Intended for healthcare professionals

Education And Debate

Monitoring global health: time for new solutions

BMJ 2004; 329 doi: (Published 04 November 2004) Cite this as: BMJ 2004;329:1096
  1. Christopher J L Murray, director (,
  2. Alan D Lopez, head of school2,
  3. Suwit Wibulpolprasert, senior adviser on health economics3
  1. 1 Harvard Initiative for Global Health, Harvard University, 104 Mount Auburn Street, Cambridge, MA 02138, USA
  2. 2 School of Population Health, University of Queensland, Herston Road, Herston, Queensland 4006, Australia
  3. 3 Office of Permanent Secretary, Ministry of Public Health, Tiwanond Road, Nonthaburi 11000, Thailand
  1. Correspondence to: C J L Murray

    Improved global health monitoring requires new technologies and methods, strengthened national capacity, norms and standards, and gold standard global reporting. The World Health Organization's many functions limit its capacity for global reporting, and a new global health monitoring organisation is needed to provide independent gold standard health information to the world


    Sound information on financial and human resources invested in health, health interventions delivered to people in need, and the impact of these efforts on people's health is critical for planning health systems, implementing programmes, epidemic response, allocating budgets for research and development, monitoring progress, and evaluating what works and what does not. Although all countries collect a wide range of health information through registries, surveys, and vital registration systems, huge gaps hinder our ability to respond to global health challenges, which are alarming at a time when global investments in AIDS, tuberculosis, and malaria are increasing and when there is renewed focus on health goals as exemplified by the UN Millennium Declaration.1

    The availability of valid, reliable, and comparable health information to inform local, regional, national, and global decisions can be furthered through four interconnected efforts: improving the technology and methods for population health measurement; strengthening national capacity and motivating governments to collect and analyse useful health data; establishing global norms and standards for what are the core health related measurements and how to measure them; and reporting to the globe valid, reliable, and comparable assessments of inputs, service delivery, and achievements for health. Although many challenges and initiatives are under way for the first three of these components, the fourth area is currently the weakest and getting worse, not better. We explore the problem and the potential solution to global monitoring and evaluation and briefly review the other three areas as necessary.

    Technology and methods of health measurement

    For several critical measures of …

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