A basic requirement for evaluating the cost-effectiveness of health interventions is a comprehensive assessment of the amount of ill health (premature death and disability) attributable to specific diseases and injuries. A new indicator, the number of disability-adjusted life years (DALYs), was developed to assess the burden of disease and injury in 1990 for over 100 causes by age, sex and region. The DALY concept provides an integrative, comprehensive methodology to capture the entire amount of ill health which will, on average, be incurred during one's lifetime because of new cases of disease and injury in 1990. It differs in many respects from previous attempts at global and regional health situation assessment which have typically been much less comprehensive in scope, less detailed, and limited to a handful of causes. This paper summarizes the DALY estimates for 1990 by cause, age, sex and region. For the first time, those responsible for deciding priorities in the health sector have access to a disaggregated set of estimates which, in addition to facilitating cost-effectiveness analysis, can be used to monitor global and regional health progress for over a hundred conditions. The paper also shows how the estimates depend on particular values of the parameters involved in the calculation.
PIP: Evaluating the cost-effectiveness of health interventions requires a comprehensive assessment of the amount of ill health attributable to specific diseases and injuries. Unlike previous attempts at global and regional health situation assessments which have been generally less comprehensive in scope, less detailed, and limited to relatively few causes, the disability-adjusted life year (DALY), a new indicator, was developed to assess the burden of disease and injury in 1990 for more than 100 causes by age, sex, and region. The measure provides an integrative, comprehensive methodology to capture the entire amount of ill health which will, on average, be incurred during one's lifetime because of new cases of disease and injury in 1990. This paper summarizes the DALY estimates for 1990 by cause, age, sex, and region, giving those responsible for deciding health sector priorities access to a disaggregated set of estimates. The paper also shows how the estimates depend upon particular values of the parameters involved in the calculation.