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New Global Health Estimates by the WHO

Bar diagram on numbers of deaths from major global challenges 2019.

The World Health Organization (WHO) recently released a new issue of their Global Health Estimates (GHE), updated for 2000 to 2019. At Global2030, we utilize this data for major global challenges that result from limited access to vital resources such as food, clean water or health care. We assess the relative importance of these challenges and their progress towards internationally agreed time-bound targets if given – such as the UN Sustainable Development Goals (SDGs) set in 2015.

Furthermore, we compare the GHE data to those earlier published in the Global Burden of Disease study from the Institute for Health Metrics and Evaluation (IHME).

 

1)   Major Global Health Estimates

 

Below we present GHE data on major global challenges due to limited access to vital resources, in descending order of the related numbers of deaths (WHO 2020).

Lower respiratory infections – mainly pneumonia – killed approximately 2.59 million people worldwide in 2019. This is the highest death toll from infectious diseases and includes 740,000 child deaths under 5. The total figure changed little from 2.57 million in 2015, but child deaths decreased from 863,000; however, this is likely insufficient to meet the 2025 WHO target.

Neonatal conditions claimed the lives of 2.04 million newborns in 2019. This is a reduction from 2.25 million in 2015. Unfortunately, the GHE do not provide neonatal mortality ratios to assess the trend towards related SDG target 3.2.

Diarrhoeal diseases, mostly caused by unsafe water and sanitation contaminated by E.coli, rotavirus etc., led to 1.52 million deaths in 2019. Although this is down from 1.67 million in 2015, it does not indicate that we are on track to meet SDG targets 6.1 and 6.2 to achieve access to safe water and sanitation for all by 2030.

 

Numbers of Deaths from Major Global Challenges in 2019
(in millions)

Bar diagram on numbers of deaths from major global challenges 2019.

Data source: WHO 2020 (Global Health Estimates).

Road traffic accidents resulted in 1.28 million deaths in 2019. This is slightly more than the 1.25 million in 2015, indicating that the 2020 target to halve the number of related deaths will likely be missed (SDG 3.6).

Tuberculosis killed 1.21 million people in 2019. This is fewer than the 1.31 million in 2015, but not a sufficient decrease to meet SDG target 3.3 to end tuberculosis by 2030.

Acute and chronic hepatitis B and C led to 1.11 million deaths in 2019. Up from 1.07 million in 2015, hepatitis is the only major infectious disease that continues to increase, diverging from SDG 3.3 and WHO members' targets to reduce the death toll by 2030.

HIV/AIDS claimed 675,000 lives in 2019. Through huge efforts, the death toll has been reduced from 819,000 in 2015, but we are not on track to meet SDG 3.3 to end AIDS by 2030.

Malaria killed 411,000 people in 2019, predominantly children. The reduction from 459,000 in 2015 is not sufficient to end malaria by 2030, as required by SDG target 3.3.

Nutritional deficiencies claimed the lives of 263,000 people in 2019. That was only slightly less than the 272,000 deaths in 2015. Moreover, undernourishment led to further multiple deaths by aggravating several diseases. The trend is not on track to meet SDG target 2.1 to end hunger by 2030.

Maternal conditions resulted in the deaths of 196,000 girls and women in 2019. A clear reduction from 221,000 in 2015 was achieved. However, the GHE lack a maternal mortality ratio to assess progress towards the related SDG target 3.2.

Measles killed 166,000 people – mostly children – in 2019. This figure increased slightly from 156,000 in 2015, diverging from the 2020 target by WHO members to eliminate measles in 4 of 6 world regions.

Armed conflicts led to the loss of 72,500 lives in 2019. That death toll was much higher in 2015, reaching 186,000 deaths. Thus, the current trend can be viewed as in accordance with SDG 16.1 to reduce death rates related to violence (not time-bound).

Natural disasters are estimated to have claimed the lives of 6090 people in 2019. In 2015, it was 14,700, so the current trend could be considered on track to reach a substantial reduction of related deaths by 2030 (SDG target 11.5). However, success is dependent on disaster preparedness as well as natural variation in the occurrence of disasters.

