We’re excited to announce the release of the Global Burden of Disease (GBD) model context protocol (MCP) through Claude from Anthropic. Dr. Ali Mokdad, IHME Professor and Chief Strategy Officer for Population Health at the University of Washington, discusses this tool and its capabilities. Use Claude to explore virtually all aspects of GBD 2023 study estimates including, but not limited to: – Burden (deaths, DALYs, YLLs, YLDs for any cause, location, or year) – Risk factors – Mortality and longevity – Comparisons, development context, detailed data and methods – Ready-made profiles for a location, disease, or risk factor Visit our website for an overview of the GBD MCP and FAQs: http://ms.spr.ly/63327aqaQL An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. http://ms.spr.ly/63323aqaQf Where to follow us: • http://ms.spr.ly/63325aqaQ7 • http://ms.spr.ly/63327aqaQh • http://ms.spr.ly/63329aqavB • http://ms.spr.ly/63321aqavD

The decisions made today will determine the health of billions by 2050 — but which choices carry the greatest leverage?

The Lancet Commission on 21st Century Global Threats to Health stands as an independent voice bringing together diverse experts to examine the broad set…

The decisions made today will determine the health of billions by 2050 — but which choices carry the greatest leverage?

The Lancet Commission on 21st Century Global Threats to Health stands as an independent voice bringing together diverse experts to examine the broad set…

