Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Geographies in GBD 2015

The geographies included in GBD 2015 have been arranged into a set of hierarchical categories composed of seven super-regions and a further nested set of 21 regions containing 195 countries and territories. Eight additional subnational assessments were done for Brazil, China, India, Japan, Kenya, Saudi Arabia, South Africa, Sweden, and the USA (methods appendix pp 611–24). For this study we present data at the national and territory level.

List of causes and sequelae

The GBD cause and sequelae list is organised hierarchically (methods appendix 625–53). At Level 1 there are three cause groups: communicable, maternal, neonatal, and nutritional diseases (Group 1 diseases); non-communicable diseases; and injuries. These Level 1 aggregates are subdivided at Level 2 of the hierarchy into 21 cause groupings. The disaggregation into Levels 3 and 4 contains the finest level of detail for causes captured in GBD 2015. Sequelae of diseases and injuries are organised at Levels 5 and 6 of the hierarchy. The finest detail for all sequelae estimated in GBD is at Level 6 and is aggregated into summary sequelae categories (Level 5) for causes with large numbers of sequelae. Sequelae in GBD are mutually exclusive and collectively exhaustive, and thus our YLD estimates at each level of the hierarchy sum to the total of the level above. Prevalence aggregations are estimated at the level of individuals who might have more than one sequela or disease and therefore are not additive.

The cause and sequelae list was expanded based upon feedback after the release of GBD 2013 and input from GBD 2015 collaborators. Nine causes for which non-fatal outcomes are estimated were added: Ebola virus disease, motor-neuron disease, environmental heat and cold exposure, four subtypes of leukaemia, and two subtypes of non-melanoma skin cancer (methods appendix pp 625–53). The incorporation of these changes expanded the cause list from the 301 causes with non-fatal estimates examined in GBD 2013, to 310 causes with non-fatal estimates and from 2337 to 2619 unique sequelae at Level 6 of the hierarchy. At the newly created Level 5 of the hierarchy there were 154 summary sequela categories. The methods appendix (pp 654–61) provides a list of International Classification of Diseases version 9 (ICD-9) and version 10 (ICD-10) codes used in the extraction of hospital and claims data, mapped to GBD 2015 non-fatal causes, impairments, and nature of injury categories.

Period of analysis

A complete set of age-specific, sex-specific, cause-specific, and geography-specific incidence and prevalence numbers and rates were computed for the years 1990, 1995, 2000, 2005, 2010, and 2015. In this study we focus on trends for main and national results over the past decade, from 2005 to 2015, together with more detailed results for 2015. Online data visualisations at vizhub provide access to results for all GBD metrics.

Non-fatal modelling strategies vary substantially between causes. Figure 1 outlines the general process of non-fatal outcome estimation from data inputs to finalisation of YLD burden results; step 3b of that process identifies alternative modelling approaches used for specific causes (methods appendix pp 603, 604). The starting point for non-fatal estimation is the compilation of data sources identified through systematic analysis and extractions based on predetermined inclusion and exclusion criteria (methods appendix p 603). As part of the inclusion criteria, we defined disease-specific or injury-specific reference case definitions and study methods, as well as alternative allowable case definitions and study methods which were adjusted for if we detected a systematic bias. We used 15 types of primary data sources representing disease prevalence, incidence, mortality risk, duration, remission, or severity in the estimation process (oval shapes in figure 1).

Data sources

For this iteration of the study, we updated data searches through systematic data and literature reviews for 85 causes published up to Oct 31, 2015. For other causes, input from GBD collaborators resulted in the identification and inclusion of a small number of additional studies published after January, 2013. Data were systematically screened from household surveys archived in the Global Health Data Exchange, sources suggested to us by in-country experts, and surveys identified in major multinational survey data catalogues and Ministry of Health and Central Statistical Office websites. Case notifications reported to WHO were updated up to and including 2015. Citations for all data sources used for non-fatal estimation in GBD 2015 are provided in searchable form through a new web tool. A description of the search terms used for cause-specific systematic reviews, inclusion and exclusion criteria, and the preferred and alternative case definitions and study methods are detailed by cause in the methods appendix (pp 26–601).

Hospital inpatient data were extracted from 284 country-year and 976 subnational-year combinations from 27 countries in North America, Latin America, Europe, and New Zealand. Outpatient encounter data were available from the USA, Norway, Sweden, and Canada for 48 country-years. For GBD 2015, we also accessed aggregate data derived from claims information in a database of US private and public insurance schemes for the years 2000, 2010, and 2012. From the linked claims data, we generated several correction factors to account for bias in health service encounter data from elsewhere, which were largely available to us aggregated by ICD code and by primary diagnosis only. First, for chronic disorders, we estimated the ratio between prevalence from primary diagnoses and prevalence from all diagnoses associated with a claim. Second, we used the claims data to generate the average number of outpatient visits per disorder. Similarly, we generated per person discharge rates from hospital inpatient data in the USA and New Zealand, the only sources with unique patient identifiers available for GBD 2015.

In GBD 2013, we calculated a geographical and temporal data representativeness index (DRI) of non-fatal data sources for each cause or impairment. The DRI represents the fraction of countries for which any incidence, prevalence, remission, or mortality risk data were available for a cause. This metric quantifies data availability, not data quality. The overall DRI and period-specific DRI measures for each cause and impairment are presented in the methods appendix (pp 662–68). DRI ranged from 90% for nine causes, including tuberculosis and measles, to less than 5% for acute hepatitis C and the category of other exposures to mechanical forces. Required case reporting resulted in high DRI values for notifiable infectious diseases; the network of population-based registries for cancers resulted in a DRI of above 50%. DRI values ranged from 6·1% in North Korea to 91·3% in the USA. Many high-income countries, as well as Brazil, India, and China, had DRI values above 63%; data availability was low in several countries, including Equatorial Guinea, Djibouti, and South Sudan.

Non-fatal disease models

In addition to the corrections applied to claims and hospital data, a number of other adjustments were applied including age–sex splitting, bias correction, adjustments for under-reporting of notification data, and computing expected values of excess mortality. In GBD 2013, we estimated expected values of excess mortality from prevalence or incidence and cause-specific mortality rate data for a few causes only, including tuberculosis and chronic obstructive pulmonary disease. In order to achieve greater consistency between our cause of death and non-fatal data, we adopted this strategy systematically for GBD 2015. We matched every prevalence data point (or incidence datapoint for short duration disorders) with the cause-specific mortality rate value corresponding to the age range, sex, year, and location of the datapoint. The ratio of cause-specific mortality rate to prevalence is conceptually equivalent to an excess mortality rate.

To estimate non-fatal health outcomes in previous iterations of GBD, most diseases and impairments were modelled in DisMod-MR, a Bayesian meta-regression tool originally developed for GBD 2010 (step 3a in figure 1).¹⁸ DisMod-MR was designed to address statistical challenges in estimation of non-fatal health outcomes, and for synthesis of often sparse and heterogeneous epidemiological data. For GBD 2015, the computational engine of DisMod-MR 2.1 remained unchanged, but we substantially rewrote the code that organises the flow of data and settings at each level of the analytical cascade. The sequence of estimation occurs at five levels: global, super-region, region, country, and where applicable, subnational locations (appendix pp 611–24). At each level of the cascade, the DisMod-MR 2.1 computational engine enforces consistency between all disease parameters. For GBD 2015, we generated fits for the years 1990, 1995, 2000, 2005, 2010, and 2015. We log-linearly interpolated estimates for the intervening years in each 5-year period. Greater detail on DisMod-MR 2.1 is available at Global Health Data Exchange and the methods appendix (pp 7–11).

In previous iterations of GBD, custom models were created for a short list of causes for which the compartment model underpinning DisMod (susceptible, diseased, and dead) was insufficient to capture the complexity of the disease or for which incidence and prevalence needed to be derived from other data. Step 3b of figure 1 describes the development of custom models with greater detail shown in the methods appendix figure 1B (p 604, and for associated write-ups pp 26–601) for HIV/AIDS, tuberculosis, malaria, cancer, neonatal disorders, infectious diseases for which we derived incidence from seroprevalence data, and infectious diseases for which we derived incidence from cause of death rates and pooled estimates of the case fatality proportion.

In GBD 2013, we estimated the country–age–sex–year prevalence of nine impairments (step 4 of figure 1). Impairments in GBD are disorders or specific domains of functional health loss that are spread across many GBD causes as sequelae and for which there are better data to estimate the occurrence of the overall impairment than for each sequela based on the underlying cause. Overall impairment prevalence was estimated with DisMod-MR 2.1 except for anaemia, for which spatiotemporal Gaussian Process regression methods were applied. We constrained cause-specific estimates of impairments, such as in the 19 causes of blindness, to sum to the total prevalence estimated for that impairment. Anaemia, epilepsy, hearing loss, heart failure, and intellectual disability were estimated at different levels of severity.

Severity distributions

In step 5, sequelae were further defined in terms of severity for 194 causes at Level 4 of the hierarchy (figure 1A). We generally followed the same approach for estimating the distribution of severity as in GBD 2013. For Ebola virus disease, we created a health state for the infectious disease episode with duration derived from average hospital admission times, and a health state for ongoing postinfection malaise and joint problems based on four follow-up studies^{19, 20, 21, 22} from which we derived an average duration. The health states for the subtypes of leukaemia and non-melanoma skin cancer were the same as the general cancer health states. For motor-neuron disease we accessed the Pooled Resource Open-Access ALS Clinical Trials (PROACT) database containing detailed information on symptoms and impairments for more than 8500 patients who took part in the trials.²³

Disability weights

We used the same disability weights as in GBD 2013 (see methods appendix pp 669–94 for a complete listing of the lay descriptions and values for the 235 health states used in GBD 2015).

Comorbidity

In step 7, we estimated the co-occurrence of different diseases by simulating 40 000 individuals in each geography–age–sex–year combination as exposed to the independent probability of having any of the sequelae included in GBD 2015 based on disease prevalence. We tested the contribution of dependent and independent comorbidity in the US Medical Expenditure Panel Surveys (MEPS) data, and found that independent comorbidity was the dominant factor even though there are well known examples of dependent comorbidity. Age was the main predictor of comorbidity such that age-specific microsimulations accommodated most of the required comorbidity correction. Taking dependent comorbidity into account changed the overall YLDs estimated in the MEPS data by only 2·5% (and ranging from 0·6% to 3·4% depending on age) in comparison to assuming independent comorbidity (methods appendix pp 18–20).²⁴

YLD computation

We report 95% uncertainty intervals (95% UI) for each quantity in this analysis using 1000 samples from the posterior distribution of prevalence and 1000 samples of the disability weight to generate 1000 samples of the YLD distribution. The 95% UI is reported as the 25th and 975th values of the distribution. We report significant changes in disease estimates between countries or over time if the change was noted in more than 950 of the 1000 samples computed for each result. For GBD 2015, we computed age-standardised prevalence YLD rates from the updated world population age standard developed for GBD 2013.²⁵ Less common diseases and their sequelae were included in 35 residual categories (methods appendix pp 695–97). For 22 of these residual categories, estimates were made from epidemiological data for incidence or prevalence. For 13 residual categories, we estimated YLDs by multiplying the residual YLL estimates by the ratio of YLDs to YLLs from the estimates for explicitly modelled Level 3 causes in the same disease category.

Socio-demographic Index

In GBD 2013, a sociodemographic status variable was computed based on a principal components analysis of income per capita, educational attainment, average age of the population, and the total fertility rate.²⁶ For GBD 2015, we excluded mean age of the population because it is directly affected by death rates. To improve interpretability for GBD 2015, we computed a Socio-demographic Index (SDI) similar to the computation of the human development index.²⁷ In the SDI, each component was weighted equally and rescaled from zero (for the lowest value observed during 1980–2015) to one (for the highest value observed) for income per capita and average years of schooling, and the reverse for the total fertility rate. The final SDI score was computed as the geometric mean of each of the components. SDI ranged from 0·060 in Mozambique in 1987 to 0·978 in District of Columbia, USA, in 2015.

Global causes of disability

Global trends in YLDs 2005 to 2015

GBD 2015 included the assessment of 2619 sequelae at Level 6 of the GBD cause hierarchy, including 1316 sequelae from injuries that contributed to the global burden of disability. Causes at Level 4 of the hierarchy that resulted in 30 million or more YLDs in 2015 included lower back pain, major depressive disorder, age-related and other hearing loss, and neck pain. Figure 2 compares the leading causes of global YLDs in 2005 and 2015, using the cause breakdowns at Level 3 of the GBD cause hierarchy. Among the ten leading causes of YLDs, iron-deficiency anaemia and depressive disorders switched ranks to positions three and four respectively, diabetes rose from the eighth to the sixth position, migraine dropped from position six to seven, and other musculoskeletal disorders dropped from rank seven to eight (figure 2).

Figure 2

Leading 30 Level 3 causes of global YLDs for both sexes combined, 1990, 2005, and 2015, with percentage change in number of YLDs, and all-age and age-standardised rates

Estimates of prevalence and YLDs at the global level for 2005 and 2015 for each cause are presented in table 3 (see results appendix pp 717–40 for full detail at the sequelae level). Prevalence and age-standardised YLDs for 21 Group 1 diseases decreased significantly and by more than 10%, including measles, African trypanosomiasis, diphtheria, lymphatic filariasis, and rabies.

Age-standardised YLD rates for all maternal causes and sequelae combined decreased between 2005 and 2015, whereas overall age-standardised YLDs for neonatal disorders increased by 3·11% (–0·32–6·79%) since 2005 to 144 YLDs per 100 000 (109–185 YLDs per 100 000) in 2015, and age-standardised YLD rates decreased and absolute numbers of cases increased for nutritional deficiencies. Age-standardised YLD rates attributable to hepatitis A, B, and C increased, and decreased for hepatitis E. The number of individuals with chronic hepatitis C infection increased from 121 million (108–133 million) in 2005 to 142 million (127–157 million) in 2015.

