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Cited by 11,386Insurance, Mortality, Demography, Risk ManagementGlobal Health and EpidemiologyHealthcare Systems and Public Health

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Projections of Global Mortality and Burden of Disease from 2002 to 2030

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Mathers, Colin D, Loncar, Dejan·2006·PLoS Medicine
DOI 10.1371/journal.pmed.0030442PMC PMC1664601
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Abstract

BACKGROUND: Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results. METHODS AND FINDINGS: Relatively simple models were used to project future health trends under three scenarios-baseline, optimistic, and pessimistic-based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs reaches 80% by 2012. Under the optimistic scenario, which also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015. CONCLUSIONS: These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries.

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Crossref · 10.1371/journal.pmed.0030442

Cites

33 of 33 references verified0 citation errors · 0 not checkable

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Figures

Figure 1 Projected Life Expectancy at Birth in 2030 by World Bank Region and Sex: Baseline, Optimistic, and Pessimistic Scenarios Compared with 2002 Estimates
Figure 1 Projected Life Expectancy at Birth in 2030 by World Bank Region and Sex: Baseline, Optimistic, and Pessimistic Scenarios Compared with 2002 EstimatesCC BY · PubMed Central
Figure 2 Global Numbers of Deaths by Age and Sex: Baseline, Optimistic, and Pessimistic Scenarios for 2030 Compared with 2002 Estimates
Figure 2 Global Numbers of Deaths by Age and Sex: Baseline, Optimistic, and Pessimistic Scenarios for 2030 Compared with 2002 EstimatesCC BY · PubMed Central
Figure 3 Baseline Projections of Deaths from Group I, Group II, and Group III Causes, World, 2002–2030
Figure 3 Baseline Projections of Deaths from Group I, Group II, and Group III Causes, World, 2002–2030CC BY · PubMed Central
Figure 4 Projections of Total AIDS Deaths (Thousands) by Income Group for Three Scenarios Scenarios are indicated: baseline (solid lines), optimistic (dotted lines), and pessimistic (dashed lines).
Figure 4 Projections of Total AIDS Deaths (Thousands) by Income Group for Three Scenarios Scenarios are indicated: baseline (solid lines), optimistic (dotted lines), and pessimistic (dashed lines).CC BY · PubMed Central
Figure 5 Projections of Global Deaths (Millions) for Selected Causes, for Three Scenarios: Baseline, Optimistic, and Pessimistic, 2002–2030
Figure 5 Projections of Global Deaths (Millions) for Selected Causes, for Three Scenarios: Baseline, Optimistic, and Pessimistic, 2002–2030CC BY · PubMed Central
Figure 6 Comparison of Baseline Projections 2002–2030 with the Original GBD Projections 1990–2020: Global Deaths for All Causes, and Major Cause Groups
Figure 6 Comparison of Baseline Projections 2002–2030 with the Original GBD Projections 1990–2020: Global Deaths for All Causes, and Major Cause GroupsCC BY · PubMed Central
Figure 7 Decomposition of Projected Change in Numbers of Deaths into Demographic and Epidemiological Components, by Broad Cause Group and Income Group, 2002–2030
Figure 7 Decomposition of Projected Change in Numbers of Deaths into Demographic and Epidemiological Components, by Broad Cause Group and Income Group, 2002–2030CC BY · PubMed Central
Figure 8 Projected Numbers of Tobacco-Caused Deaths for the World and for High-Income and Middle- plus Low-Income Countries, Three Scenarios, 2002–2030
Figure 8 Projected Numbers of Tobacco-Caused Deaths for the World and for High-Income and Middle- plus Low-Income Countries, Three Scenarios, 2002–2030CC BY · PubMed Central
Figure 9 Projected Growth in Road Traffic Fatalities, 2002–2020: A Comparison of World Bank Projections with GBD Projections
Figure 9 Projected Growth in Road Traffic Fatalities, 2002–2020: A Comparison of World Bank Projections with GBD ProjectionsCC BY · PubMed Central

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Citations

Cites

Show all 33 references

Research works printed but not linked: 23

  1. Murray, 1996, The global burden of disease, 325
  2. Murray, 1997, Lancet, 349, 1498
  3. Lee, 1992, J Am Stat Assoc, 87, 659
  4. Lee, 2000, NAAJ, 4, 80
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  7. Bronnum-Hansen, 1999, J Epidemiol Community Health, 53, 300
  8. Stover, 2002, Lancet, 360, 73
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  17. Walker, 2003, AIDS, 17, 2215
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Metadata

Authors
Mathers, C. D., & Loncar, D.
Affiliations
World Health Organization (CH)
Corresponding author
Mathers, Colin D
ORCID
Mathers, Colin D
Venue
PLoS Medicine
Publisher
Public Library of Science (PLoS)
Published
2006-11-28
Volume
3
Issue
11
Pages
e442
ISSN
  • 1549-1277 (ISSN-L)
  • 1549-1676
DOI
10.1371/journal.pmed.0030442
PMC
PMC1664601
OpenAlex
W2054931962
Cited by
11,386
References
33
Citations by year
2026: 205 · 2025: 373 · 2024: 586 · 2023: 646 · 2022: 671 · 2021: 738 · 2020: 801 · 2019: 833 · 2018: 855 · 2017: 787 · 2016: 796 · 2015: 844 · 2014: 709 · 2013: 627 · 2012: 490
FWCI
592.00
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • World Health Organization
  • Strong
Topics
  • Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Epidemiology
  • Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
Keywords
disease burden, non-communicable diseases, HIV mortality, communicable disease mortality, child mortality, economic development scenarios, age distribution of deaths, body mass index, human capital, income and mortality, death registration data
MeSH terms
Acquired Immunodeficiency Syndrome, Adolescent, Adult, Aged, Cause of Death, Child, Child, Preschool, Developing Countries, Epidemiology, Humans, Infant, Infant, Newborn, Middle Aged, Mortality, Smoking, Global Health, HIV Infections

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