Browsing by Author "Fablina Sharara"

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Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2022) Kevin S Ikuta; Lucien R Swetschinski; Gisela Robles Aguilar; Fablina Sharara; Tomislav Mestrovic; Authia P Gray; Nicole Davis Weaver; Eve E Wool; Chieh Han; Anna Gershberg Hayoon; Amirali Aali; Semagn Mekonnen Abate; Mohsen Abbasi-Kangevari; Zeinab Abbasi-Kangevari; Sherief Abd-Elsalam; Getachew Abebe; Aidin Abedi; Amir Parsa Abhari; Hassan Abidi; Richard Gyan Aboagye; Abdorrahim Absalan; Hiwa Abubaker Ali; Juan Manuel Acuna; Tigist Demssew Adane; Isaac Yeboah Addo; Oyelola A Adegboye; Mohammad Adnan; Qorinah Estiningtyas Sakilah Adnani; Muhammad Sohail Afzal; Saira Afzal; Zahra Babaei Aghdam; Bright Opoku Ahinkorah; Aqeel Ahmad; Araz Ramazan Ahmad; Rizwan Ahmad; Sajjad Ahmad; Sohail Ahmad; Sepideh Ahmadi; Ali Ahmed; Haroon Ahmed; Jivan Qasim Ahmed; Tarik Ahmed Rashid; Marjan Ajami; Budi Aji; Mostafa Akbarzadeh-Khiavi; Chisom Joyqueenet Akunna; Hanadi Al Hamad; Fares Alahdab; Ziyad Al-Aly; Mamoon A Aldeyab; Alicia V Aleman; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Beriwan Abdulqadir Ali; Liaqat Ali; Syed Shujait Ali; Yousef Alimohamadi; Vahid Alipour; Atiyeh Alizadeh; Syed Mohamed Aljunid; Kasim Allel; Sami Almustanyir; Edward Kwabena Ameyaw; Arianna Maever L Amit; Nivedita Anandavelane; Robert Ancuceanu; Catalina Liliana Andrei; Tudorel Andrei; Dewi Anggraini; Adnan Ansar; Anayochukwu Edward Anyasodor; Jalal Arabloo; Aleksandr Y Aravkin; Demelash Areda; Timur Aripov; Anton A Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Muhammad Asaduzzaman; Tahira Ashraf; Seyyed Shamsadin Athari; Daniel Atlaw; Sameh Attia; Marcel Ausloos; Tewachew Awoke; Beatriz Paulina Ayala Quintanilla; Tegegn Mulatu Ayana; Sina Azadnajafabad; Amirhossein Azari Jafari; B. Darshan; Muhammad Badar; Ashish D Badiye; Nayereh Baghcheghi; Sara Bagherieh; Atif Amin Baig; Indrajit Banerjee; Aleksandra Barac; Mainak Bardhan; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Pritish Baskaran; Saurav Basu; Abdul-Monim Mohammad Batiha; Neeraj Bedi; Melaku Ashagrie Belete; Uzma Iqbal Belgaumi; Rose G Bender; Bharti Bhandari; Dinesh Bhandari; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Suraj Bhattarai; Saeid Bitaraf; Danilo Buonsenso; Zahid A Butt; Florentino Luciano Caetano Dos Santos; Jiao Cai; Daniela Calina; Paulo Camargos; Luis Alberto Cámera; Rosario Cárdenas; Muge Cevik; Joshua Chadwick; Jaykaran Charan; Akhilanand Chaurasia; Patrick R Ching; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Fazle Rabbi Chowdhury; Dinh-Toi Chu; Isaac Sunday Chukwu; Omid Dadras; Fentaw Teshome Dagnaw; Xiaochen Dai; Saswati Das; Anna Dastiridou; Sisay Abebe Debela; Fitsum Wolde Demisse; Solomon Demissie; Diriba Dereje; Msganaw Derese; Hardik Dineshbhai Desai; Fikadu Nugusu Dessalegn; Samuel Abebe A Dessalegni; Belay Desye; Kartik Dhaduk; Meghnath Dhimal; Sameer Dhingra; Nancy Diao; Daniel Diaz; Shirin Djalalinia; Milad Dodangeh; Deepa Dongarwar; Bezabih Terefe Dora; Fariba Dorostkar; Haneil Larson Dsouza; Eleonora Dubljanin; Susanna J Dunachie; Oyewole Christopher