Browsing by Author "H.J. Larson"

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    PublicationErratum
    Erratum: Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 (The Lancet (2016) 388(10053) (1775–1812)(S0140673616314702)(10.1016/S0140-6736(16)31470-2))
    (Elsevier B.V., 2017) N.J. Kassebaum; R.M. Barber; L. Dandona; S.I. Hay; H.J. Larson; S.S. Lim; A.D. Lopez; A.H. Mokdad; M. Naghavi; C. Pinho; C. Steiner; T. Vos; H. Wang; T. Achoki; G.M. Anderson; M. Arora; S. Biryukov; J.D. Blore; A. Carter; D.C. Casey; M.M. Coates; M. Coggeshall; D.J. Dicker; E. Dossou; T. Fleming; M.S. Fraser; J. Friedman; N. Fullman; N. Graetz; J. Hancock; C. Huynh; M. Iannarone; L. Kemmer; X.R. Kulikoff; M.J. Kutz; P.Y. Liu; N. Marquez; A. Misganaw; M.D. Mooney; M. Moradi-Lakeh; M. Ng; G. Nguyen; A. Pain; K.A. Shackelford; N. Silpakit; A. Sligar; J.M. Smith; R.J.D. Sorensen; S.E. Vollset; J.A. Wagner; T. Wolock; Y. Zhao; M. Zhou; C.J.L. Murray; B.E. Ebel; N.D. Futran; K.M. Harun; Z.A. Bhutta; M.I. Nisar; N. Akseer; P. Jeemon; R. Dandona; S. Goenka; G.A. Kumar; P.W. Gething; D. Bisanzio; A. Deribew; C. Cooper; R. Ali; D.A. Bennett; V. Jha; K. Rahimi; Y. Kinfu; G.V.S. Murthy; Y. Li; S. Liu; L. Wang; X. Liang; S. Yu; P. Azzopardi; K.B. Gibney; A. Meretoja; C.E.I. Szoeke; K. Alam; S.M. Colquhoun; R.G. Weintraub; T. Wijeratne; R. Lozano; I.R. Campos-Nonato; J.C. Campuzano; H. Gomez-Dantes; H. Lamadrid-Figueroa; F. Mejia-Rodriguez; J.C. Montañez Hernandez; P. Montero; G.A. Mensah; J.A. Salomon; A.L. Thorne-Lyman; O.N. Ajala; T. Bärnighausen; E.L. Ding; M.S. Farvid; J.R.A. Fitchett; A.A. Abajobir; L.D. Knibbs; R. Lalloo; N.K.M. Alam; Y. Guo; K.H. Abate; T.T. Gebrehiwot; A.T. Gebremedhin; K.M. Abbas; F. Abd-Allah; M.A. Abdallat; A.M. Abdulle; S.F. Abera; Y.A. Melaku; F.H. Tesfay; A.F. Aregay; T.A. Bayou; B.D. Betsu; M. Gebremedhin; A.A. Gebru; G.B. Hailu; T. Tekle; A.Z. Yalew; H.G. Yebyo; V. Aboyans; I. Abubakar; R.W. Aldridge; A. Banerjee; N.M. Aburmeileh; A.O. Adebiyi; A.L. Adelekan; F.A. Ojelabi; I.A. Adedeji; A.K. Adou; K.A. Afanvi; A. Badawi; A. Agarwal; A. Agarwal; A Ahmad Kiadaliri; T.F. Akinyemiju; D.C. Schwebel; J.A. Singh; Z. Al-Aly; K. Alam; A.H. Kemp; J. Leigh; A.B. Mekonnen; D. Alasfoor; S.F. Aldhahri; A.S. Terkawi; S. Alhabib; A. Alkerwi; F. Alla; R. Al-Raddadi; U. Alsharif; E Alvarez Martin; N. Alvis-Guzman; A.T. Amare; L.G. Ciobanu; G.A. Tessema; T. Setegn; A. Amberbir; A.K. Amegah; A.A. Kudom; W. Ammar; H.L. Harb; S.M. Amrock; H.H. Andersen; R.M. Antoine; C.A.T. Antonio; E.J.A. Faraon; J. Ärnlöv; A. Larsson; V.S. Arsic Arsenijevic; A. Barac; A. Artaman; H. Asayesh; S. Atique; E.F.G.A. Avokpaho; A. Awasthi; B.P. Ayala Quintanilla; U. Bacha; M.C. Bahit; K. Balakrishnan; S.L. Barker-Collo; S. Mohammed; S. Basu; Y.T. Bayou; S. Bazargan-Hejazi; J. Beardsley; N. Bedi; T. Bekele; M.L. Bell; B.J. Biroscak; J.J. Huang; I.S. Santos; I.M. Bensenor; P.A. Lotufo; A. Berhane; C.D. Wolfe; E. Bernabé; A.S. Beyene; S. Biadgilign; B. Bikbov; A.A. Bin Abdulhak; E. Bjertness; A.S. Htet; M. Brainin; A. Brazinova; M. Majdan; J. Shen; N.J.K. Breitborde; T.S. Brugha; Z.A. Butt; R. Cárdenas; S. Fereshtehnejad; M. Kivipelto; E. Weiderpass; R. Havmoeller; S. Sindi; C.A. Castañeda-Orjuela; C.A. Castañedaorjuela; R.E. Castro; F. Catalá-López; F. Cavalleri; V. Colistro; H. Chang; J. Chang; L. Chavan; C.E. Chibueze; V.H. Chisumpa; C.C. Mapoma; F. Masiye; J.J. Choi; R. Chowdhury; D.J. Christopher; M. Cirillo; L.T. Cooper; T. Dahiru; A. Damasceno; H. Danawi; A.H. Refaat; J Das Neves; D. De Leo; R.P. Dellavalle; K. Deribe; A.D. Hailu; W. Tefera; A.Z. Giref; T. Jibat; G Temam Shifa; D.C. Des Jarlais; S.D. Dharmaratne; M. Dubey; M.H.U. Rahman; U. Ram; A. Singh; A.K. Yadav; C.L. Ellingsen; M. Savic; V. Skirbekk; I. Elyazar; S.P. Ermakov; S. Soshnikov; B. Eshrati; F. Farzadfar; A. Kasaeian; F. Pishgar; A. Esteghamati; N. Hafezi-Nejad; S. Sheikhbahaei; A. Khosravi; R. Malekzadeh; G. Roshandel; S.G. Sepanlou; V. Rahimi-Movaghar; T.A. Farid; A.R. Khan; C.S.E.S. Farinha; A. Faro; J.C. Fernandes; F. Fischer; N. Foigt; E.B. Franca; R.C. Franklin; T. Fürst; A. Majeed; K. Gambashidze; K. Kazanjan; M. Kereselidze; I. Khonelidze; M. Shakh-Nazarova; L. Sturua; A. Gamkrelidze; T. Gebre; J.M. Geleijnse; M. Giroud; M.D. Gishu; A.K. Tura; E. Glaser; P. Gona; A. Goodridge; S.V. Gopalani; A. Goto; H.C. Gugnani; R. Gupta; V. Gupta; O.F. Norheim; R.R. Hamadeh; S. Hamidi; A.J. Handal; G.J. Hankey; S. Harikrishnan; H.W. Hoek; M. Horino; N. Horita; H.D. Hosgood; D.G. Hoy; G. Hu; H. Huang; I. Huybrechts; K.M. Iburg; B.T. Idrisov; V.J. Iyer; K.H. Jacobsen; N. Jahanmehr; M.B. Jakovljevic; M. Javanbakht; A.U. Jayatilleke; S.H. Jee; D.K. Lal; S. Zodpey; G. Jiang; Y. Jiang; J.B. Jonas; Z. Kabir; R. Kamal; C.N. Kesavachandran; J. She; H. Kan; A. Karch; D. Karletsos; A. Kaul; N. Kawakami; K. Shibuya; J.F. Kayibanda; D.S. Kazi; P.N. Keiyoro; A.P. Kengne; C.S. Wiysonge; K. Sliwa; A. Keren; Y.S. Khader; E.A. Khan; Y.H. Khang; S. Won; J. Khubchandani; Y.J. Kim; Y. Kokubo; S. Kosen; P.A. Koul; A. Koyanagi; S. Krishnaswami; B Kuate Defo; B