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Alize J Ferrari, Damian Francesco Santomauro, Amirali Aali, Yohannes Habtegiorgis Abate, Cristiana Abbafati, Hedayat Abbastabar, Samar Abd ElHafeez, Michael Abdelmasseh, Sherief Mohamed Abd-Elsalam, Arash Abdollahi and 1318 more
BACKGROUND: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS: Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING: Bill & Melinda Gates Foundation.
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Ferrari, A. J., Santomauro, D. F., Aali, A., Abate, Y. H., Abbafati, C., Abbastabar, H., ElHafeez, S. A., Abdelmasseh, M., Abd-Elsalam, S. M., Abdollahi, A., Abdullahi, A., Abegaz, K. H., Zúñiga, R. A. A., Aboagye, R. G., Abolhassani, H., Abreu, L. G., Abualruz, H., Abu‐Gharbieh, E., Abu-Rmeileh, N. M., … Murray, C. J. L. (2024). Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 403(10440), 2133–2161. https://doi.org/10.1016/s0140-6736(24)00757-8
Ferrari, Alize J, et al. "Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021." The Lancet, vol. 403, no. 10440, 2024, pp. 2133–2161, https://doi.org/10.1016/s0140-6736(24)00757-8.
Ferrari, Alize J, Damian Francesco Santomauro, Amirali Aali, Yohannes Habtegiorgis Abate, Cristiana Abbafati, Hedayat Abbastabar, Samar Abd ElHafeez, et al. "Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021." The Lancet 403, no. 10440 (2024): 2133–2161. https://doi.org/10.1016/s0140-6736(24)00757-8.
Ferrari A. J., Santomauro D. F., Aali A. [и др.] Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 // The Lancet. — 2024. — Vol. 403, № 10440. — P. 2133–2161. — URL: https://doi.org/10.1016/s0140-6736(24)00757-8
@article{ferrari2024global,
title = {{Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021}},
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Ackerman and Isaac Yeboah Addo and Giovanni Addolorato and Akindele Olupelumi Adebiyi and Victor Abiola Adepoju and Habeeb Omoponle Adewuyi and Shadi Afyouni and Saira Afzal and Sina Afzal and Antonella Agodi and Aqeel Ahmad and Danish Ahmad and Firdos Ahmad and Shahzaib Ahmad and Ali Ahmed and Luai Awad Ahmed and Muktar Beshir Ahmed and Marjan Ajami and Karolina Akinosoglou and Mohammed Ahmed Akkaif and Syed Mahfuz Al Hasan and Samer O Alalalmeh and Ziyad Al‐Aly and Mohammed ALBashtawy and Robert W Aldridge and Meseret Desalegn Alemu and Megbaru Alemu and Kefyalew Addis Alene and Adel Ali Saeed Al-Gheethi and Maryam Alharrasi and Robert Kaba Alhassan and Mohammed Usman Ali and Rafat Ali and Syed Shujait Ali and Sheikh Mohammad Alif and Syed Mohamed Aljunid and Sabah Al-Marwani and Joseph Uy Almazan and Mahmoud A. Alomari and Basem Al‐Omari and Zaid Altaany and Nelson Alvis‐Guzmán and Nelson J Alvis-Zakzuk and Hassan H Alwafi and Mohammad Sami Al-Wardat and Yaser Mohammed Al‐Worafi and Safwat Aly and Karem Hasan Alzoubi and Azmeraw T. Amare and Prince Michael Amegbor and Edward Kwabena Ameyaw and Tarek Tawfik Amin and Alireza Amindarolzarbi and Sohrab Amiri and Dickson Abanimi Amugsi and Robert Ancuceanu and Deanna Anderlini and David Anderson and Pedro Prata Andrade and Cătălina Liliana Andrei and Hossein Ansari and Catherine M Antony and Saleha Anwar and Sumadi Lukman Anwar and Razique Anwer and Philip Emeka Anyanwu and Juan Pablo Arab and Jalal Arabloo and Mosab Arafat and Daniel T Araki and Aleksandr Y. 