In 2007, the Gates Foundation donated $105 million to the University of Washington -- the largest university gift ever for public health -- to establish the Institute of Health Metrics and Evaluation (IHME) to oversee this project. Murray became IHME's first director and with him came scores of full time researchers for this project. In addition to the increased size of research team, Dr. Ali Mokdad, Professor of Global Health at the University of Washington, explains that in 1990 "it used to take mainframe computers to do what laptops can do now." Modern computers allow much more sophisticated modeling of the complex interactions between risk factors and diseases around the world. The project has grown such that today's server farms still take days to compile all the demographic information, interviews, and historic and government health data.

For countries with limited or inaccurate registration of illness and death, Dr. Mokdad explained that researchers construct models of the nation's health based on any available information and the health of similar countries. Then, they repeatedly evaluate for accuracy by sampling the country's population and adjusting the model. Together, the newest models for Global Burden of Disease generate 615 million data points.

To track changes in health over the past 20 years, the Global Burden of Disease calculated DALYS, deaths, and major health risk factors for the year 2010 and recalculated data from 1990 with current models. While most of the results remain behind a paywall on the Lancet's website, IHME created a series of interactive graphics that visualize the data for comparisons by year, age group, and geographic region:

Since 1990, the main source of illness has shifted from infectious diseases (with exception for HIV/AIDS), maternal health problems, and nutritional deficiencies to noncommunicable diseases (NCDs). Even with the HIV pandemic's expansion, the areas targeted by the Millennium Development Goals -- HIV, TB, malaria, maternal and neonatal deaths -- have fallen from nearly 45 percent of DALYs to less than 30 percent. Better sanitation and public health drive this epidemiological transition away from death by pathogens and pregnancy. At the same time, as people live until advanced age, the chronic illnesses that plague the elderly become more common. Taken together, the overall burden of disease has shifted towards more disability in adults.

from "Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010" [ from "Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010" [ The Lancet

This trend plays itself out in the top causes of death and DALYs and the top risk factors for poor health. Ischemic heart disease lead all causes in both mortality and DALYs while preventable lower respiratory infections and diarrhea, still both among the top five causes of DALYs, dropped by roughly 50 percent, allowing more children survive into adulthood. High blood pressure and smoking had the greatest risk for poor health. Four of the top ten risk factors directly related to diabetes, the fastest growing major illness with 93 percent more deaths and 69 percent more DALYs than in 1990, as it spreads into the developing world.