Kucuk Bicer; H. Lam; Q. Lan; D.O. Laryea; R. Leung; S.E. Lipshultz; J.D. Wilkinson; E.P. Simard; Y. Liu; M.R. Phillips; Q. Xiao; B.K. Lloyd; R. Lunevicius; D. Pope; S. Ma; H Magdy Abd El Razek; W. Marcenes; P.A. Meaney; D.J. Margolis; M.B. Marzan; A.J. Mason-Jones; T.T. Mazorodze; A. Mehari; M.M. Mehndiratta; S.M. Woldeyohannes; B.A. Tedla; Z.A. Memish; W. Mendoza; T.J. Meretoja; F.A. Mhimbira; T.R. Miller; E.J. Mills; N. Mohamed Ibrahim; K.A. Mohammad; A. Mohammadi; G.L.D. Mola; L. Monasta; M. Montico; L. Ronfani; J.D. Monis; A.R. Moore; M. Moradilakeh; L. Morawska; R.E. Norman; R. Mori; A. Werdecker; U.O. Mueller; R. Westerman; S. Murthy; F. Pourmalek; J.B. Nachega; A.J. Paternina Caicedo; S. Seedat; B.X. Tran; A. Naheed; L. Naldi; G. Remuzzi; D. Nand; V. Nangia; D. Nash; S. Neupane; J.N. Newton; F.N. Ngalesoni; P. Nguhiu; Q.L. Nguyen; M. Nomura; L. Nyakarahuka; C.M. Obermeyer; F.A. Ogbo; I. Oh; P.R. Olivares; B.O. Olusanya; J.O. Olusanya; J.N. Opio; E. Oren; E. Ota; A.S. Oyekale; P.A. Mahesh; N. Papantoniou; V. Stathopoulou; E. Park; H. Park; S.B. Patten; V.K. Paul; A. Roy; R. Sagar; M. Satpathy; D.M. Pereira; M. Cortinovis; N. Perico; K. Pesudovs; M. Petzold; J.D. Pillay; S. Polinder; M. Qorbani; A. Rafay; S.U. Rahman; R.K. Rai; C.L. Ranabhat; T. Rangaswamy; P.V. Rao; S. Resnikoff; D. Rojas-Rueda; G.M. Ruhago; B.F. Sunguya; M.M. Saleh; J.R. Sanabria; M.D. Sanchez-Niño; R. Sarmiento-Suarez; B. Sartorius; M. Sawhney; M.I. Saylan; I.J.C. Schneider; D.A.S. Silva; E.E. Servan-Mori; M.A. Shaikh; R. Sharma; M. Shin; S. Yoon; R. Shiri; K. Shishani; I. Shiue; I.D. Sigfusdottir; D.G.A. Silveira; J.I. Silverberg; Y. Yano; O.P. Singh; P.K. Singh; V. Singh; S. Soneji; J.B. Soriano; L.A. Sposato; C.T. Sreeramareddy; K. Stroumpoulis; S. Swaminathan; B.L. Sykes; R. Tabarés-Seisdedos; K.M. Tabb; R.T. Talongwa; M. Tavakkoli; B. Taye; A.Y. Endries; G. Temam Shifa; A.J. Thomson; R. Tobe-Gai; R. Topor-Madry; J.A. Towbin; Z. Tsala Dimbuene; S. Tyrovolas; K.N. Ukwaja; O.A. Uthman; T. Vasankari; N. Venketasubramanian; F.S. Violante; S.K. Vladimirov; V.V. Vlassov; S. Weichenthal; M. Wubshet; G. Xu; B. Yakob; P. Yip; N. Yonemoto; M.Z. Younis; C. Yu; Z. Zaidi; M.E. Zaki; H. Zeeb; L.J. Zuhlke
    GBD 2015 Maternal Mortality Collaborators. Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1775–812—In this Article, an extra affiliation has been added for Simon I Hay. The affiliation for Monica Cortinovis has been edited. The funding statement for Simon I Hay has been added. These corrections have been made to the online version as of Jan 5, 2017. © 2017 Elsevier Ltd
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    PublicationArticle
    Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015
    (Elsevier Ltd, 2016) H. Wang; T.M. Wolock; A. Carter; G. Nguyen; H.H. Kyu; E. Gakidou; S.I. Hay; W. Msemburi; M.M. Coates; M.D. Mooney; M.S. Fraser; A. Sligar; H.J. Larson; J. Friedman; A. Brown; L. Dandona; N. Fullman; J. Haagsma; I. Khalil; S.S. Lim; J. Mikesell; A.H. Mokdad; M. Moradi-Lakeh; K. Pearson; BS Silpakit; MPH Sorensen; A.M. Temesgen; S.E. Vollset; L. Zoeckler; C.J.L. Murray; R. Alfonso-Cristancho; K.M. Harun; D.M. Prokop; E.J. Mills; A. Trickey; O.N. Ajala; T. Bärnighausen; E.L. Ding; M.S. Farvid; A.L. Thorne-Lyman; S. Won; J.R.A. Fitchett; J. Salomon; A.A. Abajobir; D.G. Hoy; N.K.M. Alam; K.H. Abate; T.T. Ghiwot; A.T. Gebremedhin; K.M. Abbas; M.M. Abd El Razek; F. Abd-Allah; A.M. Abdulle; S.F. Abera; Y.A. Melaku; F.H. Tesfay; G.Y. Abyu; T.A. Bayou; B.D. Betsu; A.A. Gebru; G.B. Hailu; T. Tekle; A.Z. Yalew; H.G. Yebyo; I. Abubakar; R.W. Aldridge; L.J. Abu-Raddad; N.M.E. Abu-Rmeileh; A.O. Adebiyi; I.A. Adedeji; A.L. Adelekan; F.A. Ojelabi; K. Adofo; A.K. Adou; T.F. Akinyemiju; D.C. Schwebel; J.A. Singh; N. Akseer; F.H. Al Lami; Z. Al-Aly; K. Alam; R.G. Weintraub; P.P. Chiang; A. Meretoja; A.D. Lopez; T. Wijeratne; T.R. Driscoll; A.H. Kemp; J. Leigh; A.B. Mekonnen; C.K. Karema; D. Alasfoor; S.F.S. Aldhahri; A.S. Terkawi; M.A. Alegretti; A.V. Aleman; Z.A. Alemu; C. Cooper; A. Deribew; P.W. Gething; R. Ali; D.A. Bennett; D. Bisanzio; K. Rahimi; A. Alkerwi; F. Alla; R.M.S. Al-Raddadi; M.Y. Saeedi; U. Alsharif; E. Alvarez; N. Alvis-Guzman; A.T. Amare; H.W. Hoek; A.K. Tura; L.G. Ciobanu; G.A. Tessema; A. Amberbir; A.K. Amegah; W. Ammar; H.L. Harb; S.M. Amrock; C.A.T. Antonio; P. Anwari; J. Ärnlöv; A. Larsson; A. Artaman; H. Asayesh; R.J. Asghar; R. Assadi; S. Atique; L.S. Atkins; E.F.G.A. Avokpaho; A. Awasthi; E. Bhatia; B.P. Ayala; U. Bacha; A. Badawi; A. Barac; A. Basu; Y.T. Bayou; S. Bazargan-Hejazi; J. Beardsley; N. Bedi; I.S. Santos; I.M. Bensenor; P.A. Lotufo; A.S. Beyene; Z.A. Bhutta; M.I. Nisar; S. Biadgilign; B. Bikbov; S.M. Birlik; M. Brainin; A. Brazinova; M. Majdan; N.J.K. Breitborde; E. Oren; M. Burch; Z.A. Butt; J.C. Campuzano; I.B. Heredia-Pi; E.E. Servan-Mori; R. Cárdenas; S. Fereshtehnejad; M. Kivipelto; E. Weiderpass; J.J. Carrero; R. Havmoeller; S. Sindi; C.A. Castañeda-Orjuela; J. Castillo Rivas; F. Catalá-López; R. Tabarés-Seisdedos; H. Chang; J. Chang; L. Chavan; W. Chen; M. Chibalabala; V.H. Chisumpa; C.C. Mapoma; F. Masiye; P. de