Changes in age-standardised YLDs and YLLs over time

In 2005, non-communicable diseases (NCDs) accounted for 23 of the leading 25 causes of age-standardised YLDs worldwide and 23 of the 25 leading causes in 2015 (figure 2). Although diabetes rose only two ranks in the list of leading cause of YLDs, from position eight to six between 2005 and 2015, the increase in age-standardised rate was 5·4% (3·2–7·5%). Musculoskeletal disorders occupied three of the leading 25 causes of disability in both 2005 and 2015; lower back and neck pain were the single largest cause with little change in their rates. However, age-standardised rates of YLDs increased for osteoarthritis 3·90% (3·00–4·83%) by 2015. Depressive disorders were the fourth leading cause of disability in 2005 and the third leading cause of disability in 2015, and age-standardised YLD rates associated with the disorder increased marginally (1·0% [0·5–1·5%]). Age-standardised rates of YLDs from alcohol use disorders decreased after 2005 (4·5% [2·3–6·4%]) whereas disability due to drug use disorders increased by 8·2% (6·2–10·2%).

In contrast with global trends for NCDs, both relative ranks and age-standardised YLD rates decreased for most injuries. Falls, which were the 13th leading cause of disability in 2005, dropped to the 15th rank, and age-standardised YLD rates decreased (8·58% [5·23–12·2%]). Other unintentional injuries decreased in global rank from 27th in 2005 to 34th in 2015, and age-standardiSed YLD rates decreased by 16·7% (15·7–17·9%).

The leading causes of disability varied considerably with age (figure 3). The leading cause in children younger than 5 years was iron-deficiency anaemia followed by skin diseases, protein-energy malnutrition, and diarrhoea. In older children, iron-deficiency anaemia, skin diseases, asthma, and mental health disorders such as conduct, autistic spectrum, and anxiety disorders were top ten causes of disability. In adolescents and young adults (aged between 15 and 39 years), iron-deficiency anaemia, skin diseases, depression, lower back and neck pain, and migraine led the rankings. Other mental health disorders such as anxiety disorders and schizophrenia were in the top ten causes in this age group. In middle-aged adults, musculoskeletal disorders dominated the top rankings followed by mental health disorders, especially depression. Diabetes and sense organ disorders were more prominent causes of disability in middle-age. In older adults (older than 65 years), sense organ disorders were the top-ranked cause of disability. Musculoskeletal disorders remained a dominant source of disability, and chronic obstructive pulmonary disease entered the top ten. In the oldest age groups, ischaemic heart disease and Alzheimer's and other dementias made their first appearance in the top ten.

Figure 3

Leading ten Level 3 causes of global age-specific years lived with disability in 2015

We examined the trends in YLDs and YLLs in a scatterplot (figure 4). YLLs decreased for the majority of causes. For Group 1 causes and injuries, the decrease in YLLs was accompanied by a decrease in YLDs, albeit at a slower pace. The exceptions were neonatal encephalopathy, haemolytic disease and other neonatal jaundice, leishmaniasis, meningitis, hepatitis, and sexually transmitted diseases with increasing YLD rates between 1990 and 2015. A few Group 1 disorders and injuries had a faster decrease in YLDs than in YLLs: intestinal infections, obstructed labour, and neonatal sepsis. The only NCDs with a faster decrease in YLDs compared with YLLs were epilepsy and cervical cancer. Another small number of NCDs saw an increase in YLDs and YLLs, including drug use disorders, diabetes, and Parkinson's disease. NCDs with decreasing YLLs but increasing YLDs included cancers of the prostate, testis, uterus, kidney, colorectum, and pancreas, melanoma, and congenital disorders. Some cancers (stomach and Hodgkin's lymphoma), rheumatic heart disease, asthma, chronic obstructive pulmonary disease, acute glomerulonephritis, peptic ulcer disease, gastritis, hernia, and gallbladder disease had decreasing YLLs and YLDs, but with a faster decrease in YLLs than in YLDs. The rate of change in YLDs for the main drivers of non-fatal health loss, musculoskeletal disorders, and mental and substance use disorders was small.

Figure 4

Global annualised rate of change in age-standardised years of life lost (YLLs) and years lived with disability (YLDs) for Level 3 causes between 1990 and 2015

Global distribution of disability weights across individuals

Figure 5 shows the global distribution of individuals from our comorbidity microsimulation by six categories of disability, age, and sex for the highest and lowest SDI quintile. The six categories of disability are no disability, very mild disability (disability weight less than or equal to 0·01), mild disability (from 0·01 to 0·05 inclusive), moderate (from 0·05 to 0·1 inclusive), severe (from 0·1 to 0·3 inclusive), and profound (greater than 0·3). In 2015, most of the world's population experienced mild or greater disability. Having no disability at all was most common in children. After age 25 years, the proportion of the population having no disability became progressively smaller, and by age 55 years in low SDI countries and age 75 years in high SDI countries, nearly everyone had some form of disability. Very mild to moderate disability (ie, individuals with a disability weight of 0·1 or less) was common in childhood and young adults, but was replaced by more severe disability with increasing age. The patterns were similar for both sexes, apart from a much larger amount of disability in women older than 80 years in the top SDI quintiles, reflecting the much higher average age of women in this age category. For policy considerations around the age of retirement in ageing populations, it is noteworthy that from age 60 years onwards more than half of the population had severe or worse disability. The extent to which this loss of health limits or precludes the ability to work depends on the nature of the impairments and the type of employment in older workers with that level of disability.

Figure 5

Population pyramids with the number of individuals, by age and sex, grouped by severity of their disability weight (DW) for all comorbid conditions combined into no disability, very mild disability (DW 0–0·01), mild disability (DW 0·01–0·05), ...

Typology of diseases based on YLDs and YLLs

The comparison of trends in age-standardised YLDs and YLLs provides insight into the drivers of differences in rates of increases and decreases for diseases and injuries. Diseases and injuries can be parsed into four groups. The first of these are a small set of disorders including causes such as drug use disorders and skin cancer for which age-standardised rates of both YLDs and YLLs increased at a rate of more than 0·4% per year from 2005 to 2015. A second category of diseases includes those in which YLDs are increasing but YLLs are decreasing, including disorders such as thyroid cancer, cirrhosis, and neonatal encephalopathy. One explanation for this pattern is that risk factors, broadly defined, are causing an increase in incidence, whereas access to effective treatment has improved enough to continue reducing mortality. For a third category of disorders, YLDs are essentially constant, but YLLs are decreasing. This grouping is quite large and includes many of the major causes of disability such as musculoskeletal disorders, various neurological disorders, and a number of cancers. For many infectious causes, decreased are occurring for both YLLs and YLDs but are much faster for YLLs; this pattern is to be expected if access to effective treatment is decreasing the number of deaths but not reducing prevalence or incidence. The last category includes disorders where decreases are equal, if not slightly higher, for YLDs including ischaemic heart disease, falls, cervical cancer, and other injuries. Examination of differential trends by region or country might provide insights into the role of access to treatment in reducing YLLs and, conversely, the role of increasing or decreasing risks and social determinants in driving changes in disease incidence and prevalence. More detailed exploration of these differential trends is warranted in future work.

Disease-specific issues

Mental and substance use disorders

Consistent with the findings of earlier GBD studies, GBD 2015 confirms the large contribution of mental and substance use disorders to global disability. For the first time, in GBD 2015 we found a positive association between conflict and depression and anxiety, albeit with wide uncertainty. This uncertainty is due to sparse and low-quality data for these disorders in post-conflict countries. Going forward, we plan to make separate estimates for post-traumatic stress disorder in GBD, which might add considerably more data from conflict settings and show a stronger association. GBD results have provided an evidence base to support global action such as a stated commitment by the World Bank and WHO to make mental health a global development priority³⁹ and the consideration of mental health and substance use disorders in shaping the Sustainable Development Goals.⁴⁰ Cost-effective interventions are able to reduce the burden imposed by mental and substance use disorders, including in low-income and middle-income countries.⁴¹

Increases in deaths attributable to drug use in the USA have resulted in considerable policy and media attention. In our assessment, the ten countries with the highest prevalence of opioid dependence in decreasing order in 2015 were Iran, United Arab Emirates, Russia, Morocco, the USA, Australia, Ukraine, Tunisia, Belarus, Canada, and Iraq. Among these countries, we estimated the highest excess mortality from opioid dependence in the eastern European countries at about twice the level of that in the USA, Canada, and the north African and Middle Eastern countries; the lowest rate among these highly prevalent countries was in Australia. Within the USA, prescription opioids have been estimated to account for 37% of drug overdose deaths in 2013.^{42, 43} The availability of overdose response treatments in the form of naloxone kits to laypersons has also accelerated.⁴⁴ An alternative approach is opioid substitution treatment to reduce the risk of overdose. The intensity at which countries use harm-reduction strategies such as needle exchange and opioid substitution programmes follows an inverse pattern,⁴⁵ with the most intense programmes in Australia, but very rare use of such strategies in eastern Europe, suggesting that embracing harm reduction is an effective means of reducing drug deaths.

Diabetes

To obtain standard estimates for health loss due to diabetes for GBD 2015 using both fasting plasma glucose (FPG) means and standard deviations as well as diabetes prevalence, we re-extracted all available data from 1990 to 2015. Across studies, we found 20 different case definitions for diabetes. We also included, wherever possible, studies reporting on mean FPG but not diabetes prevalence, using a regression between mean FPG and diabetes prevalence from studies reporting on both. We have also made the assessment of diabetes prevalence more consistent with cause of death data for diabetes. Our improved efforts at measuring the prevalence of diabetes confirms the increase in global age-standardised incidence, prevalence, and YLDs. Of note, the increase in YLDs at the global scale is greater than the increase in YLLs, which reflects improved access to treatments that lower case fatality. The rise of diabetes prevalence, related to the global increase in body-mass index,⁴⁶ given the costs of treating the disease⁴⁷ and the related increases in cardiovascular risks, poses one of the more important challenges to health systems in the coming years. This is particularly the case in regions with high prevalence of diabetes such as central America, north Africa and the Middle East, and Oceania.

Ezzati and colleagues⁴⁸ and the International Diabetes Federation (IDF)⁴⁹ have estimated diabetes prevalence for many countries; the intra-class correlation coefficient for the estimates from Ezzati and colleagues and the GBD for 2015 is 0·74, and for the IDF estimates is 0·65. These large differences appear to stem from the inclusion of cause of death data in the modelling for GBD and also from the inclusion of self-reported diabetes prevalence in the study by Ezzati and colleagues.⁴⁸ In GBD, these sources were excluded from our analyses because of changing patterns in the prevalence of known and unknown diabetes in surveys that vary with geography, making it difficult to crosswalk these studies.

Dementia

Brayne and colleagues^{50, 51} reported that age-specific prevalence of Alzheimer's was decreasing in the UK. Of the four studies in the USA with similar measurements over time that were reviewed, one showed a decrease, whereas no change in prevalence was seen in the remaining studies.^{52, 53} Our assessment of age-standardised prevalence showed that Alzheimer's and other dementias decreased slowly in the UK, by 3·69% (2·53–4·85%) from 2005 to 2015, but remained constant in the rest of the world. The decrease might be due to reductions in vascular dementias rather than reductions in Alzheimer's and other dementias. Our assessment also suggests that the number of individuals with Alzheimer's disease increased from 21·7 million (18·9–24·8 million) worldwide in 1990 to 46·0 million (40·2–52·7 million) in 2015. Although it is useful to know that age-standardised rates might be starting to decrease, if only slightly, the rapid increase in the absolute number of cases points to the major challenge that dementia presents to societies with increasing life expectancy. This number is similar to the most recent estimates from the World Alzheimer Report 2015 that estimated 46·8 million people living with dementia in 2015. However, there is less agreement about new cases per year: The World Alzheimer Report estimated 9·9 million new cases of dementia per year in 2015 compared with 6·44 million (5·52–7·45 million) new cases in 2015 estimated in GBD 2015. The World Alzheimer Report separately analysed prevalence and incidence whereas we use DisMod-MR 2.1 to produce internally consistent prevalence and incidence estimates. We observed a fundamental disagreement in the underlying incidence and prevalence data in many countries and decided to exclude incidence data from our modelling approach, putting greater trust in prevalence studies than incidence studies, arguing that the point of incidence in dementia is more difficult to establish than prevalence when the diagnosis over time becomes more established.

Hepatitis C

The availability of new medical treatments for chronic hepatitis C has driven considerable interest in the prevalence data for this disease. Available treatments are highly effective but costly.⁵⁴ Some programmes have been launched in Egypt and other lower-SDI countries that offer treatment at lower cost. Good data on the number of courses of treatment that have been delivered are not widely available. Given the number of individuals with chronic infection and the potential to be cured, tracking the fraction of people treated each year should be undertaken. Even in high-income countries such as the USA, the fraction of those treated among those who would benefit from treatment is not yet available.