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Shah and Pritik A Shah and Ataollah Shahbandi and Samiah Shahid and Wajeehah Shahid and Moyad Jamal Shahwan and Masood Ali Shaikh and Alireza Shakeri and Ali Shalash and Sunder Sham and Muhammad Aaqib Shamim and Mohammad Ali Shamshirgaran and Mohammad Anas Shamsi and Mohd Shanawaz and Abhishek Shankar and Mohammed Shannawaz and Medha Sharath and Amin Sharifan and Javad Sharifi‐Rad and Manoj Sharma and Rajesh Sharma and Saurab Sharma and Ujjawal Sharma and Vishal Sharma and Rajesh Padumane Shastry and Amin Shavandi and Amir Mehdi Shayan and Maryam Shayan and Amr Mohamed Elsayed Shehabeldine and Pavanchand H Shetty and Kenji Shibuya and Jemal Ebrahim Shifa and Desalegn Shiferaw and Wondimeneh Shibabaw Shiferaw and Mika Shigematsu and Rahman Shiri and Nebiyu Aniley Shitaye and Aminu Shittu and K. M. 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Steiner and Jaimie D Steinmetz and Paschalis Steiropoulos and Leo Stockfelt and Mark Andrew Stokes and Narayan Subedi and Vetriselvan Subramaniyan and Cláudia Kimie Suemoto and Muhammad Suleman and Rizwan Suliankatchi Abdulkader and Abida Sultana and Johan Sundström and Chandan Kumar Swain and Łukasz Szarpak and Payam Tabaee Damavandi and Rafael Tabarés‐Seisdedos and Ozra Tabatabaei‐Malazy and Seyed‐Amir Tabatabaeizadeh and Shima Tabatabai and Celine Tabche and Mohammad Tabish and Santosh Kumar Tadakamadla and Yasaman Taheri Abkenar and Moslem Taheri Soodejani and Amir Taherkhani and Jabeen Taiba and Iman Mamdouh Talaat and Ashis Talukder and Mircea Ştefan Tampa and Jacques Lukenze Tamuzi and Ker‐Kan Tan and Sarmila Tandukar and Haosu Tang and Razieh Tavakoli Oliaee and Seyed Mohammad Tavangar and Mojtaba Teimoori and Mohamad-Hani A. Temsah and Masayuki Teramoto and Pugazhenthan Thangaraju and Kavumpurathu Raman Thankappan and Rekha Thapar and Rasiah Thayakaran and Thirunavukkarasu Sathish and Nihal Thomas and Nikhil Kenny Thomas and Chern Choong Chern Thum and Aleš Tichopád and Jansje Henny Vera Ticoalu and Tala Tillawi and Tenaw Yimer Tiruye and Ruoyan Tobe-Gai and Marcello A. Tonelli and Roman Topór-Mądry and Anna E Torre and Mathilde Touvier and Marcos Roberto Tovani‐Palone and Jasmine Thuy Tran and Mai Thi Ngoc Tran and Nghia Minh Tran and Ngoc-Ha Tran and Domenico Tricò and Samuel Joseph Tromans and Thien Tan Tri Tai Truyen and Aristidis Michael Tsatsakis and Guesh Mebrahtom and Evangelia Eirini Tsermpini and Munkhtuya Tumurkhuu and Stefanos Tyrovolas and Arit Udoh and Muhammad Umair and Srikanth Umakanthan and Tungki Pratama Umar and Eduardo