29 research outputs found
NEXUS OF TREASURY SINGLE ACCOUNT AND FINANCIAL ACCOUNTABILITY IN OYO STATE, NIGERIA
The establishment of Treasury Single Account reduced proliferation of accounts of ministries, departments and agencies which in turn encouraged financial accountability among government organs in Oyo state. It is on this note that this study investigated how treasury single account aided financial accountability in the public sector of Oyo state. This was achieved using survey research design and the study population was made up of sampled staff of MDAs in Oyo state. Primary data was collected through the administration of questionnaires. The result of the hypotheses tested showed that three out of the four formulated hypotheses were significantly related to financial accountability except for unification of government revenue that has no significant effect. Thus, indicating that treasury single account goes a long way in aiding financial accountability. This study thus recommends that operational challenges, financial control and operational efficiency are key predictors of financial accountability in the public sector of Oyo state
ORGANISATIONAL STRATEGY AND MODERATING EFFECT OF PERFORMANCE MEASUREMENT SYSTEM ON PERFORMANCE OF NIGERIAN LISTED MANUFACTURING FIRMS
Measuring performance of manufacturing firms is essential to enable stakeholders and interested/potential investors to evaluate the general and specific actions of firms and how they perform over time. Performance measurement is said to be critical for efficient business management and thus, when selecting measurement system, organisations seem to be mostly dependant on certain designs for effective and efficient organisational operations. This study examined the influence of organisational strategy on organisational performance, as well as the moderating effect of performance measurement system between strategy and organisational performance. Organisation performance was proxy with financial and non-financial performance. This study was premised on the assumption that proper strategies by organisations enhance performance (financial and non-financial) and that the performance measurement system of organisations significantly moderates the relationships between organisational strategy and organisation performance. Based on these assumptions, this study employed the contingency theory and formulated 4 study objectives:(i) examine the impact of organisational strategy on Performance Measurement System; (ii)determine the relationship between organisational strategy and financial performance (iii) evaluate how organisational strategy influences non-financial performance and; (iv) investigate the moderating effect of Performance Measurement System on financial and non-financial performance. Data was collected through a self-administered survey of 168 respondents purposefully selected from thirty-seven listed manufacturing firms in Lagos, Nigeria, and analysis was done using PLS-SEM. The target respondents were accountants, auditors and managers of respective organisations. The main finding of this study showed that organisational strategy significantly influenced performance measurement system, financial and non-financial performance. Moreover, performance measurement system significantly moderates the relationship between organisational strategy and financial performance. Based on the empirical findings and the results of this study, it is recommended that management of manufacturing firms should maintain a good strategic position in order to achieve organisational objectives and stakeholders’ expectations
CONTINGENCY FACTORS AND FINANCIAL SUSTAINABILITY OF PHARMACEUTICAL FIRMS IN NIGERIA
Insensitivity to financial sustainability has led some firm to undeserved winding up and significance of the pharmaceutical firms to the health and economic stability of the nation requires a review of the contingency factors that are capable of influencing her financial sustainability attainments. This study therefore examines the effect of contingency factors on the financial sustainability of the pharmaceutical firms in Nigeria. The study adopts a survey research design to ascertain the effect of contingency factors on the financial sustainability of the pharmaceutical firms in Nigeria. The study gathered the data from 234 respondents out of a sample frame size of 330 from 10 largest firms in Nigeria. Multiple regression analysis revealed that leadership style (β = 0.711; p < 0.000); organization culture (β = 0.185; p = 0.000) both has positive and notable effect on the financial sustainability efforts of the pharmaceutical firms in Nigeria. The study concludes that the leadership style and organization culture enhance financial sustainability practices in the firms under the study. The study recommends that Companies’ management should adopt a transactional leadership style and resilient culture in order to achieve more financial sustainability
INFLUENCE OF INTEGRATED FINANCIAL MANAGEMENT INFORMATION SYSTEM (IFMIS) ON THE PERFORMANCE OF GOVERNMENT ENTITIES IN NIGERIA
Public Sector Performance has been a contemporary discourse among researchers in Nigeria. Despite the formidable regulatory and institutional frameworks put in place to strengthen public sector finance management in Nigeria, the domain continues to struggle with huge financial management infractions that are not in tune with the norms as well as international best practices thereby resulting to performance failure. The main objective of this study was to investigate the influence of Integrated Financial Management information System (IFMIS) on performance of government entities’ in Nigeria. The research design deployed was descriptive and inferential mixed research design using a purposive sampling technique. The study population was 1504 comprises of selected top and middle level pool officers in the Accountant-General for the Federation office on grade level 13 to 17. The study’s primary data source sample size was 306 using Krejcie and Morgan, (1970) while the interview sample size was also 3 (three). Primary data was collected using questionnaire and interview while Partial Least Square was used to analyse the quantitative data and Thematic/NVIVO was used to analyse the Qualitative data. Finding from the quantitative analysis shows that a positive statistically significant relationship exist between the two variables as the path model coefficient results indicates that IFMIS is significantly related to both financial (β = 0.466; p< 0.05) and non-financial performance of government entities’ with (β = 0.490; p< 0.001). Finding from the qualitative analysis corroborated with the quantitative findings, its results however, indicates existence of various challenges ranging from infrastructures deficient as well as capacity building issues for IFMIS operators; The study therefore concludes that IFMIS significantly influence both financial and non- financial performance of government entities with limitations of various challenges. The study recommends therefore, that government should endeavour to provide strong Information Technology (IT) infrastructure and the right capacity building of the operators as it is expected to increase the level of performance in entities’, and assist in providing more meaningful information for decision making process
Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021
Funding: Bill & Melinda Gates Foundation.Peer ReviewedArticle signat per 1420 autors/es. Membres del GBD 2021 Forecasting Collaborators:
Stein Emil Vollset*, Hazim S Ababneh, Yohannes Habtegiorgis Abate, Cristiana Abbafati, Rouzbeh Abbasgholizadeh, Mohammadreza Abbasian, Hedayat Abbastabar, Abdallah H A Abd Al Magied, Samar Abd ElHafeez, Atef Abdelkader, Michael Abdelmasseh, Sherief Abd-Elsalam, Parsa Abdi, Mohammad Abdollahi, Meriem Abdoun, Auwal Abdullahi, Mesfin Abebe, Olumide Abiodun, Richard Gyan Aboagye, Hassan Abolhassani, Mohamed Abouzid, Girma Beressa Aboye, Lucas Guimarães Abreu, Abdorrahim Absalan, Hasan Abualruz, Bilyaminu Abubakar, Hana Jihad Jihad Abukhadijah, Giovanni Addolorato, Victor Adekanmbi, Charles Oluwaseun Adetunji, Juliana Bunmi Adetunji, Temitayo Esther Adeyeoluwa, Rishan Adha, Ripon Kumar Adhikary, Qorinah Estiningtyas Sakilah Adnani, Leticia Akua Adzigbli, Fatemeh Afrashteh, Muhammad Sohail Afzal, Saira Afzal, Faith Agbozo, Antonella Agodi, Anurag Agrawal, Williams Agyemang-Duah, Bright Opoku Ahinkorah, Austin J Ahlstrom, Aqeel Ahmad, Firdos Ahmad, Muayyad M Ahmad, Sajjad Ahmad, Shahzaib Ahmad, Anisuddin Ahmed, Ayman Ahmed, Haroon Ahmed, Safoora Ahmed, Syed Anees Ahmed, Karolina Akinosoglou, Mohammed Ahmed Akkaif, Ashley E Akrami, Ema Akter, Salah Al Awaidy, Syed Mahfuz Al Hasan, Amjad S Al Mosa, Omar Al Ta’ani, Omar Ali Mohammed Al Zaabi, Fares Alahdab, Muaaz M Alajlani, Yazan Al-Ajlouni, Samer O Alalalmeh, Ziyad Al-Aly, Khurshid Alam, Noore Alam, Tahiya Alam, Zufishan Alam, Rasmieh Mustafa Al-amer, Fahad Mashhour Alanezi, Turki M Alanzi, Almaza Albakri, Wafa A Aldhaleei, Robert W Aldridge, Seyedeh Yasaman Alemohammad, Yihun Mulugeta Alemu, Adel Ali Saeed Al-Gheethi, Mohammed Khaled Al-Hanawi, Abid Ali, Amjad Ali, Iman Ali, Mohammed Usman Ali, Rafat Ali, Syed Shujait Shujait Ali, Victor Ekoche Ali, Waad Ali, Akram Al-Ibraheem, Gianfranco Alicandro, Sheikh Mohammad Alif, Syed Mohamed Aljunid, François Alla, Joseph Uy Almazan, Hesham M Al-Mekhlafi, Ahmed Yaseen Alqutaibi, Ahmad Alrawashdeh, Sahel Majed Alrousan, Salman Khalifah Al-Sabah, Mohammed A Alsabri, Zaid Altaany, Ala’a B Al-Tammemi, Jaffar A Al-Tawfiq, Khalid A Altirkawi, Deborah Oyine Aluh, Nelson Alvis-Guzman, Mohammad Sami Al-Wardat, Yaser Mohammed Al-Worafi, Hany Aly, Mohammad Sharif Alyahya, Karem H Alzoubi, Walid Al-Zyoud, Reza Amani, Edward Kwabena Ameyaw, Tarek Tawfik Amin, Alireza Amindarolzarbi, Sohrab Amiri, Mohammad Hosein Amirzade-Iranaq, Hubert Amu, Dickson A Amugsi, Robert Ancuceanu, Deanna Anderlini, David B Anderson, Pedro Prata Andrade, Catalina Liliana Andrei, Tudorel Andrei, Erick Adrian Andrews, Abhishek Anil, Sneha Anil, Amir Anoushiravani, Catherine M Antony, Ernoiz Antriyandarti, Boluwatife Stephen Anuoluwa, Saeid Anvari, Anayochukwu Edward Anyasodor, Francis Appiah, Michele Aquilano, Juan Pablo Arab, Jalal Arabloo, Elshaimaa A Arafa, Mosab Arafat, Aleksandr Y Aravkin, Ali Ardekani, Demelash Areda, Brhane Berhe Aregawi, Abdulfatai Aremu, Hany Ariffin, Mesay Arkew, Keivan Armani, Anton A Artamonov, Ashokan Arumugam, Mohammad Asghari-Jafarabadi, Charlie Ashbaugh, Thomas Astell-Burt, Seyyed Shamsadin Athari, Prince Atorkey, Maha Moh’d Wahbi Atout, Avinash Aujayeb, Marcel Ausloos, Hamzeh Awad, Adedapo Wasiu Awotidebe, Haleh Ayatollahi, Jose L Ayuso-Mateos, Sina Azadnajafabad, Fahad Khan Azeez, Rui M S Azevedo, Muhammad Badar, Soroush Baghdadi, Mahboube Bagheri, Nasser Bagheri, Ruhai Bai, Jennifer L Baker, Abdulaziz T Bako, Senthilkumar Balakrishnan, Wondu Feyisa Balcha, Ovidiu Constantin Baltatu, Martina Barchitta, Erfan Bardideh, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Hiba Jawdat Barqawi, Sandra Barteit, Afisu Basiru, João Diogo Basso, Mohammad-Mahdi Bastan, Sanjay Basu, Matteo Bauckneht, Bernhard T Baune, Mohsen Bayati, Nebiyou Simegnew Bayileyegn, Amir Hossein Behnoush, Payam Behzadi, Maryam Beiranvand, Olorunjuwon Omolaja Bello, Luis Belo, Apostolos Beloukas, Maryam Bemanalizadeh, Isabela M Bensenor, Habib Benzian, Azizullah Beran, Zombor Berezvai, Robert S Bernstein, Paulo J G Bettencourt, Kebede A Beyene, Melak Gedamu Beyene, Devidas S Bhagat, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Dinesh Bhandari, Ravi Bharadwaj, Nikha Bhardwaj, Pankaj Bhardwaj, Ashish Bhargava, Sonu Bhaskar, Vivek Bhat, Natalia V Bhattacharjee, Gurjit Kaur Bhatti, Jasvinder Singh Bhatti, Manpreet S Bhatti, Mohiuddin Ahmed Bhuiyan, Catherine Bisignano, Bijit Biswas, Tone Bjørge, Virginia Bodolica, Aadam Olalekan Bodunrin, Milad Bonakdar Hashemi, Berrak Bora Basara, Hamed Borhany, Samuel Adolf Bosoka, Alejandro Botero Carvajal, Souad Bouaoud, Soufiane Boufous, Christopher Boxe, Edward J Boyko, Oliver J Brady, Dejana Braithwaite, Michael Brauer, Javier Brazo-Sayavera, Hermann Brenner, Colin Stewart Brown, Annie J Browne, Traolach Brugha, Dana Bryazka, Norma B Bulamu, Danilo Buonsenso, Katrin Burkart, Richard A Burns, Reinhard Busse, Yasser Bustanji, Zahid A Butt, Florentino Luciano Caetano dos Santos, Mehtap Çakmak Barsbay, Daniela Calina, Luciana Aparecida Campos, Shujin Cao, Angelo Capodici, Rosario Cárdenas, Giulia Carreras, Andrea Carugno, Márcia Carvalho, Joao Mauricio Castaldelli-Maia, Giulio Castelpietra, Maria Sofia Cattaruzza, Arthur Caye, Luca Cegolon, Francieli Cembranel, Edina Cenko, Ester Cerin, Steven J Chadban, Joshua Chadwick, Chiranjib Chakraborty, Sandip Chakraborty, Julian Chalek, Jeffrey Shi Kai Chan, Rama Mohan Chandika, Sara Chandy, Jaykaran Charan, Anis Ahmad Chaudhary, Akhilanand Chaurasia, An-Tian Chen, Haowei Chen, Meng Xuan Chen, Simiao Chen, Nicolas Cherbuin, Gerald Chi, Fatemeh Chichagi, Odgerel Chimed-Ochir, Ritesh Chimoriya, Patrick R Ching, Jesus Lorenzo Chirinos-Caceres, Abdulaal Chitheer, Daniel Youngwhan Cho, William C S Cho, Dong-Woo