A new $540 million, 10-year investment from the Gates Foundation will support IHME's global public goods: the Global Burden of Disease study (GBD), forecasting of future health scenarios, and tracking of financing for global health. We discuss the investment with IHME Director Dr. Christopher Murray, including how GBD will expand to nearly 5,000 locations and why timely, local health evidence matters as global health funding declines.________________________________ Transcript: Rhonda Stewart: Welcome to Global Health Insights, a podcast from IHME, the Institute for Health Metrics and Evaluation. I'm Rhonda Stewart. In this episode we'll hear from IHME director Dr. Chris Murray about a $540 million, 10-year investment from the Gates Foundation and what it means for health evidence as a global public good. The investment will support IHME's three flagship research areas: the Global Burden of Disease Study, also known as GBD; IHME's future health scenarios forecasting platform; and its tracking of financing for global health. Knowledge about what harms health, and what works to improve it, benefits everyone. Over the next decade, GBD will expand from about 925 locations to nearly 5,000, with estimates at the state or provincial level in every country. This more detailed view can reveal health disparities that national averages hide. IHME's work is carried out with a network of more than 20,000 Collaborators in approximately 150 countries. IHME estimates have been cited in nearly 8,000 policy documents worldwide. As an organization, we were recently incredibly fortunate to receive from the Gates Foundation a very significant grant to help continue our work and wanted to talk a little bit about that grant and what it's going to allow us to do. So why don't we start there? Dr. Chris Murray: Yes, we're very excited that we received a $540 million investment, if you will, into the next 10 years of the Institute for Health Metrics and Evaluation. The purpose of that very large grant is to allow us to continue producing our three flagship what we call global public goods, and that's the global burden of disease, our future health scenarios forecasting scenario building platform, and our monitoring of resources for health, finance, and global health. So it's a great endorsement of what we've been doing over the last 20 years, and we're looking forward to the exciting directions that these new resources can allow us to go. Rhonda Stewart: When you say that health evidence is a global public good, what does that mean and why does that matter now more than ever since the GBD was first launched in the 1990s? Dr. Chris Murray: So public good is a term that actually comes out of economics. It's the idea, for example, that there are things where my enjoyment of something does not affect your enjoyment of it. So the classic one that, that students are taught in university or high school is a park. A park is a public good because you can enjoy the park, I can enjoy the park. It's not like eating food where the person who consumes the food means that somebody else doesn't consume the food. In a similar way, building up knowledge and evidence about what are health problems and what works to solve those health problems is also a public good. Because if we learn that information, then one community can use that, and another community can use it, and a third, and a fourth, and a fifth, and on and on because it's knowledge and my use of that knowledge does not decrease your ability to use that knowledge. So that's where this language around public good comes from. And you know, it's a useful idea because the other thing that economics tells us about is that for public goods, unless somebody comes along, a government or another organization, a philanthropy, and funds public goods, everybody will tend to say, well, I'm not going to pay for that because somebody else is also going to benefit. And so I'm going to wait for the other person to pay for that public good. It's called in economics the free rider problem. Fortunately for us, the Gates Foundation have the vision that even though so many people are going to benefit from what we do, they're willing to make this investment so that this is available for everybody and everybody can take action on the analyses that we do. Rhonda Stewart: This is a 10-year investment. What does that decade-long horizon allow us to do that a shorter term grant might not allow us to do? Dr. Chris Murray: This decade-long investment - and this is the third - because we've had two 10-year investments from the Gates Foundation. This is larger, but still it's been a sequence, and that's allowed us to build up this huge global movement collaboration for the global burden of disease because we can do things that will take many years to come to fruition. It allows us to recruit and retain top talent because people don't like to move around for short term projects, but they're willing to come for a longer term period. And it allows us to sort of say, hey, here are things that we can build, for example, the scenarios platform. What are the things that work best to change the burden of disease? We can take the time to build up a resource like that that wouldn't be achievable in a three-year grant. And so the long term horizon gives us that stability and the opportunity to innovate and build a better set of results for the world that we wouldn't otherwise be able to do Rhonda Stewart: With respect to the global burden of disease, this investment is going to allow us to go from roughly about 925 locations in the study to nearly 5,000. Walk us through what those kinds of changes mean for people who are looking to use the information. So, what will they be able to see in the data in 2030, for example, that they can't see today? Dr. Chris Murray: So what we've learned along the way in the now 35 years of the global burden of disease work is, initially it started out at a regional level when it was done for the World bank in 1991-93. Then it became country-specific when it was based at WHO. And then in the last 20 years, where it's been based at the Institute for Health Metrics and Evaluation, we have been able to, for where certain countries have asked for it, we've been able to do the burden of disease analysis at the subnational level. So, the first to ask for this was actually the United Kingdom. And so, then we did the burden of disease at local health authorities. Soon thereafter, Mexico, Brazil, India, China, and Nigeria were added, as well as Norway, New Zealand, and Brazil. So it's come to the point where we have about 22 countries at the subnational level currently. And what we have the vision and what we've learned from that is that as soon as you do subnational assessments, there is more local engagement. We get more Collaborators in those countries, more policy uptake, and all sorts of innovative ideas of how to use subnational burden. Use it for human resource planning, use it for resource allocation, using it for figuring out how to target different groups and needs. And so there has been a long-running list of countries that would like subnational burden. And we haven't been able to meet that demand. And now we've decided as part of this new installment of funding, we will just do subnational everywhere. And so every country will do at least to state or province. And then we will also make sure that there is no state or province, that if there's anywhere that's over a population of 10 million, we'll go to the next level. So, we're always looking at a reasonably granular view of health, which helps reveal the disparities and inequalities that exist. And that turns out to be very useful for governments. Rhonda Stewart: You said previously that national averages can obscure disparities. Can you think of a specific example where, because we were able to go deeper and to be more granular at the subnational level, there was something that was revealed that was especially useful to decision-makers and maybe even helped them to change or take a decision? Dr. Chris Murray: Well, you know, if we start in the United States, I think there's been a long tradition that even started as sort of a spin out of the original burden of disease work in the 90s of looking at county-level outcomes in the US, and then now more recently we have funding from the National Institutes of Health to do county intersected with race/ethnicity. So more than 3,000 counties in the US, five race/ethnicity groups or at least that's what you can get from the data - and there's more clearly - and that's about 15,000 units of analysis. So it's very detailed. And what it reveals is that within the US, even though we have some of the best outcomes in the world, in some counties, Asian Americans have life expectancies in the mid-90s, 95, 96. So some of the highest on record in the world, if not the highest. And at the other end we have Native Americans on the Pine Ridge Reservation in South Dakota with a life expectancy of 56. And so you have a 40-year range from the worst to the best. And even if you look more generally there is a sort of, there's a quite diffuse set of places and race/ethnicity groups with life expectancies in the US that are much more similar to a low-income