Durojaiye; Hisham Atan Edinur; Habtamu Bekele Ejigu; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Hassan El-Abid; Muhammed Elhadi; Mohamed A Elmonem; Amir Emami; Luchuo Engelbert Bain; Daniel Berhanie Enyew; Ryenchindorj Erkhembayar; Babak Eshrati; Farshid Etaee; Adeniyi Francis Fagbamigbe; Shahab Falahi; Aida Fallahzadeh; Emerito Jose A Faraon; Ali Fatehizadeh; Ginenus Fekadu; João C Fernandes; Allegra Ferrari; Getahun Fetensa; Irina Filip; Florian Fischer; Masoud Foroutan; Peter Andras Gaal; Muktar A Gadanya; Abhay Motiramji Gaidhane; Balasankar Ganesan; Mesfin Gebrehiwot; Reza Ghanbari; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Ali Gholamrezanezhad; Abdolmajid Gholizadeh; Mahaveer Golechha; Pouya Goleij; Davide Golinelli; Amador Goodridge; Damitha Asanga Gunawardane; Yuming Guo; Rajat Das Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Alemu Guta; Parham Habibzadeh; Atlas Haddadi Avval; Rabih Halwani; Asif Hanif; Md Abdul Hannan; Harapan Harapan; Shoaib Hassan; Hadi Hassankhani; Khezar Hayat; Behzad Heibati; Golnaz Heidari; Mohammad Heidari; Reza Heidari-Soureshjani; Claudiu Herteliu; Demisu Zenbaba Heyi; Kamal Hezam; Praveen Hoogar; Nobuyuki Horita; Md Mahbub Hossain; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Soodabeh Hoveidamanesh; Junjie Huang; Salman Hussain; Nawfal R Hussein; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Mohammad Tarique Imam; Mustapha Immurana; Leeberk Raja Inbaraj; Arnaud Iradukunda; Nahlah Elkudssiah Ismail; Chidozie C D Iwu; Chinwe Juliana Iwu; Merin J. Linda; Mihajlo Jakovljevic; Elham Jamshidi; Tahereh Javaheri; Fatemeh Javanmardi; Javad Javidnia; Sathish Kumar Jayapal; Umesh Jayarajah; Rime Jebai; Ravi Prakash Jha; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Salah Eddine Oussama Kacimi; Vidya Kadashetti; Laleh R Kalankesh; Rohollah Kalhor; Vineet Kumar Kamal; Himal Kandel; Neeti Kapoor; Samad Karkhah; Bekalu Getnet Kassa; Nicholas J Kassebaum; Patrick D.M.C. Katoto; Mohammad Keykhaei; Himanshu Khajuria; Abbas Khan; Imteyaz A. Khan; Maseer Khan; Md Nuruzzaman Khan; Moien A.B. Khan; Moawiah Mohammad Khatatbeh; Mona M Khater; Hamid Reza Khayat Kashani; Jagdish Khubchandani; Hanna Kim; Min Seo Kim; Ruth W Kimokoti; Niranjan Kissoon; Sonali Kochhar; Farzad Kompani; Soewarta Kosen; Parvaiz A Koul; Sindhura Lakshmi Koulmane Laxminarayana; Fiorella Krapp Lopez; Kewal Krishan; Vijay Krishnamoorthy; Vishnutheertha Kulkarni; Naveen Kumar; Om P Kurmi; Ambily Kuttikkattu; Hmwe Hmwe Kyu; Dharmesh Kumar Lal; Judit Lám; Iván Landires; Savita Lasrado; Sang-Woong Lee; Jacopo Lenzi; Sonia Lewycka; Shanshan Li; Stephen S Lim; Wei Liu; Rakesh Lodha; Michael J Loftus; Ayush Lohiya; Lászl Lorenzovici; Mojgan Lotfi; Ata Mahmoodpoor; Mansour Adam Mahmoud; Razzagh Mahmoudi; Azeem Majeed; Jamal Majidpoor; Alaa Makki; Galana Ayana Mamo; Yosef Manla; Miquel Martorell; Clara N Matei; Barney Mcmanigal; Entezar Mehrabi Nasab; Ravi Mehrotra; Addisu Melese; Oliver Mendoza-Cano; Ritesh G Menezes; Alexios-Fotios A Mentis; Georgia Micha; Irmina Maria Michalek; Ana Carolina Micheletti Gomide Nogueira Des; Neda Milevska Kostova; Shabir Ahmad Mir; Mojgan