IHME’s Global Health Insights

Delivering scientific evidence through the NUS-IHME Global Burden of Disease Research Centre

The NUS-IHME Global Burden of Disease Research Centre is a new regional hub to serve as a key analytical engine for Southeast Asia and the surrounding region by delivering scientific evidence that its leaders can translate into policy. We discuss the Centre with IHME Director Dr. Christopher Murray and Professor Chong Yap Seng, Dean of NUS Medicine, the Yong Loo Lin School of Medicine at the National University of Singapore.
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Transcript:
Rhonda Stewart: Welcome to Global Health Insights, a podcast from IHME, the Institute for Health Metrics and Evaluation. I’m Rhonda Stewart.
 
In this episode, we’ll hear from IHME Director Dr. Christopher Murray and Professor Chong Yap Seng, Dean of NUS Medicine, the Yong Loo Lin School of Medicine at the National University of Singapore. They discuss an exciting new collaboration, the NUS–IHME Global Burden of Disease Research Centre.
 
This is a new regional hub to serve as a key analytical engine for Southeast Asia and the surrounding region by delivering scientific evidence that its leaders can translate into policy. Southeast Asian countries are home to nearly 1 in 10 people worldwide and face a variety of health challenges driven by a rapidly aging population, changing disease patterns, and the growing health impacts of climate change. Yet within the region, many lack critical data and insight that would help local leaders allocate resources more efficiently, target inequities, and operate proactively rather than reactively, particularly during an outbreak or a pandemic. The Centre will study a range of issues, including antimicrobial resistance or AMR, metabolic risks, women’s health, and dietary and lifestyle factors.
 
Professor Chong and Dr. Murray, thank you so much for being with us on the podcast. Let’s talk first about how the new NUS–IHME Global Burden of Disease Research Centre came about. What was the impetus for launching the Centre? And Professor Chong, let’s start with you.
 
Professor Chong Yap Seng: Thanks, Rhonda. I think it’s a matter of admiration, friendship, and persistence that got this Centre started. I’ve been a great fan of the Global Burden of Disease study for a long time, and the work of IHME. One of their former faculty, Associate Professor Marie Ng, joined NUS Medicine a few years ago, and in 2023 or 24, she introduced me to Stephen Lim from IHME. We got along very well, and there was great interest for us to work together because I’ve been a great fan of the Global Burden of Disease study.
 
And then we persisted to discuss more and more details, and in November 2024, we signed a memorandum of understanding between NUS Medicine and IHME to work on creating a joint center. And then from there it grew and gained momentum. And in February this year, we actually launched the Centre.
 
So as I said, because we respected the work of IHME so much, we had great friends – Marie Ng with IHME, and then meeting Stephen, and then Emmanuela [Gakidou], and then finally Chris [Murray]. And we persisted and overcame all the hurdles that came in the way, and that’s how the Centre got started.
 
Rhonda Stewart: Wonderful. And Dr. Murray, what would you like to add about partnering with NUS?
 
Dr. Christopher Murray: Well, I think this was a very exciting opportunity for us. NUS is one of the leading universities in the world. And so given Marie’s history with us and her energy and Yap Seng, the willingness to foster and catalyze this sort of collaboration, this is just great. I mean, we want to be working with the best institutions in the world. And here’s this fantastic opportunity for us to be able to work with NUS and particularly the School of Medicine. So this was really simple from our point of view.
 
Rhonda Stewart: And the Centre will focus on Southeast Asian countries. Let me ask you both, why is this region particularly important to study?
 
Professor Chong Yap Seng: Okay. From my point of view, I would say that Southeast Asia is not an area that has been well studied by many people, including the region’s own investigators. And it’s an important region that’s almost 700 million people and growing quite rapidly – so I think increasingly important in terms of population and economic activity, and also an area that’s subject to a different set of diseases than you might see in other parts of the world. So a different kind of emerging infectious diseases, issues brought on by climate change, which particularly hits this area hard. So we have quite a lot of natural disasters, and of course, more than half of the population here stay in urban centers. So we are facing all these urban issues that are happening at an incredible pace. One of the big issues affecting this part of the region is our declining fertility, declining total fertility rate. So Hong Kong, Taiwan, South Korea, Singapore are probably some of the countries with the lowest total fertility rates. And this brings up a lot of questions, especially regarding women’s health as well. So I think it’s important to focus on this region to start to understand what the problems are so that we can deal with them with a strong base of data.
 
Rhonda Stewart: Dr. Murray, obviously, in the Global Burden of Disease study, that work covers regions all over the world. And so you have a perspective on the unique challenges in each region. What would you say is particularly important to study in Southeast Asia as a region?
 
Dr. Christopher Murray: You know, as Yap Seng said, this is a region that has had – I mean, there’s a lot of diversity within the region – but on average, incredible economic growth. It has been undergoing this very rapid epidemiological transition. It still has a number of diseases like dengue, let’s say, that we don’t have much in other regions, or much less.
 
But the shift from the pattern dominated by communicable, maternal, and neonatal causes toward the non-communicable diseases is very rapid. I think that puts a lot of stress on health systems in the region, and it means that these sorts of analyses that can be done through the Centre can be really helpful in both identifying the sort of unique diseases in certain countries, but just how do you manage this change?
 
You have countries with really high smoking rates in the region as well as places that are much less. The obesity epidemic is unfolding pretty quickly in some parts of it. So it’s sort of an advanced version that other regions will probably end up looking like as we go ahead a few decades, just because of the economic trajectory that’s been underway.
 
Rhonda Stewart: You both mentioned some of the different health issues and trends in the region – fertility, women’s health, NCDs. When you think about the pace of change – what are some of the most urgent or pressing issues to examine first?
 
Professor Chong Yap Seng: Well, I think as Chris mentioned, this region is unique in the sense that it’s undergone such quick socioeconomic transition. So just take Singapore, for example. We are only going to be 61 years old this year as a nation, and we’ve gone really in that time from 1965 and now from third-world to first-world very, very quickly.
 
So I think former agricultural-based economies in this region have now mostly gone into more industry and then technology-led sort of economies. And that’s going to put a huge strain on issues like obesity, diabetes, hypertension – all those things are rising very fast. And because this region hasn’t had that long history of health surveillance or public health agencies that have been very careful in monitoring the situation, we have fallen far behind in that respect. And so bringing in the methodology and precision of the Global Burden of Disease study work to this region is something that’s really important for governments to make rational decisions about where to invest in the public health structures.
 
So I think this is something that is very timely for the region. And with modern technology, AI, and digital data sources becoming increasingly available, this is really the best time to start to leverage this capability that IHME has.
 
Rhonda Stewart: How do you balance the challenge of assessing health trends at the broader regional level while taking into account issues that are specific to each country in the region? So obviously, in a region of this size, not all countries are the same. They don’t all experience health issues and trends in the same way. So how do you strike that balance of regional and country-specific analysis?
 
Professor Chong Yap Seng: Well, okay, I’ll start off first. So I would say that for example, Singapore – the Ministry of Health has worked with IHME for some time and have used the data specifically for Singapore to understand just what’s happening in Singapore. But this is something that not many of the other countries in this region have done.
 
So I think it’s timely that this Centre is set up so that we can start to help train the people in the region and expose them to the methodologies that have been developed by IHME so that other countries can start to use the kind of work IHME does to get better data about themselves. So I think it’s important both to study the region as a whole because of course the fact that it’s big and growing both in population and economic activity, and also to help countries to deal with the problems that they have within their own borders.
 