Jager; M. Petzold; J.J. Choi; Y. Khang; D.J. Christopher; S. Mohammed; T. Dahiru; S.A. Damtew; K. Deribe; G. Temam; P. Jeemon; R. Dandona; S. Goenka; G.A. Kumar; D.K. Lal; G.V.S. Murthy; S. Zodpey; J. das Neves; D.M. Pereira; D. De Leo; L. Degenhardt; R.P. Dellavalle; D.C. Des Jarlais; S.D. Dharmaratne; P.P. Doshi; K.E. Doyle; M. Dubey; M.H.U. Rahman; U. Ram; A.K. Yadav; Y.M. Elshrek; I. Elyazar; A.Y. Endries; S.P. Ermakov; B. Eshrati; A. Esteghamati; N. Hafezi-Nejad; S. Sheikhbahaei; F. Farzadfar; A. Kasaeian; R. Malekzadeh; G. Roshandel; S.G. Sepanlou; V. Rahimi-Movaghar; M. Yaseri; I.D.A. Faghmous; S.M. Langan; M. McKee; C.S. Farinha; A. Faro; J.C. Fernandes; F. Fischer; N. Foigt; T. Fürst; A. Majeed; F.G. Gankpé; T. Gebre; J.M. Geleijnse; T. Jibat; B.D. Gessner; M. Giroud; M.D. Gishu; E. Glaser; A. Goodridge; S.V. Gopalani; A. Goto; H.C. Gugnani; M.D.C. Guimaraes; R. Gupta; V. Gupta; H. Hagan; R.R. Hamadeh; S. Hamidi; M. Hammami; G.J. Hankey; Y. Hao; S. Harikrishnan; A. Koyanagi; J.M. Haro; M.T. Hedayati; V. Skirbekk; M. Horino; N. Horita; H.D. Hosgood; M. Hsairi; G. Hu; H. Huang; J.J. Huang; K.M. Iburg; B.T. Idrisov; K. Innos; V.J. Iyer; K.H. Jacobsen; N. Jahanmehr; M.B. Jakovljevic; M. Javanbakht; A.U. Jayatilleke; V. Jha; G. Jiang; Y. Jiang; J.B. Jonas; Z. Kabir; R. Kamal; C.N. Kesavachandran; J. She; H. Zhang; H. Kan; A. Karch; D. Karletsos; A. Kaul; N. Kawakami; K. Shibuya; J.F. Kayibanda; P.N. Keiyoro; A.P. Kengne; K. Sliwa; B.M. Mayosi; Y.S. Khader; A.R. Khan; E.A. Khan; J. Khubchandani; Y.J. Kim; Y. Kinfu; Y. Kokubo; S. Kosen; P.A. Koul; B. Kuate Defo; B. Kucuk Bicer; V.S. Kulkarni; H. Lam; J.O. Lam; B.X. Tran; V.C. Lansingh; R. Leung; Y. Li; S.E. Lipshultz; J.D. Wilkinson; S. Liu; L. Wang; S. Yu; B.K. Lloyd; G. Logroscino; R. Lunevicius; H. Magdy; M.E. Zaki; S. Polinder; M. Mahdavi; P.A. Mahesh; W. Marcenes; J. Martinez-Raga; M.B. Marzan; A.J. Mason-Jones; P.A. Meaney; M.M. Mehndiratta; B.A. Tedla; P. Memiah; Z.A. Memish; W. Mendoza; T.J. Meretoja; F.A. Mhimbira; T.R. Miller; M. Mirarefi; K.A. Mohammad; L. Monasta; R. Mori; A. Werdecker; U.O. Mueller; R. Westerman; B. Murimira; A. Naheed; L. Naldi; V. Nangia; D. Nash; H. Nawaz; C. Nejjari; F.N. Ngalesoni; J.D. Ngirabega; Q.L. Nguyen; O.F. Norheim; R.E. Norman; L. Nyakarahuka; C.M. Obermeyer; F.A. Ogbo; I. Oh; B.O. Olusanya; J.O. Olusanya; J.N. Opio; E. Ota; H. Park; J. Park; S.T. Patil; S.B. Patten; V.K. Paul; A. Roy; R. Sagar; E.K. Peprah; N. Perico; G. Remuzzi; K. Pesudovs; M.R. Phillips; E.P. Simard; J.D. Pillay; D. Plass; F. Pourmalek; M. Qorbani; A. Rafay; S.M. Rana; M. Rahman; S.U. Rahman; R.K. Rai; S. Rajsic; P.V. Rao; D. Rojas-Rueda; G.M. Ruhago; B.F. Sunguya; M.M. Saleh; J.R. Sanabria; R. Sarmiento-Suarez; B. Sartorius; B. Yakob; M. Sawhney; A.E. Schutte; S. Seedat; C.S. Wiysonge; M.A. Shaikh; R. Sharma; J. Shen; H.H. Shin; I.D. Sigfusdottir; D.A.S. Silva; D.G.A. Silveira; O.P. Singh; P.K. Singh; S. Soneji; J.B. Soriano; D.O. Soti; C.T. Sreeramareddy; V. Stathopoulou; N. Steel; S. Swaminathan; B.L. Sykes; R.T. Talongwa; M. Tavakkoli; B. Taye; K. Thapa; A.J. Thomson; R. Tobe-Gai; R. Topor-Madry; J.A. Towbin; Z. Tsala; N. Tsilimparis; K.N. Ukwaja; C.J. Uneke; O.A. Uthman; N. Venketasubramanian; S.K. Vladimirov; V.V. Vlassov; C.D.A. Wolfe; J.Q. Wong; G. Xu; Y. Yano; P. Yip; N. Yonemoto; S. Yoon; M.Z. Younis; C. Yu; Z. Zaidi; H. Zeeb; Y. Zhao; L.J. Zuhlke
    Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. Methods For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. Findings Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1–3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5–2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6–40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7–1·9 million) in 2005, to 1·2 million deaths (1·1–1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. Interpretation Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Funding Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
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    PublicationReview
    Five insights from the Global Burden of Disease Study 2019
    (Elsevier B.V., 2020) C. Abbafati; D.B. Machado; B. Cislaghi; O.M. Salman; M. Karanikolos; M. McKee; K.M. Abbas; O.J. Brady; H.J. Larson; S. Trias-Llimós; S. Cummins; S.M. Langan; B. Sartorius; A. Hafiz; E. Jenabi; N. Mohammad Gholi Mezerji; S. Borzouei; G. Azarian; S. Khazaei; M. Abbasi; B. Asghari; S. Masoumi; H. Komaki; A. Taherkhani; M. Adabi; M. Abbasifard; G. Bazmandegan; Z. Kamiab; A. Vakilian; M. Anjomshoa; A. Mokari; S. Sabour; M. Shahbaz; R. Saeedi; H. Ahmadieh; T. Yousefinezhadi; A. Haj-Mirzaian; R. Nikbakhsh; S. Safi; S. Asgari; S.N. Irvani; N. Jahanmehr; K. Ramezanzadeh; M. Abbasi-Kangevari; M. Khayamzadeh; H. Abbastabar; R. Shirkoohi; M. Fazlzadeh; H. Janjani; M. Hosseini; M. Mansournia; H. Tohidinik; A. Bakhtiari; A. Fazaeli; S. Mousavi; A. Hasanzadeh; B. Nabavizadeh; R. Malekzadeh; M. Hashemian; A. Pourshams; H. Salimzadeh; S.G. Sepanlou; M. Afarideh; A. Esteghamati; S. Esteghamati; A. Ghajar; B. Heidari; N. Rezaei; E. Mohamadi; A. Rahimi-Movaghar; F. Rahim; S. 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    The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3·5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers. © 2020 Elsevier Ltd
