GENEVA, Switzerland- What is the best way to estimate how many people suffer from tuberculosis, forests of Central Africa in the highlands of Peru? During a 2-day meeting organized and hosted by the World Health Organization (WHO) here, 60 leaders in the field of global health statistics have developed a set of proposals to improve the world's ability after the sick and the dead. They called for help countries better information about the illness and death and pledged to work together to produce the best estimates available from the sometimes sparse data.
Knowing how many people in what areas suffer from diseases which is crucial for developing effective public health policies. But there is a problem. In areas that have some of the most pressing public health needs, no adequate statistics guard. In many places, there are no records or birth or death. "Where the disease burden is the greatest, does not exist our ability to measure trends," said Margaret Chan, Director General of WHO, at the beginning of the meeting yesterday. And even in places where sophisticated health systems, records on causes of death are often misleading or incorrect. In the UK, 17% of deaths are recorded incorrectly said Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle.
Scientists use the available data and complex computer models to fill gaps and estimate the load of, say, turberculosis Peru or high blood pressure in Italy. In the largest ever undertaken effort, a group of scientists in December published the Global Burden of Disease (GBD) 2010 study, which found the disease dead loads as well as years of life affected by disability for 291 diseases and injuries in 20 age groups in 21 regions. On March 5, the study, which coordinates Murray will release its estimates by country for the same set of diseases. (They will also announce plans to launch a Global Burden of Disease 2.0, which will be updated annually or more frequently.)
But the computer models they use and others have become so complex that it is difficult for foreigners to test and validate the estimates. "We are in a period of large volumes of data," said Peter Piot, director of the London School of Hygiene & Tropical Medicine, who co-chaired the meeting. The ENCODE project that tries to make sense of the flood of human genetic information and CERN physics laboratory of high energies are examples, he told the meeting, "and the global burden of disease is in this category. in science, we strive to independent confirmation, but as the discoveries of physics at CERN, it is difficult to independently verify the results because no one has the resources to do it. "
In recent years, discussions on the differences between estimates from different groups have become increasingly warm. Estimates of maternal mortality by WHO, for example, were higher than those IHME published in 2010. And in 2012, estimates of the IHME of malaria deaths in adults in sub-Saharan Africa were considerably higher that the WHO figures. Tensions between the different modeling groups increased so that WHO, who originally collaborated on the GBD 2010, did not allow one of his staff members to be listed as authors on articles published in December.
In an effort to diffuse some of the tension, the Bill & Melinda Gates Foundation, which supports IHME funded WHO to organize the meeting. The effort seems to have been successful. Participants agreed that the differences between the estimates obtained by different groups can sometimes be an advantage. "The challenge different numbers can lead to the improvement of science," says Colin Mathers of the health statistics department and the WHO information systems. They drafted a series of proposals, including the WHO is expected to publish next week, which uses the global health community to invest in better data collection efforts in the field, something that everyone is d agreement is desperately needed. The managers of health statistics in countries with low and middle incomes "are often found in the darkest, most remote corners of the Ministry of Health," where they get little attention and even less money, said Henk Bekedam, director of development of the health sector in the WHO Western Pacific Region in Manila.
The participants also agreed to try to better explain their work to each other and to the broader community of public health, for example, the sharing of data sets and specialized software, as far as possible. The group also proposed to develop ways to encourage regular communication between researchers working in the field.
One problem, several participants deplored, is that global organizations of health financing rather spend limited resources on efforts "more sexy" such as vaccination campaigns and treatment efforts that statistics health. This perception needs to change, said meeting co-chair Hans Rosling of the Karolinska Institute in Stockholm, the Gapminder Foundation develops popular graphic that often reveal surprising patterns in health data and population. "You are doing an extremely important job," he told the meeting at the end. "And for Valentine's Day, I am pleased to tell you: What you are doing is very sexy."
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