Mirghafourvand; Seyyedmohammadsadeq Mirmoeeni; Erkin M Mirrakhimov; Mohammad Mirza-Aghazadeh-attari; Abay Sisay Misganaw; Awoke Misganaw; Sanjeev Misra; Esmaeil Mohammadi; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Syam Mohan; Mohammad Mohseni; Ali H Mokdad; Sara Momtazmanesh; Lorenzo Monasta; Catrin E Moore; Maryam Moradi; Mostafa Moradi Sarabi; Shane Douglas Morrison; Majid Motaghinejad; Haleh Mousavi Isfahani; Amin Mousavi Khaneghah; Seyed Ali Mousavi-Aghdas; Sumaira Mubarik; Francesk Mulita; Getaneh Baye B Mulu; Sandra B Munro; Saravanan Muthupandian; Tapas Sadasivan Nair; Atta Abbas Naqvi; Himanshi Narang; Zuhair S Natto; Muhammad Naveed; Biswa Prakash Nayak; Shumaila Naz; Ionut Negoi; Seyed Aria Nejadghaderi; Sandhya Neupane Kandel; Che Henry Ngwa; Robina Khan Niazi; Antonio Tolentino Nogueira Des; Nafise Noroozi; Hasti Nouraei; Ali Nowroozi; Virginia Nuñez-Samudio; Jerry John Nutor; Chimezie Igwegbe Nzoputam; Ogochukwu Janet Nzoputam; Bogdan Oancea; Rahman Md Obaidur; Vivek Anand Ojha; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Andrew T Olagunju; Bolajoko Olubukunola Olusanya; Ahmed Omar Bali; Emad Omer; Nikita Otstavnov; Bilcha Oumer; Jagadish Rao Padubidri; Keyvan Pakshir; Tamás Palicz; Adrian Pana; Shahina Pardhan; Jose L Paredes; Utsav Parekh; Eun-Cheol Park; Seoyeon Park; Ashish Pathak; Rajan Paudel; Uttam Paudel; Shrikant Pawar; Hamidreza Pazoki Toroudi; Minjin Peng; Umberto Pensato; Veincent Christian Filipino Pepito; Marcos Pereira; Mario F P Peres; Norberto Perico; Ionela-Roxana Petcu; Zahra Zahid Piracha; Indrashis Podder; Nayanum Pokhrel; Ramesh Poluru; Maarten J Postma; Naeimeh Pourtaheri; Akila Prashant; Ibrahim Qattea; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Saber Raeghi; Sima Rafiei; Pankaja Raghav Raghav; Leila Rahbarnia; Vafa Rahimi-Movaghar; Mosiur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Vahid Rahmanian; Pradhum Ram; Muhammad Modassar Ali Nawaz Ranjha; Sowmya J Rao; Mohammad-Mahdi Rashidi; Azad Rasul; Zubair Ahmed Ratan; Salman Rawaf; Reza Rawassizadeh; Mohammad Sadegh Razeghinia; Elrashdy Moustafa Mohamed Redwan; Misganu Teshoma Regasa; Giuseppe Remuzzi; Melese Abate Reta; Nazila Rezaei; Aziz Rezapour; Abanoub Riad; Rezaul Karim Ripon; Kristina E Rudd; Basema Saddik; Saeid Sadeghian; Umar Saeed; Mohsen Safaei; Azam Safary; Sher Zaman Safi; Maryam Sahebazzamani; Amirhossein Sahebkar; Harihar Sahoo; Saina Salahi; Sarvenaz Salahi; Hedayat Salari; Sana Salehi; Hossein Samadi Kafil; Abdallah M Samy; Nima Sanadgol; Senthilkumar Sankararaman; Francesco Sanmarchi; Brijesh Sathian; Monika Sawhney; Ganesh Kumar Saya; Subramanian Senthilkumaran; Allen Seylani; Pritik A Shah; Masood Ali Shaikh; Elaheh Shaker; Murad Ziyaudinovich Shakhmardanov; Mequannent Melaku Sharew; Athena Sharifi-Razavi; Purva Sharma; Rahim Ali Sheikhi; Ali Sheikhy; Pavanchand H Shetty; Mika Shigematsu; Jae Il Shin; Hesamaddin Shirzad-Aski; K.M. Shivakumar; Parnian Shobeiri; Seyed Afshin Shorofi; Sunil Shrestha; Migbar Mekonnen Sibhat; Negussie Boti Sidemo; Mustafa Kamal Sikder; Luís Manuel Lopes Rodrigues Silva; Jasvinder A Singh; Paramdeep Singh; Surjit Singh; Md