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    Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019
    (Elsevier B.V., 2020) C. Abbafati; D.B. Machado; B. Cislaghi; O.M. Salman; M. Karanikolos; M. McKee; K.M. Abbas; O.J. Brady; H.J. Larson; S. Trias-Llimós; S. Cummins; S.M. Langan; B. Sartorius; A. Hafiz; E. Jenabi; N. Mohammad Gholi Mezerji; S. Borzouei; G. Azarian; S. Khazaei; M. Abbasi; B. Asghari; S. Masoumi; H. Komaki; A. Taherkhani; M. Adabi; M. Abbasifard; G. Bazmandegan; Z. Kamiab; A. Vakilian; M. Anjomshoa; A. Mokari; S. Sabour; M. Shahbaz; R. Saeedi; H. Ahmadieh; T. Yousefinezhadi; A. Haj-Mirzaian; R. Nikbakhsh; S. Safi; S. Asgari; S.N. Irvani; N. Jahanmehr; K. Ramezanzadeh; M. Abbasi-Kangevari; M. Khayamzadeh; H. Abbastabar; R. Shirkoohi; M. Fazlzadeh; H. Janjani; M. Hosseini; M. Mansournia; H. Tohidinik; A. Bakhtiari; A. Fazaeli; S. Mousavi; A. Hasanzadeh; B. Nabavizadeh; R. Malekzadeh; M. Hashemian; A. Pourshams; H. Salimzadeh; S.G. Sepanlou; M. Afarideh; A. Esteghamati; S. Esteghamati; A. Ghajar; B. Heidari; N. Rezaei; E. Mohamadi; A. Rahimi-Movaghar; F. Rahim; S. Eskandarieh; M. Sahraian; F. Mohebi; A. Aminorroaya; H. Ebrahimi; F. Farzadfar; B. Mohajer; F. Pishgar; S. Saeedi Moghaddam; M. Shabani; H. Zarafshan; H. Abolhassani; N. Hafezi-Nejad; R. Heidari-Soureshjani; M. Abdollahi; M. Farahmand; P. Salamati; E. Mehrabi Nasab; M. Tajdini; S. Aghamir; R. Mirzaei; Z. Dibaji Forooshani; M.M. Khater; F. Abd-Allah; A. Abdelalim; A. Abualhasan; S.I. El-Jaafary; A. Hassan; A. Elsharkawy; A.M. Khater; H.R. Elhabashy; M.R.R. Salem; H. Salem; M. Sadeghi; M. Jafarinia; M. Amini-Rarani; N. Mohammadifard; N. Sarrafzadegan; I. Abdollahpour; A. Sarveazad; A. Tehrani-Banihashemi; J. Yoosefi Lebni; N. Manafi; H. Pazoki Toroudi; F. Dorostkar; V. Alipour; A. Sheikhtaheri; J. Arabloo; S. Azari; A. Ghashghaee; A. Rezapour; M. Naserbakht; A. Kabir; F. Mehri; M. Yousefifard; M. Asadi-Aliabadi; E. Babaee; B. Eshrati; S. Goharinezhad; M. Moradi-Lakeh; P. Abedi; V. Rashedi; V. Kumar; I.Y. Elgendy; S. Basu; J. Park; A. Pereira; O.F. Norheim; A.W. Eagan; L.E. Cahill; A. Sheikh; A.I. Abushouk; M.U.G. Kraemer; B. Thakur; T.W. Bärnighausen; M.G. Shrime; A. Abedi; C.P. Doshi; K.H. Abegaz; B.S. Geberemariyam; Y.A. Aynalem; W.S. Shiferaw; A.E. Abosetugn; V. Aboyans; E.M. Abrams; M. Gitimoghaddam; N. Kissoon; J.L. Stubbs; M. Brauer; I.O. Iyamu; J.A. Kopec; F. Pourmalek; A.P. Ribeiro; D.C. Malta; R.S. Gomez; L.G. Abreu; M.R.M. Abrigo; A.M. Almulhim; S.M.A. Dahlawi; F.H. Pottoo; R.G. Menezes; T.M. Alanzi; A.K. Alumran; A.K. Abu Haimed; M. Madadin; F.M. Alanezi; E. Abu-Gharbieh; B. Saddik; L.J. Abu-Raddad; A.M. Samy; N. El Nahas; A.S. Shalash; A.F. Nabhan; A.M. Kamath; N.J. Kassebaum; A.Y. Aravkin; S. Kochhar; R.J.D. Sorensen; A. Afshin; K. Burkart; E.A. Cromwell; L. Dandona; S.D. Dharmaratne; E. Gakidou; S.I. Hay; H.H. Kyu; A.D. Lopez; R. Lozano; A.T. Misganaw; A.H. Mokdad; M. Naghavi; D.M. Pigott; R.C. Reiner; G.A. Roth; J.D. Stanaway; S. Vollset; T. Vos; H. Wang; S.S. Lim; C.J.L. Murray; R. Kalani; K.S. Ikuta; D.Y. Cho; C.J. Kneib; C.S. Crowe; B.B. Massenburg; S.D. Morrison; A. Acebedo; J.D. Adelson; K.M. Agesa; T. Alam; S.B. Albertson; J.A. Anderson; C.M. Antony; C. Ashbaugh; M. Assmus; G. Azhar; S. Balassyano; M.S. Bannick; C.M. Barthelemy; R.G. Bender; F.B. Bennitt; G.J. Bertolacci; M.H. Biehl; C. Bisignano; A.S. Boon-Dooley; P.S. Briant; D. Bryazka; B.R. Bumgarner; C.S. Callender; J. Cao; C.D. Castle; E. Castro; K. Causey; K.M. Cercy; J. Chalek; F.J. Charlson; A.J. Cohen; H. Comfort; K. Compton; A.J. Croneberger; J.A. Cruz; M. Cunningham; R. Dandona; W.J. Dangel; F.E. Dean; N.K. DeCleene; A. Deen; L. Degenhardt; Z.V. Dingels; I.N. Dippenaar; M.A. Dirac; A.J. Dolgert; S. Emmons-Bell; K. Estep; T. Farag; V.L. Feigin; R. Feldman; G. Ferrara; A.J. Ferrari; R. Fitzgerald; L.M. Force; J.T. Fox; T.D. Frank; W. Fu; K. Fukutaki; J.E. Fuller; N. Fullman; N.C. Galles; W.M. Gardner; A. Gershberg Hayoon; E. Goren; T.M. Gorman; H.C. Gottlich; G. Guo; B. Haddock; H. Hagins; L.M. Haile; E.B. Hamilton; C. Han; H. Han; J.D. Harvey; K. Henny; H.J. Henrikson; N.J. Henry; M.E. Herbert; T. Hsiao; C.K. Huynh; V.C. Iannucci; H. Ippolito; C.M.S. Irvine; H. Jafari; D. Jahagirdar; S.L. James; C.O. Johnson; S.C. Johnson; C. Keller; L. Kemmer; P.J. Kendrick; M. Knight; J.M. Kocarnik; K.J. Krohn; S.L. Larson; K.M. Lau; J.R. Ledesma; A.T. Leever; K.E. LeGrand; H. Lescinsky; C. Lin; H. Liu; Z. Liu; J. Lo; A. Lu; J. Ma; E.R. Maddison; H. Manguerra; A. Marks; I. Martopullo; C.I. Mastrogiacomo; E.A. May; M.D. Mooney; J.F. Mosser; E.C. Mullany; J. Mumford; S.B. Munro; V. Nandakumar; J. Nguyen; M. Nguyen; E. Nichols; M.R. Nixon; C.M. Odell; K.L. Ong; A.U. Orji; S.M. Ostroff; M. Pasovic; K.R. Paulson; S.A. Pease; A. Pennini; M. Pierce; T.M. Pilz; M. Pletcher; P.C. Rao; C. Razo; S.B. Redford; N. Reinig; M.B. Reitsma; P. Rhinehart; T. Robalik; S. Roberts; N.L.S. Roberts; S. Rolfe; A.N. Sbarra; L.E. Schaeffer; K.A. Shackelford; J. Shadid; F. Sharara; D.H. Shaw; B.S. Sheena; K.E. Simpson; A. Smith; C.N. Spencer; E.E. Spurlock; B.A. Stark; C. Steiner; K.M. Steuben; D.O. Sylte; M. Tang; H.J. Taylor; S. Terrason; A.M. Thomson; A.E. Torre; R. Travillian; C.E. Troeger; A. Vongpradith; M.K. Walters; J. Wang; A. Watson; S. Watson; J.L. Whisnant; H.A. Whiteford; K.E. Wiens; L.B. Wilner; S. Wilson; E.E. Wool; S.S. Wozniak; J. Wu; S. Wulf