Malaria

Our assessment of malaria prevalence and incidence in high burden sub-Saharan Africa was based on the Malaria Atlas Project spatial analysis of prevalence surveys done across Africa between 2000 and 2015.^{55, 56} The dynamic map of malaria prevalence was updated for GBD 2015 and extended back to 1980. Children younger than 5 years in sub-Saharan Africa showed a remarkable 33·5% (24·8–46·0%) decrease in incidence from the 2005 peak of 0·78 (0·56–0·96) cases per person per year to 0·52 (0·33–0·71) in 2015. Yet there were 81·7 million (52·0–111·7 million) incident cases in this age group in 2015. The decrease in children was more rapid than that recorded for older age groups. In adolescents and adults, incidence dropped by 30·0% (17·2–39·2%) and 21·1% (15·3–26·9%), respectively, and resulted in 58·7 million (37·7–91·5 million) and 53·3 million (40·7–67·5 million) incident cases, respectively, in 2015. The observed decreases in malaria incidence underscore the remarkable effect of the scale-up of antimalarial interventions⁵⁷ across Africa in the past decade.⁵⁵ Sustaining the levels of these interventions is crucial to continue to reduce malaria morbidity on the continent, avoid resurgence, and improve on these levels that are vital to global aspirations for malaria eradication.⁵⁸ Overall, we estimate there were 286·9 million (219·7–377·3 million) cases of malaria worldwide in 2015, whereas the World Malaria Report (WMR) 2015 reports 214 million (149–303 million) cases in 2015.⁵⁹ Of these cases, the WMR estimates that 88% of cases occurred in the WHO African region (188 million) whereas we estimate 189·4 million (151·7–239·4 million; 66·1%) cases for GBD 2015. Outside of Africa, the WMR reports 26 million cases versus our estimate of 97·3 million (50·2–181·8 million), but both sets of estimates feature identical regional rankings among the six WHO regions with malaria. Increasing convergence in estimates is expected as dynamic maps of malaria prevalence and incidence become available for all malaria-endemic countries outside of Africa.

Tuberculosis

We added new data from tuberculosis prevalence surveys done in Indonesia, Ghana, and several subnational locations in India. Our analysis of tuberculosis relied on prevalence surveys, case notifications and cause-specific mortality estimates. We used the expert judgment values for the case-detection rates (CDRs) from WHO as an initial guide of how much notifications need to be increased to reflect incidence of all tuberculosis, but relied on DisMod-MR 2.1 to find an estimate that is consistent with available prevalence and cause-specific mortality rates. We found that, particularly in older age groups, our estimated CDR often falls below the all-age CDR of WHO. In GBD 2013, we used a relative risk approach to predict the proportion of HIV-infected individuals with tuberculosis. In GBD 2015, we improved our modelling strategy by making use of more abundantly available data on the proportions of HIV infected cases among all tuberculosis cases from the WHO case notifications to separate out combined HIV and tuberculosis from all forms of tuberculosis. In our modelling of tuberculosis, we have not separately estimated the incidence and prevalence related to multidrug-resistant tuberculosis. Given the policy interest in multidrug-resistant tuberculosis, we plan to include estimates for multidrug-resistant tuberculosis in future rounds of the GBD. Our global tuberculosis (all-forms) incidence estimate (10·2 million [9·2–11·5 million] cases in 2015) is slightly higher than that of WHO (9·6 million cases in 2014), and we estimate a slightly larger fraction of combined HIV and tuberculosis (13·0%) than WHO (12·0%). Our list of countries with high burden of tuberculosis is consistent with that of WHO, with a few exceptions. Afghanistan and Cambodia are lower in our estimates, and surpassed by Ukraine and Angola.

Cardiovascular diseases

Ageing and population growth have led to a growing number of people living with atherosclerotic vascular disease worldwide, despite the decrease in incident myocardial infarction and ischaemic stroke in high-income regions. Rising levels of obesity and diabetes in many countries makes this an area of major concern for global health. Increased attention will need to be directed toward this highly treatable set of disorders. Health systems will need to improve the delivery of cost-effective treatments such as blood pressure and cholesterol-lowering drugs while efforts continue to focus on decreasing tobacco smoking, improving diet, and increasing physical activity. Investments in universal primary care and public health campaigns need to be balanced against the need to improve access to emergency care, including the strengthening of pre-hospital systems and expanded access to revascularisation treatments.

Cancer

The International Agency for Research on Cancer last produced cancer estimates by country, age, sex, and cancer site for 2012 for the GLOBOCAN project.⁶⁰ The total estimated cancer incidence from GLOBOCAN for 2012 was 14·1 million individuals. By comparison, GBD 2015 estimated 18·6 million (18·0–19·4 million) new cases of cancer in 2015, which includes cases of non-melanoma skin cancer. GLOBOCAN used nine different methods to estimate incidence, which precludes the calculation of uncertainty for those estimates. The GBD relies on the strength of the mortality estimates and transformation of the mortality estimates to incidence, taking into account uncertainty associated with both the mortality estimates and with the mortality to incidence ratios. Until high-quality cancer incidence is available in all countries, the GBD approach, which maximises the amount of data used to determine incidence estimates, is highly beneficial.

Vision loss

Globally, 34·3 million (30·7–38·0 million) people are blind, an additional 24·3 million (21·6–27·6 million) have severe vision impairment, 214 million (193–237 million) have moderate vision impairment, and 663 million (638–690 million) have near vision impairment in 2015. Combined, vision loss accounts for 24·5 million (17·0–34·5 million) YLDs and is the third largest impairment after anaemia (77·9 million [52·4–111·4 million] YLDs) and hearing loss (46·2 million [31·6–63·2 million] YLDs). YLDs from vision loss are slightly lower than those for anxiety disorders, which rank ninth worldwide. Largely due to ageing, substantial increases occurred from 2005 to 2015 in the number of people with blindness (increasing by 23·3% [21·9–24·6%]), severe visual impairment (24·3% [22·4–26·0%]), moderate visual impairment (22·0% [20·1–23·7%]), and near vision impairment (22·5% [20·9–24·0%]). Most causes of vision loss can be prevented or cured using cost-effective interventions.^{61, 62}

Chronic kidney disease

Compared with our GBD 2013 estimates, we estimated global prevalence of chronic kidney disease to be lower by a third. Data for chronic kidney disease at younger ages are sparse. We increased the number of datapoints below the age of 30 years from 20 to 51, and that led to considerably lower prevalence estimates for these ages. We have used different strategies for estimating deaths versus YLDs secondary to chronic kidney disease due to other causes. In our cause of death analysis, deaths secondary to many of the causes typically categorised within the chronic kidney disease other category, such as cystic disease and other congenital renal diseases, were already counted under the primary disease following the principles of the ICD, and thus could not be recounted within the chronic kidney disease other category. In comparison, for the YLD analysis we counted chronic kidney disease from these causes in the chronic kidney disease other category. This difference in the classification of morbidity and mortality from chronic kidney disease other is driven by the underlying nature of the data on causes of death and prevalence. In future GBD versions, we plan to make explicit estimates of death and YLDs for polycystic kidney disease, an important component of the other category.

Emerging infectious diseases

Emerging and re-emerging infectious diseases pose a persistent yet dynamic challenge to global health⁶³ and to the GBD study. GBD 2015 has included Ebola virus disease in response to the devastating outbreak in west Africa starting in 2013,⁶⁴ whereas we have not captured the recent expansions of chikungunya⁶⁵ and Zika virus across the Americas,⁶⁶ for instance. Quantifying the effect of newly emerging epidemic diseases is difficult because the formal reporting of the disease events might considerably lag the first presentation of cases. As a result, contemporary events such as the substantial deviation from baseline levels in reported congenital abnormalities in Brazil in 2015,⁶⁷ now established to be associated with Zika virus,⁶⁸ will need to be incorporated into GBD 2016.

Advances in data and analysis

Future directions for GBD

With each cycle of the GBD we expect, given the present interest in subnational assessments, to report increasingly granular results. These subnational findings will be of important national policy interest, but the discipline of examining the evidence for each community and modelling at the more granular level will, we believe, improve the quality of the national estimation as well. Additions to the cause list will continue to be driven by policy interest, such as the need to incorporate Zika virus, to split diabetes into separate estimates for type 1 and type 2, and by adding diseases to our cause list that are main contributors to large residual categories, such as other cardiovascular disease, other musculoskeletal disorders, and other neurological disorders. We plan to continue to expand our networks of topic-specific and country collaborators to enhance the quality of our estimates through their feedback and by enhancing the amount of data we can bring to bear on GBD estimation. Our country collaborations to generate subnational estimates have shown us that these efforts greatly enhance access to valuable data sources, particularly administrative datasets on inpatient and outpatient episodes and unpublished surveys.

Limitations

The GBD 2015 study has some key limitations. First, although we have sought to capture and include in our estimations many sources of uncertainty, we have not captured all sources. We have not been able to routinely capture uncertainty due to different model specifications in our results. We do not have the ability to reflect the uncertainty of data sources that exist but of which we are not aware. Subnational collaborations in China and Mexico revealed many data sources not captured in previous iterations of the GBD study. Inclusion of these data sources can lead to shifts in estimates that are outside the previously estimated 95% UIs.

Second, within DisMod-MR 2.1 we estimate the average association between different types of studies for reporting on a specific outcome such as the difference between 12-month recall and point prevalence in a survey. These estimated associations from within the DisMod-MR 2.1 likelihood estimation are used to adjust the data to a reference case definition or study design. These estimated adjustment factors are themselves uncertain, which increases the overall uncertainty in our estimation. More standardisation in data collection would be highly desirable and would reduce our dependence on the relatively challenging estimation process involved in crosswalks.

Third, for some disorders the data available to estimate excess mortality by age and sex and to capture how excess mortality changes with development status are very limited. There are probably many unpublished sources of information in some countries that could be usefully brought to bear on the challenge of estimating the age–sex–year–location levels of excess mortality.

Fourth, the microsimulation step of this study assumes that prevalence within an age–sex–location–year group of different sequelae is independent. Although this is clearly known not to be the case for some pairs of disorders, the independence assumption provides reasonable overall adjustments for comorbidity. Progress in incorporating dependent comorbidity has been difficult because information on the correlation structure of prevalence is extremely limited and only available for a minor fraction of all possible pairs of conditions in the GBD study.

Fifth, we estimated separate DisMod-MR 2.1 models for 1990, 1995, 2000, 2005, 2010, and 2015. Independent estimation of each time period implies that the uncertainty intervals for each period are also independent. Furthermore, compositional bias in the data available in different time periods might lead to spurious time trends. A more appealing strategy would be to simultaneously estimate the trends in incidence, excess mortality, and remission by age and sex consistent with all the available data for a geography on prevalence, incidence, remission, excess mortality, and cause-specific mortality by age and sex. DisMod-MR 2.1 does not allow for time-varying trends in incidence, excess mortality, and remission, but a prototype DisMod-MR AT (age and time) has been developed and is being tested. Allowing for all rates to change at different paces over age and time increases the number of parameters that need to be estimated by orders of magnitude.

Sixth, we have emphasised in the reporting of results the changes from calendar year 2005 to calendar year 2015, although we have estimated results for 1990, 1995, 2000, 2005, 2010, and 2015 and interpolated for the years in between. For some disorders, reporting the change from 2005 to 2015 (such as for Ebola virus disease) does not capture the major epidemic in west Africa in 2014. Likewise, disasters and wars are often concentrated in a single year; comparisons of any two years can provide misleading inferences about trends.

Seventh, for a few disorders (eg, tetanus, neonatal sepsis, rabies, and diphtheria) we estimate disease incidence from estimates of mortality and the inverse of the case-fatality rate estimated from available studies. When the case-fatality rate is very low, these estimates of incidence are highly sensitive to very small changes in the estimated case-fatality rate and have large uncertainty intervals.

Finally, although extraordinary efforts have gone into vetting the results by GBD researchers and the collaborator network, there are probably some findings that have not been scrutinised carefully enough. Making all results and underlying data available and having an increasing number of visualisation tools are effective strategies that we will keep expanding to meet our goal of producing the highest quality global health data to our growing audience of policy makers, researchers, the media, and the general population.

