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Spheres of Influence
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| The Future Face of Disease
Renee Twombly Abstract
Christopher Murray is looking at the future of disease in a whole new way. He used the "disability-adjusted life year" (DALY) to calculate the course and effects of diseases in the future and his findings, published in The Global Burden of Disease, are surprising even to him: the top health problems of the future will be heart disease and severe depression.
By 2020, noncommunicable diseases are expected to account for 70% of all deaths in the developing world, and an epidemic of alcohol- and tobacco-related illnesses could claim 8.4 million lives each year, more than any single disease. Deaths from communicable diseases and maternal/child health diseases and nutritional ailments are estimated to decline, which "runs counter to the now widely accepted belief that infectious diseases are on the ascent worldwide," said Murray.
The DALY technique considers not only death rates but also disability rates and risk factors in calculating which diseases will have the most profound effect upon the population.
Although noncommunicable diseases are on the rise, there is plenty of unfinished business regarding communicable diseases. No government in the world spends more than 5% of its total domestic health spending on research, and much of what is being spent is going toward conditions that concern primarily the industrialized world.
Combined research and development spending on the three currently leading conditions in developing nation–spneumonia, diarrheal disease, and tuberculosis–totaled just 0.2% of the world's total health research and development spending. Yet, between them, these three diseases make up almost one-fifth of the global disease burden.
Dean Jamison, in the companion report Investing in Health Research and Development, outlines strategies for addressing and preventing the unexpected predictions in Murray's report. Jamison suggests a global consortium be established to provide a strong and reasoned voice for research allocations, as well as help reduce overlap and waste.
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