Choi, Bryan Chong, Chean Lin Chong, Hitesh Chopra, Dinh-Toi Chu, Eric Chung, Muhammad Chutiyami, Justin T Clayton, Rebecca M Cogen, Aaron J Cohen, Alyssa Columbus, Haley Comfort, Joao Conde, Jon T Connolly, Ezra E K Cooper, Samuele Cortese, Natália Cruz-Martins, Alanna Gomes da Silva, Omid Dadras, Xiaochen Dai, Zhaoli Dai, Bronte E Dalton, Giovanni Damiani, Lalit Dandona, Rakhi Dandona, Jai K Das, Saswati Das, Subasish Das, Nihar Ranjan Dash, Kairat Davletov, Fernando Pio De la Hoz, Diego De Leo, Shayom Debopadhaya, Ivan Delgado-Enciso, Edgar Denova-Gutiérrez, Nikolaos Dervenis, Hardik Dineshbhai Desai, Vinoth Gnana Chellaiyan Devanbu, Syed Masudur Rahman Dewan, Kuldeep Dhama, Amol S Dhane, Sameer Dhingra, Diana Dias da Silva, Daniel Diaz, Luis Antonio Diaz, Michael J Diaz, Adriana Dima, Delaney D Ding, Thao Huynh Phuong Do, Camila Bruneli do Prado, Masoud Dodangeh, Milad Dodangeh, Phidelia Theresa Doegah, Sushil Dohare, Wanyue Dong, Mario D’Oria, Rajkumar Doshi, Robert Kokou Dowou, Haneil Larson Dsouza, Viola Dsouza, John Dube, Samuel C Dumith, Bruce B Duncan, Andre Rodrigues Duraes, Senbagam Duraisamy, Oyewole Christopher Durojaiye, Anar Dushpanova, Sulagna Dutta, Paulina Agnieszka Dzianach, Arkadiusz Marian Dziedzic, Ejemai Eboreime, Alireza Ebrahimi, Mohammad Ebrahimi Kalan, Hisham Atan Edinur, Ferry Efendi, Terje Andreas Eikemo, Ebrahim Eini, Temitope Cyrus Ekundayo, Rabie Adel El Arab, Iman El Sayed, Osman Elamin, Noha Mousaad Elemam, Ghada Metwally Tawfik ElGohary, Muhammed Elhadi, Omar Abdelsadek Abdou Elmeligy, Adel B Elmoselhi, Mohammed Elshaer, Ibrahim Elsohaby, Mohd. Elmagzoub Eltahir, Theophilus I Emeto, Babak Eshrati, Majid Eslami, Zahra Esmaeili, Natalia Fabin, Adeniyi Francis Fagbamigbe, Omotayo Francis Fagbule, Luca Falzone, Mohammad Fareed, Carla Sofia e Sá Farinha, MoezAlIslam Ezzat Mahmoud Faris, Andre Faro, Kiana Fasihi, Ali Fatehizadeh, Nelsensius Klau Fauk, Timur Fazylov, Valery L Feigin, Ginenus Fekadu, Xiaoqi Feng, Seyed-Mohammad Fereshtehnejad, Pietro Ferrara, Nuno Ferreira, Belete Sewasew Firew, Florian Fischer, Ida Fitriana, Joanne Flavel, Luisa S Flor, Morenike Oluwatoyin Folayan, Kristen Marie Foley, Marco Fonzo, Lisa M Force, Matteo Foschi, Alberto Freitas, Ni Kadek Yuni Fridayani, Kai Glenn Fukutaki, João M Furtado, Blima Fux, Peter Andras Gaal, Muktar A Gadanya, Silvano Gallus, Balasankar Ganesan, Mohammad Arfat Ganiyani, Rupesh K Gautam, Tilaye Gebru Gebi, Miglas W Gebregergis, Mesfin Gebrehiwot, Lemma Getacher, Genanew K A Getahun, Peter W Gething, Delaram J Ghadimi, Fataneh Ghadirian, Sadegh Ghafarian, Khalid Yaser Ghailan, MohammadReza Ghasemi, Ghazal Ghasempour Dabaghi, Ramy Mohamed Ghazy, Sama Ghoba, Ehsan Gholami, Ali Gholamrezanezhad, Nasim Gholizadeh, Mahsa Ghorbani, Pooyan Ghorbani Vajargah, Elena Ghotbi, Artyom Urievich Gil, Tiffany K Gill, Alem Girmay, James C Glasbey, Ekaterina Vladimirovna Glushkova, Elena V Gnedovskaya, Laszlo Göbölös, Mohamad Goldust, Pouya Goleij, Davide Golinelli, Sameer Vali Gopalani, Alessandra C Goulart, Mahdi Gouravani, Anmol Goyal, Michal Grivna, Giuseppe Grosso, Giovanni Guarducci, Mohammed Ibrahim Mohialdeen Gubari, Stefano Guicciardi, Rafael Alves Guimarães, Snigdha Gulati, David Gulisashvili, Damitha Asanga Gunawardane, Cui Guo, Anish Kumar Gupta, Rahul Gupta, Rajeev Gupta, Renu Gupta, Sapna Gupta, Vijai Kumar Gupta, Annie Haakenstad, Najah R Hadi, Nils Haep, Abdul Hafiz, Dariush Haghmorad, Demewoz Haile, Adel Hajj Ali, Ali Hajj Ali, Arvin Haj-Mirzaian, Esam S Halboub, Sebastian Haller, Rabih Halwani, Kanaan Hamagharib Abdullah, Nadia M Hamdy, Rifat Hamoudi, Nasrin Hanifi, Graeme J Hankey, Zaim Anan Haq, Md Rabiul Haque, Harapan Harapan, Arief Hargono, Josep Maria Haro, Ahmed I Hasaballah, S. M. Mahmudul Hasan, Mohammad Hasanian, Md Saquib Hasnain, Amr Hassan, Johannes Haubold, Simon I Hay, Jeffrey J Hebert, Omar E Hegazi, Mohammad Heidari, Mehdi Hemmati, Claire A Henson, Brenda Yuliana Herrera-Serna, Claudiu Herteliu, Majid Heydari, Kamal Hezam, Irma Hidayana, Yuta Hiraike, Nguyen Quoc Hoan, Ramesh Holla, Praveen Hoogar, Nobuyuki Horita, Md Mahbub Hossain, Hassan Hosseinzadeh, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Chengxi Hu, Junjie Huang, Michael Hultström, Tsegaye Gebreyes Hundie, Aliza J Hunt, Kiavash Hushmandi, Javid Hussain, M. Azhar Hussain, Nawfal R Hussein, Hong-Han Huynh, Bing-Fang Hwang, Segun Emmanuel Ibitoye, Pulwasha Maria Iftikhar, Adalia I Ikiroma, Paul Chukwudi Ikwegbue, Irena M Ilic, Milena D Ilic, Mustapha Immurana, Mustafa Alhaji Isa, Md. Rabiul Islam, Sheikh Mohammed Shariful Islam, Faisal Ismail, Nahlah Elkudssiah Ismail, Gaetano Isola, Masao Iwagami, Ihoghosa Osamuyi Iyamu, Louis Jacob, Kathryn H Jacobsen, Morteza Jafarinia, Kasra Jahankhani, Nader Jahanmehr, Nityanand Jain, Ammar Abdulrahman Jairoun, Dr Ruchi Jakhmola Mani, Safayet Jamil, Roland Dominic G Jamora, Abubakar Ibrahim Jatau, Sabzali Javadov, Tahereh Javaheri, Shubha Jayaram, Sun Ha Jee, Jayakumar Jeganathan, Heng Jiang, Mohammad Jokar, Jost B Jonas, Nitin Joseph, Charity Ehimwenma Joshua, Mikk Jürisson, Vaishali K, Ali Kabir, Zubair Kabir, Vidya Kadashetti, Laleh R Kalankesh, Sanjay Kalra, Ashwin Kamath, Rajesh Kamath, Arun Kamireddy, Mona Kanaan, Tanuj Kanchan, Edmund Wedam Kanmiki, Kehinde Kazeem Kanmodi, Sushil Kumar Kansal, Asima Karim, Samad Karkhah, Faizan Zaffar Kashoo, Hengameh Kasraei, Molly B Kassel, Srinivasa Vittal Katikireddi, Joonas H Kauppila, Harkiran Kaur, Gbenga A Kayode, Foad Kazemi, Sina Kazemian, Fassikaw Kebede, Evie Shoshannah Kendal, Emmanuelle Kesse-Guyot, Shahram Khademvatan, Himanshu Khajuria, Amirmohammad Khalaji, Asaad Khalid, Nauman Khalid, Alireza Khalilian, Faham Khamesipour, Fayaz Khan, Mohammad Jobair Khan, Moien AB Khan, Shaghayegh Khanmohammadi, Khaled Khatab, Haitham Khatatbeh, Moawiah Mohammad Khatatbeh, Mahalaqua Nazli Khatib, Hamid Reza Khayat Kashani, Khalid A Kheirallah, Manoj Khokhar, Moein Khormali, Zahra Khorrami, Atulya Aman Khosla, Majid Khosravi, Mahmood Khosrowjerdi, Jagdish Khubchandani, Zemene Demelash Kifle, Grace Kim, Julie Sojin Kim, Min Seo Kim, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Luke D Knibbs, Ann Kristin Skrindo Knudsen, Sonali Kochhar, Ali-Asghar Kolahi, Farzad Kompani, Gerbrand Koren, Oleksii Korzh, Kewal Krishan, Varun Krishna, Vijay Krishnamoorthy, Burcu Kucuk Bicer, Md Abdul Kuddus, Mohammed Kuddus, Ilari Kuitunen, Omar Kujan, Mukhtar Kulimbet, Vishnutheertha Kulkarni, G Anil Kumar, Harish Kumar, Nithin Kumar, Rakesh Kumar, Vijay Kumar, Amartya Kundu, Dian Kusuma, Frank Kyei-Arthur, Ville Kytö, Hmwe Hmwe Kyu, Carlo La Vecchia, Ben Lacey, Muhammad