global health priorities · global health priorities relevance for planning and priority setting...
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U N I V E R S I T Y O F B E R G E N
How relevant is the global disease
burden for the Nordic region?
Ole Frithjof Norheim
Professor, Department of Global Public Health and Primary Care
(With contributions from prof. Stein Emil Vollset)
G l o b a l H e a l t h P r i o r i t i e s
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Outline
1. The Global Burden of Disease Project
2. Trends and patterns in the Nordic Countries
3. Relevance for planning and priority setting in the Nordic
countries
Global Health Priorities
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Global Health Priorities
The Global Burden of Disease Project
• International consortium, IHME, Seattle
– 1050 experts, 106 countries
• Compared by Bill Gates to the Human
Genome Project
• The Norwegian Institute of Public Health
– National study
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Malaria
HIV/AIDS
GBD 2013: Years of life lost
Violence
Stroke Road traffic accidentts
Ischemic heart disease
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GBD
• Aims to
– provide a comprehensive and coherent assessment
of the state of the world’s health from 1990 to present
• GBD 2010 Study
– 291 conditions, 67 risk factors
– Published in a dedicated Lancet triple issue 2012
• GBD 2013 ongoing
– 188 countries
– 5 papers published in the Lancet 2014-15
– 3 more to come
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P a t t e r n s o f d i s e a s e b u r d e n
Global Health Priorities
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Probability of death 0 to 14 years
Communicable
= red-shaded
NCD
= blue shaded
Accidents/violence
= green shaded
Nord
ic
So
uth
ern
Su
b-S
ahara
n
Afric
a
Global
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Probability of death 15 to 49 years
Communicable
= red-shaded
NCD
= blue shaded
Accidents/violence
= green shaded
So
uth
ern
Su
b-S
ahara
n
Afric
a
Nord
ic
Global
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Probability of death 50 to 75 years
Communicable
= red-shaded
NCD
= blue shaded
Accidents/violence
= green shaded
Double burden in Southern sub-Saharan Africa vs Nordic countries
Nord
ic
So
uth
ern
Su
b-
Sa
ha
ran
Afric
a
Global
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T r e n d s : l i f e e x p e c t a n c y
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Global Health Priorities
+5.0
+4.8
+5.5
+5.8
+6.6
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Global Health Priorities
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Global Health Priorities
+5.0
+4.8
+5.5
+5.8
+6.6
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Global Health Priorities
+3.5
+3.8
+4.3
+4.6
+4.9
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D i s e a s e b u r d e n i n N o r w a y
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D A L Y s = Y L L + Y L D
Global Health Priorities
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Global Health Priorities
Deaths
Cancer
CVD
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Global Health Priorities
YLL
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Global Health Priorities
YLD
Musculoskeletal
Mental and behavioral
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Global Health Priorities
DALYs
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Global Health Priorities
DALYs %
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Global Health Priorities
Rates
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R i s k f a c t o r s
Global Health Priorities
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Global Health Priorities
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Global Health Priorities
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Global Health Priorities
Burden of disease in Nordic countries
• We know:
– Trends in mortality and morbidity
– Magnitude
– Patterns
– Risk factors
• Caveats:
– Data are sparse for some conditions
– Gaps are filled by advanced statistical modeling
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Global Health Priorities
Relevance for planning and priority setting
• WHO World Health Assembly NCD
Resolution (2012)
– Reducing premature death from NCDs by
25% from 2010 to 2025* * (uniformly age-standardized mortality rates at ages 30–69 years)
• Norwegian Committee on Priority
Setting in the Health Sector (NOU
2014: 12)
– Pursue the goal of ‘the greatest number of
healthy life years for all, fairly distributed’
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P r o j e c t i o n s …
Global Health Priorities
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Global Health Priorities
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Current rate of change (% per decade, 2000-2010),
age-standardized death rate
Age 0-4 Age 5-49 Age 50-69 Age 0-69
Change 2000-2010
Change 2000-2010
Change 2000-2010
Change 2000-2010
Projected 2010-2030
Denmark -26% -25% -24% -24% -42%
Finland -26% -18% -16% -17% -31%
Iceland -37% -22% -22% -22% -39%
Norway -26% -23% -24% -24% -42%
Sweden -28% -21% -21% -21% -37%
Global Health Priorities
Source: Norheim et al. Web-appendix, Lancet 2015
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Summary
• The Global Burden of Disease study provides:
– Levels and trends in mortality and morbidity
– Distribution of burden by year, age and sex
– By condition and risk factors
• Highly relevant for planning and priority setting in the
Nordic countries
• Nordic collaboration would be welcome
Global Health Priorities