Christopher J L Murray1, Katrina F Ortblad1, Caterina Guinovart1, Stephen S Lim1, Timothy M Wolock1, D Allen Roberts1, Emily A Dansereau1, Nicholas Graetz1, Ryan M Barber1, Jonathan C Brown1, Haidong Wang1, Herbert C Duber1, Mohsen Naghavi1, Daniel Dicker1, Lalit Dandona2, Joshua A Salomon3, Kyle R Heuton1, Kyle Foreman4, David E Phillips1, Thomas D Fleming1, Abraham D Flaxman1, Bryan K Phillips1, Elizabeth K Johnson1, Megan S Coggeshall1, Foad Abd-Allah5, Semaw Ferede Abera6, Jerry P Abraham7, Ibrahim Abubakar8, Laith J Abu-Raddad9, Niveen Me Abu-Rmeileh10, Tom Achoki11, Austine Olufemi Adeyemo12, Arsène Kouablan Adou13, José C Adsuar14, Emilie Elisabet Agardh15, Dickens Akena16, Mazin J Al Kahbouri17, Deena Alasfoor17, Mohammed I Albittar18, Gabriel Alcalá-Cerra19, Miguel Angel Alegretti20, Zewdie Aderaw Alemu21, Rafael Alfonso-Cristancho22, Samia Alhabib23, Raghib Ali24, Francois Alla25, Peter J Allen26, Ubai Alsharif27, Elena Alvarez28, Nelson Alvis-Guzman29, Adansi A Amankwaa30, Azmeraw T Amare31, Hassan Amini32, Walid Ammar33, Benjamin O Anderson22, Carl Abelardo T Antonio34, Palwasha Anwari35, Johan Arnlöv36, Valentina S Arsic Arsenijevic37, Ali Artaman38, Rana J Asghar39, Reza Assadi40, Lydia S Atkins41, Alaa Badawi42, Kalpana Balakrishnan43, Amitava Banerjee44, Sanjay Basu45, Justin Beardsley46, Tolesa Bekele47, Michelle L Bell48, Eduardo Bernabe49, Tariku Jibat Beyene50, Neeraj Bhala51, Ashish Bhalla52, Zulfiqar A Bhutta53, Aref Bin Abdulhak54, Agnes Binagwaho55, Jed D Blore56, Berrak Bora Basara57, Dipan Bose58, Michael Brainin59, Nicholas Breitborde60, Carlos A Castañeda-Orjuela61, Ferrán Catalá-López62, Vineet K Chadha63, Jung-Chen Chang64, Peggy Pei-Chia Chiang65, Ting-Wu Chuang66, Mercedes Colomar67, Leslie Trumbull Cooper68, Cyrus Cooper69, Karen J Courville70, Benjamin C Cowie71, Michael H Criqui72, Rakhi Dandona73, Anand Dayama74, Diego De Leo75, Louisa Degenhardt76, Borja Del Pozo-Cruz77, Kebede Deribe50, Don C Des Jarlais78, Muluken Dessalegn79, Samath D Dharmaratne80, Uğur Dilmen81, Eric L Ding82, Tim R Driscoll83, Adnan M Durrani84, Richard G Ellenbogen85, Sergey Petrovich Ermakov86, Alireza Esteghamati87, Emerito Jose A Faraon34, Farshad Farzadfar88, Seyed-Mohammad Fereshtehnejad89, Daniel Obadare Fijabi90, Mohammad H Forouzanfar1, Urbano Fra Paleo14, Lynne Gaffikin91, Amiran Gamkrelidze92, Fortuné Gbètoho Gankpé93, Johanna M Geleijnse94, Bradford D Gessner95, Katherine B Gibney96, Ibrahim Abdelmageem Mohamed Ginawi97, Elizabeth L Glaser98, Philimon Gona99, Atsushi Goto100, Hebe N Gouda101, Harish Chander Gugnani102, Rajeev Gupta103, Rahul Gupta104, Nima Hafezi-Nejad87, Randah Ribhi Hamadeh105, Mouhanad Hammami106, Graeme J Hankey107, Hilda L Harb33, Josep Maria Haro108, Rasmus Havmoeller109, Simon I Hay24, Mohammad T Hedayati110, Ileana B Heredia Pi111, Hans W Hoek112, John C Hornberger113, H Dean Hosgood114, Peter J Hotez115, Damian G Hoy116, John J Huang48, Kim M Iburg117, Bulat T Idrisov118, Kaire Innos119, Kathryn H Jacobsen120, Panniyammakal Jeemon121, Paul N Jensen22, Vivekanand Jha52, Guohong Jiang122, Jost B Jonas123, Knud Juel124, Haidong Kan125, Ida Kankindi55, Nadim E Karam126, André Karch127, Corine Kakizi Karema128, Anil Kaul129, Norito Kawakami130, Dhruv S Kazi131, Andrew H Kemp132, Andre Pascal Kengne133, Andre Keren134, Maia Kereselidze92, Yousef Saleh Khader135, Shams Eldin Ali Hassan Khalifa136, Ejaz Ahmed Khan137, Young-Ho Khang138, Irma Khonelidze92, Yohannes Kinfu139, Jonas M Kinge140, Luke Knibbs101, Yoshihiro Kokubo141, S Kosen142, Barthelemy Kuate Defo143, Veena S Kulkarni144, Chanda Kulkarni145, Kaushalendra Kumar146, Ravi B Kumar147, G Anil Kumar73, Gene F Kwan148, Taavi Lai149, Arjun Lakshmana Balaji56, Hilton Lam150, Qing Lan151, Van C Lansingh152, Heidi J Larson153, Anders Larsson36, Jong-Tae Lee154, James Leigh155, Mall