Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries.Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution.Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the...

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.

This paper studies the capacity investment decisions of an agri-processor that uses a commodity input to produce a commodity output and a byproduct. Using a multiperiod model, we study the one-time processing and (output) storage capacity investment decisions, and the periodic processing and inventory decisions in the presence of input and output spot price uncertainties and uncertain production yield. We identify three capacity investment strategies, investing in storage-dominating, processingdominating or mixed portfolio, and provide conditions under which each strategy is optimal. Using a calibration based on the palm industry, we provide rules of thumb for capacity management: The processor should decrease its processing capacity with an increase in price correlation; and with an increase (a decrease) in input or output price volatility when this volatility is low (high). The storage capacity should be adjusted in a similar fashion only as a response to a change in output price volatility, otherwise it should not be altered. We find that not accounting for the byproduct revenue or inventory holding possibility in capacity planning leads to sizeable profit loss. Ignoring production yield uncertainty has a significant negative impact on profitability if the capacity planning is made based on the maximum yield possible, as often done in practice; but it has an insignificant impact if the planning is made based on the average yield.

This paper analyzes the energy efficiency (EE) investment decisions of a capital-constrained manufacturer that competes with an alternative supplier for the business of a large industrial buyer. Through a series of game-theoretic models, we characterize when it is beneficial for the buyer to offer EE instruments, including assessment assistance and procurement commitment, and how these instruments interact with third-party assessment assistance to affect the supplier’s EE investment level. We find that assessment assistance helps reduce the EE gap but procurement commitment is required to eliminate it. We also find that the availability of third-party assessment assistance reduces the buyer’s incentive to offer both of its instruments, a scenario that potentially lowers the supplier’s EE investment level. Our findings provide insights for buyers and policy makers interested in improving supply-chain EE. The online appendix is available at https://doi.org/10.1287/mnsc.2017.2941 . This paper was accepted by Vishal Gaur, operations management.

The COVID-19 pandemic has brought unprecedented growth to the e-commerce industry, triggering widespread digital service transformation across various business segments in Vietnam. A pressing concern for both businesses and policymakers is whether the sudden peak in customer interest in e-commerce can be sustained in the future. This research seeks to address this concern by considering whether and how customers’ motivations to participate in e-commerce activities have changed. We collected primary data from a self-administered survey to empirically examine how health and safety concerns influence customers’ online shopping behavior during the pandemic, alongside other known determinants for e-commerce participation, namely technology readiness and connectedness. The results confirm that health and safety concerns have a positive influence on customers’ usage of e-commerce after controlling for technology readiness and connectedness. Furthermore, customers in age groups with higher risks of severe COVID-19 symptoms and mortality are more likely to increase e-commerce usage during the social distancing and isolation period. Our results support the idea that the customer base for e-commerce and digital services have expanded beyond the typical tech-savvy and young customers in their twenties. These are promising signs for postpandemic recovery and even expansion, as firms may leverage the momentum of change in customers’ motivations and start tailoring their public relation campaigns to address a wider age range of potential consumers.