As I was reading the original “Global Burden of Disease Study,” I could not help but wonder how such a study could possibly be attempted? In this Study, the World Bank and the World Health Organization hoped to compile a standard set of data of all diseases and injuries, and produce a comprehensive estimate of the burden of these diseases, injuries, and risk factors. The study was centered on a system termed the DALY, which stands for Disability adjusted life year. The real perplexity comes in when one thinks about the aims of this study.
The purpose of the study, which I do not assume, but rather later read in chapter 1 of “Measuring the Global Burden of Disease and Risk Factors,” is that the study intended to help health policy makers, who traditionally have limited amounts of health resources, make decisions based on the greatest needs of the communities they are working with. However, I believe that a set list of different diseases with a weighted value on how devastating each may be has no practical value and may actually be severely misleading to policy makers.
The first point that I have a problem with is the intent of the study, to have a standard scale for disease based on the burden it will have on one’s lifestyle. How can we ever make a standard value for a disease the same across different countries, let alone different people? Such a generalization of how burdensome a disease may be for all people may be a very dangerous thing for policy makers to have. An international aid organization from America attempting to help a developing country in Sub Saharan Africa may be very misguided in its intervention and policy making if it understands an injury such as a broken leg the same way it would understand a broken leg in America. Having a weighted number value for diseases is exactly this type of ignorance.
The study clearly had good intentions. It was the first study to attempt to take into account risk factors and the effects these diseases have on different peoples lives. I acknowledge the importance of having a standard measure for health. But the DALY certainly is not the solution. I understand that it is unfair to criticize an attempt to solve a problem when I lack another solution myself, but I believe that we would actually be better off completely with no solution than with the study of the Global Burden of Disease. This study is misguiding and attempting to make such a scale completely ignores the complexity of what goes into health.
Rating something such as the burden of different diseases must be determined on a country-by-country basis, and even these may be categories too large. There are cultural and epidemiological differences in between areas that make it impossible to have a standard Global Burden of Disease Data Set.