Shahjahan Siraj; Samarjeet Singh Siwal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Bogdan Socea; Damtew Damtew Solomon; Yimeng Song; Chandrashekhar T Sreeramareddy; Muhammad Suleman; Rizwan Suliankatchi Abdulkader; Saima Sultana; Miklós Szócska; Seyed-Amir Tabatabaeizadeh; Mohammad Tabish; Majid Taheri; Elahe Taki; Ker-Kan Tan; Sarmila Tandukar; Nathan Y Tat; Vivian Y Tat; Belay Negash Tefera; Yibekal Manaye Tefera; Gebremaryam Temesgen; Mohamad-Hani Temsah; Samar Tharwat; Arulmani Thiyagarajan; Imad I Tleyjeh; Christopher E Troeger; Krishna Kishore Umapathi; Era Upadhyay; Sahel Valadan Tahbaz; Pascual R Valdez; Jef Van Den Eynde; H Rogier Van Doorn; Siavash Vaziri; Georgios-Ioannis Verras; Harimadhav Viswanathan; Bay Vo; Abdul Waris; Gizachew Tadesse Wassie; Nuwan Darshana Wickramasinghe; Sajad Yaghoubi; Gahin Abdulraheem Tayib Yahya Yahya; Seyed Hossein Yahyazadeh Jabbari; Arzu Yigit; Vahit Yigit; Dong Keon Yon; Naohiro Yonemoto; Mazyar Zahir; Burhan Abdullah Zaman; Sojib Bin Zaman; Moein Zangiabadian; Iman Zare; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Peng Zheng; Chenwen Zhong; Mohammad Zoladl; Alimuddin Zumla; Simon I Hay; Christiane Dolecek; Benn Sartorius; Christopher J L Murray; Mohsen Naghavi
Background: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings: From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Lancet Publishing Group, 2020) Rafael Lozano; Nancy Fullman; John Everett Mumford; Megan Knight; Celine M Barthelemy; Cristiana Abbafati; Hedayat Abbastabar; Foad Abd-Allah; Mohammad Abdollahi; Aidin Abedi; Hassan Abolhassani; Akine Eshete Abosetugn; Lucas Guimarães Abreu; Michael R M Abrigo; Abdulaziz Khalid Abu Haimed; Abdelrahman I Abushouk; Maryam Adabi; Oladimeji M Adebayo; Victor Adekanmbi; Jaimie Adelson; Olatunji O Adetokunboh; Davoud Adham; Shailesh M Advani; Ashkan Afshin; Gina Agarwal; Pradyumna Agasthi; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Rufus Olusola Akinyemi; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Samuel B Albertson; Yihun Mulugeta Alemu; Robert Kaba Alhassan; Muhammad Ali; Saqib Ali; Vahid Alipour; Syed Mohamed Aljunid; François Alla; Majid Abdulrahman Hamad Almadi; Ali Almasi; Amir Almasi-Hashiani; Nihad A Almasri; Hesham M Al-Mekhlafi; Abdulaziz M Almulhim; Jordi Alonso; Rajaa M Al-Raddadi; Khalid A Altirkawi; Nelson Alvis-Guzman; Nelson J Alvis-Zakzuk; Saeed Amini; Mostafa Amini-Rarani; Fatemeh Amiri; Arianna Maever L Amit; Dickson A Amugsi; Robert Ancuceanu; Deanna Anderlini; Catalina Liliana Andrei; Sofia Androudi; Fereshteh Ansari; Alireza Ansari-Moghaddam; Carl Abelardo T Antonio; Catherine M Antony; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Jalal Arabloo; Morteza Arab-Zozani; Aleksandr Y Aravkin; Olatunde Aremu; Johan Ärnlöv; Malke Asaad; Mehran Asadi-Aliabadi; Ali A Asadi-Pooya; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Marcel Ausloos; Leticia Avila-Burgos; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Martin Amogre Ayanore; Yared Asmare Aynalem; Getie Lake Aynalem; Muluken Altaye Ayza; Samad Azari; Peter S Azzopardi; Darshan B B; Ebrahim Babaee; Ashish D Badiye; Mohammad Amin