Among the major topics listed above, only one time-bound target and one non-time-bound goal of the SDGs can be considered on track. The SDGs urgently need a further push to be achieved. Ten years before their target year, the Millennium Development Goals (MDGs) also required such a push, which they received through the UN's 2005 World Summit.

In 2020, COVID-19 reportedly killed 1.78-1.80 million people so far and ranks among the highest death tolls in this list, not considering undiagnosed cases and its aggravating impact on other diseases (WHO 2020b; CSSE). As UN Secretary-General António Guterres recommended, the recovery from COVID-19 should be advised by the SDGs and the Paris Agreement to tackle climate change, providing an opportunity in the crisis (Guterres 2020).

 

2)   Comparison with the Global Burden of Disease Study

 

If we compare the Global Health Estimates to the Global Burden of Disease (GBD) study (see our article), the picture is as follows:

 

Numbers of Deaths from Major Global Challenges in 2019
According to GHE and GBD Data
(in millions)

GHE

GBD

Lower respiratory infections, mainly pneumonia

2.59

2.49

Neonatal conditions

2.04

1.88

Diarrhoeal diseases

1.52

1.53

Road traffic accidents

1.28

1.20

Tuberculosis

1.21

1.18

Hepatitis B and C

1.11

1.10

HIV/AIDS

0.675

0.864

Malaria

0.411

0.643

Nutritional deficiencies

0.263

0.252

Maternal conditions

0.196

0.196

Measles

0.166

0.0834

Armed conflicts

0.0725

0.0630

Natural disasters

0.00609

0.00608

Data sources: WHO 2020, GBD 2020a.

 

Whilst the estimates show large agreement, in a few topics there are considerable discrepancies. The GHE has more higher values in comparison to the GBD values. The largest discrepancy, in absolute as well as relative terms, occurs in malaria with +0.232 million or +56.6% estimated deaths (in the GBD estimate compared to the GHE). The second-largest discrepancy occurs in relative terms with −49.7% in measles, and in absolute terms with +0.189 million in HIV/AIDS (+21.9%) (Global2030's own calculations from GHE and GBD data). The GHE and the GBD study use data from national vital registration systems, while the GHE complements these with UN and GBD estimates as well as by consultation with WHO member states. For countries with incomplete vital registration, the GHE for HIV/AIDS are based on UNAIDS/WHO estimates and estimates for malaria and measles on WHO estimates (WHO 2020a, pp. 28-29, 32-33). This may explain the larger discrepancies in these topics (while there are other topics for which the GHE uses WHO or UN estimates, which have smaller discrepancies to the GBD estimates).

Regarding natural disasters, it is noteworthy that the GHE and GBD estimates share much agreement, but they are only half the scale of the number of reported deaths provided by the Centre for Research on the Epidemiology of Disasters (CRED). Their well-respected EM-DAT database is quoted as the main data source for the GHE and GBD estimates (GBD 2020b, p. 428, WHO 2020a, p. 31). CRED reports 11,755 deaths in 2019, while the GBD study estimated 6080 deaths. For 2009-2018, CRED provides a ten-year average of 45,212 reported deaths, while the GBD figures average lower, at around 38,400 estimated deaths (CRED 2020, p. 5; GBD 2020a). The advantage of estimates, over reported data, is that an estimate may fill data gaps or capture undocumented cases (the dark number). An estimate could only be smaller than a reported figure if there is substantial reason to assume that the reporting of death cases is exaggerated. However, the GBD and GHE do not provide any such claim in their methodology (GBD 2020b, pp. 428, 430, 1348; WHO 2020a, p. 31).

Even considering the limitations and discrepancies mentioned, the Global Health Estimates are a very useful data source for the assessment of major global challenges, as well the larger number of topics covered in the Global Burden of Disease study.

 

Chloë Mills and Lars Vogelsang
Global2030

 

Sources

 

Last modified: 30 December 2020
Address of this page (URI, URL): http://www.global2015.net/news/1609362000-global-health-estimates.html