New findings published in The Lancet reveal the changing burden of disease over more than 20 years on a global scale, including a fall in the number of deaths caused by pneumonia and measles in The Gambia.

This comprehensive analysis of mortality data from 188 countries is the output of an international consortium of researchers, coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

Results for The Gambia show that mortality from pneumonia dropped 21% between 1990 and 2013. At the same time, a number of diseases, including ischemic heart disease and stroke, claimed more lives in 2013 than in 1990. Importantly, life expectancy improved for both men and women in The Gambia, at an average of 6.9 years gained since 1990.

Researchers from MRC Unit The Gambia contributed to the study, which is part of an ongoing effort to produce the most timely and up-to-date understanding of what kills and ails people worldwide. Hundreds of collaborators worldwide work together to generate annual estimates of deaths by cause, years of life lost to disability, and rates of premature mortality and illness.

To make these data as useful and relevant to policymakers and country leaders as possible, findings from the Global Burden of Disease Study 2013 can be used at the global, regional, national, and even subnational levels to track trends in health over time.

In The Gambia, relevant data was collected over the decades by researchers at MRC Unit The Gambia. Unit investigators participated in discussions of the analysis, interpretation of the results and up-to-date available data.

“Up-to-date data on global burden of disease is necessary to know cause of mortality trends in different regions of the world,” said Dr Anna Roca, Theme Coordinator of Disease Control and Elimination at MRC Unit The Gambia. “The success of this analysis is the large number of investigators who participated and the amount of data gathered. These results should be useful to shape the international agenda for global health during the coming years.”

The leading killers in The Gambia were found to be malaria, pneumonia, and stroke, accounting for 32% of all deaths in 2013. Malaria was the top cause of child mortality in 2013, killing 1,482 children under the age of 5.

The study also revealed how some diseases and injuries cause different mortality patterns for males and females. For example, in The Gambia, liver cancer took a greater toll on men, killing 341 males and 131 females in 2013.

Improvements in health, reduced fertility, and shifts in the world’s age patterns have driven global gains in life expectancy. Globally, people live an average of 6.2 years longer than they did in 1990, with life expectancy rising to just under 72 years in 2013.

In The Gambia, the average life expectancy for women was 66.3 years in 2013, with men living an average of 62.9 years. By contrast, women lived an average of 58.9 years and men had a life expectancy of 56.6 years in 1990. Out of the 188 countries included in the study The Gambia ranked 147th for women and 141st for men for longest life expectancies.

Professor Umberto D’Alessandro, Director of MRC Unit The Gambia, said, “It is good news that life expectancy is increasing in The Gambia. Our research portfolio includes most of the top 10 current leading causes of death, with malaria, pneumonia, diarrhoeal diseases and liver cancer, among others, in the forefront of our research.”

“The fact that people are living longer in most parts of the world is good news but we must do more to address health disparities,” said IHME Director Dr. Christopher Murray. “Only with the best available evidence can we develop policies to improve health and save lives.”

Researchers found a widening gap between countries with the lowest and highest death rates from a given disease – a potential sign of increasing inequalities in health. They also emphasize the importance of measuring local disease burdens, as the health challenges found in one corner of a country can widely vary from those experienced a few hours away.

Paper reference: Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. Published online: 17 December 2014.
The paper is available at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61682…

The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. IHME makes this information widely available so that policymakers have the evidence they need to make informed decisions about how to allocate resources to best improve population health.