Rhonda Stewart: And Dr. Murray, how do you see that?
 
Dr. Christopher Murray: Yeah, I would just add to that that I think the value of both the country-specific work, which you obviously have to do if you’re going to inform local decision-making, local priorities. But having the ability to benchmark across countries in the region using very standardized methods is really helpful because I think it’s much easier to make a compelling case for change in a country looking to somebody in the region – looking to your neighbors essentially to say, yeah, it’s possible, look what’s being done in Singapore or look what’s being done in Vietnam, wherever you’re looking – that’s a more convincing story to say, let’s learn lessons across nations in the region. So I think that regional and of course country-specific efforts really reinforce each other to a very large extent. And I think that’s a great model for the future.
 
Rhonda Stewart: Obviously we live in a time of resource constraints with vast changes to development assistance for health. And so why is this type of collaboration across institutions so important? It would be very easy for IHME to operate on its own or NUS to operate on its own. But in terms of the collaborative model, why is that so important at this particular time?
 
Professor Chong Yap Seng: Well, for Singapore and NUS, I think it’s important because from the point of knowledge transfer, instead of trying to develop all these methodologies ourselves, we can learn from the best.
 
Dr. Christopher Murray: Right.
 
Professor Chong Yap Seng: So I think UW and IHME are the leading people in this field, and so working with them collaboratively and collegially is probably the most efficient way of bringing the methodology to this region.
 
And as you mentioned earlier, I think the region, they’re not equal in terms of resources. So having Singapore as a base to start to have this methodology is a good way to bring it to this part of the world. And one of the missions of this Centre is to train people in the region so that instead of having to go all the way to America, they can just come to Singapore, or we can go to the surrounding regions to spread the knowhow. And I think that’s something that will benefit both the region, Singapore, as well as IHME eventually.
 
Dr. Christopher Murray: You know, for quite some time now on the Global Burden of Disease front, we have been building up a network of individual researchers. We have 19,000 in the GBD network. And I think what’s really important for us now with this collaboration with the School of Medicine at NUS is adding to this large pool of individuals, this institutional relationship where we can hopefully take advantage of the incredible depth of talent and skill at NUS and bring that to bear on the countries in the region – training, research, policy uptake – in a way that will be a real addition to the collection of the many individuals that have been working with us. And the other thing for me is that I’m a huge believer that we all improve if we challenge each other. And if we can get people scrutinizing what’s done, we’re going to end up doing a better job at IHME as well. It’s really a two-way street in my mind. So all those reasons are part of why I think this will be a real success.
 
Rhonda Stewart: Dr. Murray, you mentioned policy uptake. So how do both of you hope that policymakers and other decision-makers might use the Centre’s work?
 
Dr. Christopher Murray: Well, I can start and then Yap Seng can close. I’m really keen to see, in addition to the description of the state of health in a country of the region and what are the risk factors and what are the diseases and injuries getting worse or better – I’m very keen to see more use of forecasting, bringing out what might the future look like if you pursue different policy strategies? Because I think that can be a very powerful tool, whether you’re a rich country like Singapore or a less rich country like Laos.
 
I think the scenario building task can be really useful as a vehicle for bringing the evidence and science to the decision-maker. And I think this is a region where there’s enough sophistication in government that there’ll be an audience for that type of work.
 
Professor Chong Yap Seng: Yes. And to add on to that I would say Singapore’s policymakers are very much data-driven and very long-sighted in terms of their planning. So having good data of the kind that IHME provides, I think it’s critical for us to make the right decisions.
 
So as I said, Singapore Ministry of Health has worked with IHME for some time, and I think having that Centre in Singapore will now lend them increased acuity in terms of looking at all the various problems that are present in Singapore.
 
And of course, we learned from COVID-19 that no one country can be sufficient on its own. You have to work with your neighbors to ensure health security for all. And I think that’s one of the reasons why we do want to spread the knowhow in the region to make sure that everybody has good access to data. And I think the policymakers in this part of the world will definitely value this data and act on it.
 
So I think from a policy point of view, for me that is one of the main deliverables. We are not looking for more publications and things like that. I think what we really want is to see how the data can guide policymakers to create impact in the region. And I think some of the new ideas that Chris has just brought up about forecasting are incredibly exciting to me, because I think the world is changing so fast, the governments have to really plan.
 
Rhonda Stewart: Wonderful. And before we wrap up, is there anything else that either of you would like to share about the new Centre?
 
Dr. Christopher Murray: I mean, from my point of view, we’re really appreciative of the support from NUS and to see this Centre get over the finish line and looking forward to many years of working closely together.
 
Rhonda Stewart: Great. Well, thanks so much to you both. Details about the new NUS–IHME Global Burden of Disease Research Centre can be found at healthdata.org.
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An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health. Learn more about IHME.
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How health systems and social determinants of health can guide policy

IHME Director Dr. Christopher Murray and UCLA Chancellor Dr. Julio Frenk discuss The Lancet Commission on Health Systems Performance Assessment and how the information will allow policymakers and other decision-makers to use resources strategically and improve health outcomes.
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Transcript
Rhonda Stewart: Welcome to Global Health Insights, a podcast from IHME, the Institute for Health Metrics and Evaluation. I’m Rhonda Stewart.
 
In this episode, we’ll hear from IHME Director Dr. Christopher Murray and UCLA Chancellor Dr. Julio Frenk as they talk about the Lancet Commission on Health Systems Performance Assessment. The Commission’s work builds on a report by the World Health Organization in 2000 that analyzed and ranked the performance of health systems in WHO member states.
 
In the quarter century since the WHO report, the need to understand health systems performance has become more complex and more urgent. Disease burden has evolved along with health expenditure. Globally, low-, middle-, and high-income countries face unique challenges as well as challenges that cut across all countries.
 
The Commission is made up of experts from around the world. It will estimate the performance of countries’ health systems using the best available evidence and propose enhanced measurements of health system functions and goals. The information will allow policymakers and other decision-makers to use resources strategically and improve health outcomes.
 
Dr. Frenk and Dr. Murray, people are familiar with the components of a health care system, but what makes a health system broader, and what are those specific components?
 
Dr. Julio Frenk: Well, the health care system is a subsystem of the larger concept of the health system. Specifically, what most people come in contact with on a daily basis and as part of their personal experience is the health care system. Most people in the world today are born in contact with the health care system, will die in contact with the health care system, and will spend significant parts of their lives in the health care system.
 
What that refers to is the set of institutions that are mostly charged with providing what is conventionally defined as health services or personal health services or clinical services. The health system encompasses a broader set of institutions and actors and actions which we basically define as all those actors and institutions in a society whose primary intent is to improve health. And that includes most of the entities we call the health care system, hospitals, clinics, labs, the pharmaceutical industry, et cetera, et cetera. But it includes a broader set of institutions that are concerned with conserving, promoting, or improving health in a society.
 
Rhonda Stewart: Dr. Murray, anything to add on the components of a health system?
 
Dr. Christopher Murray: Well, there’s always a contingent of people who rightly point out that there are drivers of health like educational attainment, whose primary intent is not to improve health, but happen to be super important drivers. So the notion of the health system defined by primary intent does not deny the idea that there are broader social determinants of health. It just says there are these institutions in society who we have funded and created whose primary purpose is to improve health. And it is useful for us to look at that cluster of institutions and figure out who does well and what lessons we can learn about those primary institutions that are focused on improving health.
 