Awwal Ladan, Lucie Laflamme, Chandrakant Lahariya, Daphne Teck Ching Lai, Ratilal Lalloo, Tea Lallukka, Judit Lám, Qing Lan, Tuo Lan, Iván Landires, Francesco Lanfranchi, Berthold Langguth, Van Charles Lansingh, Ariane Laplante-Lévesque, Bagher Larijani, Anders O Larsson, Savita Lasrado, Paolo Lauriola, Hilary R Lawlor, Huu-Hoai Le, Long Khanh Dao Le, Nhi Huu Hanh Le, Thao Thi Thu Le, Trang Diep Thanh Le, Janet L Leasher, Doo Woong Lee, Munjae Lee, Paul H Lee, Sang-woong Lee, Seung Won Lee, Shaun Wen Huey Lee, Yo Han Lee, James Leigh, Elvynna Leong, Ming-Chieh Li, Massimo Libra, Virendra S Ligade, Lee-Ling Lim, Stephen S Lim, Liknaw Workie Limenh, Daniel Lindholm, Paulina A Lindstedt, Stefan Listl, Gang Liu, Shiwei Liu, Shuke Liu, Xiaofeng Liu, Xuefeng Liu, Erand Llanaj, Rubén López-Bueno, José Francisco López-Gil, Arianna Maever Loreche, Paulo A Lotufo, Rafael Lozano, Jailos Lubinda, Giancarlo Lucchetti, Lisha Luo, Jay B Lusk, Lei Lv, Hawraz Ibrahim M Amin, Zheng Feei Ma, Kelsey Lynn Maass, Nikolaos Machairas, Monika Machoy, Áurea M Madureira-Carvalho, Hassan Magdy Abd El Razek, Azzam A Maghazachi, D. R. Mahadeshwara Prasad, Mehrdad Mahalleh, Phetole Walter Mahasha, Mansour Adam Mahmoud, Elham Mahmoudi, Golnaz Mahmoudvand, Maureen Makama, Elaheh Malakan Rad, Kashish Malhotra, Ahmad Azam Malik, Deborah Carvalho Malta, Yosef Manla, Ali Mansour, Mohammad Hadi Mansouri, Pejman Mansouri, Vahid Mansouri, Marjan Mansourian, Mohammad Ali Mansournia, Bishnu P Marasini, Hamid Reza Marateb, Joemer C Maravilla, Parham Mardi, Abdoljalal Marjani, Hamed Markazi Moghadam, Carlos Alberto Marrugo Arnedo, Gabriel Martinez, Ramon Martinez-Piedra, Francisco Rogerlândio Martins-Melo, Miquel Martorell, Wolfgang Marx, Roy Rillera Marzo, Sahar Masoudi, Yasith Mathangasinghe, Alexander G Mathioudakis, Medha Mathur, Navgeet Mathur, Neeta Mathur, Fernanda Penido Matozinhos, Jishanth Mattumpuram, Richard James Maude, Andrea Maugeri, Mahsa Mayeli, Mohsen Mazidi, Antonio Mazzotti, John J McGrath, Martin McKee, Anna Laura W McKowen, Michael A McPhail, Steven M McPhail, Asim Mehmood, Kamran Mehrabani-Zeinabad, Sepideh Mehravar, Tesfahun Mekene Meto, Endalkachew Belayneh Melese, Max Alberto Mendez Mendez-Lopez, Walter Mendoza, Ritesh G Menezes, George A Mensah, Laverne G Mensah, Alexios-Fotios A Mentis, Sultan Ayoub Meo, Atte Meretoja, Tuomo J Meretoja, Abera M Mersha, Tomislav Mestrovic, Kukulege Chamila Dinushi Mettananda, Sachith Mettananda, Adquate Mhlanga, Laurette Mhlanga, Tomasz Miazgowski, Irmina Maria Michalek, Ana Carolina Micheletti Gomide Nogueira de Sá, Ted R Miller, Le Huu Nhat Minh, Alireza Mirahmadi, Antonio Mirijello, Erkin M Mirrakhimov, Roya Mirzaei, Philip B Mitchell, Chaitanya Mittal, Madeline E Moberg, Atousa Moghadam Fard, Seyedehfatemeh Mohajelin, Ashraf Mohamadkhani, Ahmed Ismail Mohamed, Jama Mohamed, Mouhand F H Mohamed, Nouh Saad Mohamed, Ameen Mosa Mohammad, Soheil Mohammadi, Hussen Mohammed, Mustapha Mohammed, Shafiu Mohammed, Ali H Mokdad, Mariam Molokhia, Shaher Mohammad Momani, Sara Momtazmanesh, Lorenzo Monasta, Stefania Mondello, Mohammad Ali Moni, Fateme Montazeri, AmirAli Moodi Ghalibaf, Maryam Moradi, Yousef Moradi, Paula Moraga, Lidia Morawska, Rafael Silveira Moreira, Negar Morovatdar, Shane Douglas Morrison, Abbas Mosapour, Jonathan F Mosser, Elias Mossialos, Rohith Motappa, Vincent Mougin, Parsa Mousavi, Matías Mrejen, Sumaira Mubarik, Ulrich Otto Mueller, Francesk Mulita, Kavita Munjal, Efrén Murillo-Zamora, Khaled M Musallam, Ana-Maria Musina, Ghulam Mustafa, Woojae Myung, Ayoub Nafei, Ahamarshan Jayaraman Nagarajan, Pirouz Naghavi, Ganesh R Naik, Gurudatta Naik, Firzan Nainu, Soroush Najdaghi, Noureddin Nakhostin Ansari, Vinay Nangia, Sreenivas Narasimha Swamy, Shumaila Nargus, Delaram Narimani Davani, Bruno Ramos Nascimento, Gustavo G Nascimento, Abdallah Y Naser, Abdulqadir J Nashwan, Zuhair S Natto, Javaid Nauman, Samidi N K Navaratna, Muhammad Naveed, Nawsherwan , Biswa Prakash Nayak, Vinod C Nayak, Hadush Negash, Ionut Negoi, Ruxandra Irina Negoi, Seyed Aria Nejadghaderi, Chakib Nejjari, Soroush Nematollahi, Henok Biresaw Netsere, Marie Ng, Georges Nguefack-Tsague, Josephine W Ngunjiri, Anh Hoang Nguyen, Dang H Nguyen, Duc Hoang Nguyen, Hau Thi Hien Nguyen, Nhan Nguyen, Nhien Ngoc Y Nguyen, Phat Tuan Nguyen, QuynhAnh P Nguyen, Van Thanh Nguyen, Duc Nguyen Tran Minh, Robina Khan Niazi, Yeshambel T Nigatu, Mahdieh Niknam, Ali Nikoobar, Amin Reza Nikpoor, Nasrin Nikravangolsefid, Efaq Ali Noman, Shuhei Nomura, Syed Toukir Ahmed Noor, Nafise Noroozi, Mehran Nouri, Majid Nozari, Chisom Adaobi Nri-Ezedi, George Ntaios, Mengistu H Nunemo, Dieta Nurrika, Jerry John Nutor, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Kehinde O Obamiro, Ismail A Odetokun, Michael Safo Oduro, Oluwaseun Adeolu Ogundijo, Adesola Adenike Ogunfowokan, Abiola Ogunkoya, Ayodipupo Sikiru Oguntade, In-Hwan Oh, Tolulope R Ojo-Akosile, Hassan Okati-Aliabad, Akinkunmi Paul Okekunle, Osaretin Christabel Okonji, Andrew T Olagunju, Matthew Idowu Olatubi, Gláucia Maria Moraes Oliveira, Bolajoko Olubukunola Olusanya, Jacob Olusegun 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Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100 : a comprehensive demographic analysis for the Global Burden of Disease Study 2021
Natalia V Bhattacharjee, Austin E Schumacher, Amirali Aali, Yohannes Habtegiorgis Abate, Rouzbeh Abbasgholizadeh, Mohammadreza Abbasian, Mohsen Abbasi-Kangevari, Hedayat Abbastabar, Samar Abd ElHafeez, Sherief Abd-Elsalam, Mohammad Abdollahi, Mohammad-Amin Abdollahifar, Meriem Abdoun, Auwal Abdullahi, Mesfin Abebe, Samrawit Shawel Abebe, Olumide Abiodun, Hassan Abolhassani, Meysam Abolmaali, Mohamed Abouzid, Girma Beressa Aboye, Lucas Guimarães Abreu, Woldu Aberhe Abrha, Michael R M Abrigo, Dariush Abtahi, Hasan Abualruz, Bilyaminu Abubakar, Eman Abu-Gharbieh, Niveen ME Abu-Rmeileh, Tadele Girum Girum Adal, Mesafint Molla Adane, Oluwafemi Atanda Adeagbo Adeagbo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Bashir Aden, Abiola Victor Adepoju, Olatunji O Adetokunboh, Juliana Bunmi Adetunji, Daniel Adedayo Adeyinka, Olorunsola Israel Adeyomoye, Qorinah Estiningtyas Sakilah Adnani, Saryia Adra, Rotimi Felix Afolabi, Shadi Afyouni, Muhammad Sohail Afzal, Saira Afzal, Shahin Aghamiri, Antonella 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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations.Research reported in this publication was supported by the Bill & Melinda Gates Foundation; Queensland Department of Health, Australia; UK Department of Health and Social Care; the Norwegian