Bahrami; Atif Amin Baig; Mohammad Hossein Bakhshaei; Ahad Bakhtiari; Shankar M Bakkannavar; Arun Balachandran; Maciej Banach; Srikanta K Banerjee; Palash Chandra Banik; Agegnehu Bante Bante; Simachew Animen Bante; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H Barrero; Quique Bassat; Sanjay Basu; Bernhard T Baune; Mohsen Bayati; Bayisa Abdissa Baye; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Tariku Tesfaye Tesfaye Bekuma; Michelle L Bell; Isabela M Bensenor; Adam E Berman; Eduardo Bernabe; Robert S Bernstein; Akshaya Srikanth Bhagavathula; Dinesh Bhandari; Pankaj Bhardwaj; Anusha Ganapati Bhat; Krittika Bhattacharyya; Suraj Bhattarai; Zulfiqar A Bhutta; Ali Bijani; Boris Bikbov; Ver Bilano; Antonio Biondi; Binyam Minuye Birihane; Moses John Bockarie; Somayeh Bohlouli; Hunduma Amensisa Bojia; Srinivasa Rao Rao Bolla; Archith Boloor; Oliver J Brady; Dejana Braithwaite; Andrew M Briggs; Nikolay Ivanovich Briko; Sharath Burugina Nagaraja; Reinhard Busse; Zahid A Butt; Florentino Luciano Caetano dos Santos; Lucero Cahuana-Hurtado; Luis Alberto Cámera; Rosario Cárdenas; Giulia Carreras; Juan J Carrero; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A Castañeda-Orjuela; Giulio Castelpietra; Franz Castro; Ferrán Catalá-López; Christopher R Cederroth; Ester Cerin; Joht Singh Chandan; Angela Y Chang; Jaykaran Charan; Vijay Kumar Chattu; Sarika Chaturvedi; Ken Lee Chin; Daniel Youngwhan Cho; Jee-Young Jasmine Choi; Hanne Christensen; Dinh-Toi Chu; Michael T Chung; Liliana G Ciobanu; Massimo Cirillo; Kelly Compton; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Saad M A Dahlawi; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Jiregna Darega Gela; Aso Mohammad Darwesh; Ahmad Daryani; Aditya Prasad Dash; Gail Davey; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Jan-Walter De Neve; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Rupak Desai; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Ilse N Dippenaar; Hoa Thi Do; Fariba Dorostkar; Leila Doshmangir; Bruce B Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; David Edvardsson; Iman El Sayed; Maha El Tantawi; Islam Y Elgendy; Iqbal RF Elyazar; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Alireza Esteghamati; Oluchi Ezekannagha; Tamer Farag; Mohammad Farahmand; Emerito Jose A Faraon; Carla Sofia e Sá Farinha; Andrea Farioli; Pawan Sirwan Faris; Andre Faro; Mehdi Fazlzadeh; Valery L Feigin; Eduarda Fernandes; Pietro Ferrara; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; James L Fisher; Luisa Sorio Flor; Nataliya A Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Masoud Foroutan; Joel Msafiri Francis; Weijia Fu; Takeshi Fukumoto; João M Furtado; Mohamed M Gad; Abhay Motiramji Gaidhane; Emmanuela Gakidou; Natalie C Galles; Silvano Gallus; William M Gardner; Biniyam Sahiledengle Geberemariyam; Abiyu Mekonnen Gebrehiwot; Leake G Gebremeskel; Gebreamlak Gebremedhn Gebremeskel; Hailay Abrha Gesesew; Keyghobad Ghadiri; Mansour Ghafourifard; Ahmad Ghashghaee; Nermin Ghith; Asadollah Gholamian; Syed Amir Gilani; Paramjit Singh Gill; Tiffany K Gill; Themba G Ginindza; Mojgan Gitimoghaddam; Giorgia