Rhonda Stewart: And in addition to educational attainment, are there other factors that are not technically part of a health system but influence health systems?
 
Dr. Julio Frenk: Yeah, there’s all kinds of what are called social determinants of health, which are other institutions. I mean, the economy, the economic forces, employment is a determinant of health, and housing is a determinant of health. But the purpose of housing is not directly to improve health, it is a determinant. When we talk of the health system as larger than the health care system, we’re talking mostly about other services that are not conventionally part of or even administratively part of the health care system. For example, a lot of what we do in public health, like the provision of clean water and sanitation, or some actions to improve the environment – because the primary intent of those actions is to improve health, they are part of the health system. There are also determinants of individual health status for the individuals that form that population.
But that’s distinct and different than the education or employment or housing that are outside of the health system, although they exert a determination on the health of a community and of the individuals that comprise that community.
 
Rhonda Stewart: And tell us, both of you, what prompted the creation of the Lancet Commission on Health Systems Performance Assessment?
 
Dr. Julio Frenk: Well, let me say it was 25 years ago, a quarter of a century since the World Health Report 2000 was published. And a lot has happened in these 25 years.
 
Now that World Health Report 2000 did two things. It developed a very, I think, well thought through conceptual framework to understand what is a health system, what are the goals of health systems, what are health systems for, what are the functions that a health system has to perform to achieve its goals, and how do you define and measure performance? It was a very clearly articulated conceptual framework that’s been quite influential. Associated with the framework, the framework was translated into a measurement exercise that was carried at WHO by a new area that was created since Dr. Gro Brundtland became the Director-General in 1998 called Evidence and Information Policy that I was leading. And then within that, we have the Global Program on Evidence that Chris Murray was leading.
 
And Chris’s team orchestrated or developed a set of measurements and implemented those. And for the first time, the health system performance of all 192, I believe, was the number of member states of WHO back then – all of those were assessed and compared to produce some rankings that were highly debated, very controversial in many parts of the world, but it was the first rigorous attempt to measure and compare the performance of health systems.
 
Nothing of that scope has been carried out in this quarter-century, and yet the reality of health systems around the world has been transformed profoundly. So it’s, I think, an exercise that’s overdue to now rethink the conceptual framework, see if there are adjustments that are needed with everything that’s happened, including for example, the appearance of artificial intelligence as a major technological development and societal development, and also to try to again attempt a measurement. In the intervening 25 years, both the datasets and the analytical tools to apply to those datasets have improved enormously.
 
So we thought this is a great time to carry out again a comprehensive assessment of the performance of health systems that encompasses the entire world. There have been other assessments, but they are focused on subsets of countries. And this would be the second time that such an exercise for all countries of the world would be carried out.
 
Dr. Christopher Murray: Yeah, I think there’s, as Julio said, much better data, much better methods. But it’s also pretty timely to look at health system performance because we’ve gone through this big shock in 2025 in global health where funding was abruptly cut for a number of low-income countries due to the reductions of USAID and a number of European donors. And that’s reignited the interest globally, and in in fora with ministers of health, are there lessons you can learn about how to better organize health systems to get more health for the money, as Julio has often described in the past? So I think both the possibility of doing a much better empirical assessment and the interest – there’s a willing audience out there for whatever insights are possible in how to deliver both public health and health care more effectively, more efficiently.
 
Rhonda Stewart: Let’s talk about some of the specific challenges that face different types of countries. And let’s talk first about health systems challenges in high-income and middle-income countries. What are some of those challenges?
 
Dr. Julio Frenk: Well, there’s a huge number of challenges on the evolution of the health conditions of populations. First of all, the aging of populations has been for about a century changing the epidemiologic profile. And now we really have a very mixed bag of health challenges, both in terms of communicable diseases – some people had predicted that with the rise of non-communicable diseases, we would see communicable or infectious diseases become irrelevant. Clearly, if we needed any reminder, the COVID-19 pandemic just reminded us that infectious diseases are not going anywhere. They’re there. They continue to be a threat not just as outbreaks or pandemics, but as comorbidities of chronic illnesses and as problems in and of themselves aggravated by phenomena such as antimicrobial resistance.
 
So the nature and the complexity of health conditions in populations have continued to evolve and are extremely complex because they demand interventions that are in general much more costly, and that adds pressure. And the demand side for services is just increasing throughout all countries in the world, but particularly in high- and middle-income countries. High-income countries in particular also face, and middle-income countries as well, fiscal crises of different magnitudes and natures. We’re still feeling the after-effects of the pandemic in terms of inflation and budget constraints from all the stimulus that was mobilized to deal with the economic consequences of the pandemic. And then there are longer-term structural forces in the economy.
 
And then we’re living in times of huge polarization. So measures like public health are being undermined, like public health measures. We are seeing growing vaccine skepticism. We’ve seen basic public health measures like wearing protective face covers during an epidemic become the subject of political debate. We didn’t have that, at least not to this extreme, before the pandemic. I think the pandemic really triggered a number of challenges. They affect all countries in the world, but high-income countries and middle-income countries are certainly not exempt from those. And there are others that I’m sure Chris can add.
 
Dr. Christopher Murray: Yeah, I would add to Julio’s list there two long-term, broad drivers of health challenge that many systems need to take on.
 
The first is quite universal, and that’s the rise of obesity, where we see in any of the forecasts that we tend to make that becoming an enormous determinant of ill health in the future. It’s rising everywhere. And so nobody’s really figured out a formula to put the brakes on increases in obesity.
 
And then the second one, which is much more specific to certain localities, unfortunately very often the lowest-income localities, is rising temperature, where we know that there’s an intersection between temperature and a number of chronic conditions – heart disease, diabetes, kidney disease. And that interacts with obesity, so that we expect to see really big increases in quite expensive disorders like chronic kidney disease and diabetes in many parts of the world that will tax the available resources to deliver meaningful care.
 
So again, back to that theme, that there is this rising recognition that demand for care is going to outstrip the ability of governments, in particular, to deliver services that the public expects. And I think that creates lots of social and political pressure on health systems to perform better.
 
Rhonda Stewart: And Dr. Murray, you just referred to low-income countries, and those countries do face some specific challenges, some challenges that are slightly different or very different in some cases than the challenges faced by high-income or middle-income countries. So what are some of those specific challenges for health systems in low-income countries?
 
Dr. Christopher Murray: Well, I’ll jump in first and let Julio respond. Remember, in the lowest-income countries, we still have really quite rapid population growth. So governments with very modest resources, less than they had before because of the reductions in development assistance for health, have to provide or attempt to provide services for a rapidly growing population. The most extreme case is the Sahel, where over the next one or two generations we will see multiples of the population increase in places that are already poor and have sort of marginal prospects for growth in income per capita. And what that means is that they will face the sort of ongoing challenges of the infectious diseases characteristic of the poorest places – malaria, pneumonia, diarrhea, others, TB, depending on where, HIV.
 
There’s been a lot of progress on those diseases due to development assistance for health. Now that those monies are reduced, there’s very little fiscal space in low-income countries to replace that money with their own resources. So we’ll be back to this theme – why do some countries in the low-income world, are they able to deliver the same service at a fraction of the cost of a neighboring country? And if can we learn from that and share those results so that you can see more service delivery achieved with the limited resources that are available?
 