Institute of Public Health; St Jude Children’s Research Hospital; and the New Zealand Ministry of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law–2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Collection of these data was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00.Peer ReviewedArticle signat per 2000 autors/es: Mohsen Naghavi , Kanyin Liane Ong , Amirali Aali , Hazim S Ababneh , Yohannes Habtegiorgis Abate , Cristiana Abbafati , Rouzbeh Abbasgholizadeh , Mohammadreza Abbasian , Mohsen Abbasi-Kangevari , Hedayat Abbastabar , Samar Abd ElHafeez , Michael Abdelmasseh , Sherief Abd-Elsalam , Ahmed Abdelwahab , Mohammad Abdollahi , Mohammad-Amin Abdollahifar , Meriem Abdoun , Deldar Morad Abdulah , Auwal Abdullahi , Mesfin Abebe , Samrawit Shawel Abebe , Aidin Abedi , Kedir Hussein Abegaz , E S Abhilash , Hassan Abidi , Olumide Abiodun , Richard Gyan Aboagye , Hassan Abolhassani , Meysam Abolmaali , Mohamed Abouzid , Girma Beressa Aboye , Lucas Guimarães Abreu , Woldu Aberhe Abrha , Dariush Abtahi , Samir Abu Rumeileh , Hasan Abualruz , Bilyaminu Abubakar , Eman Abu-Gharbieh , Niveen ME Abu-Rmeileh , Salahdein Aburuz , Ahmed Abu-Zaid , Manfred Mario Kokou Accrombessi , Tadele Girum Adal , Abdu A Adamu , Isaac Yeboah Addo , Giovanni Addolorato , Akindele Olupelumi Adebiyi , Victor Adekanmbi , Abiola Victor Adepoju , Charles Oluwaseun Adetunji , Juliana Bunmi Adetunji , Temitayo Esther Adeyeoluwa , Daniel Adedayo Adeyinka , Olorunsola Israel Adeyomoye , Biruk Adie Adie Admass , Qorinah Estiningtyas Sakilah Adnani , Saryia Adra , Aanuoluwapo Adeyimika Afolabi , Muhammad Sohail Afzal , Saira Afzal , Suneth Buddhika Agampodi , Pradyumna Agasthi , Manik Aggarwal , Shahin Aghamiri , Feleke Doyore Agide , Antonella Agodi , Anurag Agrawal , Williams Agyemang-Duah , Bright Opoku Ahinkorah , Aqeel Ahmad , Danish Ahmad , Firdos Ahmad , Muayyad M Ahmad , Sajjad Ahmad , Shahzaib Ahmad , Tauseef Ahmad , Keivan Ahmadi , Amir Mahmoud Ahmadzade , Ali Ahmed , Ayman Ahmed , Haroon Ahmed , Luai A Ahmed , Mehrunnisha Sharif Ahmed , Meqdad Saleh Ahmed , Muktar Beshir Ahmed , Syed Anees Ahmed , Marjan Ajami , Budi Aji , Essona Matatom Akara , Hossein Akbarialiabad , Karolina Akinosoglou , Tomi Akinyemiju , Mohammed Ahmed Akkaif , Samuel Akyirem , Hanadi Al Hamad , Syed Mahfuz Al Hasan , Fares Alahdab , Samer O Alalalmeh , Tariq A Alalwan , Ziyad Al-Aly , Khurshid Alam , Manjurul Alam , Noore Alam , Rasmieh Mustafa Al-amer , Fahad Mashhour Alanezi , Turki M Alanzi , Sayer Al-Azzam , Almaza Albakri , Mohammed Albashtawy , Mohammad T AlBataineh , Jacqueline Elizabeth Alcalde-Rabanal , Khalifah A Aldawsari , Wafa A Aldhaleei , Robert W Aldridge , Haileselasie Berhane Alema , Mulubirhan Assefa Alemayohu , Sharifullah Alemi , Yihun Mulugeta Alemu , Adel Ali Saeed Al-Gheethi , Khalid F Alhabib , Fadwa Alhalaiqa Naji Alhalaiqa , Mohammed Khaled Al-Hanawi , Abid Ali , Amjad Ali , Liaqat Ali , Mohammed Usman Ali , Rafat Ali , Shahid Ali , Syed Shujait Shujait Ali , Gianfranco Alicandro , Sheikh Mohammad Alif , Reyhaneh Alikhani , Yousef Alimohamadi , Ahmednur Adem Aliyi , Mohammad A M Aljasir , Syed Mohamed Aljunid , François Alla , Peter Allebeck , Sabah Al-Marwani , Sadeq Ali Ali Al-Maweri , Joseph Uy Almazan , Hesham M Al-Mekhlafi , Louay Almidani , Omar Almidani , Mahmoud A Alomari , Basem Al-Omari , Jordi Alonso , Jaber S Alqahtani , Shehabaldin Alqalyoobi , Ahmed Yaseen Alqutaibi , Salman Khalifah Al-Sabah , Zaid Altaany , Awais Altaf , Jaffar A Al-Tawfiq , Khalid A Altirkawi , Deborah Oyine Aluh , Nelson Alvis-Guzman , Hassan Alwafi , Yaser Mohammed Al-Worafi , Hany Aly , Safwat Aly , Karem H Alzoubi , Reza Amani , Azmeraw T Amare , Prince M Amegbor , Edward Kwabena Ameyaw , Tarek Tawfik Amin , Alireza Amindarolzarbi , Sohrab Amiri , Mohammad Hosein Amirzade-Iranaq , Hubert Amu , Dickson A Amugsi , Ganiyu Adeniyi Amusa , Robert Ancuceanu , Deanna Anderlini , David B Anderson , Pedro Prata Andrade , Catalina Liliana Andrei , Tudorel Andrei , Colin Angus , Abhishek Anil , Sneha Anil , Amir Anoushiravani , Hossein Ansari , Ansariadi Ansariadi , Alireza Ansari-Moghaddam , Catherine M Antony , Ernoiz Antriyandarti , Davood Anvari , Saeid Anvari , Saleha Anwar , Sumadi Lukman Anwar , Razique Anwer , Anayochukwu Edward Anyasodor , Muhammad Aqeel , Juan Pablo Arab , Jalal Arabloo , Mosab Arafat , Aleksandr Y Aravkin , Demelash Areda , Abdulfatai Aremu , Olatunde Aremu , Hany Ariffin , Mesay Arkew , Benedetta Armocida , Michael Benjamin Arndt , Johan Ärnlöv , Mahwish Arooj , Anton A Artamonov , Judie Arulappan , Raphael Taiwo Aruleba , Ashokan Arumugam , Malke Asaad , Mohsen Asadi-Lari , Akeza Awealom Asgedom , Mona Asghariahmadabad , Mohammad Asghari-Jafarabadi , Muhammad Ashraf , Armin Aslani , Thomas Astell-Burt , Mohammad Athar , Seyyed Shamsadin Athari , Bantalem Tilaye Tilaye Atinafu , Habtamu Wondmagegn Atlaw , Prince Atorkey , Maha Moh'd Wahbi Atout , Alok Atreya , Avinash Aujayeb , Marcel Ausloos , Abolfazl Avan , Atalel Fentahun Awedew , Amlaku Mulat Aweke , Beatriz Paulina Ayala Quintanilla , Haleh Ayatollahi , Jose L Ayuso-Mateos , Seyed Mohammad Ayyoubzadeh , Sina Azadnajafabad , Rui M S Azevedo , Ahmed Y Azzam , Darshan B B , Abraham Samuel Babu , Muhammad Badar , Ashish D Badiye , Soroush Baghdadi , Nasser Bagheri , Sara Bagherieh , Sulaiman Bah , Saeed Bahadorikhalili , Najmeh Bahmanziari , Ruhai Bai , Atif Amin Baig , Jennifer L Baker , Abdulaziz T Bako , Ravleen Kaur Bakshi , Senthilkumar Balakrishnan , Madhan Balasubramanian , Ovidiu Constantin Baltatu , Kiran Bam , Maciej Banach , Soham Bandyopadhyay , Palash Chandra Banik , Hansi Bansal , Kannu Bansal , Franca Barbic , Martina Barchitta , Mainak Bardhan , Erfan Bardideh , Suzanne Lyn Barker-Collo , Till Winfried Bärnighausen , Francesco Barone-Adesi , Hiba Jawdat Barqawi , Lope H Barrero , Amadou Barrow , Sandra Barteit , Lingkan Barua , Zarrin Basharat , Azadeh Bashiri , Afisu Basiru , Pritish Baskaran , Buddha Basnyat , Quique Bassat , João Diogo Basso , Ann V L Basting , Sanjay Basu , Kavita Batra , Bernhard T Baune , Mohsen Bayati , Nebiyou Simegnew Bayileyegn , Thomas Beaney , Neeraj Bedi , Massimiliano Beghi , Emad Behboudi , Priyamadhaba Behera , Amir Hossein Behnoush , Masoud Behzadifar , Maryam Beiranvand , Diana Fernanda Bejarano Ramirez , Yannick Béjot , Sefealem Assefa Belay , Chalie Mulu Belete , Michelle L Bell , Muhammad Bashir Bello , Olorunjuwon Omolaja Bello , Luis Belo , Apostolos Beloukas , Rose Grace Bender , Isabela M Bensenor , Azizullah Beran , Zombor Berezvai , Alemshet Yirga Berhie , Betyna N Berice , Robert