Leinsalu119, Ricky Leung156, Yichong Li157, Yongmei Li157, Graça Maria Ferreira De Lima158, Hsien-Ho Lin159, Steven E Lipshultz160, Shiwei Liu161, Yang Liu162, Belinda K Lloyd163, Paulo A Lotufo132, Vasco Manuel Pedro Machado164, Jennifer H Maclachlan71, Carlos Magis-Rodriguez165, Marek Majdan166, Christopher Chabila Mapoma167, Wagner Marcenes168, Melvin Barrientos Marzan169, Joseph R Masci170, Mohammad Taufiq Mashal171, Amanda J Mason-Jones172, Bongani M Mayosi173, Tasara T Mazorodze174, Abigail Cecilia Mckay175, Peter A Meaney176, Man Mohan Mehndiratta177, Fabiola Mejia-Rodriguez111, Yohannes Adama Melaku178, Ziad A Memish179, Walter Mendoza180, Ted R Miller181, Edward J Mills182, Karzan Abdulmuhsin Mohammad183, Ali H Mokdad1, Glen Liddell Mola184, Lorenzo Monasta185, Marcella Montico185, Ami R Moore186, Rintaro Mori187, Wilkister Nyaora Moturi188, Mitsuru Mukaigawara189, Kinnari S Murthy73, Aliya Naheed190, Kovin S Naidoo191, Luigi Naldi192, Vinay Nangia193, K M Venkat Narayan162, Denis Nash194, Chakib Nejjari195, Robert G Nelson196, Sudan Prasad Neupane197, Charles R Newton198, Marie Ng1, Muhammad Imran Nisar199, Sandra Nolte27, Ole F Norheim200, Vincent Nowaseb201, Luke Nyakarahuka16, In-Hwan Oh202, Takayoshi Ohkubo203, Bolajoko O Olusanya204, Saad B Omer162, John Nelson Opio205, Orish Ebere Orisakwe206, Jeyaraj D Pandian207, Christina Papachristou27, Angel J Paternina Caicedo29, Scott B Patten208, Vinod K Paul209, Boris Igor Pavlin210, Neil Pearce153, David M Pereira211, Aslam Pervaiz212, Konrad Pesudovs213, Max Petzold214, Farshad Pourmalek215, Dima Qato216, Amado D Quezada111, D Alex Quistberg22, Anwar Rafay217, Kazem Rahimi24, Vafa Rahimi-Movaghar218, Sajjad Ur Rahman219, Murugesan Raju220, Saleem M Rana221, Homie Razavi222, Robert Quentin Reilly223, Giuseppe Remuzzi224, Jan Hendrik Richardus225, Luca Ronfani185, Nobhojit Roy226, Nsanzimana Sabin227, Mohammad Yahya Saeedi179, Mohammad Ali Sahraian228, Genesis May J Samonte229, Monika Sawhney230, Ione J C Schneider231, David C Schwebel232, Soraya Seedat233, Sadaf G Sepanlou234, Edson E Servan-Mori111, Sara Sheikhbahaei87, Kenji Shibuya235, Hwashin Hyun Shin236, Ivy Shiue237, Rupak Shivakoti238, Inga Dora Sigfusdottir239, Donald H Silberberg240, Andrea P Silva241, Edgar P Simard242, Jasvinder A Singh232, Vegard Skirbekk140, Karen Sliwa243, Samir Soneji244, Sergey S Soshnikov245, Chandrashekhar T Sreeramareddy246, Vasiliki Kalliopi Stathopoulou247, Konstantinos Stroumpoulis248, Soumya Swaminathan249, Bryan L Sykes250, Karen M Tabb251, Roberto Tchio Talongwa252, Eric Yeboah Tenkorang253, Abdullah Sulieman Terkawi254, Alan J Thomson255, Andrew L Thorne-Lyman256, Jeffrey A Towbin257, Jefferson Traebert258, Bach X Tran259, Zacharie Tsala Dimbuene260, Miltiadis Tsilimbaris261, Uche S Uchendu262, Kingsley N Ukwaja263, Selen Begüm Uzun81, Andrew J Vallely264, Tommi J Vasankari265, N Venketasubramanian266, Francesco S Violante267, Vasiliy Victorovich Vlassov268, Stein Emil Vollset269, Stephen Waller270, Mitchell T Wallin271, Linhong Wang161, XiaoRong Wang272, Yanping Wang273, Scott Weichenthal236, Elisabete Weiderpass274, Robert G Weintraub275, Ronny Westerman276, Richard A White277, James D Wilkinson278, Thomas Neil Williams4, Solomon Meseret Woldeyohannes279, John Q Wong280, Gelin Xu281, Yang C Yang282, Yuichiro Yano283, Gokalp Kadri Yentur57, Paul Yip284, Naohiro Yonemoto285, Seok-Jun Yoon154, Mustafa Younis286, Chuanhua Yu287, Kim Yun Jin288, Maysaa El Sayed Zaki289, Yong Zhao290, Yingfeng Zheng291, Maigeng Zhou161, Jun Zhu273, Xiao Nong Zou292, Alan D Lopez56, Theo Vos1. 1. Institute for Health Metrics and Evaluation, Seattle, WA, USA. 2. Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India. 3. Harvard University, Cambridge, MA, USA. 4. Imperial College London, London, UK. 5. Faculty of Medicine, Cairo-University, Cairo, Egypt. 