Dr. Julio Frenk: And I would just add that we’re actually seeing major reversals of challenges that we were on the path of overcoming. And this is across the board – they’re more acute in low-income countries, but you see them in middle- and even in high-income countries. To give just one concrete example, my own country of Mexico is experiencing an epidemic of an outbreak of measles that has already led to children dying from measles. So before 2025, the last death from measles in Mexico occurred in 1995. There had been no deaths in 30 years. So after 30 years of sustained progress, thanks to massive vaccination campaigns, we now see the reappearance.
 
There are concerns in the United States of a reappearance of polio cases because there’s still polio around the world and with reduced vaccination. So you’re seeing not just challenges that arise from progress – you know, the fact that countries become wealthier and reduce their fertility and that leads to aging of the population. That’s actually a movement that has consequences for health systems, but it’s positive.
 
They’re also side by side with situations where we could say that we are victims of our own success. We are now seeing the backward movements in those successes and the re-emergence of problems that we thought had been controlled or we were very near to controlling, like the example of vaccine-preventable diseases. And that really poses a set of challenges. We were almost now unaccustomed to those issues. They were no longer part of our dashboard of concerns. And now all those red lights are turning on again after decades when they were pretty much subdued.
 
And I believe overall, I would reiterate that the polarization, the rise of populist governments who doubt science, that is probably the biggest challenge. And health systems, one of their most important impacts on societies is to produce evidence to guide people making decisions. And that includes decisions at the household level, like whether to vaccinate or not. And that is a challenge for health systems to actually elevate the health literacy of the population and avoid the sort of nefarious forces of voices that sometimes from the highest position of government are doubting the benefits of scientific research and lifesaving measures like vaccines.
 
Rhonda Stewart: Those are some very sobering developments that you mentioned, Dr. Frenk. Going back to the Lancet Commission, can you both give us an idea of the subject area expertise on the Commission and the geographic representation on the Commission?
 
Dr. Julio Frenk: Go ahead, Chris.
 
Dr. Christopher Murray: Yeah, we fortunately have a Commission of experts from every region of the world, a number of people who’ve published extensively on health system performance or health systems more generally, a number of current and past health system leaders, ministers of health, secretaries of health in the mix, and I think some people that have dug deeply into certain functions, as Julio mentioned, of health systems, like human resources, or on primary care and its role in making a well-functioning health system.
 
We have people from the major agencies, WHO, the World Bank, that have been very engaged over time in trying to foster improvements in health systems or investments in health systems. It’s a mixture of expertise from around the world that hopefully will trigger lots of vigorous debate, because I’m sure we don’t all agree on what are the biggest weaknesses in health systems and how we can address them.
 
But it’ll be a group, I hope, that shares the idea that we should foster the evidence building and share that evidence – like 25 years ago, but done much, much better, to be a stimulus to looking at health systems. We’ve gone through successful decades that have been very disease- or intervention-focused in the global health arena. And I think because of the budget cuts around the world or the perception of demand outstripping the available resources, we’re in a window where there’s a lot more interest in the system part in addition to the disease-, risk-, or intervention-specific issues that global health has largely focused on since the MDG [Millennium Development Goal] era started.
 
Rhonda Stewart: What will be the duration of the Commission’s work, and what will the Commission produce?
 
Dr. Christopher Murray: Well, like every Lancet Commission out there, the duration is a little bit a function of how much we both forge consensus across the group and stimulate a parallel set of research that will feed into the report.
 
And let me pass it over to Julio. I expect that in addition to the main report, which would be in two to three years, there’ll be a number of spinoff types of research articles and other types of communications targeting health system leaders that would follow from forging a new consensus around health system performance and what lessons can be learned to share more broadly. But I hope, Julio, that sounds about right to you.
 
Dr. Julio Frenk: Absolutely. You know, I think it’s important just to place this particular Commission in the context of what’s really been one of the most innovative aspects of an incredibly innovative leadership of The Lancet under Richard Horton, which have been this figure of Lancet Commissions. I participated in, I think, the second or third Lancet Commission, and that was around the year 2010. So we’ve seen now for a little bit more than 15 years, just the figure of Lancet Commissions flourishing and producing reports that have really been hugely influential.
 
So contrary to the last time, where the first assessment was done within the confines of a multilateral agency, the World Health Organization – the premier health agency in the world, nonetheless subject to a lot of political constraints and dynamics – this time we have much less restrictions on the possibility of pursuing even highly controversial ideas and making an impact.
 
Now, what we need to guarantee as a Lancet Commission is the effective translation of the results into actual impact on policies and practices around the world. And so even though the Commission itself will culminate for sure with what I hope would be a very impactful report like the one in the year 2000 was, this time, just like being in WHO had a constraint for the political dynamics, but it had the advantages that you were closer to the space of translation into policymaking. And we did see countries where actually the framework and the findings of the Commission prompted major health reforms.
 
And of course, I’m not just talking about my own case, since I became the Minister of Health of Mexico shortly after that. And of course, I took everything that we had done with the World Health Report 2000 to a very comprehensive, ambitious health reform. But I’m talking of countries like China who saw the assessment as evidence of the urgent need to reform their health systems. And we saw countries like the United States shocked by the relatively low ranking that went counter to what people were assuming. And again, it didn’t launch the kind of comprehensive reform, but it did lead to some important reforms like the Affordable Care Act. So we need to be planning from the beginning for the afterlife of the Commission. The product of a report is not the end – it’s meant to trigger action and reforms in countries around the world.
 
Rhonda Stewart: And so before we wrap up, let’s talk a little bit more about the actions and reforms that could result from this report. As you both mentioned, we are living in a time of greater political polarization and resource constraints. So how do you hope that this work might have influence and impact on policymakers and other decision-makers?
 
Dr. Julio Frenk: Did you want to start?
 
Dr. Christopher Murray: You know, I hope that the message of getting more health for the available resources is – and presuming that we learn some insights into how to do that – that is one that will transcend the political polarization in some, maybe not all, countries, because it’s hard to champion inefficiency or less health for the money. And if you can learn some of those lessons: Are there architectures for health systems that seem to do better? Are there ways of structuring human resource development and on and on across the different functions of health systems?
 
I think there will be a pretty ready audience in many places for that sort of message. And so, I think this will be a case where the audience is much more in the policy realm probably than strictly in the academic realm, because it is such a salient, urgent topic right now. And I think whether you’re a high-income, middle-income, low-income country health system leader, there’s real interest in how do you, essentially, balance the books, with increasing demand, no expectation of huge increase in resources in many settings.
 
Dr. Julio Frenk: And for me, my hope is that the Commission, first of all, will remind people of the growing importance of health systems. Health systems in the intervening years between the WHO report and today have only increased their share of the global economic product. It is definitely now the health system that is the largest sector of the largest economy in the world, the US economy. But globally, now it represents about 10% of the global economic product, and in every country in the world – just because of the demographic dynamic and the epidemiologic transition – it’s just consuming more and more resources.
 
