GBD 2010: a multi-investigator collaboration for global comparative descriptive epidemiology.

The World Bank Group welcomes the publication of the new Global Burden of Disease Study (GBD). The Bank commissioned the fi rst GBD in 1990, and continues to make extensive use of this signal contribution to global health. Like its predecessors, the new, methodologically updated GBD 2010 marks a milestone in global health knowledge and our capacity for evidence-based action. It will once again set the terms of health policy, planning, and funding discussions for years to come. The GBD gives us a data-rich framework for comparing the importance of diff erent diseases, injuries, and risk factors in causing premature death and disability within and across populations. Its value lies not only in the data but the critical discussions it makes possible. Specifi cally, the GBD has sharpened thinking on issues as diverse as the measurement of comorbidities; the role of culture in mediating the experience of disease; the meaning of dis ability; and the impact of poverty on health. The GBD challenges us to be rigorous and clear in our arguments about the criteria that should guide programming and investment decisions at country, regional, and global levels. GBD 2010 shows the remarkable health achieve ments of the past two decades, as well as the continuing, and emerging, challenges that require action. Life expectancy is rising, and the prevalence of many communicable diseases, including HIV/AIDS, is dropping. Yet in some parts of the world, preventable illnesses, such as diarrhoea, remain stubborn causes of death in childhood. We must confront the growing burden of non-communicable diseases, and the fundamental shift from premature death towards increasing years lived with chronic illnesses and debilitating conditions. To respond eff ectively to these challenges, national and local health systems must be strengthened, even transformed, and policy and funding decisions across the development spectrum must be reassessed—from safety nets to urban planning. GBD 2010 is an indispensable resource for public health and development leaders to ensure that their investments yield the greatest possible health benefi ts, and to help end poverty and boost prosperity. The remarkable body of evidence and analysis in GBD 2010 will help us foster the conversations that are needed across the whole of government, not just in ministries of health, to fulfi l this responsibility.