A major new analysis from the Global Burden of Disease Study 2013 published in The Lancet, shows that accelerated progress against the global burden of HIV, malaria, and tuberculosis (TB) has been made since 2000 when governments worldwide adopted Millennium Development Goal (MDG) 6 to combat HIV/AIDS, malaria, and TB.
The new estimates show that worldwide, the number of people living with HIV has risen steadily to around 29 million people in 2012. The data also show that malaria is killing more people than previously estimated, although the number of deaths has fallen rapidly since 2004. Overall progress for TB looks promising -- with faster rates of decline in incidence in 12 regions of the world, compared with the decade before the Millennium Declaration.
The authors say that their assessment reveals that the HIV epidemic is smaller than previously estimated, with the overall amount of ill-health and premature death resulting from HIV roughly 25% lower than the latest estimate provided by UNAIDS in 2012. They also indicate that the global burden of malaria could be larger than recent WHO estimates.
Lead author Dr Christopher Murray, Professor of Global Health at the University of Washington, USA, explains, "We have seen a huge increase in both funding and the policy attention given to HIV/AIDS, malaria, and TB over the past 13 years, and our findings show that a focus on these specific diseases has had a real impact. However, much remains to be done and all three diseases continue to be major health challenges in 2013."
Professor Murray and an international team of researchers performed a comprehensive and rigorous analysis of the available data to track the global, regional, and national incidence, prevalence, and premature death caused by HIV, malaria, and TB for 188 countries between 1990 and 2013. They used data from all available sources including vital registration systems and verbal autopsy data.
Key findings for the three diseases include:
According to Professor Murray, "Estimates of the global burden of HIV, malaria, and TB are crucial elements of the effort to control these diseases. However, what is clear from our analysis is how little we reliably know in many countries to track progress. Rapidly reducing the massive uncertainty that surrounds the measurement of these diseases, particularly malaria, will be essential if we are to better monitor, and respond to, evidence about progress, or not, with their control."
In a linked Comment, Rifat Atun, Professor of Global Health Systems at Harvard University, Boston, USA, calls for new global standards to make available the data, methods, and models used in global health estimates of incidence, prevalence, mortality, and morbidity. He writes that, "Guidelines exist for reporting health research, including for randomised trials and observational studies. Leading economic journals only publish research articles that make available the data, models, programmes, simulations, and other computation details used in analyses to permit replication. Global health studies providing estimates of incidence, prevalence, mortality, and morbidity should be subject to similar standards to further strengthen the transparency, quality, and rigour of data, methods, and results. By providing detailed information on key data sources, key adjustments to data, modelling strategies, and uncertainty analyses, Murray and colleagues have pushed the boundaries of reporting in global health to levels expected of other disciplines and areas of health research -- an important step in the right direction."
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