Theo Vos†, Christine Allen, Megha Arora, Ryan M Barber, Zulfiqar A Bhutta, Alexandria Brown, Austin Carter, Daniel C Casey, Fiona J Charlson, Alan Z Chen, Megan Coggeshall, Leslie Cornaby, Lalit Dandona, Daniel J Dicker, Tina Dilegge, Holly E Erskine, Alize J Ferrari, Christina Fitzmaurice, Tom Fleming, Mohammad H Forouzanfar, Nancy Fullman, Peter W Gething, Ellen M Goldberg, Nicholas Graetz, Juanita A Haagsma, Catherine O Johnson, Nicholas J Kassebaum, Toana Kawashima, Laura Kemmer, Ibrahim A Khalil, Yohannes Kinfu, Hmwe H Kyu, Janni Leung, Xiaofeng Liang, Stephen S Lim, Alan D Lopez, Rafael Lozano, Laurie Marczak, George A Mensah, Ali H Mokdad, Mohsen Naghavi, Grant Nguyen, Elaine Nsoesie, Helen Olsen, David M Pigott, Christine Pinho, Zane Rankin, Nikolas Reinig, Joshua A Salomon, Logan Sandar, Alison Smith, Jeffrey Stanaway, Caitlyn Steiner, Stephanie Teeple, Bernadette A Thomas, Christopher Troeger, Joseph A Wagner, Haidong Wang, Valentine Wanga, Harvey A Whiteford, Leo Zoeckler, Amanuel Alemu Abajobir*, Kalkidan Hassen Abate*, Cristiana Abbafati*, Kaja M Abbas*, Foad Abd-Allah*, Biju Abraham*, Ibrahim Abubakar*, Laith J Abu-Raddad*, Niveen M E Abu-Rmeileh*, Ilana N Ackerman*, Akindele Olupelumi Adebiyi*, Zanfina Ademi*, Arsène Kouablan Adou*, Kossivi Agbelenko Afanvi*, Emilie Elisabet Agardh*, Arnav Agarwal*, Aliasghar Ahmad Kiadaliri*, Hamid Ahmadieh*, Oluremi N Ajala*, Rufus Olusola Akinyemi*, Nadia Akseer*, Ziyad Al-Aly*, Khurshid Alam*, Noore K M Alam*, Saleh Fahed Aldhahri*, Miguel Angel Alegretti*, Zewdie Aderaw Alemu*, Lily T Alexander*, Samia Alhabib*, Raghib Ali*, Ala'a Alkerwi*, François Alla*, Peter Allebeck*, Rajaa Al-Raddadi*, Ubai Alsharif*, Khalid A Altirkawi*, Nelson Alvis-Guzman*, Azmeraw T Amare*, Alemayehu Amberbir*, Heresh Amini*, Walid Ammar*, Stephen Marc Amrock*, Hjalte H Andersen*, Gregory M Anderson*, Benjamin O Anderson*, Carl Abelardo T Antonio*, Atsede Fantahun Aregay*, Johan Ärnlöv*, Al Artaman*, Hamid Asayesh*, Reza Assadi*, Suleman Atique*, Euripide Frinel G Arthur Avokpaho*, Ashish Awasthi*, Beatriz Paulina Ayala Quintanilla*, Peter Azzopardi*, Umar Bacha*, Alaa Badawi*, Kalpana Balakrishnan*, Amitava Banerjee*, Aleksandra Barac*, Suzanne L Barker-Collo*, Till Bärnighausen*, Lars Barregard*, Lope H Barrero*, Arindam Basu*, Shahrzad Bazargan-Hejazi*, Brent Bell*, Michelle L Bell*, Derrick A Bennett*, Isabela M Bensenor*, Habib Benzian*, Adugnaw Berhane*, Eduardo Bernabé*, Balem Demtsu Betsu*, Addisu Shunu Beyene*, Neeraj Bhala*, Samir Bhatt*, Sibhatu Biadgilign*, Kelly Bienhoff*, Boris Bikbov*, Stan Biryukov*, Donal Bisanzio*, Espen Bjertness*, Jed Blore*, Rohan Borschmann*, Soufiane Boufous*, Michael Brainin*, Alexandra Brazinova*, Nicholas J K Breitborde*, Jonathan Brown*, Rachelle Buchbinder*, Geoffrey Colin Buckle*, Zahid A Butt*, Bianca Calabria*, Ismael Ricardo Campos-Nonato*, Julio Cesar Campuzano*, Hélène Carabin*, Rosario Cárdenas*, David O Carpenter*, Juan Jesus Carrero*, Carlos A Castañeda-Orjuela*, Jacqueline Castillo Rivas*, Ferrán Catalá-López*, Jung-Chen Chang*, Peggy Pei-Chia Chiang*, Chioma Ezinne Chibueze*, Vesper Hichilombwe Chisumpa*, Jee-Young Jasmine Choi*, Rajiv Chowdhury*, Hanne Christensen*, Devasahayam Jesudas Christopher*, Liliana G Ciobanu*, Massimo Cirillo*, Matthew M Coates*, Samantha M Colquhoun*, Cyrus Cooper*, Monica Cortinovis*, John A Crump*, Solomon Abrha Damtew*, Rakhi Dandona*, Farah Daoud*, Paul I Dargan*, José das Neves*, Gail Davey*, Adrian C Davis*, Diego De Leo*, Louisa Degenhardt*, Liana C Del Gobbo*, Robert P Dellavalle*, Kebede Deribe*, Amare Deribew*, Sarah Derrett*, Don C Des Jarlais*, Samath D Dharmaratne*, Preet K Dhillon*, Cesar Diaz-Torné*, Eric L Ding*, Tim R Driscoll*, Leilei Duan*, Manisha Dubey*, Bruce Bartholow Duncan*, Hedyeh Ebrahimi*, Richard G Ellenbogen*, Iqbal Elyazar*, Matthias Endres*, Aman Yesuf Endries*, Sergey Petrovich Ermakov*, Babak Eshrati*, Kara Estep*, Talha A Farid*, Carla Sofia e Sa Farinha*, André Faro*, Maryam S Farvid*, Farshad Farzadfar*, Valery L Feigin*, David T Felson*, Seyed-Mohammad Fereshtehnejad*, Jefferson G Fernandes*, Joao C Fernandes*, Florian Fischer*, Joseph R A Fitchett*, Kyle Foreman*, F Gerry R Fowkes*, Jordan Fox*, Richard C Franklin*, Joseph Friedman*, Joseph Frostad*, Thomas Fürst*, Neal D Futran*, Belinda Gabbe*, Parthasarathi Ganguly*, Fortuné Gbètoho Gankpé*, Teshome Gebre*, Tsegaye Tewelde Gebrehiwot*, Amanuel Tesfay Gebremedhin*, Johanna M Geleijnse*, Bradford D Gessner*, Katherine B Gibney*, Ibrahim Abdelmageem Mohamed Ginawi*, Ababi Zergaw Giref*, Maurice Giroud*, Melkamu Dedefo Gishu*, Elizabeth Glaser*, William W Godwin*, Hector Gomez-Dantes*, Philimon Gona*, Amador Goodridge*, Sameer Vali Gopalani*, Carolyn C Gotay*, Atsushi Goto*, Hebe N Gouda*, Rebecca Grainger*, Felix Greaves*, Francis Guillemin*, Yuming Guo*, Rahul Gupta*, Rajeev Gupta*, Vipin Gupta*, Reyna A Gutiérrez*, Demewoz Haile*, Alemayehu Desalegne Hailu*, Gessessew Bugssa Hailu*, Yara A Halasa*, Randah Ribhi Hamadeh*, Samer Hamidi*, Mouhanad Hammami*, Jamie Hancock*, Alexis J Handal*, Graeme J Hankey*, Yuantao Hao*, Hilda L Harb*, Sivadasanpillai Harikrishnan*, Josep Maria Haro*, Rasmus Havmoeller*, Roderick J Hay*, Ileana Beatriz Heredia-Pi*, Pouria Heydarpour*, Hans W Hoek*, Masako Horino*, Nobuyuki Horita*, H Dean Hosgood*, Damian G Hoy*, Aung Soe Htet*, Hsiang Huang*, John J Huang*, Chantal Huynh*, Marissa Iannarone*, Kim Moesgaard Iburg*, Kaire Innos*, Manami Inoue*, Veena J Iyer*, Kathryn H Jacobsen*, Nader Jahanmehr*, Mihajlo B Jakovljevic*, Mehdi Javanbakht*, Achala Upendra Jayatilleke*, Sun Ha Jee*, Panniyammakal Jeemon*, Paul N Jensen*, Ying Jiang*, Tariku Jibat*, Aida Jimenez-Corona*, Ye Jin*, Jost B Jonas*, Zubair Kabir*, Yogeshwar Kalkonde*, Ritul Kamal*, Haidong Kan*, André Karch*, Corine Kakizi Karema*, Chante Karimkhani*, Amir Kasaeian*, Anil Kaul*, Norito Kawakami*, Peter Njenga Keiyoro*, Andrew Haddon Kemp*, Andre Keren*, Chandrasekharan Nair Kesavachandran*, Yousef Saleh Khader*, Abdur Rahman Khan*, Ejaz Ahmad Khan*, Young-Ho Khang*, Sahil Khera*, Tawfik Ahmed Muthafer Khoja*, Jagdish Khubchandani*, Christian Kieling*, Pauline Kim*, Cho-il Kim*, Daniel Kim*, Yun Jin Kim*, Niranjan Kissoon*, Luke D Knibbs*, Ann Kristin Knudsen*, Yoshihiro Kokubo*, Dhaval Kolte*, Jacek A Kopec*, Soewarta Kosen*, Georgios A Kotsakis*, Parvaiz A Koul*, Ai Koyanagi*, Michael Kravchenko*, Barthelemy Kuate Defo*, Burcu Kucuk Bicer*, Andreas A Kudom*, Ernst J Kuipers*, G Anil Kumar*, Michael Kutz*, Gene F Kwan*, Aparna Lal*, Ratilal Lalloo*, Tea Lallukka*, Hilton Lam*, Jennifer O Lam*, Sinead M Langan*, Anders Larsson*, Pablo M Lavados*, Janet L Leasher*, James Leigh*, Ricky Leung*, Miriam Levi*, Yichong Li*, Yongmei Li*, Juan Liang*, Shiwei Liu*, Yang Liu*, Belinda K Lloyd*, Warren D Lo*, Giancarlo Logroscino*, Katharine J Looker*, Paulo A Lotufo*, Raimundas Lunevicius*, Ronan A Lyons*, Mark T Mackay*, Mohammed Magdy Abd El Razek*, Mahdi Mahdavi*, Marek Majdan*, Azeem Majeed*, Reza Malekzadeh*, Wagner Marcenes*, David Joel Margolis*, Jose Martinez-Raga*, Felix Masiye*, João Massano*, Stephen Theodore McGarvey*, John J McGrath*, Martin McKee*, Brian J McMahon*, Peter A Meaney*, Alem Mehari*, Fabiola Mejia-Rodriguez*, Alemayehu B Mekonnen*, Yohannes Adama Melaku*, Peter Memiah*, Ziad A Memish*, Walter Mendoza*, Atte Meretoja*, Tuomo J Meretoja*, Francis Apolinary Mhimbira*, Ted R Miller*, Edward J Mills*, Mojde Mirarefin*, Philip B Mitchell*, Charles N Mock*, Alireza Mohammadi*, Shafiu Mohammed*, Lorenzo Monasta*, Julio Cesar Montañez Hernandez*, Marcella Montico*, Meghan D Mooney*, Maziar Moradi-Lakeh*, Lidia Morawska*, Ulrich O Mueller*, Erin Mullany*, John Everett Mumford*, Michele E Murdoch*, Jean B Nachega*, Gabriele Nagel*, Aliya Naheed*, Luigi Naldi*, Vinay Nangia*, John N Newton*, Marie Ng*, Frida Namnyak Ngalesoni*, Quyen Le Nguyen*, Muhammad Imran Nisar*, Patrick Martial Nkamedjie Pete*, Joan M Nolla*, Ole F Norheim*, Rosana E Norman*, Bo Norrving*, Bruno P Nunes*, Felix Akpojene Ogbo*, In-Hwan Oh*, Takayoshi Ohkubo*, Pedro R Olivares*, Bolajoko Olubukunola Olusanya*, Jacob Olusegun Olusanya*, Alberto Ortiz*, Majdi Osman*, Erika Ota*, Mahesh PA*, Eun-Kee Park*, Mahboubeh Parsaeian*, Valéria Maria de Azeredo Passos*, Angel J Paternina Caicedo*, Scott B Patten*, George C Patton*, David M Pereira*, Rogelio Perez-Padilla*, Norberto Perico*, Konrad Pesudovs*, Max Petzold*, Michael Robert Phillips*, Frédéric B Piel*, Julian David Pillay*, Farhad Pishgar*, Dietrich Plass*, James A Platts-Mills*, Suzanne Polinder*, Constance D Pond*, Svetlana Popova*, Richie G Poulton*, Farshad Pourmalek*, Dorairaj Prabhakaran*, Noela M Prasad*, Mostafa Qorbani*, Rynaz H S Rabiee*, Amir Radfar*, Anwar Rafay*, Kazem Rahimi*, Vafa Rahimi-Movaghar*, Mahfuzar Rahman*, Mohammad Hifz Ur Rahman*, Sajjad Ur Rahman*, Rajesh Kumar Rai*, Sasa Rajsic*, Usha Ram*, Puja Rao*, Amany H Refaat*, Marissa B Reitsma*, Giuseppe Remuzzi*, Serge Resnikoff*, Alex Reynolds*, Antonio L Ribeiro*, Maria Jesus Rios Blancas*, Hirbo Shore Roba*, David Rojas-Rueda*, Luca Ronfani*, Gholamreza Roshandel*, Gregory A Roth*, Dietrich Rothenbacher*, Ambuj Roy*, Rajesh Sagar*, Ramesh Sahathevan*, Juan R Sanabria*, Maria Dolores Sanchez-Niño*, Itamar S Santos*, João Vasco Santos*, Rodrigo Sarmiento-Suarez*, Benn Sartorius*, Maheswar Satpathy*, Miloje Savic*, Monika Sawhney*, Michael P Schaub*, Maria Inês Schmidt*, Ione J C Schneider*, Ben Schöttker*, David C Schwebel*, James G Scott*, Soraya Seedat*, Sadaf G Sepanlou*, Edson E Servan-Mori*, Katya A Shackelford*, Amira Shaheen*, Masood Ali Shaikh*, Rajesh Sharma*, Upasana Sharma*, Jiabin Shen*, Donald S Shepard*, Kevin N Sheth*, Kenji Shibuya*, Min-Jeong Shin*, Rahman Shiri*, Ivy Shiue*, Mark G Shrime*, Inga Dora Sigfusdottir*, Diego Augusto Santos Silva*, Dayane Gabriele Alves Silveira*, Abhishek Singh*, Jasvinder A Singh*, Om Prakash Singh*, Prashant Kumar Singh*, Anna Sivonda*, Vegard Skirbekk*, Jens Christoffer Skogen*, Amber Sligar*, Karen Sliwa*, Michael Soljak*, Kjetil Søreide*, Joan B Soriano*, Luciano A Sposato*, Chandrashekhar T Sreeramareddy*, Vasiliki Stathopoulou*, Nicholas Steel*, Dan J Stein*, Timothy J Steiner*, Sabine Steinke*, Lars Stovner*, Konstantinos Stroumpoulis*, Bruno F Sunguya*, Patrick Sur*, Soumya Swaminathan*, Bryan L Sykes*, Cassandra E I Szoeke*, Rafael Tabarés-Seisdedos*, Jukka S Takala*, Nikhil Tandon*, David Tanne*, Mohammad Tavakkoli*, Bineyam Taye*, Hugh R Taylor*, Braden J Te Ao*, Bemnet Amare Tedla*, Abdullah Sulieman Terkawi*, Alan J Thomson*, Andrew L Thorne-Lyman*, Amanda G Thrift*, George D Thurston*, Ruoyan Tobe-Gai*, Marcello Tonelli*, Roman Topor-Madry*, Fotis Topouzis*, Bach Xuan Tran*, Zacharie Tsala Dimbuene*, Miltiadis Tsilimbaris*, Abera Kenay Tura*, Emin Murat Tuzcu*, Stefanos Tyrovolas*, Kingsley N Ukwaja*, Eduardo A Undurraga*, Chigozie Jesse Uneke*, Olalekan A Uthman*, Coen H van Gool*, Yuri Y Varakin*, Tommi Vasankari*, Narayanaswamy Venketasubramanian*, Raj Kumar Verma*, Francesco S Violante*, Sergey K Vladimirov*, Vasiliy Victorovich Vlassov*, Stein Emil Vollset*, Gregory R Wagner*, Stephen G Waller*, Linhong Wang*, David A Watkins*, Scott Weichenthal*, Elisabete Weiderpass*, Robert G Weintraub*, Andrea Werdecker*, Ronny Westerman*, Richard A White*, Hywel C Williams*, Charles Shey Wiysonge*, Charles D A Wolfe*, Sungho Won*, Rachel Woodbrook*, Mamo Wubshet*, Denis Xavier*, Gelin Xu*, Ajit Kumar Yadav*, Lijing L Yan*, Yuichiro Yano*, Mehdi Yaseri*, Pengpeng Ye*, Henock Gebremedhin Yebyo*, Paul Yip*, Naohiro Yonemoto*, Seok-Jun Yoon*, Mustafa Z Younis*, Chuanhua Yu*, Zoubida Zaidi*, Maysaa El Sayed Zaki*, Hajo Zeeb*, Maigeng Zhou*, Sanjay Zodpey*, Liesl Joanna Zuhlke*, Christopher J L Murray.

