Bill & Melinda Gates Foundation

Q & A with Trevor Mundel: Global Burden of Disease Report

December 14, 2012

Impatient Optimists editor Amie Newman interviews Global Health president Trevor Mundel about the global burden of disease report.

What is the Global Burden of Disease 2010?

It is the most comprehensive study of the burden of disease at a global level to date—that is, the extent to which specific diseases are leading to premature death across the globe. It’s funded by the Gates Foundation because we believe better data helps the entire global health community solve problems more effectively and efficiently. 

What’s your reaction to the findings?

They confirm we’re making good progress in reducing the numbers who suffer from communicable disease, but we still have a lot of work to do. 

In the poorest countries in the world, fewer children are dying from causes like HIV/AIDS, malaria, and diarrhea-related diseases. In the past 50 years, the number of children who die before they turn 5 has gone down from 20 million to 6.9 million. That’s still almost 7 million children who die every year—almost all of them in poor countries—and our goal is to work with our partners to get that number close to zero. 

One of the big headlines from the GBD is that there are now more people dying of obesity related diseases than starvation and malnutrition–that non communicable diseases like cancer are overtaking communicable diseases as the leading cause of premature death–how should that effect how the world makes decisions about global health resources?

This data tells several stories. We still need to continue making progress on the diseases that are epidemic in the poorest countries in the world but don’t get sufficient attention. Millions of children are dying of malaria in sub Saharan Africa, and from diarrhea related diseases in parts of India. Around the developing world, the AIDS epidemic continues to devastate communities. 

We believe that resource decisions should be based on sound data, which is the reason we supported the study.  Clearly, there is a lot of work to be done on chronic diseases like cancer and the obesity-related illnesses that affect so many people around the world. Fortunately, there are many people doing this work. Because of the widespread impact these diseases have, health and medical research institutions in all parts of the world are putting significant resources into cures and treatments for them, which is encouraging.

But it is really important to understand these diseases do not exist in a vacuum: reducing the impact of non-communicable diseases helps solve problems related to communicable diseases and vice versa. As an example, there is growing body of evidence around early developmental linkages to non-communicable diseases, which will help inform our strategies around nutrition and maternal and child health care. Further, when we build health systems that address immunizations or family health, those structures can be relied on to address the other health problems people face in the world’s poorest countries. 

Will this have an impact the priorities of the Gates Foundation?

No, we have a longstanding strategy of focusing on the communicable diseases that disproportionately affect poor people in poor countries. This study validates the focus of our work: fewer people are dying of these diseases, but there are more lives to be saved and improved. More than anything, the report is a call to action. 

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