country than to a high-income country. And that's really useful to figure out where to target interventions, what sort of public health and medical care interventions are needed. And this is why NIH is invested in trying to do this work because it helps on a very granular disease specific level. Say, hey, we really need to target blood pressure management over here, or we need to recognize the large disparities that exist and figure out intervention strategies appropriate to each community to make a difference Rhonda Stewart: With respect to policymakers and policymaking. IHME's estimates have been cited in almost 8,000 policy documents all over the world. And can you give us some examples of how the global burden of disease work has been used in evidence-informed decision-making? Dr. Chris Murray: You know, there's lots and lots of examples of it. Some, you know, and they've evolved over the course of the GBD. I think when we first showed that mental health disorders was really a big issue, not just in certain high-income countries, but everywhere in the world, that led a number of countries to create mental health strategies, to create national institutes of mental health to both research and develop strategies. So, we really played a pretty key role in the growth of interests in tackling mental health challenges. There are lots of examples of specific applications around the GBD. In Indonesia, Minister Budi has been using the GBD to help plan for the next generation of human resources for health. How many cardiologists do we need? Well, that's a function of how much cardiovascular disease burden you have today, but even more importantly you'll have in 20 years. And we're able to answer those types of questions usefully for him and for the country of Indonesia, places where the GBD is being used to, you know, develop taxes on alcohol because the burden of disease. For example, in Botswana, where the president used the GBD to make the case that alcohol was a big cause of burden, it needed to be taxed at a higher rate to reduce alcohol consumption. Some countries have even put the GBD into legislation. So, Colombia has a law that says you need to reach certain targets by province for burden reduction. And as measured by disability-adjusted life years are sort of apex measure in the GBD. Rhonda Stewart: Going back to the health financing work, part of what that work examines is how governments respond when outside funding declines. So, how can the expansion of our health financing work help decision-makers navigate some of these new and increasing funding constraints? Dr. Chris Murray: Yes, you know, it's a huge issue, particularly since the collapse of USAID in 2025 and the sort of abrupt nature of the withdrawal of funds for some for the USAID programs led to a recognition that many countries need to look seriously at what they can finance themselves and what are alternative ways to finance their health systems. And that's, you know, if you're a middle income country, it's sort of happening anyway because development assistance for health is a relatively small share of what you spend. But for low-income countries where development assistance for health is as much as 40, 50% of health spending in a country, an abrupt cut is a big issue. So there's a lot of policy, energy, there's the Ghana reset, for example, which was led by the president of Ghana about how to rethink financing. And so there's a real need for real-time information about what ministries of finance are able to afford given debt and other constraints and what other donors are doing. How much is the decline of the US, of France, of Germany, the UK continuing, or will we see a return to higher levels of finance? Probably not, given the other constraints in the world. But it's why the salience of what's happening to the funding has become so key. And it's surprisingly difficult to know what's happening because - take the US for example - it's not enough for Congress to appropriate the funds. It turns out that through the process of apportionment by OMB and on down the chain, there can be, as we're learning many delays in how the funds get dispersed. And so that requires a more timely and more detailed understanding of the financial flows than we've even had in the past. Rhonda Stewart: And the forecasting work is the other area that's going to be further supported by the latest investment that we've received. And the forecasts run all the way out to 2100. They point to a major shift in the world's population towards sub Saharan Africa, alongside rapid changes in diseases and risk profiles. Looking out very far into the future, what are decision-makers least prepared for? Dr. Chris Murray: Oh, many things, I think, you know, we've been able to use the forecasting platform to support the Lancet Commission on 21st Century Global Threats to Health. And in that work we've looked at 17 catastrophic threats and those are very diverse. They range from obesity, which is probably the largest. Include things like sustained income inequality and low educational attainment, and then things like war or nuclear war or antimicrobial resistance, scaled-up tobacco use in Africa, a long list. And then of course, pandemics, and climate change are on that list as well. So, I think what most decision-makers are not ready for is the complexity and diversity of threats that are coming. You know, we've gone through phases. During COVID, everything was pandemics, and then, you know, we've had the pandemic treaty. But then very quickly, as COVID faded away, interest in pandemics has gone down, which is part of the cycle that we see with threats. Likewise, you know, there was a period where a lot of the attention in the policy space was around climate and health, which is one of our 17 major threats. But there isn't just two. It's not just pandemics and climate or even pandemics, climate, and conflict. There's this longer list. And so governments need to be threat-ready, they need to take on board - which our forecasting can help elucidate - but they need to be ready for in their setting, for a quite complex set of challenges that are coming and require a coordinated, sustained response from government. Rhonda Stewart: The work that we've been discussing is carried out by the Collaborator Network, which is more than 20,000 people across 150 countries. And how do you imagine that the Collaborator Network, might continue to evolve? Dr. Chris Murray: Well, that's a really important question because the Collaborator Network has been absolutely essential for the progress to-date in the burden of disease and now the forecasting work and the tracking, and financing work. It's one of the core strengths that we have in tackling these global public goods is this enormous network of Collaborators in almost every country of the world. And I think we see, as we try to make, for example, the forecasting work answer the question, for each country, what are the 20 (or whatever number) most effective ways to reduce the burden of disease in your country or location? I imagine that a Collaborator Network can be a very effective mechanism to figure out what types of policy scenarios we should be modeling and then how to convey the results to the right groups and stakeholders in different countries. So even above and beyond what we've been doing so far, just building the GBD and tracking what might happen in the future, I think that connection to sort of policy debate and choice, where these evidence never substitutes for decisions, it can help inform them. So we're hoping that the Collaborators can be a vehicle for more evidence, informed decision-making around ways to reduce the burden of disease. Rhonda Stewart: And finally, the investment from the Gates Foundation comes at a time when financing for global health has declined and there have been shrinking budgets for aid. And what does an investment of that size signal at this particular moment? Dr. Chris Murray: I mean, we feel very fortunate that we are receiving this sustained investment. And in any environment, it would be a tremendous thing because it allows us to produce the global public goods we've been talking about. But in a time when many organizations are having to retreat from some of the tasks that they were doing, the fact that we can expand what we're doing, provide more, we hope, useful, more local, more timely, and more relevant information, is just a tremendous opportunity. And you know, in the sort of public reaction and people outreach I've been receiving since the grant was awarded, I mean, that's just been the theme of it, that this is a unique opportunity for us to fill some of the gaps that are emerging on the evidence front. So we hope very much we'll be able to live up to that expectation. Rhonda Stewart: Great. Thanks very much, Chris. Dr. Chris Murray: Thank you, Rhonda. Rhonda Stewart: Details about the Global Burden of Disease Study, IHME's forecasting, and health financing work, and a wide range of related resources can be found at http://ms.spr.ly/63324aWkDk. ________________________________ An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health. Learn more about IHME. Where to follow us: LinkedIn Facebook X (Twitter) YouTube Bluesky