A. Undurraga and Brigid Unim and Bhaskaran Unnikrishnan and Carolyn Anne Unsworth and Era Upadhyay and Daniele Urso and Jibrin Sammani Usman and Seyed Mohammad Vahabi and Asokan Govindaraj Vaithinathan and Jef Van den Eynde and Orsolya Varga and Ravi Prasad Varma and Priya Vart and Tommi Juhani Vasankari and Milena Vasić and Siavash Vaziri and Balachandar Vellingiri and Narayanaswamy Venketasubramanian and Massimiliano Veroux and Georgios‐Ioannis Verras and Dominique Vervoort and Jorge Hugo Villafañe and Francesco Saverio Violante and Vasily Vlassov and Stein Emil Vollset and Simona Ruxandra Volovăț and Avina Vongpradith and Yasir Waheed and Cong Wang and Fang Wang and Ning Wang and Shu Wang and Yanzhong Wang and Yuan‐Pang Wang and Paul Ward and Emebet Gashaw Wassie and Marcia R. Weaver and Kosala Weerakoon and Robert G Weintraub and Daniel J. Weiss and Abrha Hailay and Katherine M Wells and Yi Feng Wen and Joanna L Whisnant and Harvey Whiteford and Taweewat Wiangkham and Dakshitha Praneeth Wickramasinghe and Nuwan Darshana Wickramasinghe and Angga Wilandika and Caroline Wilkerson and Peter Willeit and Anders B. Wimo and Demewoz Haile Woldegebreal and Axel Walter Wolf and Yen Jun Wong and Anthony D. Woolf and Chenkai Wu and Felicia Wu and Xinsheng Wu and Zenghong Wu and Sarah Wulf Hanson and Yanjie Xia and Hong Xiao and Xiaoyue Xu and Yvonne Yiru Xu and Lalit Yadav and Ali Yadollahpour and Sajad Yaghoubi and Kazumasa Yamagishi and Lin Yang and Yuichiro Yano and Yao Yao and Habib Yaribeygi and Mohammad Hosein Yazdanpanah and Pengpeng Ye and Sisay Shewasinad Yehualashet and Subah Abderehim Yesuf and Saber Yezli and Arzu Yiğit and Vahit Yiğit and Zeamanuel Anteneh Yigzaw and Yazachew Engida Yismaw and Dong Keon Yon and Naohiro Yonemoto and Mustafa Z Younis and Chuanhua Yu and Yong Yu and Hadiza Yusuf and Mondal Hasan Zahid and Fathiah Zakham and Leila Zaki and Nazar Zaki and Burhan Abdullah Zaman and Nelson Zamora and Ramin Zand and Ghazal G Z Zandieh and Heather Joy Zar and Armin Zarrintan and Михаил Сергеевич Застрожин and Haijun Zhang and Ning Zhang and Yunquan Zhang and Hanqing Zhao and Chenwen Zhong and Panliang Zhong and Juexiao Zhou and Zhaohua Zhu and Makan Ziafati and Magdalena Zielińska and Stephanie R M Zimsen and Mohammad Zoladl and Alimuddin I. Zumla and Samer H. Zyoud and Theo Vos and Christopher J L Murray},
journal = {The Lancet},
year = {2024},
volume = {403},
number = {10440},
pages = {2133--2161},
doi = {10.1016/s0140-6736(24)00757-8},
url = {https://doi.org/10.1016/s0140-6736(24)00757-8}
