Brocher Summer Academy in the Ethics of Global Population Health 2014: Ethical Choices for DALYs and the Measurement of the Global Burden of Diseas

Introduction :

The Brocher Summer Schools or Summer Academies bring together distinguished professors from different disciplines and countries and highly promising researchers willing to acquire a strong background on a chosen topic. Beside a high level of teaching, a limited number of participants gives the students a rare opportunity to meet personally many established international professors.

All the sessions take place at the Brocher Centre in Geneva, Switzerland in an amazing and peaceful environment on the shore of the Lake of Geneva. In 2012 the Brocher Foundation hosted two summer universities, including the University of Harvard. The next summer school will take place in 2016.


The Global Burden of Disease (GBD) project is a systematic, scientific effort to quantify the comparative magnitude of health loss due to diseases, injuries, and risk factors. From its inception in the early 1990s, scientists and philosophers recognized that ethical and philosophical questions arise at every turn. For example, it must be decided whether each year in the lifespan is to count alike, and whether future deaths and disabilities should be given the same weight as those in the present. These choices and decisions matter: the share of disease burden due to myocardial infarction could vary as much as 400% depending on what position is adopted on two of the ethical choices described in the GBD 2010 report (the discount rate—if any—for health states over time, and the choice between prevalence and incidence measures).

Between 9-13 June 2014, key experts in the field of global health policy, along with senior academics in several fields and talented younger scholars, will debate a number of issues most likely to arise in the GBD area during the next several years. Among these are the choice between health and (health-related) wellbeing as the object of study and measurement; the role of GBD in priority-setting (cost-effectiveness analysis, cost-benefit analysis, and other methods); and issues arising from the mix of categorical attribution (by cause of death, according to a classification system) and counterfactual analysis.

The goals of the Summer Academy in the Ethics of Global Population Health are: advancing the field of population-level bioethics; introducing graduate students and researchers, including academic leaders, to this emerging field, motivating and enabling them to contribute to its development; orienting policy makers and practitioners in international health on relevant ethical issues; bridging disciplines; and outlining themes for future research.

June 9

Wickler and Eyal : 50 Pills

Murray : Intro to GBD Ethics

Vos The structure of GBD

Hausman : Health cannot be Measured

Salomon : Health can be measured

Hausman response to Salomon

Salomon response to Hausman

General discussion : Can health be measured

June 10

Vos : GBD Basics: Background Lecture

Murray : Introduction

Woodward : Causal Attribution, causal modelling and disease interventions

Hall : Causal Additivity

Vos : Comments

Hausman Comments

Cotton-Barratt : Comments


Fleurbaye : Issues in the measurement of the global burden of disease

Murray : Ethical Dimensions of the Global Burden of Disease

June 11

Schroeder : Ethics and the DALY : Background Lecture

Norheim : Using Burden of Disease Data to inform priority setting in Norway

Hausman : The economic Evaluation of Health

Schokkaert Health as one component of well-being: empirical applications of equivalent income

Adler Extended preferences and the valuation of health

Fleurbaey Comments


June 12

Voorhoeve : Personal responsibility for the burden of disease

Voorhoeve : Aggregating Competing Claims

Cotton-Barratt : Uncertainty and Discounting: How Context Matters

Stefansson : Fairness and Counterfactuals


Kingma : The Limits of Naturalism: health, disease and values

Schroeder : Values in DALYs

Bognar : Age and time in the burden of disease


June 12

Saxena : WHO’s ethics agenda

Cookson : Potential uses for GBD in Priority-Setting

Lauer Comment: How WHO uses GBD in WHO-CHOICE

Hausman: The Public Value of Health

Panel – Wikler-Vos-Woodward :The Remaining Agenda for Ethics and GBD

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