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Out of Alignment? Limitations of the Global Burden of Disease in Assessing the Allocation of Global Health Aid

机译:不对齐?全球疾病负担在评估全球卫生援助分配中的局限性

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摘要

The Global Burden of Disease (GBD) project quantifies the impact of different health conditions by combining information about morbidity and premature mortality within a single metric, the Disability Adjusted Life Year. One important goal for the GBD project has been to inform decisions about global health priorities. A number of recent studies have used GBD data to argue that global health funding fails to align with the GBD. We argue that these studies’ shared assumption that global health resources should ‘align’ with the burden of disease is unfounded and has troubling implications. First, since the allocation of resources involves difficult trade-offs between different, potentially competing goals, any ‘misalignment’ of allocation and disease burdens need not necessarily indicate that the allocation of funds fails to meet recipient countries’ needs or interests. Second, using alignment as a baseline implicitly makes controversial assumptions about how harms of different magnitudes affecting different numbers of individuals should be aggregated. We discuss two alternative ways in which GBD data could help inform decisions about resource allocation, neither of which gives more than a limited role to GBD data.
机译:全球疾病负担(GBD)项目通过在单个指标(残疾调整生命年)中结合发病率和过早死亡率的信息,量化了不同健康状况的影响。 GBD项目的一个重要目标是为全球卫生优先事项的决策提供依据。最近的许多研究已经使用GBD数据来论证全球卫生资金未能与GBD保持一致。我们认为,这些研究的共同假设是,全球卫生资源应与疾病负担“保持一致”,这是没有根据的,并且具有令人不安的含义。首先,由于资源分配涉及不同的,可能相互竞争的目标之间的艰难权衡,因此分配的任何“错位”和疾病负担都不一定表明资金分配不能满足受援国的需求或利益。其次,使用一致性作为基准隐含地提出了关于如何汇总影响不同人数的不同程度危害的争议。我们讨论了GBD数据可以用来帮助做出有关资源分配决策的两种替代方法,这两种方法都不会对GBD数据起有限的作用。

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