THE GLOBAL BURDEN OF DISEASE IN 1990 - SUMMARY RESULTS, SENSITIVITY ANALYSIS AND FUTURE-DIRECTIONS

A basic requirement for evaluating the cost-effectiveness of health in terventions is a comprehensive assessment of the amount of ill health (premature death and disability) attributable to specific diseases and injuries. A new indicator, the number of disability-adjusted life yea rs (DALYs), was developed to assess the burden of disease and injury i n 1990 for over 100 causes by age, sex and region. The DALY concept pr ovides an integrative, comprehensive methodology to capture the entire amount of ill health which will, on average, be incurred during one's lifetime because of new cases of disease and injury in 1990. It diffe rs in many respects from previous attempts at global and regional heal th situation assessment which have typically been much less comprehens ive in scope, less detailed, and limited to a handful of causes. This paper summarizes the DALY estimates for 1990 by cause, age, sex and re gion. For the first time, those responsible for deciding priorities in the health sector have access to a disaggregated set of estimates whi ch, in addition to facilitating cost-effectiveness analysis, can be us ed to monitor global and regional health progress for over a hundred c onditions. The paper also shows how the estimates depend on particular values of the parameters involved in the calculation.