And the big thing is, to use that famous phrase from Professor Ramalingaswami of India, it’s not just a matter of more money for health, it’s more health for the money. And at a time when we are facing new restrictions that may slow down that growth or even lead to reversals, I think the need to think of what is the value that all of those investments produce and to maximize that value with available resources has just become much more prominent than before. I also hope that the Commission will bring back, front and center, the idea that policy, public policy, while obviously occurring in a political matrix, needs to, in the end, base its fundamental decisions on the best available evidence. That’s an ethos that’s been eroding over the last few years with the erosion of trust in science and in institutions. And I hope we can make a compelling case.
 
Finally, I hope the Commission will also allow policymakers to anticipate some technological developments that offer huge promise. Artificial intelligence is of course the most salient of those, but it also offers huge challenges. There’s no question that well-applied artificial intelligence finds in health, and health care specifically, one of its most promising and beneficial applications. But it’s really going to depend on how we deploy those technologies. It’s happened with every technology. But I think in the case of artificial intelligence, it’s even more important that we actually are able to provide some glimpses into what that technology is.
 
And lastly, alongside that, I hope it will also place front and center the urgent need to close the equity gaps, the disparities that happen within and between countries. Because we have seen in many quarters a loss of focus on closing those gaps. And technologies themselves can widen the gaps, or they can help shorten them. Some technologies, like vaccines, have been the great equalizers when deployed globally. But when vaccines are not deployed in the right way, like during the COVID pandemic, they can deepen inequalities.
 
So technologies need to be placed in that framework of accelerating the realization of the ideal that access to high-quality health services for everyone and with protection against the financial consequences of disease – that access is a fundamental human right. And I hope this work will also help to elevate again the notion of the reason why universal health coverage is a core part of the human rights agenda at a time where all of those fronts – evidence-based decision-making, a commitment to science, and a commitment to closing disparities – when all of those are under attack from different quarters. I think we hope the Commission will make an enlightened contribution to put us back on a path of progress in health which was launched during the 20th century and needs to continue going forward.
 
Rhonda Stewart: Dr. Frenk and Dr. Murray, thank you so much.
 
Dr. Julio Frenk: Well, thank you.
 
Dr. Christopher Murray: Thank you.
 
Rhonda Stewart: Details about the Lancet Commission on Health Systems Performance Assessment can be found at healthdata.org.
___________
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health. Learn more about IHME.
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Global Burden of Disease 2023 is officially released

The Global Burden of Disease Study (GBD) is the most comprehensive assessment of health trends and conditions across countries. GBD provides detailed analysis of disease burden related to life expectancy, non-communicable diseases, mental health, and many other health topics. We discuss the latest GBD with IHME Director Dr. Christopher Murray.
Read the GBD 2023 capstones, published in The Lancet:• Global demographic analysis: http://ms.spr.ly/6047s2bOv• Global causes of death: http://ms.spr.ly/6040s2bOI• Global burden of diseases, injuries, and risk factors: http://ms.spr.ly/6041s2bOLAccess and share all things related to GBD 2023: updated data visualization tools, comprehensive infographics, informative videos, workshops, webinars, and more: https://www.healthdata.org/announcing-launch-gbd-2023-study-results.________________________Transcript
Rhonda Stewart: Welcome to Global Health Insights, a podcast from IHME, the Institute for Health Metrics and Evaluation. I’m Rhonda Stewart. 
 
In this episode, we’ll hear From IHME director Dr. Christopher Murray as he talks about the latest Global Burden of Disease study, also known as GBD.  
 
GBD 2023 is a series of three papers published in The Lancet and presented at the World Health Summit in Berlin. The papers focus on demographic analysis, causes of death, and diseases, injuries, and risk factors. GBD is the largest and most detailed scientific effort undertaken to quantify health trends. GBD provides a unique platform to compare the magnitude of diseases, injuries and risk factors across age groups, sexes, countries, regions, and time. 
 
For decision-makers, the GBD approach provides a unique way to compare countries’ health progress and to understand factors that impact health such as high blood pressure, cancer, and heart disease. 
 
Led by IHME at the University of Washington, GBD is a truly global effort, with more than 16,000 researchers from over 160 countries and territories participating in the most recent update. The latest GBD includes data on topics ranging from life expectancy to mental health to noncommunicable diseases. 
 
Chris, the 2023 Global Burden of Disease study covers three capstones published in The Lancet and presented at the World Health Summit in Berlin. The papers cover demographic analysis, causes of death, and diseases, injuries, and risk factors. 
 
Let’s start by talking about the demographic analysis paper. The global age-standardized mortality rate declined significantly since 1950, but that’s only part of the story. What are some of the other key findings from that paper? 
 
Christopher Murray: Well, in the demographic analysis, there’s both the long-term view of progress in expanding life expectancy that has been quite steady, except for the big interruptions due to the HIV epidemic in sub-Saharan Africa as well as the sort of mortality crises in Eastern Europe and Central Asia that occurred in the late 80s and 90s. 
 
But other than those, up to 2019, we had this sort of pattern of progress that we got used to. Then the COVID epidemic came along: 18 million deaths related to COVID and a big drop in life expectancy, and then it really was even worse in 2021 in many countries. And then it bounced back. And so by 2023, we’ve gone in most places back to 2019 levels, but not back yet to the levels we would have expected if the pandemic hadn’t occurred. So that’s one big part of the story. 
 
Another part is the fact that we’ve seen increases in child and adolescent mortality in some parts of the world, particularly some of the high-income countries – the US and Canada stand out. And then we've seen increases in mortality related to drug use disorders, suicides to some extent, in adults that are more in the 25- to 39-year range. 
 
And then there are some changes in methods and data that we now think that younger adult mortality in Africa is higher than we previously thought and older adult mortality is little bit lower than we previously thought. 
 
Rhonda Stewart: And with the causes of death paper, noncommunicable diseases (NCDs) account for two-thirds of the world’s mortality and morbidity. What are some of the NCDs that are among the top causes and what accounts for this shift from infectious to noncommunicable diseases? 
 
Christopher Murray: Well, the shift, which is really profound, toward noncommunicable disease causes of healthy life lost, which in the GBD we tend to quantify using a measure called disability-adjusted life years, which reflects premature mortality as well as functional health loss, so this sort of notion of loss of healthy life. And those shifts are very noticeable in lower-middle-income countries and upper-middle-income countries. They’re still occurring in low-income as well, but it’s really profound in the middle-income slice of the world. 
 
So that by 2023, at the top of the list of NCDs and causes of burden is ischemic heart disease. And then the next among the NCDs is stroke, and then diabetes and chronic obstructive pulmonary disease. 
 
And then we get into things that cause functional health loss like low back pain, depression, anxiety, 
as other big NCD causes that are going up very substantially. And as we go farther down the list, there are things like lung cancer and chronic kidney disease, Alzheimer’s – these are things that are also going up. 
 
The transition toward NCDs is driven mostly by aging, that the average age of the population gets older in places, mostly because of the declines in fertility. Also, the rates of disease by age have been mostly declining, but declining at a slower rate in the older age groups than population growth. And so you get this more marked shift to NCDs because the rates of progress for the infectious diseases, communicable diseases, as well as maternal and neonatal causes tend to be faster. And so that’s also a contributor to this big transition we’re observing. 
 
Rhonda Stewart: Let’s go back for a second and talk about health loss. So you mentioned health loss and aging. Why is it so important to measure health loss, which is something that other studies really don’t do in the way that GBD does? As people live longer, you’re not necessarily living those years in good health. Why is it important to quantify that? 
 
