health professional to name the countries where alcohol caused the most health problems, what would they say?

July 2015 saw two big milestones for Nigeria’s quest to eliminate polio. First, the country hit the one-year mark of recording zero polio cases, a significant achievement in global health. Second, Nigeria finished introducing the inactivated polio vaccine (IPV) into routine immunization systems in five more states, accelerating the new vaccine’s implementation.