Lancet critique of global estimates

Monitoring country progress and achievements by making global predictions: is the tail wagging the dog?
– Ties Boerma, Cesar Victora, Carla Abouzahr

We call for a repositioning of the production of global estimates, and the transition from MDGs to SDGs provides an opportunity to do so. Neither country policy makers nor the global development community are best served by a global flood of health estimates derived from complex models as investments in country data collection, analytical capacity, and use are lagging.

  • First, we recommend a slow down in the production of estimates: the year for which the predicted statistics are published should lie much closer to the actual year of the most recent datapoints than is currently the case, thus avoiding extensive extrapolations of time trends into the future.

  • Second, global publications and academic journals should be increasingly circumspect and transparent regarding the limitations of estimates; publications should pay increased attention to empirical country data presented with careful data quality ascertainment and adjustments for biases on the basis of transparent and reproducible methods.

  • Third, donors and global development partners should reconsider their role in the production and use of global estimates. Reduced demand for real-time tracking of impact and results and improved understanding of the real world would go a long way towards increasing sustainability, building capacities, and enhancing accountability to the intended beneficiaries of development.

  • Fourth, rather than increasing investments in the production and dissemination of global estimates, increased domestic and international support is urgently needed for public health institutes, universities, and research entities in low-income and middle-income countries to develop and sustain institutional knowledge and skills for data generation, analysis, interpretation, and translation.

The Lancet, April 2018