S Bernstein , Gregory J Bertolacci , Paulo J G Bettencourt , Kebede A Beyene , Devidas S Bhagat , Akshaya Srikanth Bhagavathula , Neeraj Bhala , Ashish Bhalla , Dinesh Bhandari , Kayleigh Bhangdia , Nikha Bhardwaj , Pankaj Bhardwaj , Prarthna V Bhardwaj , Ashish Bhargava , Sonu Bhaskar , Vivek Bhat , Gurjit Kaur Bhatti , Jasvinder Singh Bhatti , Manpreet S Bhatti , Rajbir Bhatti , Zulfiqar A Bhutta , Boris Bikbov , Jessica Devin Bishai , Catherine Bisignano , Francesca Bisulli , Atanu Biswas , Bijit Biswas , Saeid Bitaraf , Bikes Destaw Bitew , Veera R Bitra , Tone Bjørge , Micheal Kofi Boachie , Mary Sefa Boampong , Anca Vasilica Bobirca , Virginia Bodolica , Aadam Olalekan Bodunrin , Eyob Ketema Bogale , Kassawmar Angaw Bogale , Somayeh Bohlouli , Obasanjo Afolabi Bolarinwa , Archith Boloor , Milad Bonakdar Hashemi , Aime Bonny , Kaustubh Bora , Berrak Bora Basara , Hamed Borhany , Arturo Borzutzky , Souad Bouaoud , Antoine Boustany , Christopher Boxe , Edward J Boyko , Oliver J Brady , Dejana Braithwaite , Luisa C Brant , Michael Brauer , Alexandra Brazinova , Javier Brazo-Sayavera , Nicholas J K Breitborde , Susanne Breitner , Hermann Brenner , Andrey Nikolaevich Briko , Nikolay Ivanovich Briko , Gabrielle Britton , Julie Brown , Traolach Brugha , Norma B Bulamu , Lemma N Bulto , Danilo Buonsenso , Richard A Burns , Reinhard Busse , Yasser Bustanji , Nadeem Shafique Butt , Zahid A Butt , Florentino Luciano Caetano dos Santos , Daniela Calina , Luis Alberto Cámera , Luciana Aparecida Campos , Ismael R Campos-Nonato , Chao Cao , Yin Cao , Angelo Capodici , Rosario Cárdenas , Sinclair Carr , Giulia Carreras , Juan J Carrero , Andrea Carugno , Cristina G Carvalheiro , Felix Carvalho , Márcia Carvalho , Joao Mauricio Castaldelli-Maia , Carlos A Castañeda-Orjuela , Giulio Castelpietra , Ferrán Catalá-López , Alberico L Catapano , Maria Sofia Cattaruzza , Christopher R Cederroth , Luca Cegolon , Francieli Cembranel , Muthia Cenderadewi , Kelly M Cercy , Ester Cerin , Muge Cevik , Joshua Chadwick , Yaacoub Chahine , Chiranjib Chakraborty , Promit Ananyo Chakraborty , Jeffrey Shi Kai Chan , Raymond N C Chan , Rama Mohan Chandika , Eeshwar K Chandrasekar , Chin-Kuo Chang , Jung-Chen Chang , Gashaw Sisay Chanie , Periklis Charalampous , Vijay Kumar Chattu , Pankaj Chaturvedi , Victoria Chatzimavridou-Grigoriadou , Akhilanand Chaurasia , Angela W Chen , An-Tian Chen , Catherine S Chen , Haowei Chen , Meng Xuan Chen , Simiao Chen , Ching-Yu Cheng , Esther T W Cheng , Nicolas Cherbuin , Wondimye Ashenafi Cheru , Ju-Huei Chien , Odgerel Chimed-Ochir , Ritesh Chimoriya , Patrick R Ching , Jesus Lorenzo Chirinos-Caceres , Abdulaal Chitheer , William C S Cho , Bryan Chong , Hitesh Chopra , Sonali Gajanan Choudhari , Rajiv Chowdhury , Devasahayam J Christopher , Isaac Sunday Chukwu , Eric Chung , Erin Chung , Eunice Chung , Sheng-Chia Chung , Muhammad Chutiyami , Zinhle Cindi , Iolanda Cioffi , Mareli M Claassens , Rafael M Claro , Kaleb Coberly , Rebecca M Cogen , Alyssa Columbus , Haley Comfort , Joao Conde , Samuele Cortese , Paolo Angelo Cortesi , Vera Marisa Costa , Simona Costanzo , Ewerton Cousin , Rosa A S Couto , Richard G Cowden , Kenneth Michael Cramer , Michael H Criqui , Natália Cruz-Martins , Silvia Magali Cuadra-Hernández , Garland T Culbreth , Patricia Cullen , Matthew Cunningham , Maria paula Curado , Sriharsha Dadana , Omid Dadras , Siyu Dai , Xiaochen Dai , Zhaoli Dai , Lachlan L Dalli , Giovanni Damiani , Jiregna Darega Gela , Jai K Das , Saswati Das , Subasish Das , Ana Maria Dascalu , Nihar Ranjan Dash , Mohsen Dashti , Anna Dastiridou , Gail Davey , Claudio Alberto Dávila-Cervantes , Nicole Davis Weaver , Kairat Davletov , Diego De Leo , Katie de Luca , Aklilu Tamire Debele , Shayom Debopadhaya , Louisa Degenhardt , Azizallah Dehghan , Lee Deitesfeld , Cristian Del Bo' , Ivan Delgado-Enciso , Berecha Hundessa Demessa , Andreas K Demetriades , Ke Deng , Xinlei Deng , Edgar Denova-Gutiérrez , Niloofar Deravi , Nebiyu Dereje , Nikolaos Dervenis , Emina Dervišević , Don C Des Jarlais , Hardik Dineshbhai Desai , Rupak Desai , Vinoth Gnana Chellaiyan Devanbu , Syed Masudur Rahman Dewan , Arkadeep Dhali , Kuldeep Dhama , Meghnath Dhimal , Sameer Dhingra , Vishal R Dhulipala , Diana Dias da Silva , Daniel Diaz , Michael J Diaz , Adriana Dima , Delaney D Ding , Huanghe Ding , Ricardo Jorge Dinis-Oliveira , M Ashworth Dirac , Shirin Djalalinia , Thao Huynh Phuong Do , Camila Bruneli do Prado , Saeid Doaei , Masoud Dodangeh , Milad Dodangeh , Sushil Dohare , Klara Georgieva Dokova , Christiane Dolecek , Regina-Mae Villanueva Dominguez , Wanyue Dong , Deepa Dongarwar , Mario D'Oria , Fariba Dorostkar , E Ray Dorsey , Wendel Mombaque dos Santos , Rajkumar Doshi , Leila Doshmangir , Robert Kokou Dowou , Tim Robert Driscoll , Haneil Larson Dsouza , Viola Dsouza , Mi Du , John Dube , Bruce B Duncan , Andre Rodrigues Duraes , Senbagam Duraisamy , Oyewole Christopher Durojaiye , Laura Dwyer-Lindgren , Paulina Agnieszka Dzianach , Arkadiusz Marian Dziedzic , Abdel Rahman E'mar , Ejemai Eboreime , Alireza Ebrahimi , Chidiebere Peter Echieh , Hisham Atan Edinur , David Edvardsson , Kristina Edvardsson , Defi Efendi , Ferry Efendi , Diyan Ermawan Effendi , Terje Andreas Eikemo , Ebrahim Eini , Michael Ekholuenetale , Temitope Cyrus Ekundayo , Iman El Sayed , Iffat Elbarazi , Teshome Bekele Elema , Noha Mousaad Elemam , Frank J Elgar , Islam Y Elgendy , Ghada Metwally Tawfik ElGohary , Hala Rashad Elhabashy , Muhammed Elhadi , Waseem El-Huneidi , Legesse Tesfaye Elilo , Omar Abdelsadek Abdou Elmeligy , Mohamed A Elmonem , Mohammed Elshaer , Ibrahim Elsohaby , Theophilus I Emeto , Luchuo Engelbert Bain , Ryenchindorj Erkhembayar , Christopher Imokhuede Esezobor , Babak Eshrati , Sharareh Eskandarieh , Juan Espinosa-Montero , Habtamu Esubalew , Farshid Etaee , Natalia Fabin , Adewale Oluwaseun Fadaka , Adeniyi Francis Fagbamigbe , Ayesha Fahim , Saman Fahimi , Aliasghar Fakhri-Demeshghieh , Luca Falzone , Mohammad Fareed , Carla Sofia e Sá Farinha , MoezAlIslam Ezzat Mahmoud Faris , Pawan Sirwan Faris , Andre Faro , Abidemi Omolara Fasanmi , Ali Fatehizadeh , Hamed Fattahi , Nelsensius Klau Fauk , Pooria Fazeli , Valery L Feigin , Alireza Feizkhah , Ginenus Fekadu , Xiaoru Feng , Seyed-Mohammad Fereshtehnejad , Abdullah Hamid Feroze , Daniela Ferrante , Alize J Ferrari , Nuno Ferreira , Getahun Fetensa , Bikila Regassa Feyisa , Irina Filip , Florian Fischer , Joanne Flavel , David Flood , Bobirca Teodor Florin , Nataliya A Foigt , Morenike Oluwatoyin Folayan , Artem Alekseevich Fomenkov , Behzad Foroutan , Masoud