*Authors listed alphabetically. †Corresponding author.

Institute for Health Metrics and Evaluation (Prof T Vos PhD, C Allen BA, M Arora BSA, R M Barber BS, A Brown MA, A Carter BS, D C Casey BA, F J Charlson PhD, A Z Chen BS, M Coggeshall BA, L Cornaby BS, Prof L Dandona MD, D J Dicker BS, T Dilegge BS, H E Erskine PhD, A J Ferrari PhD, C Fitzmaurice MD, T Fleming BS, M H Forouzanfar MD, N Fullman MPH, E M Goldberg BS, N Graetz MPH, J A Haagsma PhD, C O Johnson PhD, N J Kassebaum MD, T Kawashima MS, L Kemmer PhD, I A Khalil MD, H H Kyu PhD, J Leung PhD, Prof S S Lim PhD, Prof A D Lopez PhD, L Marczak PhD, Prof A H Mokdad PhD, Prof M Naghavi PhD, G Nguyen MPH, E Nsoesie PhD, H Olsen MAIS, D M Pigott DPhil, C Pinho BA, Z Rankin BS, N Reinig BS, L Sandar BS, A Smith BA, J Stanaway PhD, C Steiner MPH, S Teeple BA, B A Thomas MD, C Troeger MPH, J A Wagner BS, H Wang PhD, V Wanga MS, Prof H A Whiteford PhD, L Zoeckler BA, L T Alexander BA, G M Anderson MSEE, B Bell MLIS, K Bienhoff MA, S Biryukov BS, J Blore PhD, J Brown MAIS, M M Coates MPH, F Daoud BS, K Estep MPA, K Foreman PhD, J Fox BS, J Friedman BA, J Frostad MPH, W W Godwin BS, J Hancock MLS, C Huynh BA, M Iannarone MSc, P Kim BA, M Kutz BS, F Masiye PhD, M Mirarefin MPH, M D Mooney BS, M Moradi-Lakeh MD, E Mullany BA, J E Mumford BA, M Ng PhD, P Rao MPH, M B Reitsma BS, A Reynolds BA, G A Roth MD, K A Shackelford BA, A Sivonda MHA, A Sligar MPH, P Sur BA, Prof S E Vollset DrPH, R Woodbrook MLIS/MA, Prof M Zhou PhD, Prof C J L Murray DPhil), Harborview/UW Medicine (R G Ellenbogen MD), School of Dentistry (G A Kotsakis DDS), Harborview Injury Prevention and Research Center (C N Mock PhD), University of Washington, Seattle, WA, USA (Prof B O Anderson MD, N D Futran MD, P N Jensen PhD, D A Watkins MD); Centre of Excellence in Women and Child Health (Prof Z A Bhutta PhD), Aga Khan University, Karachi, Pakistan (M I Nisar MSc); Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada (Prof Z A Bhutta PhD, N Akseer MSc); School of Public Health (F J Charlson PhD, H E Erskine PhD, A J Ferrari PhD, J Leung PhD, Prof H A Whiteford PhD, A A Abajobir MPH, L D Knibbs PhD), School of Dentistry (Prof R Lalloo PhD), Centre for Clinical Research (J G Scott PhD), The University of Queensland, Brisbane, QLD, Australia (N K M Alam MPH, H N Gouda PhD, Y Guo PhD, Prof J J McGrath MD); Queensland Centre for Mental Health Research, Brisbane, QLD, Australia (F J Charlson PhD, H E Erskine PhD, A J Ferrari PhD, J Leung PhD, Prof H A Whiteford PhD); Centre for Control of Chronic Conditions (P Jeemon PhD), Public Health Foundation of India, New Delhi, India (Prof L Dandona MD, R Dandona PhD, G A Kumar PhD); Department of Zoology (P W Gething PhD), Nuffield Department of Medicine (D Bisanzio PhD, A Deribew PhD), NIHR Musculoskeletal Biomedical Research Centre (Prof C Cooper FMedSci), University of Oxford, Oxford, UK (R Ali FRCP, D A Bennett PhD, K Rahimi DM); Centre for Research & Action in Public Health, Faculty of Health, University of Canberra, Canberra, ACT, Australia (Y Kinfu PhD); National Center for Chronic and Noncommunicable Disease Control and Prevention (L Duan MD, Y Li MPH, S Liu PhD, Y Jin MS, Prof L Wang MD, P Ye MPH, Prof M Zhou PhD), Chinese Center for Disease Control and Prevention (Prof X Liang MD), Beijing, China; Melbourne School of Population and Global Health (Prof A D Lopez PhD), Department of Paediatrics (P Azzopardi MEpi), The Peter Doherty Institute for Infection and Immunity (K B Gibney FRACP), Department of Medicine (A Meretoja PhD), Murdoch Childrens Research Institute (K Alam PhD, P Azzopardi MEpi, R Borschmann PhD, S M Colquhoun PhD, Prof G C Patton MD, R G Weintraub MBBS), Institute of Health and Ageing (Prof C E I Szoeke PhD), The University of Melbourne, Melbourne, VIC, Australia (Z Ademi PhD, K Alam PhD, R Borschmann PhD, S M Colquhoun PhD, Prof H R Taylor AC, R G Weintraub MBBS); National Institute of Public Health, Cuernavaca, Mexico (R Lozano MD, I R Campos-Nonato PhD, J C Campuzano PhD, H Gomez-Dantes MSc, I B Heredia-Pi PhD, F Mejia-Rodriguez MD, J C Montañez Hernandez MSc, M J Rios Blancas MPH, Prof E E Servan-Mori MSc); Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA (G A Mensah MD); Department of Global Health and Population (Prof J A Salomon PhD), Department of Nutrition (A L Thorne-Lyman ScD), Harvard T H Chan School of Public Health (O N Ajala MD, Prof T Bärnighausen MD, I R Campos-Nonato PhD, E L Ding ScD, M S Farvid PhD, G R Wagner MD), Harvard Medical School (M Osman MD, M G Shrime MD), Harvard University, Boston, MA, USA (J R A Fitchett MD); Jimma University, Jimma, Ethiopia (K H Abate MS, T T Gebrehiwot MPH, A T Gebremedhin MPH); La Sapienza, University of Rome, Rome, Italy (C Abbafati PhD); Virginia Tech, Blacksburg, VA, USA (Prof K M Abbas PhD); Department of Neurology, Cairo University, Cairo, Egypt (Prof F Abd-Allah MD); NMSM Government College Kalpetta, Kerala, India (Prof B Abraham MPhil); Institute for Global Health (Prof I Abubakar PhD), Farr Institute of Health Informatics Research (A Banerjee DPhil), Department of Epidemiology and Public Health (H Benzian PhD), University College London, London, UK; Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Doha, Qatar (L J Abu-Raddad PhD); Institute of Community and Public Health, Birzeit University, Ramallah, Palestine (N M Abu-Rmeileh PhD); Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine (I N Ackerman PhD, Prof R Buchbinder PhD), School of Public Health and Preventive Medicine (Prof B Gabbe PhD), Department of Medicine, School of Clinical Sciences at Monash Health (Prof A G Thrift PhD), Monash University, Melbourne, VIC, Australia; College of Medicine (A O Adebiyi MD), University of Ibadan, Ibadan, Nigeria (R O Akinyemi PhD); University College Hospital, Ibadan, Nigeria (A O Adebiyi MD); University of Basel, Basel, Switzerland (Z Ademi PhD, T Fürst PhD); Association Ivoirienne pour le Bien-Être Familial, Abidjan, Côte d'Ivoire (A K Adou MD); Direction du District Sanitaire de Haho, Notse, Togo (K A Afanvi MD); Faculte des Sciences de Sante, Universite de Lome, Lome, Togo (K A Afanvi MD); Institution of Public Health Sciences, Stockholm, Sweden (E E Agardh PhD); Dalla Lana School of Public Health (N Akseer MSc), Department of Nutritional Sciences, Faculty of Medicine (A Badawi PhD), Centre for Addiction and Mental Health (S Popova PhD), University of Toronto, Toronto, ON, Canada (A Agarwal BHSc); McMaster University, Hamilton, ON, Canada (A Agarwal BHSc); Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit (A Ahmad Kiadaliri PhD), Skane University Hospital, Department of Clinical Sciences Lund (Prof B Norrving PhD), Lund University, Lund, Sweden; Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran (A Ahmad Kiadaliri PhD); Ophthalmic Research Center (H Ahmadieh MD, M Yaseri PhD), School of Public Health (N Jahanmehr PhD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, Labbafinejad Medical Center, Tehran, Iran (H Ahmadieh MD); University of Pittsburgh Medical Center, McKeesport, PA, USA (O N Ajala MD); Newcastle University, Newcastle upon Tyne, UK (R O Akinyemi PhD); Washington University in Saint Louis, St Louis, MO, USA (Z Al-Aly MD); Sydney School of Public Health (Prof T R Driscoll PhD), The University of Sydney, Sydney, NSW, Australia (K Alam PhD, Prof A H Kemp PhD, J Leigh PhD, A B Mekonnen MS); Queensland Health, Brisbane, QLD, Australia (N K M Alam MPH); King Saud University, Riyadh, Saudi Arabia (S F Aldhahri MD, K A Altirkawi MD); King Fahad Medical City, Riyadh, Saudi Arabia (S F Aldhahri MD); Department of Preventive and Social Medicine, Faculty of Medicine, University of the Republic, Montevideo, Uruguay (M A Alegretti MD); Debre Markos University, Debre Markos, Ethiopia (Z A Alemu MPH); King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia (S Alhabib PhD); Luxembourg Institute of Health (LIH), Strassen, Luxembourg (A Alkerwi PhD); School of Public Health, University of Lorraine, Nancy, France (Prof F Alla PhD, F Guillemin PhD); Department of Public Health Sciences (P Allebeck PhD, R H S Rabiee MPH), Department of Clinical Science, Intervention and Technology (Prof J J Carrero PhD), Department of Neurobiology, Care Sciences and Society (NVS) (S M Fereshtehnejad PhD), Department of Medical Epidemiology and Biostatistics (E Weiderpass PhD), Karolinska Institutet, Stockholm, Sweden (R Havmoeller PhD); Ministry of Health, Jeddah, Saudi Arabia (R Al-Raddadi PhD); Charité Universitätsmedizin, Berlin, Germany (U Alsharif MPH); Universidad de Cartagena, Cartagena de Indias, Colombia (Prof N Alvis-Guzman PhD); School of Medicine (A T Amare MPH, Y A Melaku MPH), University of Adelaide, Adelaide, SA, Australia (L G Ciobanu MS); College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia (A T Amare MPH); Dignitas International, Zomba, Malawi (A Amberbir PhD); Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran (H Amini MSPH); Department of Epidemiology and Public Health (H Amini MSPH, T Fürst PhD), Swiss Tropical and Public Health Institute, Basel, Switzerland (C K Karema MSc); Ministry of Public Health, Beirut, Lebanon (W Ammar PhD, H L Harb MPH); Oregon Health & Science University, Portland, OR, USA (S M Amrock MD); Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark (H H Andersen MSc); Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, Manila, Philippines (C A T Antonio MD); School of Public Health (Y A Melaku MPH), Mekelle University, Mekelle, Ethiopia (A F Aregay MS, B D Betsu MS, G B Hailu MSc, H G Yebyo MS); Department of Medical Sciences, Uppsala University, Uppsala, Sweden (Prof J Ärnlöv PhD, Prof A Larsson PhD); Dalarna University, Falun, Sweden (Prof J Ärnlöv PhD); Consultant, Windsor, ON, Canada (A Artaman PhD); Department of Medical Emergency, School of Paramedic, Qom University of Medical Sciences, Qom, Iran (H Asayesh PhD); Mashhad University of Medical Sciences, Mashhad, Iran (R Assadi PhD); Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan (S Atique MS); Institut de Recherche Clinique du Bénin, Cotonou, Benin Republic (E F G A Avokpaho MPH); Laboratoire d'Etudes et de Recherche-Action en Santé (LERAS Afrique), Parakou, Benin Republic (E F G A Avokpaho MPH); Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India (A Awasthi MSc); The Judith Lumley Centre for Mother, Infant and Family Health Research, La Trobe University, Melbourne, VIC, Australia (B P Ayala Quintanilla PhD); Peruvian National Institute of Health, Lima, Peru (B P Ayala Quintanilla PhD); Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia (P Azzopardi MEpi); School of Health Sciences, University of Management and Technology, Lahore, Pakistan (U Bacha PhD); Public Health Agency of Canada, Toronto, ON, Canada (A Badawi PhD); Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India (K Balakrishnan PhD); Faculty of Medicine, University of Belgrade, Belgrade, Serbia (A Barac PhD); School of Psychology, University of Auckland, Auckland, New Zealand (S L Barker-Collo PhD); Africa Health Research Institute, Mtubatuba, South Africa (Prof T Bärnighausen MD); Institute of Public Health, Heidelberg University, Heidelberg, Germany (Prof T Bärnighausen MD, S Mohammed PhD); Department of Occupational and Environmental Health (Prof L Barregard MD), Health Metrics Unit (Prof M Petzold PhD), University of Gothenburg, Gothenburg, Sweden; Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia (L H Barrero ScD); School of Health Sciences, University of Canterbury, Christchurch, New Zealand (A Basu PhD); College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA (Prof S Bazargan-Hejazi PhD); David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA (Prof S Bazargan-Hejazi PhD); Kermanshah University of Medical Science, Kermanshah, Iran (Prof S Bazargan-Hejazi PhD); School of Medicine (K N Sheth MD), Yale University, New Haven, CT, USA (Prof M L Bell PhD, J J Huang MD); Internal Medicine Department (Prof I S Santos PhD), University of São Paulo, São Paulo, Brazil (I M Bensenor PhD, Prof P A Lotufo DrPH); Department of Epidemiology and Health Promotion, College of Dentistry (H Benzian PhD), New York University, New York, NY, USA; Debre Berhane University, Debre Berhan, Ethiopia (A Berhane PhD); Division of Health and Social Care Research (Prof C D Wolfe MD), King's College London, London, UK (E Bernabé PhD, Prof R J Hay DM); College of Health and Medical Sciences (H S Roba MPH), Haramaya University, Harar, Ethiopia (A S Beyene MPH); Queen Elizabeth Hospital Birmingham, Birmingham, UK (N Bhala DPhil); University of Otago Medical School, Wellington, New Zealand (N Bhala DPhil); Department of Infectious Disease Epidemiology (T Fürst PhD), Department of Epidemiology and Biostatistics (F B Piel PhD), Division of Brain Sciences (Prof T J Steiner PhD), Imperial College London, London, UK (S Bhatt DPhil, F Greaves PhD, Prof A Majeed MD, M Soljak PhD); Independent Public Health Consultants, Addis Ababa, Ethiopia (S Biadgilign MPH); Department of Nephrology Issues of Transplanted Kidney, Academician V I Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russia (B Bikbov MD); Department of Community Medicine (Prof E Bjertness PhD), University of Oslo, Oslo, Norway (A S Htet MPhil); Transport and Road Safety (TARS) Research (S Boufous PhD), National Drug and Alcohol Research Centre (Prof L Degenhardt PhD), Brien Holden Vision Institute (Prof S Resnikoff MD), University of New South Wales, Kensington, NSW, Australia (B Calabria PhD, Prof P B Mitchell MD); Danube-University Krems, Krems, Austria (Prof M Brainin PhD); Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia (A Brazinova PhD, M Majdan PhD); International Neurotrauma Research Organization, Vienna, Austria (A Brazinova PhD); Departments of Pediatrics and Neurology (W D Lo MD), College of Medicine (J Shen PhD), The Ohio State University, Columbus, OH, USA (Prof N J K Breitborde PhD); Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, VIC, Australia (Prof R Buchbinder PhD); University of California, San Francisco, San Francisco, CA, USA (G C Buckle MD); Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan (Z A Butt PhD); National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia (B Calabria PhD, A Lal PhD); Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA (H Carabin PhD); Metropolitan Autonomous University, Mexico City, Mexico (R Cárdenas ScD); University at Albany, Rensselaer, NY, USA (Prof D O Carpenter MD); Colombian National Health Observatory, Instituto Nacional de Salud, Bogotá, Colombia (C A Castañeda-Orjuela MSc); Epidemiology and Public Health Evaluation Group, Public Health Department, Universidad Nacional de Colombia, Bogotá, Colombia (C A Castañeda-Orjuela MSc); Caja Costarricense de Seguro Social, San Jose, Costa Rica (Prof J Castillo Rivas MPH); Universidad de Costa Rica, San Pedro, Montes de Oca, Costa Rica (Prof J Castillo Rivas MPH); Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain (F Catalá-López PhD); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada (F Catalá-López PhD); School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan (Prof J Chang PhD); Clinical Governance Unit, Gold Coast Health, Southport, QLD, Australia (P P Chiang PhD); National Center for Child Health and Development, Setagaya, Japan (C E Chibueze PhD); University of Zambia, Lusaka, Zambia (V H Chisumpa MPhil, F Masiye PhD); University