Giussani; Mustefa Glagn; Elena V Gnedovskaya; Myron Anthony Godinho; Salime Goharinezhad; Sameer Vali Gopalani; Amir Hossein Goudarzian; Bárbara Niegia Garcia Goulart; Mohammed Ibrahim Mohialdeen Gubari; Rafael Alves Guimarães; Rashid Abdi Guled; Teklemariam Gultie; Yuming Guo; Rahul Gupta; Nima Hafezi-Nejad; Abdul Hafiz; Teklehaimanot Gereziher Haile; Randah R Hamadeh; Sajid Hameed; Samer Hamidi; Chieh Han; Hannah Han; Demelash Woldeyohannes Handiso; Asif Hanif; Graeme J Hankey; Josep Maria Haro; Ahmed I Hasaballah; Md Mehedi Hasan; Abdiwahab Hashi; Shoaib Hassan; Amr Hassan; Soheil Hassanipour; Hadi Hassankhani; Rasmus J Havmoeller; Simon I Hay; Khezar Hayat; Golnaz Heidari; Reza Heidari-Soureshjani; Delia Hendrie; Claudiu Herteliu; Thomas R Hird; Hung Chak Ho; Michael K Hole; Ramesh Holla; Praveen Hoogar; Kathleen Pillsbury Hopf; Nobuyuki Horita; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Vivian Chia-rong Hsieh; Guoqing Hu; Tanvir M Huda; Ayesha Humayun; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Nayu Ikeda; Olayinka Stephen Ilesanmi; Milena D Ilic; Leeberk Raja Inbaraj; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; M Mofizul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Hiroyasu Iso; Chinwe Juliana Iwu; Jalil Jaafari; Farhad Jadidi-Niaragh; Morteza Jafarinia; Deepa Jahagirdar; Mohammad Ali Jahani; Nader Jahanmehr; Mihajlo Jakovljevic; Hosna Janjani; Tahereh Javaheri; Achala Upendra Jayatilleke; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S Ji; Peng Jia; Yetunde O John-Akinola; Jost B Jonas; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Zubair Kabir; Leila R Kalankesh; Rohollah Kalhor; Aruna M Kamath; Tanuj Kanchan; Neeti Kapoor; Behzad Karami Matin; Marina Karanikolos; Seyed M Karimi; Nicholas J Kassebaum; Srinivasa Vittal Katikireddi; Gbenga A Kayode; Peter Njenga Keiyoro; Yousef Saleh Khader; Mohammad Khammarnia; Maseer Khan; Ejaz Ahmad Khan; Young-Ho Khang; Khaled Khatab; Amir M Khater; Mona M Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Jagdish Khubchandani; Neda Kianipour; Yun Jin Kim; Ruth W Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimäki; Cameron J Kneib; Jonathan M Kocarnik; Sonali Kochhar; Stefan Kohler; Jacek A Kopec; Anna V Korotkova; Vladimir Andreevich Korshunov; Soewarta Kosen; Anirudh Kotlo; Parvaiz A Koul; Ai Koyanagi; Kewal Krishan; Kris J Krohn; Nuworza Kugbey; Vaman Kulkarni; G Anil Kumar; Nithin Kumar; Manasi Kumar; Om P Kurmi; Dian Kusuma; Hmwe Hmwe Kyu; Carlo La Vecchia; Ben Lacey; Dharmesh Kumar Lal; Ratilal Lalloo; Iván Landires; Van Charles Lansingh; Anders O Larsson; Savita Lasrado; Kathryn Mei-Ming Lau; Paolo Lauriola; Jeffrey V Lazarus; Jorge R Ledesma; Paul H Lee; Shaun Wen Huey Lee; Andrew T Leever; Kate E LeGrand; James Leigh; Matilde Leonardi; Shanshan Li; Stephen S Lim; Lee-Ling Lim; Xuefeng Liu; Giancarlo Logroscino; Alan D Lopez; Platon D Lopukhov; Paulo A Lotufo; Alton Lu; Jianing Ma; 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Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding: Bill & Melinda Gates Foundation. © 2020 Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license