Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases.
The disability-adjusted life year (DALY) initially appeared attractive as a health metric in the Global Burden of Disease (GBD) program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that...
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ftdoajarticles:oai:doaj.org/article:124db1bd0f6349d3a1268e3c8d4ebb9f 2023-05-15T15:09:41+02:00 Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. Charles H King Anne-Marie Bertino 2008-03-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000209 https://doaj.org/article/124db1bd0f6349d3a1268e3c8d4ebb9f EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2267491?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000209 https://doaj.org/article/124db1bd0f6349d3a1268e3c8d4ebb9f PLoS Neglected Tropical Diseases, Vol 2, Iss 3, p e209 (2008) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2008 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000209 2022-12-30T21:59:59Z The disability-adjusted life year (DALY) initially appeared attractive as a health metric in the Global Burden of Disease (GBD) program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that the DALY would be useful in policy settings, reflecting normative valuations as a standardized unit of ill health. However, the design of the DALY and its use in policy estimates contain inherent flaws that result in systematic undervaluation of the importance of chronic diseases, such as many of the neglected tropical diseases (NTDs), in world health. The conceptual design of the DALY comes out of a perspective largely focused on the individual risk rather than the ecology of disease, thus failing to acknowledge the implications of context on the burden of disease for the poor. It is nonrepresentative of the impact of poverty on disability, which results in the significant underestimation of disability weights for chronic diseases such as the NTDs. Finally, the application of the DALY in policy estimates does not account for the nonlinear effects of poverty in the cost-utility analysis of disease control, effectively discounting the utility of comprehensively treating NTDs. The present DALY framework needs to be substantially revised if the GBD is to become a valid and useful system for determining health priorities. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Daly ENVELOPE(63.761,63.761,-67.513,-67.513) PLoS Neglected Tropical Diseases 2 3 e209 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Charles H King Anne-Marie Bertino Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
The disability-adjusted life year (DALY) initially appeared attractive as a health metric in the Global Burden of Disease (GBD) program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that the DALY would be useful in policy settings, reflecting normative valuations as a standardized unit of ill health. However, the design of the DALY and its use in policy estimates contain inherent flaws that result in systematic undervaluation of the importance of chronic diseases, such as many of the neglected tropical diseases (NTDs), in world health. The conceptual design of the DALY comes out of a perspective largely focused on the individual risk rather than the ecology of disease, thus failing to acknowledge the implications of context on the burden of disease for the poor. It is nonrepresentative of the impact of poverty on disability, which results in the significant underestimation of disability weights for chronic diseases such as the NTDs. Finally, the application of the DALY in policy estimates does not account for the nonlinear effects of poverty in the cost-utility analysis of disease control, effectively discounting the utility of comprehensively treating NTDs. The present DALY framework needs to be substantially revised if the GBD is to become a valid and useful system for determining health priorities. |
format |
Article in Journal/Newspaper |
author |
Charles H King Anne-Marie Bertino |
author_facet |
Charles H King Anne-Marie Bertino |
author_sort |
Charles H King |
title |
Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. |
title_short |
Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. |
title_full |
Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. |
title_fullStr |
Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. |
title_full_unstemmed |
Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. |
title_sort |
asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2008 |
url |
https://doi.org/10.1371/journal.pntd.0000209 https://doaj.org/article/124db1bd0f6349d3a1268e3c8d4ebb9f |
long_lat |
ENVELOPE(63.761,63.761,-67.513,-67.513) |
geographic |
Arctic Daly |
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Arctic Daly |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 2, Iss 3, p e209 (2008) |
op_relation |
http://europepmc.org/articles/PMC2267491?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000209 https://doaj.org/article/124db1bd0f6349d3a1268e3c8d4ebb9f |
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https://doi.org/10.1371/journal.pntd.0000209 |
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PLoS Neglected Tropical Diseases |
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e209 |
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