of Witwatersrand, Johannesburg, South Africa (V H Chisumpa MPhil); Seoul National University Medical Library, Seoul, South Korea (J J Choi PhD); Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK (R Chowdhury PhD); Bispebjerg University Hospital, Copenhagen, Denmark (Prof H Christensen DMSCi); Christian Medical College, Vellore, India (Prof D J Christopher MD); University of Salerno, Baronissi, Italy (Prof M Cirillo MD); MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK (Prof C Cooper FMedSci); NIHR Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK (Prof C Cooper FMedSci); IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Bergamo, Italy (M Cortinovis Biotech D, N Perico MD, Prof G Remuzzi MD); Centre for International Health, Dunedin School of Medicine (Prof J A Crump MD), Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine (Prof S Derrett PhD), University of Otago, Dunedin, New Zealand (Prof R G Poulton PhD); Wolaita Sodo University, Wolaita Sodo, Ethiopia (S A Damtew MPH); School of Public Health (K Deribe MPH, A D Hailu MPH), Addis Ababa University, Addis Ababa, Ethiopia (S A Damtew MPH, A Z Giref PhD, D Haile MPH, T Jibat MS, B Taye PhD); Guy's and St Thomas' NHS Foundation Trust, London, UK (Prof P I Dargan FRCP); i3S - Instituto de Investigação e Inovação em Saúde and INEB - Instituto de Engenharia Biomédica (J das Neves PhD), Faculty of Medicine (J Massano MD, J V Santos BHlthSc); University of Porto, Porto, Portugal; Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton, UK (Prof G Davey MD); Public Health England, London, UK (Prof A C Davis PhD, F Greaves PhD, Prof J N Newton FRCP, Prof N Steel PhD); Griffith University, Brisbane, QLD, Australia (Prof D De Leo DSc); Stanford University, Stanford, CA, USA (L C Del Gobbo PhD); University of Colorado School of Medicine and the Colorado School of Public Health, Aurora, CO, USA (R P Dellavalle MD); Brighton and Sussex Medical School, Brighton, UK (K Deribe MPH); KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya (A Deribew PhD); Mount Sinai Beth Israel, New York, NY, USA (Prof D C Des Jarlais PhD); Icahn School of Medicine at Mount Sinai, New York, NY, USA (Prof D C Des Jarlais PhD); Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka (S D Dharmaratne MD); Centre for Control of Chronic Conditions (P Jeemon PhD), Public Health Foundation of India, Gurgaon, India (P K Dhillon PhD, P Ganguly MD, Prof S Zodpey PhD); Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (C Diaz-Torné MD); International Institute for Population Sciences, Mumbai, India (M Dubey MPhil, M H U Rahman MPhil, Prof U Ram PhD, A Singh PhD, R K Verma MPhil, A K Yadav MPhil); Federal University of Rio Grande do Sul, Porto Alegre, Brazil (B B Duncan PhD, C Kieling MD, Prof M I Schmidt MD); University of North Carolina, Chapel Hill, NC, USA (B B Duncan PhD); Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute (H Ebrahimi MD, F Pishgar MD, F Farzadfar MD, A Kasaeian PhD, M Parsaeian PhD), Liver and Pancreaticobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital (H Ebrahimi MD), Multiple Sclerosis Research Center, Neuroscience Institute (P Heydarpour MD), Hematology-Oncology and Stem Cell Transplantation Research Center (A Kasaeian PhD), Digestive Diseases Research Institute (Prof R Malekzadeh MD, G Roshandel PhD, S G Sepanlou PhD), Department of Epidemiology and Biostatistics, School of Public Health (M Parsaeian PhD), Uro-Oncology Research Center (F Pishgar MD), Sina Trauma and Surgery Research Center (Prof V Rahimi-Movaghar MD), Tehran University of Medical Sciences, Tehran, Iran (M Yaseri PhD); Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia (I Elyazar PhD); Charité University Medicine Berlin, Berlin, Germany (Prof M Endres MD); Arba Minch University, Arba Minch, Ethiopia (A Y Endries MPH); The Institute of Social and Economic Studies of Population, Russian Academy of Sciences, Moscow, Russia (Prof S P Ermakov DSc); Federal Research Institute for Health Organization and Informatics, Ministry of Health of the Russian Federation, Moscow, Russia (Prof S P Ermakov DSc); Ministry of Health and Medical Education, Tehran, Iran (B Eshrati PhD); Arak University of Medical Sciences, Arak, Iran (B Eshrati PhD); University of Louisville, Louisville, KY, USA (T A Farid MD, A R Khan MD); DGS Directorate General of Health, Lisboa, Portugal (C S E S Farinha MSc); Universidade Aberta, Lisboa, Portugal (C S E S Farinha MSc); Federal University of Sergipe, Aracaju, Brazil (Prof A Faro PhD); Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA (M S Farvid PhD); National Institute for Stroke and Applied Neurosciences (V L Feigin PhD), Auckland University of Technology, Auckland, New Zealand (B J Te Ao MPH); School of Medicine (G F Kwan MD), Boston University, Boston, MA, USA (Prof D T Felson MD); Institute of Education and Sciences, German Hospital Oswaldo Cruz, São Paulo, Brazil (Prof J G Fernandes PhD); Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK (J C Fernandes PhD); Bielefeld University, Bielefeld, Germany (F Fischer MPH); Alzheimer Scotland Dementia Research Centre (I Shiue PhD), University of Edinburgh, Edinburgh, UK (Prof F G R Fowkes PhD); James Cook University, Townsville, QLD, Australia (R C Franklin PhD); Department of Infectious Disease Epidemiology (T Fürst PhD), Department of Epidemiology and Biostatistics (F B Piel PhD), Division of Brain Sciences (Prof T J Steiner PhD), Imperial College London, London, UK (F Greaves PhD, Prof A Majeed MD, M Soljak PhD); Indian Institute of Public Health Gandhinagar, Ahmedabad, India (P Ganguly MD, V J Iyer MPH); Leras Afrique, Cotonou, Benin (F G Gankpé MD); CHU Hassan II, Fès, Morocco (F G Gankpé MD); The Task Force for Global Health, Decatur, GA, USA (T Gebre PhD); Ludwig Maximilians University, Munich, Germany (A T Gebremedhin MPH); Division of Human Nutrition (J M Geleijnse PhD), Wageningen University, Wageningen, Netherlands (T Jibat MS); Agence de Médecine Préventive, Paris, France (B D Gessner MD); The Royal Melbourne Hospital, Melbourne, VIC, Australia (K B Gibney FRACP); College of Medicine, University of Hail, Hail, Saudi Arabia (I A Ginawi MD); University Hospital of Dijon, Dijon, France (Prof M Giroud MD); College of Health and Medical Sciences (H S Roba MPH), Haramaya University, Dire Dawa, Ethiopia (M D Gishu MS, A K Tura MPH); Kersa Health and Demographic Surveillance System, Harar, Ethiopia (M D Gishu MS); Heller School for Social Policy and Management (E Glaser PhD), Brandeis University, Waltham, MA, USA (Y A Halasa MS, Prof D S Shepard PhD, E A Undurraga PhD); University of Massachusetts Boston, Boston, MA, USA (Prof P Gona PhD); Instituto de Investigaciones Cientificas y Servicios de Alta Tecnologia-INDICASAT-AIP, Ciudad del Saber, Panamá (A Goodridge PhD); Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia (S V Gopalani MPH); University of British Columbia, Vancouver, BC, Canada (C C Gotay PhD, Prof N Kissoon MD, J A Kopec PhD, F Pourmalek PhD); Division of Epidemiology, Center for Public Health Sciences (A Goto PhD), National Cancer Center, Tokyo, Japan (M Inoue MD); Centre for International Health, Dunedin School of Medicine (Prof J A Crump MD), Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine (Prof S Derrett PhD), University of Otago, Wellington, New Zealand (R Grainger PhD); West Virginia Bureau for Public Health, Charleston, WV, USA (R Gupta MD); Eternal Heart Care Centre and Research Institute, Jaipur, India (R Gupta PhD); Department of Anthropology, University of Delhi, Delhi, India (V Gupta PhD); National Institute of Psychiatry Ramon de la Fuente, Mexico City, Mexico (R A Gutiérrez PhD); Department of Global Public Health and Primary Care (A K Knudsen PhD, Prof S E Vollset DrPH), University of Bergen, Bergen, Norway (A D Hailu MPH, Prof O F Norheim PhD); Kilte Awlaelo Health and Demographic Surveillance System, Mekelle, Ethiopia (G B Hailu MSc); Arabian Gulf University, Manama, Bahrain (Prof R R Hamadeh DPhil); Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates (S Hamidi PhD); Wayne County Department of Health and Human Services, Detroit, MI, USA (M Hammami MD); University of New Mexico, Albuquerque, NM, USA (A J Handal PhD); School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia (Prof G J Hankey MD); Harry Perkins Institute of Medical Research, Nedlands, WA, Australia (Prof G J Hankey MD); Western Australian Neuroscience Research Institute, Nedlands, WA, Australia (Prof G J Hankey MD); School of Public Health, Sun Yat-sen University, Guangzhou, China (Prof Y Hao PhD); Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India (S Harikrishnan DM); Parc Sanitari Sant Joan de Déu - CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain (J M Haro MD); Universitat de Barcelona, Barcelona, Spain (J M Haro MD); International Foundation for Dermatology, London, UK (Prof R J Hay DM); Department of Psychiatry, University Medical Center Groningen (Prof H W Hoek MD), University of Groningen, Groningen, Netherlands (A K Tura MPH); Department of Epidemiology, Mailman School of Public Health (Prof H W Hoek MD), Columbia University, New York, NY, USA (Prof V Skirbekk PhD); Nevada Division of Public and Behavioral Health, Department of Health and Human Services, Carson City, NV, USA (M Horino MPH); Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan (N Horita MD); Albert Einstein College of Medicine, Bronx, NY, USA (Prof H D Hosgood PhD); Public Health Division, The Pacific Community, Noumea, New Caledonia (D G Hoy PhD); International Relations Division, Ministry of Health, Nay Pyi Taw, Myanmar (A S Htet MPhil); Cambridge Health Alliance, Cambridge, MA, USA (H Huang MD); Aarhus University, Aarhus, Denmark (K M Iburg PhD); National Institute for Health Development, Tallinn, Estonia (K Innos PhD); Graduate School of Medicine (M Inoue MD), School of Public Health (Prof N Kawakami MD), University of Tokyo, Tokyo, Japan (K Shibuya MD); Department of Global and Community Health, George Mason University, Fairfax, VA, USA (K H Jacobsen PhD); Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia (Prof M B Jakovljevic PhD); University of Aberdeen, Aberdeen, UK (M Javanbakht PhD); Postgraduate Institute of Medicine, Colombo, Sri Lanka (A U Jayatilleke PhD); Institute of Violence and Injury Prevention, Colombo, Sri Lanka (A U Jayatilleke PhD); Graduate School of Public Health, Yonsei University, Seoul, South Korea (Prof S H Jee PhD); Centre for Chronic Disease Control, New Delhi, India (P Jeemon PhD, D Prabhakaran DM); Department of Health Development, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan (Y Jiang PhD); Department of Ocular Epidemiology and Visual Health, Institute of Ophthalmology Conde de Valencia, Mexico City, Mexico (A Jimenez-Corona PhD); General Directorate of Epidemiology, Ministry of Health, Mexico City, Mexico (A Jimenez-Corona PhD); Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany (Prof J B Jonas MD); University College Cork, Cork, Ireland (Z Kabir PhD); Society for Education, Action and Research in Community Health, Gadchiroli, India (Y Kalkonde MD); CSIR-Indian Institute of Toxicology Research, Lucknow, India (R Kamal MSc, C N Kesavachandran PhD); Fudan University, Shanghai, China (H Kan MD); Epidemiological and Statistical Methods Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany (A Karch MD); Hannover-Braunschweig Site, German Center for Infection Research, Braunschweig, Germany (A Karch MD); Quality and Equity Health Care, Kigali, Rwanda (C K Karema MSc); Case Western University Hospitals, Cleveland, OH, USA (C Karimkhani MD); Oklahoma State University, Tulsa, OK, USA (A Kaul MD); Institute of Tropical and Infectious Diseases, Nairobi, Kenya (P N Keiyoro PhD); School of Continuing and Distance Education, Nairobi, Kenya (P N Keiyoro PhD); Farr Institute (Prof R A Lyons MD), Swansea University, Swansea, UK (Prof A H Kemp PhD); Assuta Hospitals, Assuta Hashalom, Tel Aviv, Israel (Prof A Keren MD); Jordan University of Science and Technology, Irbid, Jordan (Prof Y S Khader ScD); Health Services Academy, Islamabad, Pakistan (E A Khan MPH); College of Medicine (Prof Y H Khang MD), Graduate School of Public Health (Prof S Won PhD), Seoul National University, Seoul, South Korea; New York Medical College, Valhalla, NY, USA (S Khera MD, M Tavakkoli MD); Executive Board of the Health Ministers' Council for Cooperation Council States, Riyadh, Saudi Arabia (Prof T A M Khoja FRCP); Ball State University, Muncie, IN, USA (J Khubchandani PhD); Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil (C Kieling MD); Korea Health Industry Development Institute, Cheongju-si, South Korea (C Kim PhD); Department of Health Sciences, Northeastern University, Boston, MA, USA (Prof D Kim DrPH); Southern University College, Skudai, Malaysia (Y J Kim PhD); Centre for Disease Burden (A K Knudsen PhD, Prof S E Vollset DrPH), Department of Health Promotion (J C Skogen PhD), Norwegian Institute of Public Health, Oslo, Norway (M Savic PhD, Prof V Skirbekk PhD); Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan (Y Kokubo PhD); Division of Cardiology (D Kolte MD), Brown University, Providence, RI, USA (Prof S T McGarvey PhD); Center for Community Empowerment, Health Policy and Humanities, NIHRD, Jakarta, Indonesia (S Kosen MD); Sher-i-Kashmir Institue of Medical Sciences, Srinagar, India (Prof P A Koul MD); Research and Development Unit, Parc Sanitari Sant Joan de Deu (CIBERSAM), Barcelona, Spain (A Koyanagi MD); Research Center of Neurology, Moscow, Russia (M Kravchenko PhD, Prof Y Y Varakin MD); Department of Demography and Public Health Research Institute (Prof B Kuate Defo PhD), Department of Social and Preventive Medicine, School of Public Health (Prof B Kuate Defo PhD), University of Montreal, Montreal, QC, Canada; Institute of Public Health, Hacettepe University, Ankara, Turkey (B Kucuk Bicer PhD); University of Cape Coast, Cape Coast, Ghana (A A Kudom PhD); Department of Public Health (S Polinder PhD), Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands (Prof E J Kuipers PhD); Work Organizations, Work Disability Prevention, The Finnish Institute of Occupational Health, Helsinki, Finland (T Lallukka PhD, R Shiri PhD); Department of Public Health, Faculty of Medicine (T Lallukka PhD), University of Helsinki, Helsinki, Finland (T J Meretoja PhD); Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines (Prof H Lam PhD); Johns Hopkins Bloomberg School of Public Health (J O Lam PhD, Prof J B Nachega PhD), Johns Hopkins University, Baltimore, MD, USA (B X Tran PhD); London School of Hygiene & Tropical Medicine, London, UK (S M Langan PhD, Prof M McKee DSc); Servicio de Neurologia, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile (P M Lavados MD); College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA (J L Leasher OD); State University of New York, Albany, Rensselaer, NY, USA (R Leung PhD); Tuscany Regional Centre for Occupational Injuries and Diseases, Florence, Italy (M Levi PhD); San Francisco VA Medical Center, San Francisco, CA, USA (Y Li PhD); National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China (Prof J Liang MD); Emory University, Atlanta, GA, USA (Prof Y Liu PhD, Prof M R Phillips MD); Eastern Health Clinical School (B K Lloyd PhD), Monash University, Fitzroy, VIC, Australia; Turning Point, Eastern Health, Melbourne, VIC, Australia (B K