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AU - Grivna, Michal AU - Guan, Shi‐Yang AU - Guarducci, Giovanni AU - Gubari, Mohammed Ibrahim Mohialdeen AU - Dechasa, Mesay AU - Guha, Avirup AU - Guicciardi, Stefano AU - Gulati, Snigdha AU - Gulisashvili, David AU - Gunawardane, Damitha Asanga AU - Guo, Cui AU - Gupta, Anish Kumar AU - Gupta, Bhawna AU - Gupta, Ishita AU - Gupta, Mohak AU - Gupta, Rajeev AU - Gupta, Veer Bala AU - Gupta, Vijai Kumar AU - Gupta, Vivek AU - Gutiérrez, Reyna Alma AU - Habibzadeh, Farrokh AU - Habibzadeh, Parham AU - Haddadi, Rasool AU - Hadi, Najah R AU - Haep, Nils AU - Hafezi‐Nejad, Nima AU - Hafiz, Abdul AU - Hagins, Hailey AU - Halboub, Esam Saleh AU - Halimi, Aram AU - Haller, Sebastian AU - Halwani, Rabih AU - Hamilton, Erin B AU - Hankey, Graeme J. AU - Hannan, Md Abdul AU - Haque, Md. Nuruzzaman AU - Harapan, Harapan AU - Haro, Josep Maria AU - Hartvigsen, Jan AU - Hasaballah, Ahmed I AU - Hasan, Ikramul AU - Hasanian, Mohammad AU - Hasnain, Md Saquib AU - Hassan, Amr AU - Haubold, Johannes AU - Havmoeller, Rasmus J. AU - Hay, Simon Iain AU - Hayat, Khezar AU - Hébert, Jeffrey J. AU - Hegazi, Omar E AU - Heidari, Golnaz AU - Helfer, Bartosz AU - Hemmati, Mehdi AU - Hendrie, Delia V. 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AU - Jadidi‐Niaragh, Farhad AU - Jafarinia, Morteza AU - Jaggi, Khushleen AU - Jahankhani, Kasra AU - Jahanmehr, Nader AU - Jahrami, Haitham AU - Jain, Akhil AU - Jain, Nityanand AU - Jairoun, Ammar Abdulrahman AU - Jaiswal, Abhishek AU - Jakovljević, Mihajlo AU - Jatau, Abubakar Ibrahim AU - Javadov, Sabzali AU - Javaheri, Tahereh AU - Jayapal, Sathish Kumar AU - Jayaram, Shubha AU - Jee, Sun Ha AU - Jeganathan, Jayakumar AU - Jeyakumar, Angeline AU - Jha, Anil Kumar AU - Jiang, Heng Bo AU - Jin, Yinzi AU - Jonas, Jost Bruno AU - Joó, Tamás AU - Joseph, Abel AU - Joseph, Nitin AU - Joshua, Charity Ehimwenma AU - Jozwiak, Jacek Jerzy AU - Jürisson, Mikk AU - Vaishali, K AU - Kaambwa, Billingsley AU - Kabir, Ali AU - Kabir, Zubair AU - Kadashetti, Vidya AU - Kalani, Rizwan AU - Kalankesh, Leila Ranandeh AU - Kaliyadan, Feroze AU - Kalra, Sanjay AU - Kamenov, Kaloyan AU - Kamyari, Naser AU - Kanagasabai, Thanigaivelan AU - Kandel, Himal AU - Kanmanthareddy, Arun AU - Kanmodi, Kehinde Kazeem AU - Kantar, Rami S. 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AU - Keshtkar, Kamyab AU - Kesse‐Guyot, Emmanuelle AU - Keykhaei, Mohammad AU - Khajuria, Himanshu AU - Khalaji, Amirmohammad AU - Khalid, Asaad AU - Khalid, Nauman AU - Khalilian, Alireza AU - Khamesipour, Faham AU - Khan, Asaduzzaman AU - Khan, Ikramullah AU - Khan, Maseer AU - Khan, Moien AB AU - Khanmohammadi, Shaghayegh AU - Khatab, Khaled AU - Khatami, Fatemeh AU - Khatatbeh, Moawiah Mohammad AU - Khater, Amir M AU - Kashani, Hamid Reza Khayat AU - Khidri, Feriha Fatima AU - Khodadoust, Elaheh AU - Khormali, Moein AU - Khorrami, Zahra AU - Kifle, Zemene Demelash AU - Kim, Min Seo AU - Kimokoti, Ruth W AU - Kısa, Adnan AU - Kısa, Sezer AU - Knudsen, Ann Kristin AU - Kocarnik, Jonathan AU - Kochhar, Sonali AU - Koh, Hyun Yong AU - Kolahi, Ali‐Asghar AU - Kompani, Farzad AU - Koren, Gerbrand AU - Korzh, Oleksii AU - Kosen, Soewarta AU - Laxminarayana, Sindhura Lakshmi Koulmane AU - Krishan, Kewal AU - Krishna, Varun AU - Krishnamoorthy, Vijay K. 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