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    Five insights from the Global Burden of Disease Study 2019
    Abbafati, C ; Abbas, KM ; Abbasi, M ; Abbasifard, M ; Abbasi-Kangevari, M ; Abbastabar, H ; Abd-Allah, F ; Abdelalim, A ; Abdollahi, M ; Abdollahpour, I ; Abedi, A ; Abedi, P ; Abegaz, KH ; Abolhassani, H ; Abosetugn, AE ; Aboyans, V ; Abrams, EM ; Abreu, LG ; Abrigo, MRM ; Abu Haimed, AK ; Abualhasan, A ; Abu-Gharbieh, E ; Abu-Raddad, LJ ; Abushouk, AI ; Acebedo, A ; Ackerman, IN ; Adabi, M ; Adair, T ; Adamu, AA ; Adebayo, OM ; Adedeji, IA ; Adekanmbi, V ; Adelson, JD ; Adeoye, AM ; Adetokunboh, OO ; Adham, D ; Advani, SM ; Afarideh, M ; Afshari, M ; Afshin, A ; Agardh, EE ; Agarwal, G ; Agasthi, P ; Agesa, KM ; Aghaali, M ; Aghamir, SMK ; Agrawal, A ; Ahmad, T ; Ahmadi, A ; Ahmadi, K ; Ahmadi, M ; Ahmadieh, H ; Ahmadpour, E ; Ahmed, MB ; Aji, B ; Akalu, TY ; Akinyemi, RO ; Akinyemiju, T ; Akombi, B ; Akunna, CJ ; Alahdab, F ; Al-Aly, Z ; Alam, K ; Alam, N ; Alam, S ; Alam, T ; Alanezi, FM ; Alanzi, TM ; Albertson, SB ; Alcalde-Rabanal, JE ; Alema, NM ; Alemu, BW ; Alemu, YM ; Alhabib, KF ; Alhassan, RK ; Ali, M ; Ali, S ; Alicandro, G ; Alijanzadeh, M ; Alinia, C ; Alipour, V ; Alizade, H ; Aljunid, SM ; Alla, F ; Allebeck, P ; Almadi, MAH ; Almasi, A ; Almasi-Hashiani, A ; Almasri, NA ; Al-Mekhlafi, HM ; Almulhim, AM ; Alonso, J ; Al-Raddadi, RM ; Altirkawi, KA ; Alumran, AK ; Alvis-Guzman, N ; Alvis-Zakzuk, NJ ; Amare, AT ; Amare, B ; Amini, S ; Amini-Rarani, M ; Aminorroaya, A ; Amiri, F ; Amit, AML ; Amugsi, DA ; Amul, GGH ; Anbesu, EW ; Ancuceanu, R ; Anderlini, D ; Anderson, JA ; Andrei, CL ; Andrei, T ; Androudi, S ; Angus, C ; Anjomshoa, M ; Ansari, F ; Ansari, I ; Ansari-Moghaddam, A ; Antonazzo, IC ; Antonio, CAT ; Antony, CM ; Antriyandarti, E ; Anvari, D ; Anwer, R ; Appiah, SCY ; Arabloo, J ; Arab-Zozani, M ; Aravkin, AY ; Arba, AAK ; Aremu, O ; Ariani, F ; Aripov, T ; Armoon, B ; Arnlov, J ; Arowosegbe, OO ; Aryal, KK ; Arzani, A ; Asaad, M ; Asadi-Aliabadi, M ; Asadi-Pooya, AA ; Asgari, S ; Asghari, B ; Jafarabadi, MA ; Ashbaugh, C ; Assmus, M ; Atafar, Z ; Athari, SS ; Atnafu, DD ; Atout, MMW ; Atre, SR ; Atteraya, MS ; Ausloos, F ; Ausloos, M ; Avila-Burgos, L ; Avokpaho, EFGA ; Quintanilla, BPA ; Ayano, G ; Ayanore, MA ; Aynalem, GL ; Aynalem, YA ; Ayza, MA ; Azari, S ; Azarian, G ; Azene, ZN ; Azhar, G ; Azzopardi, PS ; Darshan, BB ; Babaee, E ; Badawi, A ; Badiye, AD ; Bagherzadeh, M ; Bagli, E ; Bahrami, MA ; Baig, AA ; Bairwa, M ; Bakhshaei, MH ; Bakhtiari, A ; Bakkannavar, SM ; Balachandran, A ; Balakrishnan, S ; Balalla, S ; Balassyano, S ; Baldasseroni, A ; Ball, K ; Ballew, SH ; Balzi, D ; Banach, M ; Banerjee, SK ; Banik, PC ; Bannick, MS ; Bante, AB ; Bante, SA ; Baraki, AG ; Barboza, MA ; Barker-Collo, SL ; Barnighausen, TW ; Barrero, LH ; Barthelemy, CM ; Barua, L ; Barzegar, A ; Basaleem, H ; Bassat, Q ; Basu, S ; Baune, BT ; Bayati, M ; Baye, BA ; Bazmandegan, G ; Becker, JS ; Bedi, N ; Beghi, E ; Behzadifar, M ; Bejot, Y ; Bekuma, TTT ; Bell, ML ; Bello, AK ; Bender, RG ; Bennett, DA ; Bennitt, FB ; Bensenor, IM ; Benziger, CP ; Berhe, K ; Berman, AE ; Bernabe, E ; Bernstein, RS ; Bertolacci, GJ ; Bhagavathula, AS ; Bhageerathy, R ; Bhala, N ; Bhandari, D ; Bhardwaj, P ; Bhat, AG ; Bhattacharyya, K ; Bhattarai, S ; Bhutta, ZA ; Bibi, S ; Biehl, MH ; Bijani, A ; Bikbov, B ; Bilano, V ; Bin Sayeed, MS ; Biondi, A ; Birihane, BM ; Bisanzio, D ; Bisignano, C ; Biswas, RK ; Bitew, H ; Bjorge, T ; Bockarie, MJ ; Bohlouli, S ; Bohluli, M ; Bojia, HA ; Bolla, SR ; Boloor, A ; Boon-Dooley, AS ; Borges, G ; Borzi, AM ; Borzouei, S ; Bose, D ; Bosetti, C ; Boufous, S ; Bourne, R ; Brady, OJ ; Braithwaite, D ; Brauer, M ; Brayne, C ; Breitborde, NJK ; Breitner, S ; Brenner, H ; Breusov, AV ; Briant, PS ; Briggs, AM ; Briko, AN ; Briko, NI ; Britton, GB ; Brugha, T ; Bryazka, D ; Buchbinder, R ; Bumgarner, BR ; Burkart, K ; Burnett, RT ; Nagaraja, SB ; Busse, R ; Butt, ZA ; Caetano dos Santos, FL ; Cahill, LE ; Cahuana-Hurtado, L ; Cai, T ; Callender, CSKH ; Camera, LA ; Campos-Nonato, IR ; Rincon, JCC ; Cao, J ; Car, J ; Cardenas, R ; Carreras, G ; Carrero, JJ ; Carvalho, F ; Castaldelli-Maia, JM ; Castaneda-Orjuela, CA ; Castelpietra, G ; Castle, CD ; Castro, E ; Castro, F ; Catala-Lopez, F ; Causey, K ; Cederroth, CR ; Cercy, KM ; Cerin, E ; Chalek, J ; Chandan, JS ; Chang, AR ; Chang, AY ; Chang, J-C ; Chang, K-L ; Charan, J ; Charlson, FJ ; Chattu, VK ; Chaturvedi, S ; Cherbuin, N ; Chimed-Ochir, O ; Chin, KL ; Chirinos-Caceres, JL ; Cho, DY ; Choi, J-YJ ; Christensen, H ; Chu, D-T ; Chung, MT ; Chung, S-C ; Cicuttini, FM ; Ciobanu, LG ; Cirillo, M ; Cislaghi, B ; Classen, TKD ; Cohen, AJ ; Collins, EL ; Comfort, H ; Compton, K ; Conti, S ; Cooper, OR ; Corso, B ; Cortesi, PA ; Costa, VM ; Cousin, E ; Cowden, RG ; Cowie, BC ; Cromwell, EA ; Croneberger, AJ ; Cross, DH ; Cross, M ; Crowe, CS ; Cruz, JA ; Cummins, S ; Cunningham, M ; Dahlawi, SMA ; Dai, H ; Dai, H ; Damasceno, AAM ; Damiani, G ; D'Amico, E ; Dandona, L ; Dandona, R ; Daneshpajouhnejad, P ; Dangel, WJ ; Danielsson, A-K ; Gela, JD ; Dargan, PI ; Darwesh, AM ; Daryani, A ; Das, JK ; Das Gupta, R ; Das Neves, J ; Dash, AP ; Davey, G ; Davila-Cervantes, CA ; Davis, AC ; Davitoiu, DV ; Davletov, K ; De Leo, D ; De Neve, J-W ; Dean, FE ; DeCleene, NK ; Deen, A ; Degenhardt, L ; DeLang, M ; Dellavalle, RP ; Demeke, FM ; Demoz, GT ; Demsie, DG ; Denova-Gutierrez, E ; Dereje, ND ; Deribe, K ; Dervenis, N ; Desai, R ; Desalew, A ; Dessie, GA ; Deuba, K ; Dharmaratne, SD ; Dhungana, GP ; Dianatinasab, M ; da Silva, DD ; Diaz, D ; Forooshani, ZSD ; Dichgans, M ; Didarloo, A ; Dingels, ZV ; Dippenaar, IN ; Dirac, MA ; Djalalinia, S ; Do, HT ; Dokova, K ; Doku, DT ; Dolecek, C ; Dolgert, AJ ; Dorostkar, F ; Doshi, CP ; Doshi, PP ; Doshmangir, L ; Douiri, A ; Doxey, MC ; Doyle, KE ; Driscoll, TR ; Dubljanin, E ; Dunachie, SJ ; Duncan, BB ; Duraes, AR ; Eagan, AW ; Ebrahimi, H ; Kalan, ME ; Edvardsson, D ; Effiong, A ; Ehrlich, JR ; El Nahas, N ; El Sayed, I ; Zaki, MES ; El Tantawi, M ; Elbarazi, I ; Elgendy, IY ; Elhabashy, HR ; El-Jaafary, SI ; Elsharkawy, A ; Elyazar, IRF ; Emamian, MH ; Emmons-Bell, S ; Erskine, HE ; Eshrati, B ; Eskandari, K ; Eskandarieh, S ; Esmaeilnejad, S ; Esmaeilzadeh, F ; Esteghamati, A ; Esteghamati, S ; Estep, K ; Etemadi, A ; Etisso, AE ; Ezekannagha, O ; Fanzo, J ; Farag, T ; Farahmand, M ; Faraj, A ; Faraon, EJA ; Fareed, M ; Faridnia, R ; Farinha, CSES ; Farioli, A ; Faris, PS ; Faro, A ; Faruque, M ; Farzadfar, F ; Fattahi, N ; Fazaeli, AA ; Fazlzadeh, M ; Feigin, VL ; Feldman, R ; Fereshtehnejad, S-M ; Fernandes, E ; Ferrara, G ; Ferrara, P ; Ferrari, AJ ; Ferreira, ML ; Feyissa, GT ; Filip, I ; Fischer, F ; Fisher, JL ; Fitzgerald, R ; Flohr, C ; Flor, LS ; Foigt, NA ; Folayan, MO ; Fomenkov, AA ; Force, LM ; Fornari, C ; Foroutan, M ; Fox, JT ; Francis, JM ; Frank, TD ; Franklin, RC ; Freitas, M ; Fu, W ; Fukumoto, T ; Fukutaki, K ; Fuller, JE ; Fullman, N ; Furtado, JM ; Gad, MM ; Gaidhane, AM ; Gakidou, E ; Galles, NC ; Gallus, S ; Gamkrelidze, A ; Garcia-Basteiro, AL ; Gardner, WM ; Geberemariyam, BS ; Gebrehiwot, AM ; Gebremedhin, KB ; Gebremeskel, GG ; Gebremeskel, LG ; Gebresillassie, BM ; Gebreslassie, AAAA ; Geramo, YCD ; Geremew, A ; Hayoon, AG ; Gesesew, HA ; Gething, PW ; Gezae, KE ; Ghadimi, M ; Ghadiri, K ; Ghaffarifar, F ; Ghafourifard, M ; Ghajar, A ; Ghamari, F ; Ghashghaee, A ; Ghiasvand, H ; Ghith, N ; Gholamian, A ; Ghosh, R ; Giampaoli, S ; Gilani, SA ; Gill, PS ; Gill, TK ; Gillum, RF ; Ginawi, IA ; Ginindza, TG ; Gitimoghaddam, M ; Giussani, G ; Glagn, M ; Glushkova, EV ; Gnedovskaya, EV ; Godinho, MA ; Goharinezhad, S ; Golechha, M ; Goli, S ; Gomez, RS ; Gona, PN ; Gopalani, SV ; Goren, E ; Gorini, G ; Gorman, TM ; Gottlich, HC ; Goudarzi, H ; Goudarzian, AH ; Goulart, AC ; Goulart, BNG ; Grada, A ; Greaves, F ; Grivna, M ; Grosso, G ; Gubari, MIM ; Gudi, N ; Gugnani, HC ; Guimaraes, ALS ; Guimaraes, RA ; Guled, RA ; Gultie, T ; Guo, G ; Guo, Y ; Gupta, R ; Gupta, R ; Sharan, S ; Gupta, T ; Haagsma, JA ; Hachinski, V ; Haddock, B ; Hafezi-Nejad, N ; Hafiz, A ; Hagins, H ; Haile, LM ; Haile, TG ; Haj-Mirzaian, A ; Haj-Mirzaian, A ; Hall, BJ ; Halvaei, I ; Hamadeh, RR ; Abdullah, KH ; Hameed, S ; Hamidi, S ; Hamilton, EB ; Hammer, MS ; Han, C ; Han, H ; Handiso, DW ; Hanif, A ; Hankey, GJ ; Haririan, H ; Haro, JM ; Harvey, JD ; Hasaballah, AI ; Hasan, MM ; Hasanpoor, E ; Hasanzadeh, A ; Hashemian, M ; Hashi, A ; Hassan, A ; Hassan, S ; Hassanipour, S ; Hassankhani, H ; Havmoeller, RJ ; Hay, RJ ; Hay, SI ; Hayat, K ; Heibati, B ; Heidari, B ; Heidari, G ; Heidari-Soureshjani, R ; Hendrie, D ; Henny, K ; Henok, A ; Henrikson, HJ ; Henry, NJ ; Herbert, ME ; Herteliu, C ; Heydarpour, F ; Hird, TR ; Ho, HC ; Hoek, HW ; Hole, MK ; Holla, R ; Hollingsworth, B ; Hoogar, P ; Hopf, KP ; Horita, N ; Hosgood, HD ; Hossain, N ; Hosseini, M ; Hosseinzadeh, M ; Hostiuc, M ; Hostiuc, S ; Househ, M ; Hoy, DG ; Hsairi, M ; Hsiao, T ; Hsieh, VC-R ; Hu, G ; Hu, K ; Huda, TM ; Hugo, FN ; Humayun, A ; Hussain, R ; Huynh, CK ; Hwang, B-F ; Iannucci, VC ; Iavicoli, I ; Ibeneme, CU ; Ibitoye, SE ; Ikeda, N ; Ikuta, KS ; Ilesanmi, OS ; Ilic, IM ; Ilic, MD ; Imani-Nasab, MH ; Inbaraj, LR ; Ippolito, H ; Iqbal, U ; Irvani, SSN ; Irvine, CMS ; Islam, MM ; Islam, M ; Islam, SMS ; Islami, F ; Iso, H ; Ivers, RQ ; Iwu, CCD ; Iwu, CJ ; Iyamu, IO ; Jaafari, J ; Jacobsen, KH ; Jadidi-Niaragh, F ; Jafari, H ; Jafarinia, M ; Jahagirdar, D ; Jahani, MA ; Jahanmehr, N ; Jakovljevic, M ; Jalali, A ; Jalilian, F ; James, SL ; Janjani, H ; Janodia, MD ; Javaheri, T ; Javidnia, J ; Jayatilleke, AU ; Jeemon, P ; Jenabi, E ; Jha, RP ; Jha, V ; Ji, JS ; Jia, P ; Johansson, L ; John, O ; John-Akinola, YO ; Johnson, CO ; Johnson, SC ; Jonas, JB ; Joo, T ; Joshi, A ; Joukar, F ; Jozwiak, JJ ; Jurisson, M ; Kabir, A ; Kabir, Z ; Kalani, H ; Kalani, R ; Kalankesh, LR ; Kalhor, R ; Kamath, AM ; Kamiab, Z ; Kanchan, T ; Kapoor, N ; Matin, BK ; Karanikolos, M ; Karch, A ; Karim, MA ; Karimi, SE ; Karimi, SA ; Karimi, SM ; Kasa, AS ; Kassa, GM ; Kassebaum, NJ ; Katikireddi, SV ; Kawakami, N ; Kayode, GA ; Karyani, AK ; Keddie, SH ; Keiyoro, PN ; Keller, C ; Kemmer, L ; Kendrick, PJ ; Kereselidze, M ; Khader, YS ; Khafaie, MA ; Khalid, N ; Khammarnia, M ; Khan, EA ; Khan, G ; Khan, M ; Khang, Y-H ; Khatab, K ; Khater, AM ; Khater, MM ; Khatib, MN ; Khayamzadeh, M ; Khazaei, S ; Khazaie, H ; Khodayari, MT ; Khoja, AT ; Khubchandani, J ; Khundkar, R ; Kianipour, N ; Kieling, C ; Kim, C-I ; Kim, D ; Kim, Y-E ; Kim, YJ ; Kimokoti, RW ; Kinfu, Y ; Kisa, A ; Kisa, S ; Kissimova-Skarbek, K ; Kissoon, N ; Kivimaki, M ; Kneib, CJ ; Knibbs, LD ; Knight, M ; Knudsen, AKS ; Kocarnik, JM ; Kochhar, S ; Koh, DSQ ; Kohler, S ; Kolola, T ; Komaki, H ; Kopec, JA ; Korotkova, AV ; Korshunov, VA ; Kosen, S ; Kotlo, A ; Koul, PA ; Koyanagi, A ; Kraemer, MUG ; Kravchenko, MA ; Krishan, K ; Krohn, KJ ; Kromhout, H ; Shaji, KS ; Defo, BK ; Bicer, BK ; Kugbey, N ; Kulkarni, V ; Kumar, GA ; Kumar, M ; Kumar, N ; Kumar, P ; Kumar, V ; Kumaresh, G ; Kurmi, OP ; Kusuma, D ; Kyu, HH ; La Vecchia, C ; Ben, L ; Lal, DK ; Lalloo, R ; Lallukka, T ; Lam, JO ; Lami, FH ; Lan, Q ; Landires, I ; Lang, JJ ; Langan, SM ; Lansingh, VC ; Lansky, S ; Larson, HJ ; Larson, SL ; Larsson, AO ; Lasrado, S ; Lassi, ZS ; Lau, KM-M ; Lauriola, P ; Lavados, PM ; Lazarus, JV ; Leal, LF ; Leasher, JL ; Ledesma, JR ; Lee, PH ; Lee, SWH ; Leever, AT ; LeGrand, KE ; Leigh, J ; Leonardi, M ; Lescinsky, H ; Leung, J ; Levi, M ; Lewington, S ; Li, B ; Li, S ; Lim, L-L ; Lin, C ; Lin, R-T ; Linehan, C ; Linn, S ; Listl, S ; Liu, H-C ; Liu, S ; Liu, S ; Liu, X ; Liu, Y ; Liu, Z ; Lo, J ; Lodha, R ; Logroscino, G ; Looker, KJ ; Lopez, AD ; Lopez, JCF ; Lopukhov, PD ; Lorkowski, S ; Lotufo, PA ; Lozano, R ; Lu, A ; Lucas, TCD ; Lugo, A ; Lunevicius, R ; Lyons, RA ; Ma, J ; Machado, DB ; MacLachlan, JH ; Madadin, M ; Maddison, ER ; Maddison, R ; Madotto, F ; Abd El Razek, HM ; Abd El Razek, MM ; Mahasha, PW ; Mahdavi, MM ; Mahmoudi, M ; Mai, HT ; Majeed, A ; Malagon-Rojas, JN ; Maled, V ; Maleki, A ; Maleki, S ; Malekzadeh, R ; Malta, DC ; Mamun, AA ; Manafi, A ; Manafi, N ; Manda, AL ; Manguerra, H ; Mansour-Ghanaei, F ; Mansouri, B ; Mansournia, MA ; Herrera, AMM ; Mapoma, CC ; Maravilla, JC ; Marks, A ; Martin, RV ; Martini, S ; Martins-Melo, FR ; Martopullo, I ; Masaka, A ; Masoumi, SZ ; Massano, J ; Massenburg, BB ; Mastrogiacomo, CI ; Mathur, MR ; Matsushita, K ; Maulik, PK ; May, EA ; Mazidi, M ; McAlinden, C ; McGrath, JJ ; Mckee, M ; Medina-Solis, CE ; Meharie, BG ; Mehndiratta, MM ; Nasab, EM ; Mehri, F ; Mehrotra, R ; Mehta, KM ; Meitei, WB ; Mekonnen, T ; Melese, A ; Memiah, PTN ; Memish, ZA ; Mendoza, W ; Menezes, RG ; Mengesha, EW ; Mengesha, MB ; Mensah, GA ; Mereke, A ; Mereta, ST ; Meretoja, A ; Meretoja, TJ ; Mestrovic, T ; Miazgowski, B ; Miazgowski, T ; Michalek, IM ; Mihretie, KM ; Miller, TR ; Mills, EJ ; Milne, GJ ; Mini, GK ; Miri, M ; Mirica, A ; Mirrakhimov, EM ; Mirzaei, H ; Mirzaei, M ; Mirzaei, R ; Mirzaei-Alavijeh, M ; Misganaw, AT ; Mitchell, PB ; Mithra, P ; Moazen, B ; Moghadaszadeh, M ; Mohajer, B ; Mohamad, O ; Mohamadi, E ; Mohammad, DK ; Mohammad, Y ; Mezerji, NMG ; Mohammadbeigi, A ; Mohammadian-Hafshejani, A ; Mohammadifard, N ; Mohammadpourhodki, R ; Mohammed, AS ; Mohammed, H ; Mohammed, JA ; Mohammed, S ; Mohebi, F ; Bandpei, MAM ; Mokari, A ; Mokdad, AH ; Molokhia, M ; Momen, NC ; Monasta, L ; Mondello, S ; Mooney, MD ; Moosazadeh, M ; Moradi, G ; Moradi, M ; Moradi-Joo, M ; Moradi-Lakeh, M ; Moradzadeh, R ; Moraga, P ; Morales, L ; Morawska, L ; Velasquez, IM ; Morgado-da-Costa, J ; Morrison, SD ; Mosapour, A ; Mosser, JF ; Mouodi, S ; Mousavi, SM ; Khaneghah, AM ; Mueller, UO ; Mukhopadhyay, S ; Mullany, EC ; Mumford, JE ; Munro, SB ; Muriithi, MK ; Musa, KI ; Mustafa, G ; Muthupandian, S ; Nabavizadeh, B ; Nabhan, AF ; Naderi, M ; Nagarajan, AJ ; Nagel, G ; Naghavi, M ; Naghshtabrizi, B ; Naik, G ; Naimzada, MD ; Nair, S ; Najafi, F ; Naldi, L ; Nandakumar, V ; Nandi, AK ; Nangia, V ; Nansseu, JR ; Naserbakht, M ; Nayak, VC ; Nazari, J ; Ndejjo, R ; Ndwandwe, DE ; Negoi, I ; Negoi, RI ; Netsere, HB ; Neupane, S ; Ngari, KN ; Nguefack-Tsague, G ; Ngunjiri, JW ; Nguyen, CT ; Nguyen, DN ; Nguyen, HLT ; Nguyen, J ; Nguyen, M ; Nguyen, M ; Nguyen, TH ; Nichols, E ; Nigatu, D ; Nigatu, YT ; Nikbakhsh, R ; Nikpoor, AR ; Nixon, MR ; Nnaji, CA ; Nomura, S ; Norheim, OF ; Norrving, B ; Noubiap, JJ ; Motlagh, SN ; Nowak, C ; Nsoesie, EO ; Nunez-Samudio, V ; Oancea, B ; Odell, CM ; Ogbo, FA ; Oghenetega, OB ; Oh, I-H ; Okunga, EW ; Oladnabi, M ; Olagunju, AT ; Olusanya, BO ; Olusanya, JO ; Oluwasanu, MM ; Bali, AO ; Omer, MO ; Ong, KL ; Ong, S ; Onwujekwe, OE ; Oren, E ; Orji, AU ; Orpana, HM ; Ortega-Altamirano, DV ; Ortiz, A ; Osarenotor, O ; Osei, FB ; Ostojic, SM ; Ostroff, SM ; Oiu, AO ; Otstavnov, N ; Otstavnov, SS ; Overland, S ; Owolabi, MO ; Section, MPA ; Padubidri, JR ; Pakhale, S ; Pakhare, AP ; Pakshir, K ; Palladino, R ; Pana, A ; Panda-Jonas, S ; Pandey, A ; Pangaribuan, HU ; Park, E-K ; Park, J ; Parmar, PGK ; Parry, CDH ; Pasovic, M ; Pasupula, DK ; Patel, JR ; Patel, SK ; Paternina-Caicedo, AJ ; Pathak, A ; Pathak, M ; Patten, SB ; Patton, GC ; Paudel, D ; Paudel, S ; Paulson, KR ; Toroudi, HP ; Pease, SA ; Peden, AE ; Pennini, A ; Pepito, VCF ; Peprah, EK ; Pereira, A ; Pereira, DM ; Pereira, J ; Perico, N ; Pescarini, JM ; Pesudovs, K ; Pham, HQ ; Phillips, MR ; Piccinelli, C ; Pierce, M ; Pigott, DM ; Pilgrim, T ; Pilz, TM ; Pinheiro, M ; Piradov, MA ; Pirsaheb, M ; Pishgar, F ; Plana-Ripoll, O ; Plass, D ; Pletcher, M ; Pokhrel, KN ; Polibin, RV ; Polinder, S ; Polkinghorne, KR ; Pond, CD ; Postma, MJ ; Pottoo, FH ; Pourjafar, H ; Pourmalek, F ; Kalhori, RP ; Pourshams, A ; Poznanska, A ; Prada, SI ; Prakash, S ; Prakash, V ; Prasad, N ; Preotescu, L ; Pribadi, DRA ; Pupillo, E ; Quazi Syed, Z ; Rabiee, M ; Rabiee, N ; Radfar, A ; Rafiee, A ; Rafiei, A ; Raggi, A ; Rahim, F ; Rahimi-Movaghar, A ; Rahman, MHU ; Rahman, MA ; Rajabpour-Sanati, A ; Rajati, F ; Rakovac, I ; Ram, P ; Ramezanzadeh, K ; Rana, SM ; Ranabhat, CL ; Ranta, A ; Rao, PC ; Rao, SJ ; Rasella, D ; Rashedi, V ; Rastogi, P ; Rath, GK ; Rathi, P ; Rawaf, DL ; Rawaf, S ; Rawal, L ; Rawassizadeh, R ; Rawat, R ; Razo, C ; Boston, S ; Regassa, LD ; Reiner, RC ; Reinig, N ; Reitsma, MB ; Remuzzi, G ; Renjith, V ; Renzaho, AMN ; Resnikoff, S ; Rezaei, N ; Rezaei, N ; Rezai, MS ; Rezapour, A ; Rhinehart, P-A ; Riahi, SM ; Ribeiro, ALP ; Ribeiro, DC ; Ribeiro, D ; Rickard, J ; Rivera, JA ; Robalik, T ; Roberts, NLS ; Roberts, S ; Robinson, SR ; Rodriguez-Ramirez, S ; Roever, L ; Rolfe, S ; Romoli, M ; Ronfani, L ; Room, R ; Roshandel, G ; Rostamian, M ; Roth, GA ; Rothenbacher, D ; Rubagotti, E ; Rumisha, SF ; Rwegerera, GM ; Saadatagah, S ; Sabour, S ; Sachdev, PS ; Saddik, B ; Sadeghi, E ; Sadeghi, M ; Saeedi, R ; Moghaddam, SS ; Saeidi, S ; Safari, Y ; Safi, S ; Safiri, S ; Sagar, R ; Sahebkar, A ; Sahraian, MA ; Sajadi, SM ; Salahshoor, MR ; Salam, N ; Salama, JS ; Salamati, P ; Zahabi, SS ; Salem, H ; Salem, MR ; Salimi, Y ; Salimzadeh, H ; Salman, OM ; Salomon, JA ; Salz, I ; Samad, Z ; Kafil, HS ; Sambala, EZ ; Samy, AM ; Sanabria, J ; Sanchez-Pimienta, TG ; Santomauro, DF ; Santos, IS ; Santos, JV ; Santric-Milicevic, MM ; Saraswathy, SYI ; Sarmiento-Suarez, R ; Sarrafzadegan, N ; Sartorius, B ; Sarveazad, A ; Sathian, B ; Sathish, T ; Sattin, D ; Savic, M ; Sawyer, SM ; Saxena, D ; Saxena, S ; Saylan, M ; Sbarra, AN ; Schaeffer, LE ; Schiavolin, S ; Schlaich, MP ; Schmidt, MI ; Schutte, AE ; Schwebel, DC ; Schwendicke, F ; Seedat, S ; Sekerija, M ; Senbeta, AM ; Senthilkumaran, S ; Sepanlou, SG ; Serdar, B ; Serre, ML ; Servan-Mori, E ; Sha, F ; Shabani, M ; Shackelford, KA ; Shadid, J ; Shafaat, O ; Shahabi, S ; Shahbaz, M ; Shaheen, AA ; Shaikh, MA ; Shalash, AS ; Shams-Beyranvand, M ; Shamsi, M ; Shamsizadeh, M ; Shannawaz, M ; Sharafi, K ; Sharafi, Z ; Sharara, F ; Sharifi, H ; Sharma, R ; Shaw, DH ; Sheena, BS ; Sheikh, A ; Sheikhtaheri, A ; Shetty, BSK ; Shetty, RS ; Shibuya, K ; Shield, KD ; Shiferaw, WS ; Shigematsu, M ; Il Shin, J ; Shin, M-J ; Shiri, R ; Shirkoohi, R ; Shivakumar, KM ; Shrime, MG ; Shuval, K ; Siabani, S ; Sierpinski, R ; Sigfusdottir, ID ; Sigurvinsdottir, R ; Silva, DAS ; Silva, JP ; Simonetti, B ; Simpson, KE ; Singh, A ; Singh, JA ; Singh, P ; Sinha, DN ; Skiadaresi, E ; Skou, ST ; Skryabin, VY ; Sliwa, K ; Smith, A ; Smith, EUR ; Sobngwi, E ; Soheili, A ; Sokhan, A ; Soltani, S ; Somefun, OD ; Soofi, M ; Sorensen, RJD ; Soriano, JB ; Sorrie, MB ; Soshnikov, S ; Soyiri, IN ; Spencer, CN ; Spotin, A ; Spurlock, EE ; Sreeramareddy, CT ; Srinivasan, V ; Sripada, K ; Stanaway, JD ; Stark, BA ; Steel, N ; Stefan, SC ; Stein, C ; Stein, DJ ; Steiner, C ; Steiner, TJ ; Steuben, KM ; Stockfelt, L ; Stokes, MA ; Stovner, LJ ; Straif, K ; Stranges, S ; Stubbs, JL ; Suchdev, PS ; Sudaryanto, A ; Sufiyan, MB ; Suleria, HAR ; Abdulkader, RS ; Sulo, G ; Sultan, I ; Swope, CB ; Sykes, BL ; Sylte, DO ; Szocska, M ; Szumowski, L ; Tabares-Seisdedos, R ; Tabb, KM ; Tabuchi, T ; Tadakamadla, SK ; Taddele, BW ; Tadesse, DB ; Taherkhani, A ; Tahir, Z ; Tajdini, M ; Takahashi, K ; Takala, JS ; Tamiru, AT ; Tang, M ; Tanser, FC ; Tareque, MI ; Tarigan, IU ; Taveira, N ; Taylor, HJ ; Teagle, WL ; Teame, H ; Tediosi, F ; Tefera, YG ; Tehrani-Banihashemi, A ; Teklehaimanot, BF ; Tela, FG ; Temsah, M-H ; Terrason, S ; Tesema, GA ; Tessema, ZT ; Thakur, B ; Thankappan, KR ; Thapar, R ; Thomas, N ; Thomson, AM ; Thrift, AG ; Thurston, GD ; Titova, MV ; Tlou, B ; Tohidinik, HR ; Tonelli, M ; Topor-Madry, R ; Topouzis, F ; Torre, AE ; Touvier, M ; Tovani-Palone, MR ; Traini, E ; Tran, BX ; Travillian, R ; Trias-Llimos, S ; Troeger, CE ; Truelsen, TC ; Tsai, AC ; Tsatsakis, A ; Car, LT ; Tyrovolas, S ; Uddin, R ; Ullah, I ; Ullah, S ; Umeokonkwo, CD ; Undurraga, EA ; Unnikrishnan, B ; Upadhyay, E ; Uthman, OA ; Vacante, M ; Vaicekonyte, R ; Vakilian, A ; Valdez, PR ; Valli, A ; Van Donkelaar, A ; Vardavas, C ; Varughese, S ; Vasankari, TJ ; Vasconcelos, AMN ; Vasseghian, Y ; Veisani, Y ; Venketasubramanian, N ; Vidale, S ; Violante, FS ; Vlassov, V ; Vollset, SE ; Vongpradith, A ; Vos, T ; Vu, GT ; Vujcic, IS ; Vukovic, A ; Vukovic, R ; Hawariat, FGW ; Waheed, Y ; Wallin, MT ; Walters, MK ; Wamai, RG ; Wang, F ; Wang, H ; Wang, H ; Wang, J ; Wang, Y ; Wang, Y ; Wang, Y-P ; Ward, JL ; Watson, A ; Watson, S ; Wei, J ; Wei, MYW ; Weintraub, RG ; Weiss, DJ ; Weiss, J ; Welay, FT ; Weldesamuel, GT ; Werdecker, A ; West, JJ ; Westerman, R ; Whisnant, JL ; Whiteford, HA ; Wiangkham, T ; Wickramasinghe, ND ; Wiens, KE ; Wijeratne, T ; Wilner, LB ; Wilson, S ; Wiysonge, CS ; Wojtyniak, B ; Woldu, G ; Wolfe, CDA ; Wondmeneh, TG ; Wondmieneh, AB ; Wool, EE ; Wozniak, SS ; Wu, A-M ; Wu, C ; Wu, J ; Hanson, SW ; Wunrow, HY ; Xie, Y ; Xu, G ; Xu, R ; Yadgir, S ; Jabbari, SHY ; Yamada, T ; Yamagishi, K ; Yaminfirooz, M ; Yano, Y ; Yaya, S ; Yazdi-Feyzabadi, V ; Yearwood, JA ; Yeheyis, TY ; Yeshitila, YG ; Yilgwan, CS ; Yilma, MT ; Yip, P ; Yonemoto, N ; Yoon, S-J ; Lebni, JY ; York, HW ; Younis, MZ ; Younker, TP ; Yousefi, B ; Yousefi, Z ; Yousefifard, M ; Yousefinezhadi, T ; Yousuf, AY ; Yu, C ; Yu, Y ; Yuan, C-W ; Yuce, D ; Yusefzadeh, H ; Zadey, S ; Moghadam, TZ ; Zaidi, SS ; Zaki, L ; Zakzuk, J ; Bin Zaman, S ; Zamani, M ; Zamanian, M ; Zandian, H ; Zangeneh, A ; Zarafshan, H ; Zastrozhin, MS ; Zewdie, KA ; Zhang, J ; Zhang, Y ; Zhang, Z-J ; Zhao, JT ; Zhao, X-JG ; Zhao, Y ; Zheleva, B ; Zheng, P ; Zhou, M ; Zhu, C ; Ziapour, A ; Zimsen, SRM ; Zlavog, BS ; Zodpey, S ; Lim, SS ; Murray, CJL (ELSEVIER SCIENCE INC, 2020-10-17)
    The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3·5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.
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    Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019
    Lozano, R ; Fullman, N ; Mumford, JE ; Knight, M ; Barthelemy, CM ; Abbafati, C ; Abbastabar, H ; Abd-Allah, F ; Abdollahi, M ; Abedi, A ; Abolhassani, H ; Abosetugn, AE ; Abreu, LG ; Abrigo, MRM ; Abu Haimed, AK ; Abushouk, AI ; Adabi, M ; Adebayo, OM ; Adekanmbi, V ; Adelson, JD ; Adetokunboh, OO ; Adham, D ; Advani, SM ; Afshin, A ; Agarwal, G ; Agasthi, P ; Aghamir, SMK ; Agrawal, A ; Ahmad, T ; Akinyemi, RO ; Alahdab, F ; Al-Aly, Z ; Alam, K ; Albertson, SB ; Alemu, YM ; Alhassan, RK ; Ali, M ; Ali, S ; Alipour, V ; Aljunid, SM ; Alla, F ; Almadi, MAH ; Almasi, A ; Almasi-Hashiani, A ; Almasri, NA ; Al-Mekhlafi, HM ; Almulhim, AM ; Alonso, J ; Al-Raddadi, RM ; Altirkawi, KA ; Alvis-Guzman, N ; Alvis-Zakzuk, NJ ; Amini, S ; Amini-Rarani, M ; Amiri, F ; Amit, AML ; Amugsi, DA ; Ancuceanu, R ; Anderlini, D ; Andrei, CL ; Androudi, S ; Ansari, F ; Ansari-Moghaddam, A ; Antonio, CAT ; Antony, CM ; Antriyandarti, E ; Anvari, D ; Anwer, R ; Arabloo, J ; Arab-Zozani, M ; Aravkin, AY ; 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Briggs, AM ; Briko, NI ; Nagaraja, SB ; Busse, R ; Butt, ZA ; Luciano Caetano dos Santos, F ; Cahuana-Hurtado, L ; Camera, LA ; Cardenas, R ; Carreras, G ; Carrero, JJ ; Carvalho, F ; Castaldelli-Maia, JM ; Castaneda-Orjuela, CA ; Castelpietra, G ; Castro, F ; Catala-Lopez, F ; Causey, K ; Cederroth, CR ; Cercy, KM ; Cerin, E ; Chandan, JS ; Chang, AY ; Charan, J ; Chattu, VK ; Chaturvedi, S ; Chin, KL ; Cho, DY ; Choi, J-YJ ; Christensen, H ; Chu, D-T ; Chung, MT ; Ciobanu, LG ; Cirillo, M ; Comfort, H ; Compton, K ; Cortesi, PA ; Costa, VM ; Cousin, E ; Dahlawi, SMA ; Damiani, G ; Dandona, L ; Dandona, R ; Gela, JD ; Darwesh, AM ; Daryani, A ; Dash, AP ; Davey, G ; Davila-Cervantes, CA ; Davletov, K ; De Neve, J-W ; Denova-Gutierrez, E ; Deribe, K ; Dervenis, N ; Desai, R ; Dharmaratne, SD ; Dhungana, GP ; Dianatinasab, M ; da Silva, DD ; Diaz, D ; Dippenaar, IN ; Hoa, TD ; Dorostkar, F ; Doshmangir, L ; Duncan, BB ; Duraes, AR ; Eagan, AW ; Edvardsson, D ; El Sayed, I ; El Tantawi, M ; 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Rafiei, A ; Raggi, A ; Rahim, F ; Rahman, MA ; Rajabpour-Sanati, A ; Rana, SM ; Ranabhat, CL ; Rao, SJ ; Rasella, D ; Rashedi, V ; Rath, GK ; Rathi, P ; Rawaf, DL ; Rawaf, S ; Rawal, L ; Rawassizadeh, R ; Razo, C ; Renjith, V ; Renzaho, AMN ; Reshmi, B ; Rezaei, N ; Riahi, SM ; Ribeiro, DC ; Rickard, J ; Roberts, NLS ; Roever, L ; Romoli, M ; Ronfani, L ; Roshandel, G ; Rubagotti, E ; Rwegerera, GM ; Sabour, S ; Sachdev, PS ; Saddik, B ; Sadeghi, E ; Sadeghi, M ; Safari, Y ; Sagar, R ; Sahebkar, A ; Sahraian, MA ; Sajadi, SM ; Salahshoor, MR ; Salem, H ; Salem, MR ; Salomon, JA ; Kafil, HS ; Samy, AM ; Sanabria, J ; Santric-Milicevic, MM ; Saraswathy, SYI ; Sarmiento-Suarez, R ; Sartorius, B ; Sarveazad, A ; Sathian, B ; Sathish, T ; Sattin, D ; Savic, M ; Sawyer, SM ; Saxena, D ; Sbarra, AN ; Schaeffer, LE ; Schiavolin, S ; Schmidt, MI ; Schutte, AE ; Schwebel, DC ; Schwendicke, F ; Seedat, S ; Sha, F ; Shahabi, S ; Shaheen, AA ; Shaikh, MA ; Shamsizadeh, M ; Shannawaz, M ; Sharafi, K ; Sharara, F ; Sharifi, H ; Shaw, DH ; Sheikh, A ; Sheikhtaheri, A ; Shetty, BSK ; Shibuya, K ; Shiferaw, WS ; Shigematsu, M ; Shin, JI ; Shiri, R ; Shirkoohi, R ; Shivakumar, KM ; Shrime, MG ; Shuval, K ; Siabani, S ; Sierpinski, R ; Sigfusdottir, ID ; Sigurvinsdottir, R ; Silva, DAS ; Silva, JP ; Simonetti, B ; Simpson, KE ; Singh, JA ; Singh, P ; Sinha, DN ; Skryabin, VY ; Smith, EUR ; Soheili, A ; Soltani, S ; Soofi, M ; Sorensen, RJD ; Soriano, JB ; Sorrie, MB ; Soyiri, IN ; Spurlock, EE ; Sreeramareddy, CT ; Stanaway, JD ; Steel, N ; Stein, C ; Stokes, MA ; Sufiyan, MB ; Suleria, HAR ; Sultan, I ; Szumowski, L ; Tabares-Seisdedos, R ; Tabuchi, T ; Tadakamadla, SK ; Taddele, BW ; Tadesse, DB ; Taherkhani, A ; Tamiru, AT ; Tanser, FC ; Tareque, MI ; Tarigan, IU ; Teagle, WL ; Tediosi, F ; Tefera, YG ; Tela, FGG ; Tessema, ZT ; Thakur, B ; Titova, MV ; Tonelli, M ; Topor-Madry, R ; Topouzis, F ; Tovani-Palone, MR ; Tran, BX ; Travillian, RS ; Troeger, CE ; Car, LT ; Uddin, R ; Ullah, I ; Umeokonkwo, CD ; Unnikrishnan, B ; Upadhyay, E ; Uthman, OA ; Vacante, M ; Valdez, PR ; Varughese, S ; Vasankari, TJ ; Vasseghian, Y ; Venketasubramanian, N ; Violante, FS ; Vlassov, V ; Vollset, SE ; Vongpradith, L ; Vos, T ; Waheed, Y ; Walters, MK ; Wamai, RG ; Wang, H ; Wang, Y-P ; Weintraub, RG ; Weiss, J ; Werdecker, A ; Westerman, R ; Wilner, LB ; Woldu, G ; Wolfe, CDA ; Wu, A-M ; Hanson, SW ; Xie, Y ; Xu, R ; Jabbari, SHY ; Yamagishi, K ; Yano, Y ; Yaya, S ; Yazdi-Feyzabadi, V ; Yearwood, JA ; Yeshitila, YG ; Yip, P ; Yonemoto, N ; Younis, MZ ; Yousefi, Z ; Yousefinezhadi, T ; Yusefzadeh, H ; Zadey, S ; Moghadam, TZ ; Zaidi, SS ; Zaki, L ; Bin Zaman, S ; Zamani, M ; Zamanian, M ; Zandian, H ; Zastrozhin, MS ; Zewdie, KA ; Zhang, Y ; Zhao, X-JG ; Zhao, Y ; Zheng, P ; Zhu, C ; Ziapour, A ; Zlavog, BS ; Zodpey, S ; Murray, CJL (ELSEVIER SCIENCE INC, 2020-10-17)
    BACKGROUND: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. METHODS: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. FINDINGS: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2-47·5) in 1990 to 60·3 (58·7-61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9-3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6-421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0-3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5-1040·3]) residing in south Asia. INTERPRETATION: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC. FUNDING: Bill & Melinda Gates Foundation.
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    Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study
    James, SL ; Castle, CD ; Dingels, Z ; Fox, JT ; Hamilton, EB ; Liu, Z ; Roberts, NLS ; Sylte, DO ; Bertolacci, GJ ; Cunningham, M ; Henry, NJ ; LeGrand, KE ; Abdelalim, A ; Abdollahpour, I ; Abdulkader, RS ; Abedi, A ; Abegaz, KH ; Abosetugn, AE ; Abushouk, A ; Adebayo, OM ; Adsuar, JC ; Advani, SM ; Agudelo-Botero, M ; Ahmad, T ; Ahmed, MB ; Ahmed, R ; Aichour, MTE ; Alahdab, F ; Alanezi, FM ; Alema, NM ; Alemu, BW ; Alghnam, SA ; Ali, BA ; Ali, S ; Alinia, C ; Alipour, V ; Aljunid, SM ; Almasi-Hashiani, A ; Almasri, NA ; Altirkawi, K ; Amer, YSA ; Andrei, CL ; Ansari-Moghaddam, A ; Antonio, CAT ; Anvari, D ; Appiah, SCY ; Arabloo, J ; Arab-Zozani, M ; Arefi, Z ; Aremu, O ; Ariani, F ; Arora, A ; Asaad, M ; Ayala Quintanilla, BP ; Ayano, G ; Ayanore, MA ; Azarian, G ; Badawi, A ; Badiye, AD ; Baig, AA ; Bairwa, M ; Bakhtiari, A ; Balachandran, A ; Banach, M ; Banerjee, SK ; Banik, PC ; Banstola, A ; Barker-Collo, SL ; Baernighausen, TW ; Barzegar, A ; Bayati, M ; Bazargan-Hejazi, S ; Bedi, N ; Behzadifar, M ; Belete, H ; Bennett, DA ; Bensenor, IM ; Berhe, K ; Bhagavathula, AS ; Bhardwaj, P ; Bhat, AG ; Bhattacharyya, K ; Bhutta, ZA ; Bibi, S ; Bijani, A ; Boloor, A ; Borges, G ; Borschmann, R ; Borzi, AM ; Boufous, S ; Braithwaite, D ; Briko, NI ; Brugha, T ; Budhathoki, SS ; Car, J ; Cardenas, R ; Carvalho, F ; Castaldelli-Maia, JM ; Castaneda-Orjuela, CA ; Castelpietra, G ; Catala-Lopez, F ; Cerin, E ; Chandan, JS ; Chapman, JR ; Chattu, VK ; Chattu, SK ; Chatziralli, I ; Chaudhary, N ; Cho, DY ; Choi, J-YJ ; Chowdhury, MAK ; Christopher, DJ ; Dinh-Toi, C ; Cicuttini, FM ; Coelho, JM ; Costa, VM ; Dahlawi, SMA ; Daryani, A ; Alberto Davila-Cervantes, C ; De Leo, D ; Demeke, FM ; Demoz, GT ; Demsie, DG ; Deribe, K ; Desai, R ; Nasab, MD ; da Silva, DD ; Forooshani, ZSD ; Hoa, TD ; Doyle, KE ; Driscoll, TR ; Dubljanin, E ; Adema, BD ; Eagan, AW ; Elemineh, DA ; El-Jaafary, S ; El-Khatib, Z ; Ellingsen, CL ; Zaki, MES ; Eskandarieh, S ; Eyawo, O ; Faris, PS ; Faro, A ; Farzadfar, F ; Fereshtehnejad, S-M ; Fernandes, E ; Ferrara, P ; Fischer, F ; Folayan, MO ; Fomenkov, AA ; Foroutan, M ; Francis, JM ; Franklin, RC ; Fukumoto, T ; Geberemariyam, BS ; Gebremariam, H ; Gebremedhin, KB ; Gebremeskel, LG ; Gebremeskel, GG ; Gebremichael, B ; Gedefaw, GA ; Geta, B ; Getenet, AB ; Ghafourifard, M ; Ghamari, F ; Gheshlagh, RG ; Gholamian, A ; Gilani, SA ; Gill, TK ; Goudarzian, AH ; Goulart, AC ; Grada, A ; Grivna, M ; Guimaraes, RA ; Guo, Y ; Gupta, G ; Haagsma, JA ; Hall, BJ ; Hamadeh, RR ; Hamidi, S ; Handiso, DW ; Haro, JM ; Hasanzadeh, A ; Hassan, S ; Hassanipour, S ; Hassankhani, H ; Hassen, HY ; Havmoeller, R ; Hendrie, D ; Heydarpour, F ; Hijar, M ; Ho, HC ; Chi, LH ; Hole, MK ; Holla, R ; Hossain, N ; Hosseinzadeh, M ; Hostiuc, S ; Hu, G ; Ibitoye, SE ; Ilesanmi, OS ; Inbaraj, LR ; Irvani, SSN ; Islam, MM ; Islam, SMS ; Ivers, RQ ; Jahani, MA ; Jakovljevic, M ; Jalilian, F ; Jayaraman, S ; Jayatilleke, AU ; Jha, RP ; John-Akinola, YO ; Jonas, JB ; Jones, KM ; Joseph, N ; Joukar, F ; Jozwiak, JJ ; Jungari, SB ; Jurisson, M ; Kabir, A ; Kahsay, A ; Kalankesh, LR ; Kalhor, R ; Kamil, TA ; Kanchan, T ; Kapoor, N ; Karami, M ; Kasaeian, A ; Kassaye, HG ; Kavetskyy, T ; Kayode, GA ; Keiyoro, PN ; Kelbore, AG ; Khader, YS ; Khafaie, MA ; Khalid, N ; Khalil, IA ; Khalilov, R ; Khan, M ; Khan, EA ; Khan, J ; Khanna, T ; Khazaei, S ; Khazaie, H ; Khundkar, R ; Kiirithio, DN ; Kim, Y-E ; Kim, YJ ; Kim, D ; Kisa, S ; Kisa, A ; Komaki, H ; Kondlahalli, SKM ; Koolivand, A ; Korshunov, VA ; Koyanagi, A ; Kraemer, MUG ; Krishan, K ; Defo, BK ; Bicer, BK ; Kugbey, N ; Kumar, N ; Kumar, M ; Kumar, V ; Kumar, N ; Kumaresh, G ; Lami, FH ; Lansingh, VC ; Lasrado, S ; Latifi, A ; Lauriola, P ; La Vecchia, C ; Leasher, JL ; Lee, SWH ; Li, S ; Liu, X ; Lopez, AD ; Lotufo, PA ; Lyons, RA ; Machado, DB ; Madadin, M ; Abd El Razek, MM ; Mahotra, NB ; Majdan, M ; Majeed, A ; Maled, V ; Malta, DC ; Manafi, N ; Manafi, A ; Manda, A-L ; Manjunatha, N ; Mansour-Ghanaei, F ; Mansournia, MA ; Maravilla, JC ; Mason-Jones, AJ ; Masoumi, SZ ; Massenburg, BB ; Maulik, PK ; Mehndiratta, MM ; Melketsedik, ZA ; Memiah, PTN ; Mendoza, W ; Menezes, RG ; Mengesha, MM ; Meretoja, TJ ; Meretoja, A ; Merie, HE ; Mestrovic, T ; Miazgowski, B ; Miazgowski, T ; Miller, TR ; Mini, GK ; Mirica, A ; Mirrakhimov, EM ; Mirzaei-Alavijeh, M ; Mithra, P ; Moazen, B ; Moghadaszadeh, M ; Mohamadi, E ; Mohammad, Y ; Darwesh, AM ; Mohammadian-Hafshejani, A ; Mohammadpourhodki, R ; Mohammed, S ; Mohammed, JA ; Mohebi, F ; Bandpei, MAM ; Molokhia, M ; Monasta, L ; Moodley, Y ; Moradi, M ; Moradi, G ; Moradi-Lakeh, M ; Moradzadeh, R ; Morawska, L ; Moreno Velasquez, I ; Morrison, SD ; Mossie, TB ; Muluneh, AG ; Musa, KI ; Mustafa, G ; Naderi, M ; Nagarajan, AJ ; Naik, G ; Naimzada, MD ; Najafi, F ; Nangia, V ; Nascimento, BR ; Naserbakht, M ; Nayak, V ; Nazari, J ; Ndwandwe, DE ; Negoi, I ; Ngunjiri, JW ; Trang, HN ; Cuong, TN ; Diep, NN ; Huong, LTN ; Nikbakhsh, R ; Ningrum, DNA ; Nnaji, CA ; Ofori-Asenso, R ; Ogbo, FA ; Oghenetega, OB ; Oh, I-H ; Olagunju, AT ; Olagunju, TO ; Bali, AO ; Onwujekwe, OE ; Orpana, HM ; Ota, E ; Otstavnov, N ; Otstavnov, SS ; Mahesh, PA ; Padubidri, JR ; Pakhale, S ; Pakshir, K ; Panda-Jonas, S ; Park, E-K ; Patel, SK ; Pathak, A ; Pati, S ; Paulos, K ; Peden, AE ; Pepito, VCF ; Pereira, J ; Phillips, MR ; Polibin, R ; Polinder, S ; Pourmalek, F ; Pourshams, A ; Poustchi, H ; Prakash, S ; Pribadi, DRA ; Puri, P ; Quazi Syed, Z ; Rabiee, N ; Rabiee, M ; Radfar, A ; Rafay, A ; Rafiee, A ; Rafiei, A ; Rahim, F ; Rahimi, S ; Rahman, MA ; Rajabpour-Sanati, A ; Rajati, F ; Rakovac, I ; Rao, SJ ; Rashedi, V ; Rastogi, P ; Rathi, P ; Rawaf, S ; Rawal, L ; Rawassizadeh, R ; Renjith, V ; Resnikoff, S ; Rezapour, A ; Ribeiro, AI ; Rickard, J ; Rios Gonzalez, CM ; Roever, L ; Ronfani, L ; Roshandel, G ; Saddik, B ; Safarpour, H ; Safdarian, M ; Sajadi, SM ; Salamati, P ; Salem, MRR ; Salem, H ; Salz, I ; Samy, AM ; Sanabria, J ; Riera, LS ; Milicevic, MMS ; Sarker, AR ; Sarveazad, A ; Sathian, B ; Sawhney, M ; Sayyah, M ; Schwebel, DC ; Seedat, S ; Senthilkumaran, S ; Seyedmousavi, S ; Sha, F ; Shaahmadi, F ; Shahabi, S ; Shaikh, MA ; Shams-Beyranvand, M ; Sheikh, A ; Shigematsu, M ; Shin, JI ; Shiri, R ; Siabani, S ; Sigfusdottir, ID ; Singh, JA ; Singh, PK ; Sinha, DN ; Soheili, A ; Soriano, JB ; Sorrie, MB ; Soyiri, IN ; Stokes, MA ; Sufiyan, MB ; Sykes, BL ; Tabares-Seisdedos, R ; Tabb, KM ; Taddele, BW ; Tefera, YM ; Tehrani-Banihashemi, A ; Tekulu, GH ; Tesema, AKT ; Tesfay, BE ; Thapar, R ; Titova, MV ; Tlaye, KG ; Tohidinik, HR ; Topor-Madry, R ; Khanh, BT ; Bach, XT ; Tripathy, JP ; Tsai, AC ; Tsatsakis, A ; Car, LT ; Ullah, I ; Ullah, S ; Unnikrishnan, B ; Upadhyay, E ; Uthman, OA ; Valdez, PR ; Vasankari, TJ ; Veisani, Y ; Venketasubramanian, N ; Violante, FS ; Vlassov, V ; Waheed, Y ; Wang, Y-P ; Wiangkham, T ; Wolde, HF ; Woldeyes, DH ; Wondmeneh, TG ; Wondmieneh, AB ; Wu, A-M ; Wyper, GMA ; Yadav, R ; Yadollahpour, A ; Yano, Y ; Yaya, S ; Yazdi-Feyzabadi, V ; Ye, P ; Yip, P ; Yisma, E ; Yonemoto, N ; Yoon, S-J ; Youm, Y ; Younis, MZ ; Yousefi, Z ; Yu, C ; Yu, Y ; Moghadam, TZ ; Zaidi, Z ; Bin Zaman, S ; Zamani, M ; Zandian, H ; Zarei, F ; Zhang, Z-J ; Zhang, Y ; Ziapour, A ; Zodpey, S ; Dandona, R ; Dharmaratne, SD ; Hay, S ; Mokdad, AH ; Pigott, DM ; Reiner, RC ; Vos, T (BMJ PUBLISHING GROUP, 2020-10-01)
    BACKGROUND: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. METHODS: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. RESULTS: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. CONCLUSIONS: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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    The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study
    Franklin, RC ; Peden, AE ; Hamilton, EB ; Bisignano, C ; Castle, CD ; Dingels, Z ; Hay, S ; Liu, Z ; Mokdad, AH ; Roberts, NLS ; Sylte, DO ; Theo, V ; Abady, GG ; Abosetugn, AE ; Ahmed, R ; Alahdab, F ; Andrei, CL ; Antonio, CAT ; Arabloo, J ; Arba, AAK ; Badiye, AD ; Bakkannavar, SM ; Banach, M ; Banik, PC ; Banstola, A ; Barker-Collo, SL ; Barzegar, A ; Bayati, M ; Bhardwaj, P ; Bhaumik, S ; Bhutta, ZA ; Bijani, A ; Boloor, A ; Carvalho, F ; Chowdhury, MAK ; Dinh-Toi, C ; Colquhoun, SM ; Dagne, H ; Dagnew, B ; Dandona, L ; Dandona, R ; Daryani, A ; Dharmaratne, SD ; Forooshani, ZSD ; Hoa, TD ; Driscoll, TR ; Eagan, AW ; El-Khatib, Z ; Fernandes, E ; Filip, I ; Fischer, F ; Gebremichael, B ; Gupta, G ; Haagsma, JA ; Hassan, S ; Hendrie, D ; Chi, LH ; Hole, MK ; Holla, R ; Hostiuc, S ; Househ, M ; Ilesanmi, OS ; Inbaraj, LR ; Irvani, SSN ; Islam, MM ; Ivers, RQ ; Jayatilleke, AU ; Joukar, F ; Kalhor, R ; Kanchan, T ; Kapoor, N ; Kasaeian, A ; Khan, M ; Khan, EA ; Khubchandani, J ; Krishan, K ; Kumar, GA ; Lauriola, P ; Lopez, AD ; Madadin, M ; Majdan, M ; Maled, V ; Manafi, N ; Manafi, A ; McKee, M ; Meles, HG ; Menezes, RG ; Meretoja, TJ ; Miller, TR ; Mithra, P ; Mohammadian-Hafshejani, A ; Mohammadpourhodki, R ; Mohebi, F ; Molokhia, M ; Mustafa, G ; Negoi, I ; Cuong, TN ; Huong, LTN ; Olagunju, AT ; Olagunju, TO ; Padubidri, JR ; Pakshir, K ; Pathak, A ; Polinder, S ; Pribadi, DRA ; Rabiee, N ; Radfar, A ; Rana, SM ; Rickard, J ; Safari, S ; Salamati, P ; Samy, AM ; Sarker, AR ; Schwebel, DC ; Senthilkumaran, S ; Shaahmadi, F ; Shaikh, MA ; Shin, JI ; Singh, PK ; Soheili, A ; Stokes, MA ; Suleria, HAR ; Tarigan, IU ; Temsah, M-H ; Tesfay, BE ; Valdez, PR ; Veisani, Y ; Ye, P ; Yonemoto, N ; Yu, C ; Yusefzadeh, H ; Bin Zaman, S ; Zhang, Z-J ; James, SL (BMJ PUBLISHING GROUP, 2020-10-01)
    BACKGROUND: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017. METHODS: Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning. RESULTS: Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes. CONCLUSIONS: There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.
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    The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
    Sepanlou, SG ; Safiri, S ; Bisignano, C ; Ikuta, KS ; Merat, S ; Saberifiroozi, M ; Poustchi, H ; Tsoi, D ; Colombara, DV ; Abdoli, A ; Adedoyin, RA ; Afarideh, M ; Agrawal, S ; Ahmad, S ; Ahmadian, E ; Ahmadpour, E ; Akinyemiju, T ; Akunna, CJ ; Alipour, V ; Almasi-Hashiani, A ; Almulhim, AM ; Al-Raddadi, RM ; Alvis-Guzman, N ; Anber, NH ; Angus, C ; Anoushiravani, A ; Arabloo, J ; Araya, EM ; Asmelash, D ; Ataeinia, B ; Ataro, Z ; Atout, MMW ; Ausloos, F ; Awasthi, A ; Badawi, A ; Banach, M ; Bejarano Ramirez, DF ; Bhagavathula, AS ; Bhala, N ; Bhattacharyya, K ; Biondi, A ; Bolla, SR ; Boloor, A ; Borzi, AM ; Butt, ZA ; Alberto Camera, LLA ; Campos-Nonato, IR ; Carvalho, F ; Dinh-Toi, C ; Chung, S-C ; Cortesi, PA ; Costa, VM ; Cowie, BC ; Daryani, A ; de Courten, B ; Demoz, GT ; Desai, R ; Dharmaratne, SD ; Djalalinia, S ; Hoa, TD ; Dorostkar, F ; Drake, TM ; Dubey, M ; Duncan, BB ; Effiong, A ; Eftekhari, A ; Elsharkawy, A ; Etemadi, A ; Farahmand, M ; Farzadfar, F ; Fernandes, E ; Filip, I ; Fischer, F ; Gebremedhin, KBB ; Geta, B ; Gilani, SA ; Gill, PS ; Alma Gutierrez, R ; Haile, MT ; Haj-Mirzaian, A ; Hamid, SS ; Hasankhani, M ; Hasanzadeh, A ; Hashemian, M ; Hassen, HY ; Hay, SI ; Hayat, K ; Heidari, B ; Henok, A ; Chi, LH ; Hostiuc, M ; Hostiuc, S ; Hsieh, VC-R ; Igumbor, EU ; Ilesanmi, OS ; Irvani, SSN ; Balalami, NJ ; James, SL ; Jeemon, P ; Jha, RP ; Jonas, JB ; Jozwiak, JJ ; Kabir, A ; Kasaeian, A ; Kassaye, HG ; Kefale, AT ; Khan, RKMA ; Khan, EA ; Khater, A ; Kim, YJ ; Koyanagi, A ; La Vecchia, C ; Lim, L-L ; Lopez, AD ; Lorkowski, S ; Lotufo, PA ; Lozano, R ; Abd El Razek, MM ; Hue, TM ; Manafi, N ; Manafi, A ; Mansournia, MA ; Mantovani, LG ; Mazzaglia, G ; Mehta, D ; Mendoza, W ; Menezes, RG ; Mengesha, MM ; Meretoja, TJ ; Mestrovic, T ; Miazgowski, B ; Miller, TR ; Mirrakhimov, EM ; Mithra, P ; Moazen, B ; Moghadaszadeh, M ; Mohammadian-Hafshejani, A ; Mohammed, S ; Mokdad, AH ; Montero-Zamora, PA ; Moradi, G ; Naimzada, MD ; Nayak, V ; Negoi, I ; Trang, HN ; Ofori-Asenso, R ; Oh, I-H ; Olagunju, TO ; Padubidri, JR ; Pakshir, K ; Pana, A ; Pathak, M ; Pourshams, A ; Rabiee, N ; Radfar, A ; Rafiei, A ; Ramezanzadeh, K ; Rana, SMM ; Rawaf, S ; Rawaf, DL ; Reiner, RC ; Roever, L ; Room, R ; Roshandel, G ; Safari, S ; Samy, AM ; Sanabria, J ; Sartorius, B ; Schmidt, MI ; Senthilkumaran, S ; Shaikh, MA ; Sharif, M ; Sharifi, A ; Shigematsu, M ; Singh, JA ; Soheili, A ; Suleria, HAR ; Teklehaimanot, BF ; Tesfay, BE ; Vacante, M ; Vahedian-Azimi, A ; Valdez, PR ; Vasankari, TJ ; Giang, TV ; Waheed, Y ; Weldegwergs, KG ; Werdecker, A ; Westerman, R ; Wondafrash, DZ ; Wondmieneh, AB ; Yeshitila, YG ; Yonemoto, N ; Yu, C ; Zaidi, Z ; Zarghi, A ; Zelber-Sagi, S ; Zewdie, KA ; Zhang, Z-J ; Zhao, X-J ; Naghavi, M ; Malekzadeh, R (ELSEVIER INC, 2020-03-01)
    BACKGROUND: Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. METHODS: We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. FINDINGS: In 2017, cirrhosis caused more than 1·32 million (95% UI 1·27-1·45) deaths (440 000 [416 000-518 000; 33·3%] in females and 883 000 [838 000-967 000; 66·7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2·4% (2·3-2·6) of total deaths globally in 2017 compared with 1·9% (1·8-2·0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21·0 (19·2-22·3) per 100 000 population in 1990 to 16·5 (15·8-18·1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32·2 [25·8-38·6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10·1 [9·8-10·5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3·7 [3·3-4·0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103·3 [64·4-133·4] per 100 000 in 2017). There were 10·6 million (10·3-10·9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33·2% for compensated cirrhosis and 54·8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases more than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. INTERPRETATION: Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH. FUNDING: Bill & Melinda Gates Foundation.