Lloyd PhD); Nationwide Children's Hospital, Columbus, OH, USA (W D Lo MD); University of Bari, Bari, Italy (Prof G Logroscino PhD); University of Bristol, Bristol, UK (K J Looker PhD); Aintree University Hospital National Health Service Foundation Trust, Liverpool, UK (Prof R Lunevicius PhD); School of Medicine, University of Liverpool, Liverpool, UK (Prof R Lunevicius PhD); Royal Children's Hospital, Melbourne, VIC, Australia (M T Mackay MBBS, R G Weintraub MBBS); Aswan University Hospital, Aswan Faculty of Medicine, Aswan, Egypt (M Magdy Abd El Razek MBBCh); Social Security Organization Research Institute, Tehran, Iran (M Mahdavi PhD); Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands (M Mahdavi PhD); Division of Population and Patient Health, King's College London Dental Institute, London, UK (Prof W Marcenes PhD); Perelman School of Medicine (P A Meaney MD), University of Pennsylvania, Philadelphia, PA, USA (D J Margolis PhD); University Hospital Doctor Peset, University of Valencia, Valencia, Spain (J Martinez-Raga PhD); CEU Cardenal Herrera University, Moncada (Valencia), Spain (J Martinez-Raga PhD); Hospital Pedro Hispano/ULS Matosinhos, Matosinhos, Portugal (J Massano MD); Alaska Native Tribal Health Consortium, Anchorage, AK, USA (B J McMahon MD); Children's Hospital of Philadelphia, Philadelphia, PA, USA (P A Meaney MD); College of Medicine, Howard University, Washington, DC, USA (A Mehari MD); University of Gondar, Gondar, Ethiopia (A B Mekonnen MS, B A Tedla BS); University of West Florida, Pensacola, FL, USA (P Memiah PhD); Saudi Ministry of Health, Riyadh, Saudi Arabia (Prof Z A Memish MD); College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Prof Z A Memish MD); United Nations Population Fund, Lima, Peru (W Mendoza MD); Department of Neurology, Helsinki University Hospital, Helsinki, Finland (A Meretoja PhD); Helsinki University Hospital, Comprehensive Cancer Center, Breast Surgery Unit, Helsinki, Finland (T J Meretoja PhD); Ifakara Health Institute, Bagamoyo, Tanzania (F A Mhimbira MS); Pacific Institute for Research & Evaluation, Calverton, MD, USA (T R Miller PhD); Centre for Population Health, Curtin University, Perth, WA, Australia (T R Miller PhD); University of Ottawa, Ottawa, ON, Canada (E J Mills PhD); Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran (A Mohammadi PhD); Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria (S Mohammed PhD); Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy (L Monasta DSc, M Montico MSc, L Ronfani PhD); Department of Community Medicine, Gastrointestinal and Liver Disease Research Center, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran (M Moradi-Lakeh MD); International Laboratory for Air Quality and Health (L Morawska PhD), Institute of Health and Biomedical Innovation (R E Norman PhD), Queensland University of Technology, Brisbane, QLD, Australia; Competence Center Mortality-Follow-Up of the German National Cohort (A Werdecker PhD), Federal Institute for Population Research, Wiesbaden, Germany (Prof U O Mueller PhD, R Westerman PhD); Graduate School of Public Health (Prof J B Nachega PhD), Public Health Dynamics Laboratory (A J Paternina Caicedo MD), University of Pittsburgh, Pittsburgh, PA, USA; West Herts Hospitals NHS Trust, Watford, Hertfordshire, UK (M E Murdoch FRCP); Stellenbosch University, Cape Town, South Africa (Prof J B Nachega PhD, Prof S Seedat PhD, Prof C S Wiysonge PhD); Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany (Prof G Nagel PhD, Prof D Rothenbacher MD); International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh (A Naheed PhD); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (Prof L Naldi MD, Prof G Remuzzi MD); Suraj Eye Institute, Nagpur, India (V Nangia MD); Ministry of Health and Social Welfare, Dar es Salaam, Tanzania (F N Ngalesoni MSc); Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam (Q L Nguyen MD); Institute For Research, Socio-Economic Development and Communication, Yaoundé, Cameroon (P M Nkamedjie Pete MS); Hospital Universitari de Bellvitge, L'Hospitalet, Spain (J M Nolla PhD); Federal University of Pelotas, Pelotas, Brazil (Prof B P Nunes PhD); Centre for Health Research, Western Sydney University, Sydney, NSW, Australia (F A Ogbo MPH); Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea (Prof I Oh PhD); Teikyo University School of Medicine, Tokyo, Japan (Prof T Ohkubo MD); Universidad Autonoma de Chile, Talca, Chile (Prof P R Olivares PhD); Center for Healthy Start Initiative, Lagos, Nigeria (B O Olusanya PhD, J O Olusanya MBA); IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain (Prof A Ortiz PhD); YBank, Cambridge, MA, USA (M Osman MD); St Luke's International University, Tokyo, Japan (E Ota PhD); JSS Medical College, JSS University, Mysore, India (Prof Mahesh PA DNB); Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea (E Park PhD); Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Prof V M D A Passos PhD); Universidad de Cartagena, Cartagena, Colombia (A J Paternina Caicedo MD); Department of Community Health Sciences (Prof S B Patten PhD), University of Calgary, Calgary, AB, Canada (Prof M Tonelli MD); REQUIMTE/LAQV, Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal (Prof D M Pereira PhD); National Institute of Respiratory Diseases, Mexico City, Mexico (Prof R Perez-Padilla MD); Flinders University, Adelaide, SA, Australia (Prof K Pesudovs PhD); University of the Witwatersrand, Johannesburg, South Africa (Prof M Petzold PhD); Shanghai Jiao Tong University School of Medicine, Shanghai, China (Prof M R Phillips MD); Durban University of Technology, Durban, South Africa (J D Pillay PhD); Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany (D Plass DrPH); Department of Anesthesiology (A S Terkawi MD), University of Virginia, Charlottesville, VA, USA (J A Platts-Mills MD); University of Newcastle, Callaghan, NSW, Australia (Prof C D Pond PhD); The Fred Hollows Foundation, Sydney, NSW, Australia (N M Prasad DO); Centre for Eye Research Australia, Melbourne, VIC, Australia (N M Prasad DO); Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran (M Qorbani PhD); A T Still University, Kirksville, MO, USA (A Radfar MD); Contech School of Public Health, Lahore, Pakistan (A Rafay MS); Research and Evaluation Division, BRAC, Dhaka, Bangladesh (M Rahman PhD); Hamad Medical Corporation, Doha, Qatar (S U Rahman FCPS); Society for Health and Demographic Surveillance, Suri, India (R K Rai MPH); ERAWEB Program, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria (S Rajsic MD); Walden University, Minneapolis, MN, USA (Prof A H Refaat PhD); Suez Canal University, Ismailia, Egypt (Prof A H Refaat PhD); Department of Biomedical and Clinical Sciences L Sacco, University of Milan, Milan, Italy (Prof G Remuzzi MD); Hospital das Clinicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (Prof A L Ribeiro MD); (ISGlobal) Instituto de Salud Global de Barcelona, Barcelona, Spain (D Rojas-Rueda PhD); Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran (G Roshandel PhD); All India Institute of Medical Sciences, New Delhi, India (A Roy DM, R Sagar MD, M Satpathy PhD, Prof N Tandon PhD); Ballarat Health Service, Ballarat, VIC, Australia (R Sahathevan PhD); Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia (R Sahathevan PhD); Marshall University J Edwards School of Medicine, Huntington, WV, USA (J R Sanabria MD); Case Western Reserve University, Cleveland, OH, USA (J R Sanabria MD); IIS-Fundacion Jimenez Diaz, Madrid, Spain (M D Sanchez-Niño PhD); Universidad Ciencias Aplicadas y Ambientales, Bogotá, Colombia (R Sarmiento-Suarez MPH); University of KwaZulu-Natal, Durban, South Africa (Prof B Sartorius PhD); Marshall University, Huntington, WV, USA (M Sawhney PhD); Swiss Research Institute of Public Health and Addiction (M P Schaub PhD), University of Zurich, Zurich, Switzerland (H G Yebyo MS); Federal University of Santa Catarina, Florianópolis, Brazil (I J C Schneider PhD, D A S Silva PhD); German Cancer Research Center, Heidelberg, Germany (B Schöttker MPH); Institute of Health Care and Social Sciences, FOM University, Essen, Germany (B Schöttker MPH); University of Alabama at Birmingham, Birmingham, AL, USA (D C Schwebel PhD, J A Singh MD); Department of Public Health, An-Najah University, Nablus, Palestine (A Shaheen PhD); Independent Consultant, Karachi, Pakistan (M A Shaikh MD); Indian Institute of Technology Ropar, Rupnagar, India (R Sharma MA); ICMR National Institute of Epidemiology, Chennai, India (U Sharma MPH); Research Institute at Nationwide Children's Hospital, Columbus, OH, USA (J Shen PhD); Department of Public Health Science, Graduate School (Prof M Shin PhD), Department of Preventive Medicine, College of Medicine (S Yoon PhD), Korea University, Seoul, South Korea; Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK (I Shiue PhD); Reykjavik University, Reykjavik, Iceland (I D Sigfusdottir PhD); Brasília University, Brasília, Brazil (D G A Silveira MD); Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India (O P Singh PhD); Institute for Human Development, New Delhi, India (P K Singh PhD); Alcohol and Drug Research Western Norway (J C Skogen PhD), Stavanger University Hospital, Stavanger, Norway (K Søreide PhD); Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa (Prof K Sliwa PhD), Department of Psychiatry (Prof D J Stein PhD), University of Cape Town, Cape Town, South Africa (D A Watkins MD); Instituto de Investigación Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Cátedra UAM-Linde, Palma de Mallorca, Spain (Prof J B Soriano PhD); Department of Clinical Neurological Sciences, Western University, London, ON, Canada (L A Sposato MD); Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia (C T Sreeramareddy MD); Attikon University Hospital, Athens, Greece (V Stathopoulou PhD); University of East Anglia, Norwich, UK (Prof N Steel PhD); South African Medical Research Council Unit on Anxiety & Stress Disorders, Cape Town, South Africa (Prof D J Stein PhD); Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway (Prof T J Steiner PhD, Prof L J Stovner PhD); Department of Dermatology, University Hospital Muenster, Muenster, NRW, Germany (S Steinke DrMed); Norwegian Advisory Unit on Headache, St Olavs Hospital, Trondheim, Norway (Prof L J Stovner PhD); Alexandra General Hospital of Athens, Athens, Greece (K Stroumpoulis PhD); Centre Hospitalier Public du Cotentin, Cherbourg, France (K Stroumpoulis PhD); Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (B F Sunguya PhD); Indian Council of Medical Research, New Delhi, India (S Swaminathan MD); Departments of Criminology, Law & Society, Sociology, and Public Health, University of California, Irvine, Irvine, CA, USA (Prof B L Sykes PhD); Department of Medicine, University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain (Prof R Tabarés-Seisdedos PhD); WSH Institute, Ministry of Manpower, Singapore, Singapore (J S Takala DSc); Tampere University of Technology, Tampere, Finland (J S Takala DSc); Chaim Sheba Medical Center, Tel Hashomer, Israel (Prof D Tanne MD); Tel Aviv University, Tel Aviv, Israel (Prof D Tanne MD); James Cook University, Cairns, QLD, Australia (B A Tedla BS); Outcomes Research Consortium (A S Terkawi MD), Cleveland Clinic, Cleveland, OH, USA (Prof E M Tuzcu MD); Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia (A S Terkawi MD); Adaptive Knowledge Management, Victoria, BC, Canada (A J Thomson PhD); WorldFish, Penang, Malaysia (A L Thorne-Lyman ScD); Nelson Institute of Environmental Medicine, School of Medicine (Prof G D Thurston ScD), New York University, Tuxedo, NY, USA; National Center for Child Health and Development, Tokyo, Japan (R Tobe-Gai PhD); Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland (R Topor-Madry PhD); Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland (R Topor-Madry PhD); Aristotle University of Thessaloniki, Thessaloniki, Greece (Prof F Topouzis PhD); Hanoi Medical University, Hanoi, Vietnam (B X Tran PhD); Department of Population Sciences and Development, Faculty of Economics and Management, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Z Tsala Dimbuene PhD); African Population and Health Research Center, Nairobi, Kenya (Z Tsala Dimbuene PhD); Department of Medicine, University of Crete, Heraklion, Greece (Prof M Tsilimbaris PhD); Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, CIBERSAM, Barcelona, Spain (S Tyrovolas PhD); Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria (K N Ukwaja MD); Ebonyi State University, Abakaliki, Nigeria (C J Uneke PhD); Warwick Medical School, University of Warwick, Coventry, UK (O A Uthman PhD); National Institute for Public Health and the Environment, Bilthoven, Netherlands (C H van Gool PhD); UKK Institute for Health Promotion Research, Tampere, Finland (Prof T Vasankari PhD); Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore (N Venketasubramanian FRCP); University of Bologna, Bologna, Italy (Prof F S Violante MD); Federal Research Institute for Health Organization and Informatics, Moscow, Russia (S K Vladimirov PhD); National Research University Higher School of Economics, Moscow, Russia (Prof V V Vlassov MD); National Institute for Occupational Safety and Health, Washington, DC, USA (G R Wagner MD); Uniformed Services University of Health Sciences, Bethesda, MD, USA (Prof S G Waller MD); McGill University, Montreal, QC, Canada (S Weichenthal PhD); Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway (E Weiderpass PhD); Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway (E Weiderpass PhD); Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland (E Weiderpass PhD); German National Cohort Consortium, Heidelberg, Germany (R Westerman PhD); Department of Infectious Disease Epidemiology and Modelling (R A White PhD), Norwegian Institute of Public Health, Oslo, Norway (M Savic PhD, Prof V Skirbekk PhD); Centre of Evidence-based Dermatology, University of Nottingham, Nottingham, UK (Prof H C Williams DSc); South African Medical Research Council, Cape Town, South Africa (Prof C S Wiysonge PhD); National Institute for Health Research Comprehensive Biomedical Research Centre, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK (Prof C D Wolfe MD); St Paul's Hospital, Millennium Medical College, Addis Ababa, Ethiopia (M Wubshet PhD); St John's Medical College and Research Institute, Bangalore, India (Prof D Xavier MD); Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China (Prof G Xu PhD); Global Health Research Center, Duke Kunshan University, Kunshan, China (Prof L L Yan PhD); Department of Preventive Medicine, Northwestern University, Chicago, IL, USA (Y Yano MD); Social Work and Social Administration Department and The Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China (Prof P Yip PhD); Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan (N Yonemoto MPH); Jackson State University, Jackson, MS, USA (Prof M Z Younis DrPH); Department of Epidemiology and Biostatistics, School of Public Health (Prof C Yu PhD), Global Health Institute (Prof C Yu PhD), Wuhan University, Wuhan, China; University Hospital, Setif, Algeria (Prof Z Zaidi PhD); Faculty of Medicine, Mansoura University, Mansoura, Egypt (Prof M E Zaki PhD); Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany (Prof H Zeeb PhD); Red Cross War Memorial Children's Hospital, Cape Town, South Africa (L J Zuhlke PhD).