Hanson; H. Wunrow; R. Xu; S. Yadgir; J.A. Yearwood; H.W. York; C. Yuan; J.T. Zhao; P. Zheng; S.R.M. Zimsen; B.S. Zlavog; A.Y. Chang; E. Oren; R. Buchbinder; K.L. Chin; Y. Guo; K.R. Polkinghorne; A.G. Thrift; Shaun Wen Huey Lee; I.N. Ackerman; F.M. Cicuttini; S. Li; S. Zaman; H. Suleria; J. Zhang; B.C. Cowie; T. Wijeratne; G.C. Patton; S.M. Sawyer; T. Adair; A. Meretoja; O.O. Adetokunboh; A.A. Adamu; C.J. Iwu; C.D.H. Parry; S. Seedat; D.E. Ndwandwe; P.W. Mahasha; D.J. Stein; C.A. Nnaji; E.Z. Sambala; C.S. Wiysonge; O.M. Adebayo; O.S. Ilesanmi; M.O. Owolabi; A.M. Adeoye; I.A. Adedeji; V. Adekanmbi; S.E. Ibitoye; Y.O. John-Akinola; M.M. Oluwasanu; O.B. Oghenetega; R.O. Akinyemi; H. Zandian; D. Adham; T. Zahirian Moghadam; S.M. Advani; W.L. Teagle; D. Braithwaite; P. Agasthi; S. Saadatagah; M. Afshari; E.E. Agardh; P. Allebeck; A. Danielsson; K. Deuba; J.J. Carrero; D.K. Mohammad; S. Fereshtehnejad; J. Ärnlöv; C. Nowak; C.R. Cederroth; A. Ahmadi; A. Pathak; E.J. Mills; O.P. Kurmi; A.T. Olagunju; G. Agarwal; T. Sathish; M. Aghaali; A. Mohammadbeigi; A. Agrawal; T. Ahmad; K. Ahmadi; S. Maleki; M. Naderi; M.R. Salahshoor; R. Pourmirza Kalhori; A. Almasi; Y. Salimi; S. Siabani; A. Ziapour; A. Barzegar; H. Khazaie; N. Kianipour; F. Amiri; S. Salehi Zahabi; M. Mirzaei; M. Shamsi; F. Najafi; A. Jalali; K. Ghadiri; F. Heydarpour; N. Fattahi; B. Karami Matin; A. Kazemi Karyani; M. Pirsaheb; F. Rajati; E. Sadeghi; Y. Safari; K. Sharafi; S. Soltani; Y. Vasseghian; Z. Atafar; F. Jalilian; M. Mirzaei-Alavijeh; S. Saeidi; M. Soofi; A. Zangeneh; B. Mansouri; M. Ahmadi; M.A. Khafaie; S. Safiri; M. Moghadaszadeh; M. Asghari Jafarabadi; L. Doshmangir; F. Jadidi-Niaragh; M. Ghafourifard; A. Spotin; M. Khodayari; H. Samadi Kafil; L.R. Kalankesh; E. Ahmadpour; B. Yousefi; F. Ansari; H. Hassankhani; S. Karimi; H. Haririan; S. Mereta; M.B. Ahmed; G.T. Feyissa; L.G. Ciobanu; B. Aji; G.L. Aynalem; B. Gebresillassie; Y.G. Tefera; T.Y. Akalu; A.G. Baraki; G.A. Tesema; Z.T. Tessema; A.T. Tamiru; Z.N. Azene; H.B. Netsere; Y. Yano; T. Akinyemiju; C. Wu; S. Zadey; Z. Samad; J.S. Ji; P.P. Doshi; O. John; V. Jha; P.K. Maulik; K. Pesudovs; S. Resnikoff; P.B. Mitchell; P.S. Sachdev; B. Akombi; M.A. Godinho; R.Q. Ivers; A.E. Peden; R. Biswas; S. Boufous; C.J. Akunna; F. Alahdab; M.S. Hammer; A. van Donkelaar; Z. Al-Aly; R.P. Dellavalle; S. Alam; R.V. Martin; N. Alam; D. De Leo; S.K. Tadakamadla; K. Alam; J.E. Alcalde-Rabanal; L. Avila-Burgos; E. Serván-Mori; E. Denova-Gutiérrez; S. Rodríguez-Ramírez; L. Morales; A. Poznańska; B. Wojtyniak; J.A. Rivera; I.R. Campos-Nonato; J. Campuzano Rincon; T.G. Sánchez-Pimienta; M.B. Mengesha; F.T. Welay; N.M. Alema; D.G. Demsie; H. Teame; B.F. Teklehaimanot; B.W. Alemu; T. Gultie; A.B. Bante; Y.G. Yeshitila; Y.C.D. Geramo; M. Glagn; M.B. Sorrie; F.G. W/hawariat; A. Amare; A. Kasa; Y. Alemu; K.M. Mihretie; D.D. Atnafu; F.M. Demeke; A. Melese; S.A. Bante; G.A. Dessie; E.W. Mengesha; D. Nigatu; M.A.H. Almadi; K.F. Alhabib; Y. Mohammad; K.A. Altirkawi; M. Temsah; N. Kugbey; M.A. Ayanore; R.K. Alhassan; M. Ali; S. Ali; G. Alicandro; R. Kalhor; M. Alijanzadeh; C. Alinia; H. Yusefzadeh; A. Didarloo; H. Alizade; A. Nikpoor; S.M. Aljunid; F. Alla; L.F. Leal; A. Almasi-Hashiani; R. Moradzadeh; M. Zamanian; J. Nazari; S. Amini; F. Ghamari; N.A. Almasri; M. Khan; H.M. Al-Mekhlafi; N. Bedi; J. Alonso; E.S.P. Ciber; R.M. Al-Raddadi; J. Zakzuk; N. Alvis-Guzman; N.J. Alvis-Zakzuk; C.A. Castañeda-Orjuela; J.N. Malagón-Rojas; K. Gezae; H.A. Gesesew; S. Muthupandian; G.G. Gebremeskel; K. Berhe; B. Amare; M.A. Ayza; L.G. Gebremeskel; A.A.A. Gebreslassie; H. Bitew; K.A. Zewdie; F.G.G. Tela; T.K. Gill; J. Noubiap; Z.S. Lassi; D. Bhandari; A.L. Amit; C.T. Antonio; E.A. Faraon; J.F. Lopez; S.R. Atre; S.H. Ballew; K. Matsushita; A.T. Khoja; P. Daneshpajouhnejad; M. Ghadimi; O. Shafaat; J. Fanzo; D.A. Amugsi; G.H. Amul; D.S.Q. Koh; N. Venketasubramanian; E.W. Anbesu; J.A. Mohammed; T.G. Wondmeneh; C. Andrei; R.I. Negoi; D.V. Davitoiu; A. Manda; I. Negoi; L. Preotescu; M. Hostiuc; S. Hostiuc; R. Ancuceanu; M. Hasan; J. Leung; D. Anderlini; A.A. Mamun; J.C. Maravilla; J.J. McGrath; R. Lalloo; R. Uddin; H.E. Erskine; L.D. Knibbs; A.M. Mantilla Herrera; D.F. Santomauro; A. Mirica; M. Ausloos; C. Herteliu; A. Oţoiu; A. Pana; T. Andrei; S. Ştefan; S. Androudi; C. Angus; I. Ansari; H. Pourjafar; M. Shams-Beyranvand; A. Ansari-Moghaddam; M. Khammarnia; I. Antonazzo; P. Ferrara; S. Conti; P.A. Cortesi; C. Fornari; P.H. Lee; E. Antriyandarti; Z. Yousefi; A. Rafiei; J. Javidnia; R. Faridnia; D. Anvari; A. Goudarzian; M. Moosazadeh; M. Rezai; A. Daryani; M. Fareed; R. Anwer; S. Appiah; D. Paudel; M. 