6. College of Health Sciences, School of Public Health, Mekelle, Ethiopia. 7. University of Texas School of Medicine San Antonio, San Antonio, TX, USA. 8. University College London, London, UK. 9. Weill Cornell Medical College in Qatar, Doha, Qatar. 10. Institute of Community and Public Health-Birzeti University, Ramallah, West Bank, Occupied Palestinian Territory. 11. Ministry of Health, Gaborone, Botswana. 12. Evidence For Action (MamaYe), Freetown, Western Area, Sierra Leone. 13. Association Ivoirienne Pour Le Bien Etre Familial, Abidjan, Côte d'Ivoire. 14. University of Extremadura, Cáceres, Spain. 15. Institution of Public Health Sciences, Stockholm, Sweden. 16. Makerere University, Kampala, Uganda. 17. Ministry of Health, Muscat, Oman. 18. Independent, Damascus, Syria. 19. Grupo de Investigación en Ciencias de la Salud y Neurociencias (CISNEURO), Cartagena de Indias, Colombia. 20. Facultad de Medicina, Departamento de Medicina Preventiva y Social, Universidad de la República, Montevideo, Uruguay. 21. Debre Markos University, Debre Markos, Ethiopia. 22. University of Washington, Seattle, WA, USA. 23. National Guard Health Affairs, Riyadh, Saudi Arabia. 24. University of Oxford, Oxford, UK. 25. School of Public Health, University of Lorraine, Nancy, France. 26. Ministry of Health, Belmopan, Cayo, Belize. 27. Charité Universitätsmedizin Berlin, Berlin, Germany. 28. Government, Madrid, Spain. 29. Universidad de Cartagena, Cartagena de Indias, Colombia. 30. Albany State University, Albany, GA, USA. 31. Department of Epidemiology, University of Groningen, Groningen, The Netherlands; College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia. 32. Kurdistan Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan, Iran. 33. Ministry of Public Health, Beirut, Lebanon. 34. College of Public Health, University of the Philippines Manila, Manila, Philippines. 35. UNFPA, Kabul, Afghanistan. 36. Uppsala University, Uppsala, Sweden. 37. Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Belgrade, Serbia. 38. Median Inc, Windsor, ON, Canada. 39. South Asian Public Health Forum, Islamabad, Pakistan. 40. Mashhad University of Medical Sciences, Mashhad, Iran. 41. Ministry of Health, Wellness, Human Services and Gender Relations, Castries, St. Lucia. 42. Public Health Agency of Canada, Toronto, ON, Canada. 43. Sri Ramachandra University, Chennai, India. 44. University of Birmingham, Birmingham, UK. 45. Stanford University, Stanford, CA, USA. 46. Oxford University, Ho Chi Minh City, Vietnam. 47. Madawalabu University, Bale Goba, Ethiopia. 48. Yale University, New Haven, CT, USA. 49. King's College London, London, UK. 50. Addis Ababa University, Addis Ababa, Ethiopia. 51. Wellington Hospital, Wellington, New Zealand. 52. Postgraduate Institute of Medical Education and Research, Chandigarh, India. 53. Aga Khan University Medical Center, Nairobi, Kenya. 54. University of Missouri-Kansas City, Kansas City, MO, USA. 55. Ministry of Health, Kigali, Rwanda. 56. University of Melbourne, Melbourne, VIC, Australia. 57. General Directorate of Health Research, Ankara, Turkey. 58. World Bank, Washington, DC, USA. 59. Danube-University Krems, Krems, Austria. 60. University of Arizona, Tucson, AZ, USA. 61. Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Colombia. 62. Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency (AEMPS), Ministry of Health, Madrid, Spain. 63. National Tuberculosis Institute, Bangalore, India. 64. National Taiwan University, Taipei, Taiwan. 65. General Practice and Primary Health Care Academic Centre, Melbourne, VIC, Australia. 66. Department of Parasitology, College of Medicine, Taipei Medical University, Taipei, Taiwan; Center for International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 67. UNICEM, Montevideo, Uruguay. 68. Mayo Clinic, Rochester, MN, USA. 69. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 70. Hospital Dr. Gustavo N. Collado, Chitre, Herrera, Panama. 71. Victorian Infectious Diseases Reference Laboratory, North Melbourne, VIC, Australia. 72. University of California, San Diego, La Jolla, CA, USA. 73. Public Health Foundation of India, New Delhi, India. 74. Emory University School of Medicine, Atlanta, GA, USA. 75. Griffith University, Brisbane, QLD, Australia. 76. University of New South Wales, Sydney, NSW, Australia. 77. University of Auckland, Auckland, New Zealand. 78. Beth Israel Medical Center, New York, NY, USA. 79. Africa Medical and Research Foundation in Ethiopia, Addis Ababa, Ethiopia. 80. University of Peradeniya, Peradeniya, Sri Lanka. 81. Ministry of Health, Ankara, Turkey. 82. Harvard School of Public Health, Cambridge, MA, USA. 83. Sydney School of Public Health, Sydney, NSW, Australia. 84. National Institutes of Health, Montgomery Village, MD, USA. 85. Harborview and University of Washington Medicine, Seattle, WA, USA. 86. The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia. 87. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. 88. Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. 89. Department of Neurobiology, Care Sciences and Society (NVS), Stockholm, Sweden. 90. Heller Graduate School, Waltham, MA, USA. 91. Stanford University School of Medicine, Stanford, CA, USA. 92. National Centre for Disease Control and Public Health, Tbilisi, Georgia. 93. Clinique Coopérative de Parakou, Parakou, Borgou, Benin. 94. Division of Human Nutrition, Wageningen University, Wageningen, Netherlands. 95. Agence de Medecine Preventive, Paris, France. 96. Monash University, Melbourne, VIC, Australia. 97. College of Medicine, University of Hail, Hail, Saudi Arabia. 98. Heller School for Social Policy and Management, Waltham, MA, USA. 99. University of Massachusetts Medical School, Worcester, MA, USA. 100. Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan. 101. University of Queensland, Brisbane, QLD, Australia. 102. Saint James School of Medicine, Kralendijk, Bonaire, Netherlands Antilles. 103. Fortis Escorts Hospital, Jaipur, India. 104. Kanawha Charleston Health Department, Charleston, WV, USA. 105. Arabian Gulf University, Manama, Bahrain. 106. Wayne County Department of Health and Human Services, Detroit, MI, USA. 107. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia. 108. Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain. 109. Karolinska Institutet, Stockholm, Sweden. 110. Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran. 111. National Institute of Public Health of Mexico, Cuernavaca, Morelos, Mexico. 112. Parnassia Psychiatric Institute, The Hague, Netherlands. 113. Cedar Associates, Menlo Park, CA, USA. 114. Albert Einstein College of Medicine, Bronx, NY, USA. 115. Baylor College of Medicine, Houston, TX, USA. 116. School of Population Health, Brisbane, QLD, Australia; Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia. 117. Aarhus University, Aarhus, Denmark. 118. Brandeis University, Waltham, MA, USA. 119. National Institute for Health Development, Tallinn, Estonia. 120. George Mason University, Fairfax, VA, USA. 121. Centre for Chronic Disease Control, New Delhi, India. 122. Tianjin Centers for Diseases Control and Prevention, Tianjin, China. 123. Department of Ophthalmology, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany. 124. The National Institute of Public Health, Copenhagen, Denmark. 125. Fudan University, Shanghai, China. 126. University of Balamand, Beirut, Lebanon. 127. Helmholtz Centre for Infection Research, Braunschweig, Germany; German Center for Infection Research (DZIF), Hannover-Braunschweig site, Germany. 128. Malaria & Other Parasitic Diseases Division, Kigali, Rwanda. 