Global Health Priorities · Global Health Priorities Relevance for planning and priority setting • WHO World Health Assembly NCD Resolution (2012) – Reducing premature death from

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

[email protected]

(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


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

Malaria

HIV/AIDS

GBD 2013: Years of life lost

Violence

Stroke Road traffic accidentts

Ischemic heart disease

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


P a t t e r n s o f d i s e a s e b u r d e n


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


Communicable

= red-shaded

NCD

= blue shaded

Accidents/violence

= green shaded

So

uth

ern

Su

b-S

ahara

n

Afric

a

Nord

ic

Global


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

T r e n d s : l i f e e x p e c t a n c y



+5.0

+4.8

+5.5

+5.8

+6.6



+5.0

+4.8

+5.5

+5.8

+6.6


+3.5

+3.8

+4.3

+4.6

+4.9

D i s e a s e b u r d e n i n N o r w a y


D A L Y s = Y L L + Y L D



Deaths

Cancer

CVD


YLL


YLD

Musculoskeletal

Mental and behavioral


DALYs


DALYs %


Rates

R i s k f a c t o r s





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


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’

P r o j e c t i o n s …



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%


Source: Norheim et al. Web-appendix, Lancet 2015

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


Documents

Global Health Priorities · Global Health Priorities Relevance for planning and priority setting • WHO World Health Assembly NCD Resolution (2012) – Reducing premature death from