By Irene Edwards

Dr. Alan Lopez, professor of medical statistics and population health and head of the School of Population Health at the University of Queensland, Australia, will deliver a lecture entitled "Global Health Priorities: Diseases, Injuries, Risk Factors," on Tuesday, Apr. 8 at 3 p.m. in Masur Auditorium, Bldg. 10. This lecture is the third in a year-long series on global health issues sponsored by the Fogarty International Center to commemorate its 35th anniversary.

Priority-setting in health requires comparable, timely and relevant information on the major causes of disease and injury, and how these are changing. Much is known, for some populations, about the levels, trends and causes of mortality, and on the effects of population exposure to certain risk factors, but there have been few attempts to integrate health statistics in a manner that yields comparable, summary measures of the disease burden caused by fatal and non-fatal conditions and the major risk factors associated with them.

Dr. Alan Lopez Lopez, together with Dr. Christopher J.L. Murray, is the author of The Global Burden of Disease Study (1990 and 2000), a critical and systematic review of all available data and information on the incidence, prevalence and mortality from over 130 diseases and injuries worldwide summarized in a time-based metric (disability adjusted life years, or DALYs). This work is the first to identify clearly the growing burden of chronic, non-communicable diseases in developing countries. Until this study, it was widely assumed that communicable diseases were, and would remain, the major source of illness and death in developing countries. Lopez and Murray modeled different scenarios, including an optimistic one predicated on the decline in communicable disease DALY's. Whether or not this is realistic, as drug and insecticide resistance continue to spread, DALY's due to non-communicable diseases will continue to increase. Hence the world is faced with the unfinished agenda of infectious diseases and a new and urgent agenda of increased morbidity and mortality due to cardiovascular disease, diabetes, cancer and mental illness.

Worldwide, two causes of disease appear to be increasing at a rapid pace, tobacco and HIV/AIDS. While there is some uncertainty about projected HIV deaths, depending on the deployment of anti-retroviral therapy, tobacco will, on current trends, kill about 10 million people a year by 2030, double the current annual toll, unless efforts to reduce consumption, particularly among men in poor countries, are accelerated. The DALY is now used to assess disease trends, to evaluate the cost-effectiveness of different therapies, and to prioritize research needs across a broad spectrum of conditions and guide research resource allocation.

A graduate of the University of Western Australia, Lopez received an M.S. in statistics from Purdue University and a Ph.D. in medical demography from the Australian National University in Canberra. He was associated with the World Health Organization from 1979 to 2002, first in the division of health statistics, then in the global epidemiological surveillance unit, the tobacco or health programme, the programme on substance abuse, the epidemiology and burden of disease unit, and finally as senior science advisor to the director-general on scientific standards for WHO data and publications and the development of evidence-based guidelines. He was editor-in-chief of the World Health Report 2002.

Lopez returned to his native Australia this year to take up his current positions at the University of Queensland. All who are interested are welcome to attend the lecture and to meet Lopez at an informal reception following the talk.