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Kieling; E. Cousin; B.B. Duncan; B.N.G. Goulart; M.I. Schmidt; C. Stein; R.G. Cowden; J.H. MacLachlan; J. Leigh; M. Cross; M.L. Ferreira; E.U.R. Smith; T.R. Driscoll; T.M. Huda; D.G. Hoy; N. Horita; D.H. Cross; H. Dai; G. Hu; A.A.M. Damasceno; G. Damiani; C. La Vecchia; J. Sanabria; A. Pandey; M.R. Mathur; S. Zodpey; G. Kumar; D.K. Lal; K. Hamagharib Abdullah; M. Hosseinzadeh; A.M. Darwesh; A. Faraj; A. Omar Bali; R. Das Gupta; A.P. Dash; G. Davey; K. Deribe; K.B. Gebremedhin; A.B. Wondmieneh; N.D. Dereje; C.A. Dávila-Cervantes; K. Davletov; A. Mereke; B. Serdar; T.G. Haile; D.B. Tadesse; G.T. Weldesamuel; G.T. Demoz; G. Woldu; D. Handiso; N. Dervenis; F. Topouzis; R. Desai; G.P. Dhungana; M. Emamian; D. Diaz; S. Djalalinia; T.H. Nguyen; G.T. Vu; H.T. Do; K. Dokova; D.T. Doku; S. Neupane; J.S. Takala; M.C. Doxey; K.E. Doyle; A.M.N. Renzaho; F.A. Ogbo; S.R. Robinson; A. Vukovic; I.M. Ilic; M.M. Santric-Milicevic; I.S. Vujcic; E. Dubljanin; R. Vukovic; D. Rasella; A.R. Duraes; M. Ebrahimi Kalan; A. Effiong; C.D. Pond; J.R. Ehrlich; X. Liu; M.Y.W. Wei; I. El Sayed; M. El Tantawi; M. El Sayed Zaki; I. Elbarazi; A.C. Tsai; I.R. Elyazar; V. Yazdi-Feyzabadi; K. Eskandari; H. Sharifi; I. Halvaei; F. Ghaffarifar; L. Zaki; E. Hasanpoor; F. Esmaeilzadeh; A. Etemadi; Q. Lan; T.Y. Yeheyis; A.E. Etisso; O. Ezekannagha; C.S. e Farinha; A. Farioli; F.S. Violante; P.S. Faris; A. Faro; J.O. Lam; I. Filip; F. Fischer; L.S. Flor
    Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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    Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
    (Lancet Publishing Group, 2016) N.J. Kassebaum; R.M. Barber; L. Dandona; S.I. Hay; H.J. Larson; S.S. Lim; A.D. Lopez; A.H. Mokdad; M. Naghavi; C. Pinho; C. Steiner; T. Vos; H. Wang; T. Achoki; G.M. Anderson; M. Arora; S. Biryukov; J.D. Blore; A. Carter; D.C. Casey; M.M. Coates; M. Coggeshall; D.J. Dicker; E. Dossou; T. Fleming; M.S. Fraser; J. Friedman; N. Fullman; N. Graetz; J. Hancock; C. Huynh; M. Iannarone; L. Kemmer; X.R. Kulikoff; M.J. Kutz; P.Y. Liu; N. Marquez; A. Misganaw; M.D. Mooney; M. Moradi-Lakeh; M. Ng; G. Nguyen; A. Pain; K.A. Shackelford; N. Silpakit; A. Sligar; J.M. Smith; R.J.D. Sorensen; S.E. Vollset; J.A. Wagner; T. Wolock; Y. Zhao; M. Zhou; C.J.L. Murray; B.E. Ebel; N.D. Futran; K.M. Harun; Z.A. Bhutta; M.I. Nisar; N. Akseer; P. Jeemon; R. Dandona; S. Goenka; G.A. Kumar; P.W. Gething; D. Bisanzio; A. Deribew; C. Cooper; R. Ali; D.A. Bennett; V. Jha; K. Rahimi; Y. Kinfu; G.V.S. Murthy; Y. Li; S. Liu; L. Wang; X. Liang; S. Yu; P. Azzopardi; K.B. Gibney; A. Meretoja; C.E.I. Szoeke; K. Alam; S.M. Colquhoun; R.G. Weintraub; T. Wijeratne; R. Lozano; I.R. Campos-Nonato; J.C. Campuzano; H. Gomez-Dantes; H. Lamadrid-Figueroa; F. Mejia-Rodriguez; J.C. Montañez Hernandez; P. Montero; G.A. Mensah; J.A. Salomon; A.L. Thorne-Lyman; O.N. Ajala; T. Bärnighausen; E.L. Ding; M.S. Farvid; J.R.A. Fitchett; A.A. Abajobir; L.D. Knibbs; R. Lalloo; N.K.M. Alam; Y. Guo; K.H. Abate; T.T. Gebrehiwot; A.T. Gebremedhin; K.M. Abbas; F. Abd-Allah; M.A. Abdallat; A.M. Abdulle; S.F. Abera; Y.A. Melaku; F.H. Tesfay; A.F. Aregay; T.A. Bayou; B.D. Betsu; M. Gebremedhin; A.A. Gebru; G.B. Hailu; T. Tekle; A.Z. Yalew; H.G. Yebyo; V. Aboyans; I. Abubakar; R.W. Aldridge; A. Banerjee; N.M. Aburmeileh; A.O. Adebiyi; A.L. Adelekan; F.A. Ojelabi; I.A. Adedeji; A.K. Adou; K.A. Afanvi; A. Badawi; A. Agarwal; A Ahmad Kiadaliri; T.F. Akinyemiju; D.C. Schwebel; J.A. Singh; Z. Al-Aly; A.H. Kemp; J. Leigh; A.B. Mekonnen; D. Alasfoor; S.F. Aldhahri; A.S. Terkawi; S. Alhabib; A. Alkerwi; F. Alla; R. Al-Raddadi; U. Alsharif; E Alvarez Martin; N. Alvis-Guzman; A.T. Amare; L.G. Ciobanu; G.A. Tessema; T. Setegn; A. Amberbir; A.K. Amegah; A.A. Kudom; W. Ammar; H.L. Harb; S.M. Amrock; H.H. Andersen; R.M. Antoine; C.A.T. Antonio; E.J.A. Faraon; J. Ärnlöv; A. Larsson; V.S. Arsic Arsenijevic; A. Barac; A. Artaman; H. Asayesh; S. Atique; E.F.G.A. Avokpaho; A. Awasthi; B.P. Ayala Quintanilla; U. Bacha; M.C. Bahit; K. Balakrishnan; S.L. Barker-Collo; S. Mohammed; S. Basu; Y.T. Bayou; S. Bazargan-Hejazi; J. Beardsley; N. Bedi; T. Bekele; M.L. Bell; B.J. Biroscak; J.J. Huang; I.S. Santos; I.M. Bensenor; P.A. Lotufo; A. Berhane; C.D. Wolfe; E. Bernabé; A.S. Beyene; S. Biadgilign; B. Bikbov; A.A. Bin Abdulhak; E. Bjertness; A.S. Htet; M. Brainin; A. Brazinova; M. Majdan; J. Shen; N.J.K. Breitborde; T.S. Brugha; Z.A. Butt; R. Cárdenas; S. Fereshtehnejad; M. Kivipelto; E. Weiderpass; R. Havmoeller; S. Sindi; C.A. Castañeda-Orjuela; C.A. Castañedaorjuela; R.E. Castro; F. Catalá-López; F. Cavalleri; V. Colistro; H. Chang; J. Chang; L. Chavan; C.E. Chibueze; V.H. Chisumpa; C.C. Mapoma; F. Masiye; J.J. Choi; R. Chowdhury; D.J. Christopher; M. Cirillo; L.T. Cooper; T. Dahiru; A. Damasceno; H. Danawi; A.H. Refaat; J