129. Oklahoma State University, Tulsa, OK, USA. 130. School of Public Health, Tokyo, Japan. 131. University of California San Francisco, San Francisco, CA, USA. 132. University of São Paulo, São Paulo, Brazil. 133. South African Medical Research Council, Cape Town, Western Cape, South Africa. 134. Cardiology, Hadassah Ein Kerem University Hospital, Jerusalem, Israel. 135. Jordan University of Science and Technology, Al-Ramtha, Jordan. 136. Supreme Council of Health, Doha, Qatar. 137. Health Services Academy, Islamabad, Punjab, Pakistan. 138. Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea. 139. University of Canberra, Canberra, ACT, Australia. 140. Norwegian Institute of Public Health, Oslo, Norway. 141. Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 142. Center for Community Empowerment, Health Policy & Humanities, NIHRD, Jakarta, Indonesia. 143. University of Montreal, Montreal, QC, Canada. 144. Arkansas State University, Jonesboro, AR, USA. 145. Rajrajeshwari Medical College & Hospital, Bangalore, Karnataka, India. 146. International Institute for Population Sciences, Mumbai, Maharashtra, India. 147. Indian Institute of Public Health, Public Health Foundation of India, Gurgaon, Haryana, India. 148. Boston Medical Center, Boston, MA, USA. 149. Fourth View Consulting, Tallinn, Estonia. 150. Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines. 151. National Cancer Institute, Rockville, MD, USA. 152. IAPB and Vision 2020 LA, Weston, FL, USA. 153. London School of Hygiene and Tropical Medicine, Bloomsbury, UK. 154. Korea University, Seoul, South Korea. 155. University of Sydney, Sydney, NSW, Australia. 156. University at Albany, The State University of New York, Rensselaer, NY, USA. 157. Genentech, Inc, South San Francisco, CA, USA. 158. Unidade Local de Saude de Matosinhos, Public Health Department, Porto, Portugal. 159. Institute of Epidemiology and Preventive Medicine, Taipei, Taiwan. 160. Wayne State University, Miami, FL, USA. 161. National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 162. Emory University, Atlanta, GA, USA. 163. Eastern Health Clinical School, VIC, Australia; Turning Point, Eastern Health, Fitzroy, VIC, Australia. 164. Northern Region Health Administration, Public Health Department, Porto, Portugal. 165. Centro Nacional para la Prevención y el Control del VIH/SIDA, Mexico City, Mexico. 166. Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia. 167. University of Zambia, Lusaka, Zambia. 168. Queen Mary, University of London, London, UK. 169. University of the East Ramon Magsaysay Medical Center, Quezon City, Philippines. 170. Elmhurst Hospital Center, Mount Sinai Services, Elmhurst, NY, USA. 171. Ministry of Public Health, Kabul, Afghanistan. 172. University of York, York, UK. 173. University of Cape Town, Cape Town, Western Cape, South Africa. 174. AIDC EC, Port Elizabeth, Eastern Cape, South Africa. 175. EmergentCorp, Belize City, Belize. 176. Pereleman School of Medicine, Philadelphia, PA, USA. 177. Janakpuri Superspecialty Hospital, New Delhi, India. 178. Mekelle University, Mekelle, Ethiopia. 179. Ministry of Health, Riyadh, Saudi Arabia. 180. UNFPA, Lima, Peru. 181. Pacific Institute for Research & Evaluation, Calverton MD, USA; Centre for Population Health Research, Curtin University, Perth, WA, Australia. 182. University of Ottawa, Ottawa, ON, Canada. 183. University of Salahaddin, Erbil, Iraq. 184. University of Papua New Guinea, Port Moresby, NCD, Papua New Guinea. 185. Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy. 186. University of North Texas, Denton, TX, USA. 187. National Center for Child Health and Development, Setagaya, Tokyo, Japan. 188. Egerton University, Egerton, Rift Valley, Kenya. 189. Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan. 190. International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh. 191. University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa. 192. Azienda Ospedaliera papa Giovanni XXIII, Bergamo, Italy. 