Christopher Murray: Well, the reason in the 34-year history of the Global Burden of Disease that we’ve always focused on, in addition to reporting standard metrics like death and death rates and causes of death and disease incidence and prevalence, is we roll these up into measures of health loss so that we capture these conditions like mental health disorders, like musculoskeletal disorders, 
like drug use, where most of the effect is reducing people’s functional health and not necessarily increasing death rates. 
 
So if you only focus on death, you’re not going to pay attention to things like anxiety and depression and schizophrenia, or back pain, neck pain, that are quite widely experienced and really have a major effect on people’s life. So that’s why we like to look at health loss. When we do look at health loss, there’s a second component to it, which is we’re saying that if you die at a young age, let’s say from an injury at 25, a road traffic injury, that’s a greater loss of health than if you die at 95 from, let’s say, lung cancer. 
 
So we want to capture both the amount of life that somebody’s lost due to premature death, as well as this dimension of things that cause disability or impairment that don’t necessarily kill you. When you do that, you end up with this more complicated, mixed view of what are the leading causes. They include things like back pain or depression. And they also suggest that as lifespan has increased, 
We’re not making a lot of progress on reducing the number of years that people live with substantial loss of health function. 
 
Rhonda Stewart: Interesting. And let’s talk about risk factors. So the analysis notes that half of the world’s disease burden is not only preventable, but there are almost 100 modifiable risk factors. What are some of those and how do they contribute to disease burden? 
 
Christopher Murray: Well, the biggest sources of burden, of risk factor–attributable burden, 
are a mixture of things that are both behavioral, metabolic, and environmental. At the top is high blood pressure. It’s the number one risk factor around the world. And then that accounts for, as a percent of health loss, more than 8% of all burden is related to high blood pressure. 
 
And then we have, as number two, we have particulate air pollution, both indoor and outdoor, and that’s also slightly over 8% of all burden. And then we fall into a behavioral risk, which is smoking, as number three, and then high blood sugar is number four. Then low birth weight and short gestation, a 
critical risk for neonatal death, comes in at number five. 
Obesity and overweight is number six. And then we get into kidney dysfunction, high cholesterol, 
child growth failure. And interestingly now, which is sort of new for GBD 2023 in the top 10 is lead. 
And that’s a change from previous assessments, that lead is now so prominent. 
 
Rhonda Stewart: Okay, let’s go back for a second to some of the things you mentioned about anxiety and depression. The latest GBD provides really important information on mental health. Tell us about some of those findings. 
 
Christopher Murray: Well, mental health as a share of health loss is going up quite steadily around the world. And there’s a sort of steady rise that started in some countries. We can see that rise starting around 2010. 
 
But there was a big jump in anxiety and depression during COVID And although it’s come down somewhat after COVID, it has not come down to the sort of pre-COVID levels. And so there is this rise in the burden of mental health disorders. 
 
A lot of controversy as to what’s driving that, with theories ranging from device use, cell phone use, social media use, and then exacerbated by COVID lockdowns for children particularly. But it’s very hard to get a definitive answer. What we see in the data is that things are getting worse, and that trend started before COVID and is certainly made worse by COVID. 
 
Rhonda Stewart: It’s important to note that although IHME coordinates the GBD, the work is carried out by a global network of almost 16,000 researchers. What does their participation add to the study? 
 
Christopher Murray: Well, we take a very collaborative approach to the burden of disease and have done now for at least the last 16, 17 years of the study. And the reason that the network of collaborators matter so much is in multiple dimensions. So first, they find and contribute data that we might not know about, whether that’s a local study on the prevalence of depression or something on tobacco use. You know, there’s a broad array of studies that are often not part of one of the well-known global datasets like the Demographic and Health Surveys. So they identify and contribute important datasets. 
 
The collaborators help interpret data, giving that local knowledge that’s so critical. Like if there was a certain survey, they didn’t go to two provinces in a country because they were war-torn or because the rainy season was particularly challenging, or other biases that might exist in data sources for a particular country. And so that local insight, local knowledge is really essential. 
 
Then they help interpret the modeling process where we take all the raw data that’s out there on every health condition and over time and then use models to iron out fluctuations in the data or inconsistency across studies or make estimates where in years where we don’t have studies or data, and the Collaborators help in making sure those models pass the sort of face validity test – do they match local insight and understanding. 
 
And then lastly, they play a key role in writing papers, interpreting the results, thinking about local policy implications. And that’s why in addition to the capstones that we’re publishing now, we will follow suit with hundreds, or now with each cycle of GBD, thousands of reports and papers written by the Collaborators covering local regional disease-specific, risk-specific patterns that emerged from the study. 
 
Rhonda Stewart: And new data sources and new modeling methods have helped to expand the depth and the breadth of the latest GBD, contributing to the results that you’ve been talking about. Tell us about that. 
 
Christopher Murray: Well, you know, one of the important aspects of the Global Burden of Disease study is we are collectively across the collaboration always looking for ways to enhance the quality of the analysis. And so that’s, as we discussed, new datasets, but it’s also capturing methods innovation. 
So for this cycle, some of the main innovations have included a new approach to measuring or estimating all-cause mortality by age and sex that is much more driven by the data and does not use anymore what has always been a feature of demographic analysis, a thing called model life tables –that the original ones date back to the 1960s and they’ve been periodically revised and have a heavy influence on, for example, what we did in the past or what the UN Population Division or WHO does for life expectancy and age-specific mortality. 
 
And now we have very much a statistically driven empirical approach that doesn’t depend as much or at all on these model life tables. And that’s, for example, contributed to our understanding that mortality in some parts of sub-Saharan Africa is higher at younger adult ages and lower at older adult ages as an example. 
 
Other innovations, we’ve added as we do each round, some new causes. So we’ve added some of the thyroid diseases, we’ve added electrocution as a cause of injury, and a number of other causes have been broken into more detailed categories. We’ve very substantially revised the outcomes related to some key risks, particularly sexual violence against children, where the data is now there for many more risks, outcomes, diseases than we had previously appreciated. and as I mentioned earlier, a pretty big change in our understanding of lead, driven in that case by new data. 
 
But it does reflect our commitment to use the Burden of Proof methods to always be looking at what is the evidence base on the relationship between the risk exposure and particular disease outcomes. 
 
Rhonda Stewart: There are numerous examples of how GBD has been used by policymakers and others. You mentioned that one of the things that’s so useful about the Collaborator Network is their ability to gather information that might be policy-relevant at a local level. So what value does the GBD have for evidence-based decision-making by policymakers and other decision-makers? 
 
Christopher Murray: You know, primarily what the GBD provides is the broad comparative view for a country or a region or a province where it’s done subnationally of what are the biggest diseases and injuries, and are they getting worse, are they getting better, what are the biggest risk factors – that can become the targets for public health action. 
 
We’ve looked at how people are using in government, particularly the GBD. And so we’ve been trying to examine, how the user base out there is making use of the GBD. And it’s very interesting because what you find is thousands, actually, of examples of governments in reports, in policy analyses, using the GBD for a range of activities, priority setting, formulating strategic plans, using the current and future burden that comes from forecasting to plan human resource development – you know, what specialties, for example, to train – using the GBD for agenda setting to identify problems that maybe government hasn’t really tackled or had a plan for, but look to be large problems and therefore warrant policy review and formulation. And then some explicit examples where the results are used to push through policy change or legislation. 
 