Das Neves; J.V. Santos; D. De Leo; R.P. Dellavalle; K. Deribe; A.D. Hailu; W. Tefera; A.Z. Giref; T. Jibat; G Temam Shifa; D.C. Des Jarlais; S.D. Dharmaratne; M. Dubey; M.H.U. Rahman; U. Ram; A. Singh; A.K. Yadav; C.L. Ellingsen; M. Savic; V. Skirbekk; I. Elyazar; S.P. Ermakov; S. Soshnikov; B. Eshrati; F. Farzadfar; A. Kasaeian; F. Pishgar; A. Esteghamati; N. Hafezi-Nejad; S. Sheikhbahaei; A. Khosravi; R. Malekzadeh; G. Roshandel; S.G. Sepanlou; V. Rahimi-Movaghar; T.A. Farid; A.R. Khan; C.S.E.S. Farinha; A. Faro; J.C. Fernandes; F. Fischer; N. Foigt; E.B. Franca; R.C. Franklin; T. Fürst; A. Majeed; K. Gambashidze; K. Kazanjan; M. Kereselidze; I. Khonelidze; M. Shakh-Nazarova; L. Sturua; A. Gamkrelidze; T. Gebre; J.M. Geleijnse; M. Giroud; M.D. Gishu; A.K. Tura; E. Glaser; P. Gona; A. Goodridge; S.V. Gopalani; A. Goto; H.C. Gugnani; R. Gupta; V. Gupta; A.D. Hailu; O.F. Norheim; R.R. Hamadeh; S. Hamidi; A.J. Handal; G.J. Hankey; S. Harikrishnan; H.W. Hoek; M. Horino; N. Horita; H.D. Hosgood; D.G. Hoy; G. Hu; H. Huang; I. Huybrechts; K.M. Iburg; B.T. Idrisov; V.J. Iyer; K.H. Jacobsen; N. Jahanmehr; M.B. Jakovljevic; M. Javanbakht; A.U. Jayatilleke; S.H. Jee; D.K. Lal; S. Zodpey; G. Jiang; Y. Jiang; J.B. Jonas; Z. Kabir; R. Kamal; C.N. Kesavachandran; J. She; H. Kan; A. Karch; D. Karletsos; A. Kaul; N. Kawakami; K. Shibuya; J.F. Kayibanda; D.S. Kazi; P.N. Keiyoro; A.P. Kengne; C.S. Wiysonge; K. Sliwa; A. Keren; Y.S. Khader; E.A. Khan; Y.H. Khang; S. Won; J. Khubchandani; Y.J. Kim; Y. Kokubo; S. Kosen; P.A. Koul; A. Koyanagi; S. Krishnaswami; B Kuate Defo; B Kucuk Bicer; H. Lam; Q. Lan; D.O. Laryea; R. Leung; S.E. Lipshultz; J.D. Wilkinson; E.P. Simard; Y. Liu; M.R. Phillips; Q. Xiao; B.K. Lloyd; R. Lunevicius; D. Pope; S. Ma; H Magdy Abd El Razek; M Magdy Abd El Razek; W. Marcenes; P.A. Meaney; D.J. Margolis; M.B. Marzan; A.J. Mason-Jones; T.T. Mazorodze; A. Mehari; M.M. Mehndiratta; S.M. Woldeyohannes; B.A. Tedla; Z.A. Memish; W. Mendoza; T.J. Meretoja; F.A. Mhimbira; T.R. Miller; E.J. Mills; N. Mohamed Ibrahim; K.A. Mohammad; A. Mohammadi; G.L.D. Mola; L. Monasta; M. Montico; L. Ronfani; J.D. Monis; A.R. Moore; M. Moradilakeh; L. Morawska; R.E. Norman; R. Mori; A. Werdecker; U.O. Mueller; R. Westerman; S. Murthy; F. Pourmalek; J.B. Nachega; A.J. Paternina Caicedo; S. Seedat; B.X. Tran; A. Naheed; L. Naldi; G. Remuzzi; D. Nand; V. Nangia; D. Nash; S. Neupane; J.N. Newton; F.N. Ngalesoni; P. Nguhiu; Q.L. Nguyen; M. Nomura; L. Nyakarahuka; C.M. Obermeyer; F.A. Ogbo; I. Oh; P.R. Olivares; B.O. Olusanya; J.O. Olusanya; J.N. Opio; E. Oren; E. Ota; A.S. Oyekale; P.A. Mahesh; N. Papantoniou; V. Stathopoulou; E. Park; H. Park; S.B. Patten; V.K. Paul; A. Roy; R. Sagar; M. Satpathy; D.M. Pereira; M. Cortinovis; N. Perico; K. Pesudovs; M. Petzold; J.D. Pillay; S. Polinder; M. Qorbani; A. Rafay; M. Rahman; S.U. Rahman; R.K. Rai; C.L. Ranabhat; T. Rangaswamy; P.V. Rao; S. Resnikoff; D. Rojas-Rueda; G.M. Ruhago; B.F. Sunguya; M.M. Saleh; J.R. Sanabria; M.D. Sanchez-Niño; R. Sarmiento-Suarez; B. Sartorius; M. Sawhney; M.I. Saylan; I.J.C. Schneider; D.A.S. Silva; E.E. Servan-Mori; M.A. Shaikh; R. Sharma; M. Shin; S. Yoon; R. Shiri; K. Shishani; I. Shiue; I.D. Sigfusdottir; D.G.A. Silveira; J.I. Silverberg; Y. Yano; O.P. Singh; P.K. Singh; V. Singh; S. Soneji; J.B. Soriano; L.A. Sposato; C.T. Sreeramareddy; K. Stroumpoulis; S. Swaminathan; B.L. Sykes; R. Tabarés-Seisdedos; K.M. Tabb; R.T. Talongwa; M. Tavakkoli; B. Taye; A.Y. Endries; G. Temam Shifa; A.J. Thomson; R. Tobe-Gai; R. Topor-Madry; J.A. Towbin; Z. Tsala Dimbuene; S. Tyrovolas; K.N. Ukwaja; O.A. Uthman; T. Vasankari; N. Venketasubramanian; F.S. Violante; S.K. Vladimirov; V.V. Vlassov; S. Weichenthal; M. Wubshet; G. Xu; B. Yakob; P. Yip; N. Yonemoto; M.Z. Younis; C. Yu; Z. Zaidi; M.E. Zaki; H. Zeeb; L.J. Zuhlke
    Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10–54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and/or miscarriage. Historical patterns suggest achievement of SDG 3.1 will require 91% coverage of one antenatal care visit, 78% of four antenatal care visits, 81% of in-facility delivery, and 87% of skilled birth attendance. Interpretation Several challenges to improving reproductive health lie ahead in the SDG era. Countries should establish or renew systems for collection and timely dissemination of health data; expand coverage and improve quality of family planning services, including access to contraception and safe abortion to address high adolescent fertility; invest in improving health system capacity, including coverage of routine reproductive health care and of more advanced obstetric care—including EmOC; adapt health systems and data collection systems to monitor and reverse the increase in indirect, other direct, and late maternal deaths, especially in high SDI locations; and examine their own performance with respect to their SDI level, using that information to formulate strategies to improve performance and ensure optimum reproductive health of their population. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