193. Suraj Eye Institute, Nagpur, Maharashtra, India. 194. School of Public Health, City University of New York, New York, NY, USA. 195. Faculty of Medicine, Fez, Morocco. 196. National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA. 197. Norwegian Center for Addiction Research (SERAF), University of Oslo, Oslo, Norway. 198. Kenya Medical Research Institute Wellcome Trust Programme, Kilifi, Kenya. 199. Aga Khan University, Karachi, Pakistan. 200. University of Bergen, Bergen, Norway. 201. Polytechnic of Namibia, Windhoek, Namibia. 202. Kyung Hee University, Seoul, Korea. 203. Teikyo University School of Medicine, Tokyo, Japan. 204. Center for Healthy Start Initiative, Ikoyi, Lagos, Nigeria. 205. Lira District Local Government, Lira Municipal Council, Northern Uganda, Uganda. 206. Toxicology Unit, Faculty of Pharmacy, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria. 207. Christian Medical College Ludhiana, Ludhiana, India. 208. University of Calgary, Calgary, AB, Canada. 209. AIIMS, New Delhi, India. 210. Independent, Waigani, NCD, Papua New Guinea. 211. 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine and ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal. 212. Postgraduate Medical Institute, Lahore, Punjab, Pakistan. 213. Flinders University, Adelaide, SA, Australia. 214. Centre for Applied Biostatistics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 215. University of British Columbia, Vancouver, BC, Canada. 216. College of Pharmacy, University of Illinois, Chicago, IL, USA. 217. Contech Intl., Lahore, Punjab, Pakistan. 218. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. 219. Hamad Medical Corporation, Doha, Qatar. 220. University of Missouri, Columbia, MO, USA. 221. Department of Public Health, University of the Punjab, Lahore, Punjab, Pakistan. 222. Center for Disease Analysis, Louisville, CO, USA. 223. Private consultant, Cairns, QLD, Australia. 224. IRCCS Mario Negri Institute for Pharmacological Research, Centro Anna Maria Astori, Bergamo, Italy. 225. Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands. 226. BARC Hospital, Mumbai, Maharashtra, India. 227. Rwanda Bio-Medical Center, Kigali, Rwanda. 228. MS Research Center, Tehran University of Medical Sciences, Tehran, Iran. 229. National HIV/AIDS & STI Surveillance and Strategic Information Unit, National Epidemiology Center, Department of Health, Manila, National Capital Region, Philippines. 230. Marshall University, Huntington, WV, USA. 231. Federal University of Santa Catarina, Florianópolis, Brazil. 232. University of Alabama at Birmingham, Birmingham, AL, USA. 233. Stellenbosch University, Cape Town, Western Cape, South Africa. 234. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 235. University of Tokyo, Tokyo, Japan. 236. Health Canada, Ottawa, ON, Canada. 237. Heriot-Watt University, Edinburgh, UK. 238. Center for Clinical Global Health Education, Johns Hopkins University, Baltimore, MD, USA. 239. Reykjavik University, Reykjavik, Iceland. 240. University of Pennsylvania, Philadelphia, PA, USA. 241. Instituto Nacional de Epidemiología Dr Juan H Jara, Mar del Plata, Buenos Aires, Argentina. 242. Surveillance and Health Services Research Program American Cancer Society, Atlanta, GA, USA. 243. Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa, Cape Town, Western Cape, South Africa. 244. Dartmouth College, Lebanon, NH, USA. 245. Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia. 246. Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Kajang, Selangor, Malaysia. 247. Centre Hospitalier Nord Deux-Sevres, Bressuire, France. 248. KEELPNO (Centre for Disease Control, Greece, dispatched to "Alexandra" General Hospital of Athens), Athens, Greece. 