Together with around 60 participants from dozens of countries, I attended the annual Global Burden of Disease (GBD) of the Institute of Health Metrics and Evaluation (IHME) last April 8 to 16, 2018. I was one of two representatives of the Philippines.
The GBD is particularly important for EpiMetrics. Our chairman, Dr. John Wong, was the 2016 IHME Roux Prize Awardee. The Roux Prize is an annual award given to a researcher or policy maker who used the GBD in novel ways to promote better health outcomes. Our novel approach was to use the GBD results and the well-known Pareto rule (80% of effects are due to 20% of causes) to demonstrate that if the Philippine health sector focused on a set of 48 diseases (20% of all causes), then we can address 80% of the burden, as measured by disability-adjusted life years (DALYs). A DALY represents a year’s worth of loss of healthy life, and is a convenient measure that incorporates both sickness and death to allow apples-to-apples comparison of all diseases.
That research project was our first in EpiMetrics. When we were starting out in 2015, we were constantly bidding for projects, and Dr. Wong was contacting his colleagues for possible opportunities. It was the United Nations Children’s Fund (UNICEF) Philippine country office that first invested in us by funding this project. Since then, that project has branched out into three more research projects, and is now well-known in public health circles as the “Top 48” diseases project.
I attended the training to learn more about the technical methods behind the GBD, as well as to learn from my fellow participants how the GBD can be used for communicating health. For five 10-hour days, we did just that. We dove deep into the mathematical, computational, and philosophical assumptions, and conducted exercises on how we can use the GBD results to convince policy-makers to make more rational decisions on health care.
I also learned much from fellow participants over meals and during coffee breaks. We shared many common problems on how to communicate the GBD: Some government technocrats insist on their own models rather than seeing the value of the GBD. Others lament the hostility they experience from local policy-makers because GBD estimates sometimes negate national priorities. Most struggle with communicating what a DALY is, especially to senior health policy-makers and the public.
But we also brainstormed on possible solutions to these problems. A lot of academicians pledged to use GBD more extensively in their classes to prepare the next generation of health professionals. Policy-makers pledged to share what the GBD is to their colleagues and be champions within their institutions. Researchers like myself pledged to use the GBD even more in our studies, and I’m happy that EpiMetrics has been on the right track with that.
Moving forward, I hope that EpiMetrics will be able to train more Filipinos on the GBD. If you or your institution are interested in getting involved, reach out to us!