Examples are tobacco and alcohol, but others as well where governments have used the results to argue in parliaments and legislatures for legislation to tackle a risk or a disease. 
 
So a pretty innovative, diverse set of uses. And we keep learning about more and more ways that the GBD is used to enhance resource allocation or prioritization. 
 
Rhonda Stewart: Great. Well, thanks so much, Chris. 
 
Christopher Murray: Okay, thank you. 
 
Rhonda Stewart: Details about the Global Burden of Disease study and a wide range of GBD-related resources can be found at healthdata.org. ________________________An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health. Learn more about IHME.Where to follow us:
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Advocating for access to oral health care in rural Nigeria

In Nigeria, less than 20% of the population has access to oral health care. This reflects a stark reality in many parts of the world--dental health remains one of the most neglected areas of public health.Dr. Adekemi Adeniyan, Executive Director of the Dentalcare Foundation, rural dentist, and advocate for oral health advancement in Nigeria, has been named IHME's 2025 Roux Prize winner. The Roux Prize recognizes individuals all over the globe who have used evidence-based health data to improve population health. The prize is sponsored by IHME’s founding board member David Roux and his wife, Barbara.• Learn more about Dr. Adeniyan's work and impact in her community: https://www.healthdata.org/research-analysis/library/2025-roux-prize-recipient-dr-adekemi-adeniyan• Read the press release announcement about Dr. Adeniyan for this year's Roux Prize: https://www.healthdata.org/news-events/newsroom/news-releases/ihmes-2025-roux-prize-awarded-rural-health-equity-advocate_______________________________Transcript
Rhonda Stewart: Welcome to Global Health Insights, a podcast from IHME, the Institute for Health Metrics and Evaluation. Hi, I’m Rhonda Stewart.  
 
In Nigeria, less than 20% of the population has access to oral health care. This reflects a stark reality: in many parts of the world, dental health remains one of the most neglected areas of public health. The Dentalcare Foundation has deployed mobile dental clinics and Nigeria’s first solar-powered tele-dental kiosks, delivering care to over 100,000 people in rural communities. 
 
Dr. Adekemi Adeniyan is the Executive Director of the Dentalcare Foundation. She is a rural dentist, advocate for oral health advancement, and winner of the 2025 Roux Prize. Now in its 12th year, the Roux Prize recognizes individuals all over the globe who have used evidence-based health data to improve population health. 
 
The prize is sponsored by IHME’s founding board member David Roux and his wife, Barbara. 
 
Dr. Adeniyan is passionate about collaboration. The Dentalcare Foundation has trained over 2,500 teachers and community health workers to promote oral health in their localities, helping to create a network of advocates that multiplies her impact across borders. 
 
Dr. Adeniyan joined the conversation from Nigeria. 
 
Dr. Adeniyan, congratulations on being named the 2025 Roux Prize winner on behalf of the Dentalcare Foundation. Before we dive into your work, tell us about why the foundation was established – what are the problems that it was created to solve? 
 
Dr. Adekemi Adeniyan: Thank you so much. It’s such an honor to be here and such an honor to be the 2025 Roux Prize winner. 
 
You know, I grew up in Agege, Lagos, Nigeria. It’s kind of a slum and a crowded community. And in that community, access to health care, especially dental care, is almost nonexistent. And for me, I saw many of our neighbors living with toothache for years. They couldn’t afford treatment. And I myself, at the age of 7, I had toothache and I couldn’t even afford to tell my parents about it because one, there was no access to a dental care facility. And at that time my parents couldn’t even afford it. 
 
So communities like this experience children’s laughter being silenced with pain. And this is something that can easily be prevented. So years later, as a dentist, I got to serve in a rural community in Nigeria. That was when I realized that little had changed. Nothing had changed. In fact, patients would travel hours to come into my dental clinic just to have one tooth removed. They wouldn't be able to pay for it. 
 
I would see many children come in, some who had never owned a toothbrush or seen a dentist in their life. And this broke my heart. Day to day, day to day. 
 
So that was why I decided to start Dentalcare Foundation – to make sure that every child has access to dental health care no matter where they are born, no matter where they find themselves. 
 
And the mission of the organization is simple. We just bring oral health care and education to communities that have been long forgotten. And our biggest problem, should I say the problem that we’ve been created to solve, is inequity – oral health inequity. 
 
For instance, in Nigeria, less than 20% have ever visited a dentist. And many in the rural communities where I work, they don’t even have access to a dentist. There’s only one dentist to every 100,000 people. And that in itself is a gap. 
 
If you want to compare it to the World Health Organization’s recommendation, which is like one dentist to 7,500 people, that’s a really staggering gap. And so that’s why my organization goes to ensure that there’s proper education. Because tooth decay and gum diseases are more common in this area of the world, yet their education is lacking. 
 
Rhonda Stewart: That’s incredibly powerful. So for you, it was a mix of personal experience and then things that you’ve seen as a physician and as a dentist. 
 
Dr. Adekemi Adeniyan: I feel like the organization was born out of pain and purpose. 
 
Rhonda Stewart: Yes, born out of pain and purpose. You spoke about the situation in Nigeria. What do you think accounts for the small number of dentists in the country? 
 
Dr. Adekemi Adeniyan: Well, first of all, we are a country of over 200 million people, and the country has fewer than 5,000 dentists. So you can imagine 5,000 dentists serving over 200 million people. And most of these dentists are concentrated in the major cities like Lagos and Abuja. So a child in a rural village could grow up and never, ever see a dentist. 
 
Now, number two is that most of the public dental clinics are very, very underfunded. Preventive care is not prioritized, and oral health care is generally not seen as overall well-being. And most of the national health campaigns that is in Nigeria, they are tailored toward malaria, maternal health, HIV, and it’s understandable. But rarely do you find things that are tailored toward oral health. And because of the lack of dentists and the lack of information, this gap is always existing. So even though poor oral health is linked to heart diseases, diabetes, pregnancy complications and all, it’s still being silent because nobody hears about it. 
 
And that’s why my advocacy really focuses on helping people and policymakers understand why the mouth is not separate from the body and why we need to change the narrative. 
 
Rhonda Stewart: And you just alluded to this in a very powerful way. Why is it that you think that dental care is such an overlooked component of public health? 
 
Dr. Adekemi Adeniyan: Well, that’s so interesting because I feel like this is a question I always ask myself all the time. But I think it’s because dental care doesn’t really scream for attention like every other health issue that we have, until it’s too late. 
 
A toothache doesn’t come like an emergency until someone can’t eat, someone can’t sleep, or someone can’t go to school because of pain. And the truth is, globally, 3.5 billion people around the world have been affected by oral health, yet it’s still being silent. That is because most people think is not a priority. 
 
Most countries spend less than 1% of their health budget on dental care – for Nigeria especially. And this is just negligible. And I would say part of it is perception. Perception, perception, perception. People think oral health is cosmetic. People think oral health is just one of those things that can be sidelined. 
 
But the truth is oral health is about your dignity. It’s about your confidence, about an opportunity. A child who hides their smile may struggle in school or in social life. It can even affect your relationship, or getting a job. So when we talk about oral health, we are really talking about the potential of people, but it’s seen in the wrong perspective. That’s why I think the perception around oral health needs to change. 
 
Rhonda Stewart: Absolutely. In addition to your work with the Dentalcare Foundation, you are also the founder of a health edtech company called Smile Superheroes. Tell us about that work. 
 