249. National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India. 250. Department of Criminology, Law and Society (and Sociology), University of California-Irvine, Chicago, IL, USA. 251. University of Illinois, Champaign, IL, USA. 252. Ministry of Health-MINSANTE, Yaounde, Centre, Cameroon. 253. Memorial University, St John's, NL, Canada. 254. Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA; Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia. 255. Adaptive Knowledge Management, Victoria, BC, Canada. 256. The Earth Institute, Columbia University, New York, NY, USA. 257. Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 258. University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil. 259. Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. 260. Department of Population Sciences and Development, Faculty of Economics and Management, University of Kinshasa, Kinshasa, Democratic Republic of the Congo. 261. Department of Medicine, University of Crete, Heraklion, Greece. 262. Department of Veterans Affairs, Washington, DC, USA. 263. Department of Internal Medicine, Federal Teaching Hospital Abakaliki, Abakailiki, Ebonyi State, Nigeria. 264. The Kirby Institute, Sydney, NSW, Australia. 265. UKK Institute for Health Promotion Research, Tampere, Finland. 266. Neuroscience Centre, Raffles Hospital, Singapore, Singapore. 267. University of Bologna, Bologna, Italy. 268. Higher School of Economics, Moscow, Russia. 269. Norwegian Institute of Public Health, Oslo, Norway; University of Bergen, Bergen, Norway. 270. Uniformed Services University of Health Sciences, Bethesda, MD, USA. 271. VA Medical Center and Georgetown University Neurology Department, Washington, DC, USA. 272. Shandong University Affiliated Jinan Central Hospital, Jinan, China. 273. National Office for Maternal and Child Health Surveillance, Chengdu, China. 274. Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden. 275. University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia. 276. University of Marburg, Marburg, Germany. 277. Department of Infectious Disease Epidemiology, Division of Infectious Disease Control and Department of Health Statistics, Division of Epidemiology, Oslo, Norway. 278. University of Miami, Miami, FL, USA. 279. Institute of Public Health, University of Gondar, Gondar, Ethiopia. 280. Ateneo School of Medicine and Public Health, Pasig City, Metro Manila, Philippines. 281. Nanjing University School of Medicine, Jinling Hospital, Nanjing, China. 282. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 283. Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan. 284. The University of Hong Kong, Hong Kong, Hong Kong. 285. National Center of Neurology and Psychiatry, Kodira, Tokyo, Japan. 286. Jackson State University, Jackson, MS, USA. 287. Department of Epidemiology and Biostatistics, School of Public Health and Global Health Institute, Wuhan University, Wuhan, China. 288. TCM MEDICAL TK SDN BHD, Nusajaya, Johor Bahru, Malaysia. 289. Mansoura Faculty of Medicine, Mansoura, Egypt. 290. Chongqing Medical University, Chongqing, China. 291. Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. 292. Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Abstract
BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration. METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets. FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990. INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action. FUNDING: Bill & Melinda Gates Foundation.
BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration. METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets. FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990. INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action. FUNDING: Bill & Melinda Gates Foundation.
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