Foroutan , Ingeborg Forthun , Daniela Fortuna , Matteo Foschi , Kayode Raphael Fowobaje , Kate Louise Francis , Richard Charles Franklin , Alberto Freitas , Joseph Friedman , Sara D Friedman , Takeshi Fukumoto , John E Fuller , Blima Fux , Peter Andras Gaal , Muktar A Gadanya , Abhay Motiramji Gaidhane , Santosh Gaihre , Emmanuela Gakidou , Yaseen Galali , Natalie C Galles , Silvano Gallus , Mandukhai Ganbat , Aravind P Gandhi , Balasankar Ganesan , Mohammad Arfat Ganiyani , MA Garcia-Gordillo , William M Gardner , Jalaj Garg , Naval Garg , Rupesh K Gautam , Semiu Olatunde Gbadamosi , Tilaye Gebru Gebi , Miglas W Gebregergis , Mesfin Gebrehiwot , Teferi Gebru Gebremeskel , Simona Roxana Georgescu , Tamirat Getachew , Peter W Gething , Molla Getie , Keyghobad Ghadiri , Sulmaz Ghahramani , Khalid Yaser Ghailan , Mohammad-Reza Ghasemi , Ghazal Ghasempour Dabaghi , Afsaneh Ghasemzadeh , Ahmad Ghashghaee , Fariba Ghassemi , Ramy Mohamed Ghazy , Ajnish Ghimire , Sama Ghoba , Maryam Gholamalizadeh , Asadollah Gholamian , Ali Gholamrezanezhad , Nasim Gholizadeh , Mahsa Ghorbani , Pooyan Ghorbani Vajargah , Aloke Gopal Ghoshal , Paramjit Singh Gill , Tiffany K Gill , Richard F Gillum , Themba G Ginindza , Alem Girmay , James C Glasbey , Elena V Gnedovskaya , Laszlo Göbölös , Myron Anthony Godinho , Amit Goel , Ali Golchin , Mohamad Goldust , Mahaveer Golechha , Pouya Goleij , Nelson G M Gomes , Philimon N Gona , Sameer Vali Gopalani , Giuseppe Gorini , Houman Goudarzi , Alessandra C Goulart , Bárbara Niegia Garcia Goulart , Anmol Goyal , Ayman Grada , Simon Matthew Graham , Michal Grivna , Giuseppe Grosso , Shi-Yang Guan , Giovanni Guarducci , Mohammed Ibrahim Mohialdeen Gubari , Mesay Dechasa Gudeta , Avirup Guha , Stefano Guicciardi , Rafael Alves Guimarães , Snigdha Gulati , Damitha Asanga Gunawardane , Sasidhar Gunturu , Cui Guo , Anish Kumar Gupta , Bhawna Gupta , Manoj Kumar Gupta , Mohak Gupta , Rajat Das Gupta , Rajeev Gupta , Sapna Gupta , Veer Bala Gupta , Vijai Kumar Gupta , Vivek Kumar Gupta , Lami Gurmessa , Reyna Alma Gutiérrez , Farrokh Habibzadeh , Parham Habibzadeh , Rasool Haddadi , Mostafa Hadei , Najah R Hadi , Nils Haep , Nima Hafezi-Nejad , Alemayehu Hailu , Arvin Haj-Mirzaian , Esam S Halboub , Brian J Hall , Sebastian Haller , Rabih Halwani , Randah R Hamadeh , Sajid Hameed , Samer Hamidi , Erin B Hamilton , Chieh Han , Qiuxia Han , Asif Hanif , Nasrin Hanifi , Graeme J Hankey , Fahad Hanna , Md Abdul Hannan , Md Nuruzzaman Haque , Harapan Harapan , Arief Hargono , Josep Maria Haro , Ahmed I Hasaballah , Ikramul Hasan , M Tasdik Hasan , Hamidreza Hasani , Mohammad Hasanian , Abdiwahab Hashi , Md Saquib Hasnain , Ikrama Hassan , Soheil Hassanipour , Hadi Hassankhani , Johannes Haubold , Rasmus J Havmoeller , Simon I Hay , Jiawei He , Jeffrey J Hebert , Omar E Hegazi , Golnaz Heidari , Mohammad Heidari , Mahsa Heidari-Foroozan , Bartosz Helfer , Delia Hendrie , Brenda Yuliana Herrera-Serna , Claudiu Herteliu , Hamed Hesami , Kamal Hezam , Catherine L Hill , Yuta Hiraike , Ramesh Holla , Nobuyuki Horita , Md Mahbub Hossain , Sahadat Hossain , Mohammad-Salar Hosseini , Hassan Hosseinzadeh , Mehdi Hosseinzadeh , Ahmad Hosseinzadeh Adli , Mihaela Hostiuc , Sorin Hostiuc , Mohamed Hsairi , Vivian Chia-rong Hsieh , Rebecca L Hsu , Chengxi Hu , Junjie Huang , Michael Hultström , Ayesha Humayun , Tsegaye Gebreyes Hundie , Javid Hussain , M Azhar Hussain , Nawfal R Hussein , Foziya Mohammed Hussien , Hong-Han Huynh , Bing-Fang Hwang , Segun Emmanuel Ibitoye , Khalid S Ibrahim , Pulwasha Maria Iftikhar , Desta Ijo , Adalia I Ikiroma , Kevin S Ikuta , Paul Chukwudi Ikwegbue , Olayinka Stephen Ilesanmi , Irena M Ilic , Milena D Ilic , Mohammad Tarique Imam , Mustapha Immurana , Sumant Inamdar , Endang Indriasih , Muhammad Iqhrammullah , Arnaud Iradukunda , Kenneth Chukwuemeka Iregbu , Md Rabiul Islam , Sheikh Mohammed Shariful Islam , Farhad Islami , Faisal Ismail , Nahlah Elkudssiah Ismail , Hiroyasu Iso , Gaetano Isola , Masao Iwagami , Chidozie C D Iwu , Ihoghosa Osamuyi Iyamu , Mahalaxmi Iyer , Linda Merin J , Jalil Jaafari , Louis Jacob , Kathryn H Jacobsen , Farhad Jadidi-Niaragh , Morteza Jafarinia , Abdollah Jafarzadeh , Khushleen Jaggi , Kasra Jahankhani , Nader Jahanmehr , Haitham Jahrami , Nityanand Jain , Ammar Abdulrahman Jairoun , Abhishek Jaiswal , Elham Jamshidi , Mark M Janko , Abubakar Ibrahim Jatau , Sabzali Javadov , Tahereh Javaheri , Sathish Kumar Jayapal , Shubha Jayaram , Rime Jebai , Sun Ha Jee , Jayakumar Jeganathan , Anil K Jha , Ravi Prakash Jha , Heng Jiang , Yingzhao Jin , Olatunji Johnson , Mohammad Jokar , Jost B Jonas , Tamas Joo , Abel Joseph , Nitin Joseph , Charity Ehimwenma Joshua , Grace Joshy , Jacek Jerzy Jozwiak , Mikk Jürisson , Vaishali K , Billingsley Kaambwa , Ali Kabir , Zubair Kabir , Vidya Kadashetti , Dler Hussein Kadir , Rizwan Kalani , Laleh R Kalankesh , Leila R Kalankesh , Feroze Kaliyadan , Sanjay Kalra , Vineet Kumar Kamal , Sivesh Kathir Kamarajah , Rajesh Kamath , Zahra Kamiab , Naser Kamyari , Thanigaivelan Kanagasabai , Tanuj Kanchan , Himal Kandel , Arun R Kanmanthareddy , Edmund Wedam Kanmiki , Kehinde Kazeem Kanmodi , Suthanthira Kannan S , Sushil Kumar Kansal , Rami S Kantar , Neeti Kapoor , Mehrdad Karajizadeh , Shama D Karanth , Reema A Karasneh , Ibraheem M Karaye , André Karch , Asima Karim , Salah Eddin Karimi , Arman Karimi Behnagh , Faizan Zaffar Kashoo , Qalandar Hussein Abdulkarim Kasnazani , Hengameh Kasraei , Nicholas J Kassebaum , Molly B Kassel , Joonas H Kauppila , Navjot Kaur , Norito Kawakami , Gbenga A Kayode , Foad Kazemi , Sina Kazemian , Tahseen Haider Kazmi , Getu Mosisa Kebebew , Adera Debella Kebede , Fassikaw Kebede , Tibebeselassie S Keflie , Peter Njenga Keiyoro , Cathleen Keller , Jaimon Terence Kelly , John H Kempen , Jessica A Kerr , Emmanuelle Kesse-Guyot , Himanshu Khajuria , Amirmohammad Khalaji , Nauman Khalid , Anees Ahmed Khalil , Alireza Khalilian , Faham Khamesipour , Ajmal Khan , Asaduzzaman Khan , Gulfaraz Khan , Ikramullah Khan , Imteyaz A Khan , M Nuruzzaman Khan , Maseer Khan , Mohammad Jobair Khan , Moien AB Khan , Zeeshan Ali Khan , Mahammed Ziauddin Khan suheb , Shaghayegh Khanmohammadi , Khaled Khatab , Fatemeh Khatami , Haitham Khatatbeh , Moawiah Mohammad Khatatbeh , Armin Khavandegar , Hamid Reza Khayat Kashani , Feriha Fatima Khidri , Elaheh Khodadoust , Mohammad Khorgamphar , Moein Khormali , Zahra Khorrami , Ahmad Khosravi , Mohammad Ali Khosravi , Zemene Demelash Kifle , Grace Kim , Jihee Kim , Kwanghyun Kim , Min Seo Kim , Yun Jin Kim , Ruth W Kimokoti , Kasey E Kinzel , Adnan Kisa , Sezer Kisa , Desmond Klu , Ann Kristin Skrindo Knudsen , Jonathan M Kocarnik , Sonali Kochhar , Timea Kocsis , David S Q Koh , Ali-Asghar Kolahi , Kairi Kolves , Farzad Kompani , Gerbrand Koren , Soewarta Kosen , Karel Kostev , Parvaiz A Koul , Sindhura Lakshmi Koulmane Laxminarayana , Kewal Krishan , Hare Krishna , Varun Krishna , Vijay Krishnamoorthy , Yuvaraj Krishnamoorthy , Kris J Krohn , Barthelemy Kuate Defo , Burcu Kucuk Bicer , Md Abdul Kuddus , Mohammed Kuddus , Ilari Kuitunen , Mukhtar Kulimbet , Vishnutheertha Kulkarni , Akshay Kumar , Ashish Kumar , Harish Kumar , Manasi Kumar , Rakesh Kumar , Madhulata Kumari , Fantahun Tarekegn Kumie , Satyajit Kundu , Om P Kurmi , Asep Kusnali , Dian
