Giving Compass' Take:

• Kody Crowell argues that the Global Burden of Disease metrics can be improved through the inclusion of narratives, local knowledge, and community health priorities.

• How can funders examine their own data and evaluate the completeness of their data? 

• Learn more about good data practices. 

The disability-adjusted life year (DALY), calculated for a single disease, accounts for both the years of life lost due to premature death caused by the disease and the years of life lost due to disability of living with the disease and enduring its consequences. It makes comparable any two completely distinct diseases and is used in the priority-setting of many current global health efforts. The Global Burden of Disease (GBD) depends on the DALY for its calculations.

Critics have targeted the manner in which the GBD study determines disability weightings for different diseases. Disability weights are used to represent the severity of a disease condition. The universal usage of these weights and their failure to account for both qualitative cultural differences and differential access to resources around the world is a cause for concern.

For example, it is conceivable to imagine that in developed Western nations, easy access to eyecare professionals has decidedly limited the impact of vision impairment on our daily lives. While the delivery of eyeglasses is a cost-effective intervention, the infrastructure may simply not be present to offer such solutions in developing nations.

  • One cost of such metrics as the DALY is the loss of narrative: the reduction of all of an individual’s suffering is aggregated at a population level into one number.
  • Another stems from the idea that demands for quantitative data can potentially undermine local knowledge.
  • Lastly, it is important to consider the question of assuming blind neutrality health priority-setting.

Read the full article on the Global Burden of Disease by Kody Crowell at The McGill International Review.