Measuring health at a global level with a unified tool: A review of institutional and methodological milestones of the Global Burden of Disease project

Abstract

The Global Burden of Disease (GBD) project represents one of the most comprehensive initiatives of health quantification to date. The Institute of Health Metrics and Evaluations
(IHME), its hosting organization, produces estimates that have become increasingly influential in global health, with a clear ambition to inform policies. The following working paper, first of two volumes included in this research, provides a thorough examination of the historical development of the GBD by looking at its conceptual, methodological, and organizational evolutions. In this first volume, we will focus on the main measurement of the study, the disability-adjusted life years (DALY), and its two components: years of life lost (YLL) and years lost to disability (YLD). The work will then explore some of the most prominent critiques of the project and will try to understand how the GBD has addressed these issues methodologically. Finally, the work ponders on the institutional influences that could have affected the project, while trying to trace the most important actors in the development of its estimates. The research relies on a literature review (non-structured) of published studies and commentaries. It follows a chronological development of the GBD estimates since their first publication in 1993 to the version released in 2019.