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The burden of bacterial antimicrobial resistance in the WHO African region in 2019: a cross-country systematic analysis
Background A critical and persistent challenge to global health and modern health care is the threat of antimicrobial resistance (AMR). Previous studies have reported a disproportionate burden of AMR in low-income and middleincome countries, but there remains an urgent need for more in-depth analyses across Africa. This study presents one of the most comprehensive sets of regional and country-level estimates of bacterial AMR burden in the WHO African region to date. Methods We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen-drug combinations for countries in the WHO African region in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). We obtained data from research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. Findings In the WHO African region in 2019, there were an estimated 1 center dot 05 million deaths (95% UI 829 000-1 316 000) associated with bacterial AMR and 250 000 deaths (192 000-325 000) attributable to bacterial AMR. The largest fatal AMR burden was attributed to lower respiratory and thorax infections (119 000 deaths [92 000-151 000], or 48% of all estimated bacterial pathogen AMR deaths), bloodstream infections (56 000 deaths [37 000-82 000], or 22%), intraabdominal infections (26 000 deaths [17 000-39 000], or 10%), and tuberculosis (18 000 deaths [3850-39 000], or 7%). Seven leading pathogens were collectively responsible for 821 000 deaths (636 000-1 051 000) associated with resistance in this region, with four pathogens exceeding 100 000 deaths each: Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus. Third-generation cephalosporin-resistant K pneumoniae and meticillinresistant S aureus were shown to be the leading pathogen-drug combinations in 25 and 16 countries, respectively (53% and 34% of the whole region, comprising 47 countries) for deaths attributable to AMR. Interpretation This study reveals a high level of AMR burden for several bacterial pathogens and pathogen-drug combinations in the WHO African region. The high mortality rates associated with these pathogens demonstrate an urgent need to address the burden of AMR in Africa. These estimates also show that quality and access to health care and safe water and sanitation are correlated with AMR mortality, with a higher fatal burden found in lower resource settings.
Our cross -country analyses within this region can help local governments to leverage domestic and global funding to create stewardship policies that target the leading pathogen-drug combinations
Global, regional, and national burden of epilepsy, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Background: Epilepsy is one of the most common serious neurological disorders and affects individuals of all ages across the globe. The aim of this study is to provide estimates of the epilepsy burden on the global, regional, and national levels for 1990–2021. Methods: Using well established Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) methodology, we quantified the prevalence of active idiopathic (epilepsy of genetic or unknown origin) and secondary epilepsy (epilepsy due to an underlying abnormality of the brain structure or chemistry), as well as incidence, death, and disability-adjusted life-years (DALYs) by age, sex, and location (globally, 21 GBD regions and seven super-regions, World Bank country income levels, Socio-demographic Index [SDI], and 204 countries) and their trends from 1990 to 2021. Vital registrations and verbal autopsies provided information about deaths, and data on the prevalence and severity of epilepsy, largely came from population representative surveys. All estimates were calculated with 95% uncertainty intervals (UIs). Findings: In 2021, there were 51·7 million (95% UI 44·9–58·9) people with epilepsy (idiopathic and secondary combined) globally, with an age-standardised prevalence of 658 per 100 000 (569–748). Idiopathic epilepsy had an age-standardised prevalence of 307 per 100 000 (235–389) globally, with 24·2 million (18·5–30·7) prevalent cases, and secondary epilepsy had a global age-standardised prevalence of 350 per 100 000 (322–380). In 2021, 0·7% of the population had active epilepsy (0·3% attributed to idiopathic epilepsy and 0·4% to secondary epilepsy), and the age-standardised global prevalence of epilepsy from idiopathic and secondary epilepsy combined increased from 1990 to 2021 by 10·8% (1·1–21·3), mainly due to corresponding changes in secondary epilepsy. However, age-standardised death and DALY rates of idiopathic epilepsy reduced from 1990 to 2021 (decline of 15·8% [8·8–22·8] and 14·5% [4·2–24·2], respectively). There were three-fold to four-fold geographical differences in the burden of active idiopathic epilepsy, with the bulk of the burden residing in low-income to middle-income countries: 82·1% (81·1–83·4) of incident, 80·4% prevalent (79·7–82·7), 84·7% (83·7–85·1) fatal epilepsy, and 87·9% (86·2–89·2) epilepsy DALYs. Interpretation: Although the global trends in idiopathic epilepsy deaths and DALY rates have improved in the preceding decades, in 2021 there were almost 52 million people with active epilepsy (24 million from idiopathic epilepsy and 28 million from secondary epilepsy), with the bulk of the burden (>80%) residing in low-income to middle-income countries. Better treatment and prevention of epilepsy are required, along with further research on risk factors of idiopathic epilepsy, good-quality long-term epilepsy surveillance studies, and exploration of the possible effect of stigma and cultural differences in seeking medical attention for epilepsy. Funding: Bill and Melinda Gates Foundatio
Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021
Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
