核心观点
本研报旨在评估扩大已证实具有成本效益的健康干预措施的全球覆盖范围所带来的潜在益处。报告采用“可能性的艺术”方法,通过分析特定健康干预措施对全球疾病负担和经济发展的影响,提供对机遇和影响的高层次视角。
研究方法
研报采用了自下而上的方法,评估了约90种疾病(约占全球疾病负担的85%)和27种风险因素(约占总风险归因疾病负担的98%),并使用九步分析方法估计了通过扩大特定干预措施可实现的疾病负担潜在减少。
具体步骤包括:
- 选择疾病进行深入分析:基于IHME GBD 2021数据集,选择约80%的全球疾病负担(以DALY衡量)的领先健康条件进行深入分析,并确保涵盖主要健康挑战。
- 估计风险归因疾病负担:对于疾病负担归因于特定风险因素的情况(例如,2型糖尿病与高BMI相关),纳入了27种风险因素(涵盖代谢、环境或职业以及行为类别)的更精细的风险归因疾病负担估计。
- 识别和分类干预措施:通过临床文献回顾,确定了具有成本效益且可扩展的干预措施,包括旨在减少疾病发生率的预防措施和旨在解决已建立疾病的治疗干预措施。
- 估计效应量:从系统评价中提取干预措施的有效性估计,并分别针对发病率和死亡率进行估计。
- 估计目标采用率:开发了两种情景来估计目标采用率:理想最佳实践情景和理论最大情景。
- 估计干预措施启动时间:考虑了扩大干预措施覆盖范围所需的时间,并使用s形曲线模拟现实生活中的情景。
- 定义干预措施顺序:针对每种疾病,量化一个或多个相关干预措施的影响,并按干预类型顺序计算其影响:环境和行为干预措施首先应用,其次是健康促进和预防措施,最后是治疗干预措施。
- 计算对伤残寿命年、寿命损失年和死亡的影响:模型应用于估计在25年时间内通过扩大已证实具有成本效益的健康干预措施可实现的全球疾病负担的潜在减少。
- 估计对预期寿命和健康调整预期寿命的影响:通过重新计算基于扩大健康干预措施后每 capita 剩余死亡率和YLD的缩略寿命表,估计了对预期寿命和健康调整预期寿命的影响。
模型结果经过临床专家审查和与外部证据进行比较,以确保其合理性和准确性。
研究结论
扩大已证实具有成本效益的健康干预措施的全球覆盖范围可以带来显著的健康和经济益处。
- 健康改善:通过扩大干预措施覆盖范围,可以显著减少全球疾病负担,从而提高预期寿命和健康调整预期寿命。
- 经济收益:健康改善可以带来多种经济收益,包括:
- 减少过早死亡带来的劳动力供给增加
- 减少健康条件带来的出勤率提高
- 非正式护理人员的劳动力参与率提高
- 健康状况改善带来的生产力提高
- 儿童未来收入潜力的提高
- 非正式护理人员的生产力提高
然而,该分析也存在一些局限性,例如数据、临床证据和假设的固有局限性。
进一步的研究将有助于完善这些估计。
Stronger health,
February 2026
Table of contents
Estimate the health improvements from scalingselected health interventions3
Estimate the incremental cost and economic return
This appendix outlinesthe methodology and key assumptions underlying the Prioritizing Health model,which assesses the global disease burden and models the potential impact of scaling proven cost-effective
This analysis represents an “art of the possible” approach, aiming to estimate the potential benefitsof expanding access to proven health interventions on a global scale. While it provides a high-levelperspective on the opportunities and impact, it is important to acknowledge that there are inherent
The model comprises three main analytical steps:
—Estimate the health improvements from scaling selected health interventions.
—Quantify the economic benefit of improved health.
—Estimate the incremental cost and economic return.
Estimate the health improvements from scaling selected health interventions
The model adopted a bottom-up approach, assessing individual health conditions in detail and estimatingthe potential reduction in disease burden achievable through the scale-up of specific interventions. Itencompassed approximately 90 conditions, representing about 85 percent of the total global diseaseburden, and incorporated risk-attributable burden from around 27 risk factors, which together accounted
For the remaining conditions—constituting the residual 15 percent of the global disease burden—an averageimpact proportion was applied, derived from comparable conditions within the same disease group or
1. Select conditions for in-depth analysis
The model used the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease (GBD)2021 data suite as the analytical baseline. Projections of future disease burden were drawn from IHME’sforecast estimates, which are based on a comprehensive and systematically curated global health database.Nevertheless, forecasts of disease burden are inherently uncertain, and unanticipated health shocks, policy
Within the GBD data set, disease burden is quantified using disability-adjusted life years (DALYs) andcauses are organized in a hierarchical structure: Level 0 aggregates all causes; Level 1 distinguishesbroad cause groupings of communicable, noncommunicable, and injury causes; Level 2 disaggregatesdisease burden into 22 major disease groups, including cancers, cardiovascular disorders, and mentaldisorders; and Levels 3 and 4 comprise progressively more detailed, condition-specific classifications
regions, income archetypes,2and age groups. Additional conditions were included where needed to ensurerepresentativeness. This process resulted in a preliminary list of 46 conditions, presented in Exhibit 2.
Web Exhibit <2> of <5>
severity reduction, or both. For certain broad disease categories, more detailed analysis at a lowerclassification level was deemed necessary to improve accuracy. In such cases, Level 3 categories werereplaced with their corresponding Level 4 disease classifications. This refinement was applied to conditionssuch as diabetes mellitus (assessed separately as type 1 and type 2), stroke (ischemic stroke, intracerebralhemorrhage, and subarachnoid hemorrhage), headache disorders (migraine and tension-type), blindness and
Following these adjustments, the final deep-dive analysis covered 89 diseases, with all disease groups wellrepresented, covering about 85 percent of the total global disease burden.
2. Estimate risk-attributable disease burden
For conditions in which disease burden is attributable to specific risk factors (for example, type 2 diabeteslinked to high BMI or ischemic heart disease associated with high blood pressure), more-granular risk-attributable disease burden estimates were incorporated into the model. The analysis included 27 riskfactors spanning metabolic, environmental or occupational, and behavioral categories, aligned with the
According to the IHME risk burden data set, most conditions are associated with multiple risk factors thatcontribute jointly to the overall disease burden. These risk factors are often interdependent—for instance,metabolic risks such as high fasting plasma glucose and high BMI may overlap in their contribution todisease outcomes. To prevent double counting when estimating the potential impact of interventions
3. Identify and categorize interventions
A review of clinical literature was conducted to identify cost-effective and scalable interventions withthe greatest potential for health impact, including both preventive measures aimed at reducing diseaseincidence and therapeutic interventions addressing established disease. The objective of this process wasto determine high-impact interventions that could substantially reduce disease burden if implemented moreeffectively and if access gaps were minimized. Sources used for the intervention review included clinicalg