Christopher J L Murray and Theo Vos prepared the first draft. Alan D Lopez and Christopher J L Murray conceived the study and provided overall guidance. All other authors provided data, developed models, reviewed results, initiated modelling infrastructure, and/or reviewed and contributed to the report.

Bruce Bartholow Duncan and Maria Inês Schmidt have received additional funding from the Brazilian Ministry of Health (Process No 25000192049/2014-14). Itamar S Santos reports grants from FAPESP (Brazilian public agency), outside the submitted work. Carl Abelardo T Antonio reports grants, personal fees and non-financial support from Johnson & Johnson (Philippines), Inc, outside the submitted work. Cyrus Cooper reports other from Alliance for Better Bone Health, other from Amgen, other from Eli Lilly, other from GSK, other from Medtronic, other from Merck, other from Novartis, other from Pfizer, other from Roche, other from Servier, outside the submitted work. Walter Mendoza is currently employed by the Peru Country Office of the United Nations Population Fund, an institution which does not necessarily endorse this study. Donald S Shepard would like to acknowledge grant support from Sanofi Pasteur. Rafael Tabarés-Seisdedos and Ferrán Catalá-López are supported in part by grant PROMETEOII/2015/021 from Generalitat Valenciana, and Rafael Tabarés-Seisdedos is supported by the national grant PI14/00894 from ISCIII-FEDER. Walter Mendoza is currently employed by the Peru Country Office of the United Nations Population Fund, an institution which does not necessarily endorse this study. Veena J Iyer has received a Public Health Research Initiative Fellowship (2014-17) from the Department of Science and Technology (DST) for a project titled “Relationship between Enteric Fever incidence and Climate in the city of Ahmedabad, 1990–2014”. Pablo M Lavados reports grants, personal fees and non-financial support from BAYER, non-financial support from Boehringer Ingelheim, grants and personal fees from AstraZeneca, grants from CONICYT, and grants from The George Institute for Global Health, outside the submitted work. Noela M Prasad reports and is an employee of an international NGO that raises funds from the Australian Public, and holds a honorary position at CERA, which receives Operational Infrastructure Support from the Victorian Government. Bradford D Gessner reports grants from Crucell, GSK, Hilleman Labs, Novartis, Pfizer, Merck, and Sanofi Pasteur, outside the submitted work. Ai Koyanagi's work is supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII - General Branch Evaluation and Promotion of Health Research - and the European Regional Development Fund (ERDF-FEDER). Dorairaj Prabhakaran reports grants from the Bill & Melinda Gates Foundation. Matthias Endres reports that The Center for Stroke Research Berlin has received institutional funding from the German Ministry for Research and Education (BMBF). Katharine J Looker has received funding from the World Health Organization for the HSV-2 seroprevalence review which informs this work; during the study, KJL also received separate funding from the World Health Organization, USAID/PATH, Sexual Health 24 and the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Evaluation of Interventions at the University of Bristol; these funders had no role in the writing of the manuscript nor the decision to submit it for publication, and the views expressed in this Article do not necessarily represent the views, decisions or policies of the World Health Organization, the NHS, the NIHR, the Department of Health or Public Health England. Donal Bisanzio is supported by Bill and Melinda Gates Foundation (#OPP1068048). Thomas Fürst has received financial support from the Swiss National Science Foundation (SNSF; project no P300P3-154634). Rodrigo Sarmiento-Suarez receives institutional support from Universidad de Ciencias Aplicadas y Ambientales, UDCA, Bogotá Colombia. Ronan A Lyons is supported by two grants: The Farr Institute of Health Informatics Research: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates), and The Wellcome Trust. Grant No MR/K006525/1, and the National Centre for Population Health and Wellbeing Research. Health and Care Research Wales. Stefanos Tyrovolas's work is supported by the Foundation for Education and European Culture (IPEP), the Sara Borrell postdoctoral programme (reference no CD15/00019 from the Instituto de Salud Carlos III (ISCIII - Spain) and the Fondos Europeo de Desarrollo Regional (FEDER). Manami Inoue is the beneficiary of a financial contribution from the AXA Research fund as chair holder of the AXA Department of Health and Human Security, Graduate School of Medicine, The University of Tokyo from Nov 1, 2012; the AXA Research Fund has no role in this work. Sinead M Langan holds an NIHR Clinician Scientist Fellowship (NIHR/CS/010/014); the views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. Scott Weichenthal acknowledges financial support from the Cancer Research Society of Canada. Yogeshwar Kalkonde is a Wellcome Trust/ DBT India Alliance Intermediate Fellow in Public Health. John J McGrath received a NHMRC John Cade Fellowship (APP1056929). Sarah Derrett reports grants, personal fees, non-financial support and other from EuroQol Research Foundation, outside the submitted work. Dan J Stein reports personal fees from Lundbeck, personal fees from Novartis, personal fees from AMBRF, grants from NRGF, personal fees from Biocodex, personal fees from Sevier, grants from MRC, personal fees from SUN, and personal fees from CIPLA, outside the submitted work. Tea Lallukka reports funding from The Academy of Finland, grant #287488. Charles D A Wolfe's research was funded and supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author (s) and not necessarily those of the NHS, the NIHR, or the Department of Health. The other authors declare no competing interests.