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    Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015
    (Lancet Publishing Group, 2016) H. Wang; M. Naghavi; C. Allen; R.M. Barber; A. Carter; D.C. Casey; F.J. Charlson; A.Z. Chen; M.M. Coates; M. Coggeshall; L. Dandona; D.J. Dicker; H.E. Erskine; A.J. Ferrari; C. Fitzmaurice; K. Foreman; M.H. Forouzanfar; M.S. Fraser; N. Fullman; E.M. Goldberg; N. Graetz; J.A. Haagsma; S.I. Hay; C. Huynh; C.O. Johnson; N.J. Kassebaum; X.R. Kulikoff; M. Kutz; H.H. Kyu; H.J. Larson; J. Leung; S.S. Lim; M. Lind; R. Lozano; N. Marquez; J. Mikesell; A.H. Mokdad; M.D. Mooney; G. Nguyen; E. Nsoesie; D.M. Pigott; C. Pinho; G.A. Roth; L. Sandar; N. Silpakit; A. Sligar; R.J.D. Sorensen; J. Stanaway; C. Steiner; S. Teeple; B.A. Thomas; C. Troeger; A. VanderZanden; S.E. Vollset; V. Wanga; H.A. Whiteford; T. Wolock; L. Zoeckler; T. Achoki; A. Afshin; L.T. Alexander; G.M. Anderson; B. Bell; S. Biryukov; J.D. Blore; A. Brown; J. Brown; K. Cercy; A. Chew; A.J. Cohen; F. Daoud; E. Dossou; K. Estep; A. Flaxman; J. Friedman; J. Frostad; W.W. Godwin; J. Hancock; L. Kemmer; I.A. Khalil; P.Y. Liu; F. Masiye; A. Millear; M. Mirarefin; A. Misganaw; M. Moradi-Lakeh; K. Morgan; M. Ng; A. Pain; J. Quame-Amaglo; P. Rao; M.B. Reitsma; K.A. Shackelford; P. Sur; J.A. Wagner; T. Vos; A.D. Lopez; C.J.L. Murray; R.G. Ellenbogen; C.N. Mock; D.A. Quistberg; B.O. Anderson; C.D. Blosser; N.D. Futran; S.R. Heckbert; P.N. Jensen; T.J. Montine; D.L. Tirschwell; D.A. Watkins; Z.A. Bhutta; M.I. Nisar; N. Akseer; N.K.M. Alam; L.D. Knibbs; R. Lalloo; H.N. Gouda; J.J. McGrath; P. Jeemon; R. Dandona; G.A. Kumar; P.W. Gething; C. Cooper; S.C. Darby; A. Deribew; R. Ali; D.A. Bennett; V. Jha; K. Rahimi; Y. Kinfu; I.D.A. Faghmous; S.M. Langan; M. McKee; G.V.S. Murthy; N. Pearce; B. Roberts; I.R. Campos-Nonato; J.C. Campuzano; H. Gomez-Dantes; I.B. Heredia-Pi; F. Mejia-Rodriguez; J.C. Montañez Hernandez; P. Montero; M.J. Rios Blancas; E.E. Servan-Mori; S. Villalpando; L. Duan; S. Liu; L. Wang; P. Ye; X. Liang; S. Yu; G.A. Mensah; J.A. Salomon; A.L. Thorne-Lyman; O.N. Ajala; T. Bärnighausen; E.L. Ding; M.S. Farvid; G.R. Wagner; P. James; M. Osman; M.G. Shrime; J.R.A. Fitchett; A.K. Knudsen; C.L. Ellingsen; N.H. Krog; M. Savic; A.D. Hailu; O.F. Norheim; K.H. Abate; T.T. Gebrehiwot; A.T. Gebremedhin; C. Abbafati; K.M. Abbas; F. Abd-Allah; S.F. Abera; Y.A. Melaku; F.H. Tesfay; G.Y. Abyu; A.F. Aregay; B.D. Betsu; A.A. Gebru; G.B. Hailu; A.Z. Yalew; H.G. Yebyo; D.M.X. Abreu; E.B. Franca; L.J. Abu-Raddad; A.L. Adelekan; R.O. Akinyemi; F.A. Ojelabi; Z. Ademi; T. Fürst; P. Azzopardi; B.C. Cowie; K.B. Gibney; J.H. MacLachlan; A. Meretoja; K. Alam; R. Borschmann; S.M. Colquhoun; G.C. Patton; R.G. Weintraub; C.E.I. Szoeke; L. Vijayakumar; M.A. Bohensky; H.R. Taylor; T. Wijeratne; A.K. Adou; J.C. Adsuar; K.A. Afanvi; E.E. Agardh; J. Rehm; A. Badawi; M.P. Lindsay; S. Popova; A. Agarwal; A. Agrawal; P.J. Hotez; A. Ahmad; B. Norrving; A.S. Akanda; T.F. Akinyemiju; D.C. Schwebel; J.A. Singh; F.H. Al Lami; S. Alabed; Z. Al-Aly; T.R. Driscoll; A.H. Kemp; J. Leigh; A.B. 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Younis; Z. Zaidi; M.E. Zaki; F. Zannad; D.E. Zavala; H. Zeeb; D. Zonies; L.J. Zuhlke
    Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
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    Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015
    (Lancet Publishing Group, 2016) S.S. Lim; K. Allen; L. Dandona; M.H. Forouzanfar; N. Fullman; E.M. Goldberg; S.I. Hay; M. Holmberg; M.J. Kutz; H.J. Larson; A.D. Lopez; C.R. McNellan; A.H. Mokdad; M.D. Mooney; M. Naghavi; H.E. Olsen; D.M. Pigott; T. Vos; H. Wang; T. Achoki; A. Afshin; C. Allen; G.M. Anderson; R. Barber; K.A. Bienhoff; J. Blore; M. Brauer; A. Carter; D. Casey; F.J. Charlson; A.Z. Chen; M.M. Coates; M. Coggeshall; A.J. Cohen; A. Deshpande; H.E. Erskine; A.J. Ferrari; C. Fitzmaurice; K. Foreman; M. Fraser; J. Friedman; J. Frostad; W. Godwin; N. Graetz; M. Griswold; J.A. Haagsma; A. Haakenstad; N.J. Kassebaum; L. Kemmer; X.R. Kulikoff; H.H. Kyu; J. Leung; M. Lind; P.Y. Liu; F. Masiye; M. Mirarefin; A. Misganaw; M. Moradi-Lakeh; G. Nguyen; C. Pinho; P.C. Rao; M.B. Reitsma; G.A. Roth; D.F. Santomauro; K. Shackelford; N. Silpakit; A. Sligar; R.J.D. Sorensen; J.D. Stanaway; C. Steiner; P. Sur; S.E. Vollset; V. Wanga; H.A. Whiteford; Y. Zhao; M. Zhou; C.J.L. Murray; G.A. 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    Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8–61·8) and varied widely by country, ranging from 85·5 (84·2–86·5) in Iceland to 20·4 (15·4–24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0–10·4), and gains on the MDG index (a median change of 10·0 [6·7–13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1–8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. Funding Bill & Melinda Gates Foundation. © 2016 The Authors(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
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