Dr. Adekemi Adeniyan: Yeah, Smile Superheroes is a health edtech company. And the main aim of the company is to simplify health information for children. 
 
So what we do is that we use storybooks, animation, and virtual reality to make learning about health fun, inclusive, and most unforgettable for them. I often describe this as the Disney of health care, because we believe that children everywhere deserve to see themselves as the heroes of their own health story. 
 
And that is why we create the stories and animations to allow children to think about health in a different way – allowing children to literally step inside a storybook or an animation and learn how to play but also learn about their health. 
 
Rhonda Stewart: That’s fantastic. And let’s talk a little bit about the impact of your work. We would love to hear about the impact of your Smile Superheroes work, as well as the impact of your Dentalcare Foundation work. 
 
Dr. Adekemi Adeniyan: Yeah, it’s a great thing because what started as a one-man organization, Dentalcare Foundation today has become a movement. And that’s the way I see it because we’ve provided free oral health care and education to over 120,000 children, not just in Nigeria, but across Philippines, South Africa, Ghana, just across the world. We’ve trained community health workers and teachers to promote daily brushing and oral hygiene in schools because we believe that they have first contact with children. 
 
And our Healthy Mouth campaign has distributed over 30,000 toothbrushes and hygiene kits in many rural communities. In Nigeria, we’ve partnered with Ministry of Health Education. We created the first dental kiosk in Nigeria that is reaching over 45,000 people in the rural community. And that itself, it’s great work. And coupled with what we are doing with Smile Superheroes, I was able to write the first oral health storybook in Nigeria called The Girl Who Found Her Smile. 
 
And that storybook has also become a movement, becoming the first virtual reality story or health storybook in Africa, not just in Nigeria, where children can immerse themselves in virtual reality and learn about their health and learn about their mouth. 
 
Rhonda Stewart: That’s fantastic. You mentioned the wonderful collaborative efforts, the ways that you’ve trained professionals in other countries. Tell us what’s next for you and the Dentalcare Foundation. 
 
Dr. Adekemi Adeniyan: I believe that what’s next is always about innovation, and I would say basically innovation for equity. Innovation, innovation, innovation. 
 
Part of our next movement is just expanding into other countries. Last year, we’ve been able to expand into Philippines to establish the work. But we don’t just want to stop there, we want to move into Southeast Asia. Other countries are experiencing the same thing that we do in Nigeria. We’re working on setting up toothbrushing hubs, vibrant community spaces for children where they can learn how to brush, have access to clean water, and also kind of create a safe environment to talk about their mouth. 
 
We are thinking of launching new creative projects that are merging arts, technology, and public health using virtual reality, games, music to teach oral health in schools and marketplaces. And we want to do it in the languages that these children understand. 
 
We want to take this to them and make them feel like they own the narrative. So one of the things that we’re also going to be doing is expanding our mobile dental units and tele-dental care through thinking about expanding it into different countries and different regions where they do not have access to a dental clinic. 
 
So basically, I would say that our vision is really, really bold, and we intend to pursue it because the main aim is to ensure that no child anywhere will suffer from a toothache, And that’s where we are going. 
 
Rhonda Stewart: Wonderful. Well, Dr. Adeniyan, thank you so much. The work that you do is so powerful, and it really does touch an area of health that is very much underrepresented. So thank you, and congratulations again for your win with the Roux Prize. 
 
Dr. Adekemi Adeniyan: Oh, thank you so much. You know, winning the Roux Prize has given me a global platform, and the truth is we’re going to use it to prove that oral health innovation can start from everywhere, can start from Nigeria and inspire the whole world. And that’s the aim. 
 
Rhonda Stewart: Fantastic. Thank you again. 
 
Dr. Adekemi Adeniyan: Thank you. 
 
Rhonda Stewart: Details about the Dentalcare Foundation can be found at dcarefoundation.org. 
__________________________
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health. Learn more about IHME.Where to follow us:
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Financing Global Health 2025: Cuts could reverse decades of progress

Development assistance for health (DAH) is at its lowest level in 15 years. This funding backs health programs around the world and addresses diseases and conditions including HIV/AIDS, malaria, tuberculosis, and maternal and child health.
In 2025, many donors (including the United States) cut back sharply on their contributions. There are concerns that cuts to development assistance for health could reverse decades of progress made.
Lead author Dr. Angela Apeagyei (Assistant Professor at IHME) and senior author Dr. Joe Dieleman (Professor at IHME) outline changes to DAH and share highlights from the report, Financing Global Health in this episode. 
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health. Learn more about IHME.Where to follow us:
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Health trends in the ASEAN region

“We chose these four topics to highlight some of the ongoing and emerging population health challenges faced by the region in recent years,” said Dr. Marie Ng, lead author and Affiliate Associate Professor at IHME and Associate Professor at National University of Singapore’s Yong Loo Lin School of Medicine. She discussed this four-paper series that studied the burden of mental disorders, cardiovascular diseases, smoking, and injuries in the Association of Southeast Asian Nations (ASEAN) region.Read the podcast transcriptRead the press release for the ASEAN series
Access each paper in the ASEAN series:
Burden of mental health disorders
Burden of cardiovascular disease
Burden of smoking
Burden of injuries
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health. Learn more about IHME.Where to follow us:
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Understanding health care spending in the United States

Health care spending in the US is expected to reach more than $7 trillion by 2031. New research by IHME examines US health care spending by county and health condition and finds significant variation. Where you live, the type of care you receive, and how it’s paid for makes a difference. Understanding these trends is critical to identifying ways to reduce costs and increase access to care. We discuss the data with study author IHME Associate Professor Dr. Joe Dieleman.
Transcript
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health.
Learn more about IHME: https://www.healthdata.org/ 
Where to follow us:
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The growing crisis of obesity in the US

It’s an issue across every state and every age group: sharply rising rates of overweight and obesity. The most comprehensive study of current and future trends in the United States finds that by 2050, 213 million adults and more than 43 million children and adolescents are expected to have overweight or obesity. IHME researchers note that urgent action is needed to tackle the complex factors contributing to this problem. We discuss the data with study author Affiliate Associate Professor Marie Ng.
Transcript
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health.
Learn more about IHME: https://www.healthdata.org/ 
Where to follow us:
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Facebook
X (Twitter)
YouTube

Measuring well-being across the US

Race, gender, and where you live can have a profound impact on your well-being. In a first-of-its kind analysis, new data shows significant disparities in individual well-being as measured by lifespan, education, and income. As researchers point out, these disparities are not merely statistics, but a call for action. We discuss the data with study author IHME Associate Professor Laura Dwyer-Lindgren. 
Transcript
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health.
Learn more about IHME: https://www.healthdata.org/ 
Where to follow us:
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Community Health Workers are key to remote global care

Half the world’s population lacks access to essential health services. Dr. Madeleine Ballard, CEO and co-founder of the Community Health Impact Coalition (CHIC) and community health worker Prossy Muyingo discuss the critical role played by community health workers.
Transcript
On behalf of CHIC, Dr. Ballard has been named the 2024 Roux Prize winner. The Roux Prize recognizes individuals all over the globe who have used evidence-based health data to improve population health. The prize is sponsored by IHME’s founding board member David Roux and his wife, Barbara.
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health.
Learn more about IHME: https://www.healthdata.org/ 
Where to follow us:
LinkedIn
Facebook
X (Twitter)
YouTube