The book follows Christopher Murray, an eccentric, industrious and singularly focused man as he tries to save the world through more accurate health data. How can we solve sickness if we don’t know what is making people sick?
But basic information about what actually kills people and makes them sick is trickier to tabulate. In 2010, approximately 53 million people died worldwide, and, for all but a fraction, no one knows definitively why.
Add up deaths attributed to just four causes diarrhea, pneumonia, malaria, and measles and you had more deaths than the number of dead children.
Whenever advocates of this or that program promised their specific intervention was the most important, Jamison liked to ask what program was second-most important? No one could answer him. No one seemed to know why his or her area was more important than any other, or even what the others were. No one seemed to want to know.
Simply count deaths, on the other hand, and the pneumonia that kills a one-year-old is no different than the stroke that kills a seventy-year-old. To know the total health loss from any problem the burden of disease, he and Jamison started calling it. Murray concluded that you had to measure the years of healthy life lost, not just the ages at which people died or the number of lives taken.
One particularly surreal instance was the North Korean delegations complaints that estimates of their country mens healthy life expectancy had to be incorrect. Healthy life expectancy in North Korea is the same as life expectancy, because nobody is sick, they said. Murray tried not to laugh. What do you do? he says. Of course we paid no attention to it, but it was one of those very bizarre moments for the translator.
He was incredibly well read and very detail-oriented, Murray would remember later. He was just stunned and probably somewhat frustrated that the empirical basis for what we do in global health was so weak.
Not everybody was benefiting at the same rate, however. Look at survival gains not by region, but by age, and it was clear who our rapid health improvements had benefited and who had been left behind. Around the world, Murray reported, children under the age of ten, regardless of sex, were 60 to 70 percent less likely to die in 2010 than they would have been in 1970. In the ages of ten to fourteen, improvement was close to 50 percent. In terms of absolute numbers, the shift from 1970 to 2010 death rates meant almost 20 million child and adolescent lives saved a number equal to almost the entire military death toll of World War II, averted. And not just once. Every year. The WHO, UNICEF, and others should take a bow.
The big surprise to us was back and neck pain, he said. It has a big effect on peoples lives and its pretty universal. The same was true with depression. And diabetes. And COPD. And falls. If migraines struck you, or you suffered from anxiety, you were not uptight or spoiled; you were a typical human being in painand you would be typical anywhere in the world. Even in central sub-Saharan Africa nAngola, the Central African Republic, Congo, the Democratic Republic of the Congo, Equatorial Guinea, and Gabon where the leading cause of years lived with disability was iron-deficiency anemia, a close second was major depressive disorder. Third was low back pain.
Header photo © medium.com
Body photo © amazon.com