Blue Marble Health and the Global Burden of Disease Study 2013

The concept of blue marble health emerged as a novel framework for global health in 2013 [1, 2]. Succinctly put, today most or at least one-half of the world’s neglected diseases occur among the poor living in wealthy countries, especially in the group of 20 (G20) nations and Nigeria [1–4]. Based on data mostly compiled and released by theWHO (and other published sources), approximately one-half of the major helminth infections occur among the G20 countries and Nigeria, as well as most of the dengue, leishmaniasis, leprosy, Chagas disease, and possibly other neglected tropical diseases (NTDs) [1–3]. In addition, most (57%) of the tuberculosis (TB) cases are found in these countries, as are almost one-half of the malaria (45%) and HIV/AIDS (44%) cases [4]. The term “blue marble” is based on a famous Earth photograph taken by astronauts from an Apollo mission, which has since become an important symbol for the health of our planet [5]. We sometimes refer to the G20 nations and Nigeria as the blue marble health countries. An important policy implication of blue marble health is that because these neglected diseases are endemic to wealthy nations with high gross domestic products (GDPs), in many cases the resources to combat these diseases through treatment and prevention measures, as well as resources for research and development for new technologies, should be available [6]. By taking greater ownership of their own public health control and policy efforts, the blue marble health countries could eliminate at least one-half of the world’s neglected diseases [6]. In addition, we found that the blue marble health countries account for approximately 70% of the deaths from noncommunicable diseases [7]. Shown in Figs 1–3 is an analysis of data from the GBD 2013 that focused on the disabilityadjusted life years (DALYs) due to NTDs and HIV/AIDS, TB, and malaria [8]. The GBD 2013 largely confirms the conclusions of theWHO and other data analyzed previously. Thus, the G20 nations and Nigeria together account for 51% of the global DALYs due to NTDs and helminth infections and most of the DALYs resulting from Chagas disease, dengue, and leprosy (Figs 1 and 2). In addition, the blue marble health countries account for approximately 60% of the global TB DALYs and 43% and 42% of the malaria and HIV/AIDSDALYs, respectively (Fig 3). Shown in Table 1 is a comparison of the estimates based on eitherWHO (and other) data and GBD 2013 data. It is interesting to note that for the helminth infections, for example, despite the fact that theWHO PCT data evaluates children or children and adults at risk who require mass drug administration, whereas the GBD 2013 estimates DALYs from actual