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“Without good data, we’re flying blind. If you can’t see it, you can’t solve it.”

So wrote Kofi Annan, the former United Nations Secretary General, in the journal Nature. His commentary in February celebrated two new studies that mapped the African continent in 5 by 5 square kilometers, uncovering local health and educational disparities through an unprecedented level of detail.

For the senior author of both papers, Annan’s shoutout was almost as meaningful as the maps themselves.

“That was a lovely thing to see,” said Simon Hay, Director of Geospatial Science at UW’s Institute for Health Metrics and Evaluation. “It was a highlight of my career, not just because he’s someone who was so pivotal in establishing the Millennium Development Goals and he was championing the value of local data. He’s one of my heroes.”

Hay’s Local Burden of Disease (LBD) team was already on the map well before the twin Nature studies. They’ve been digging ever deeper into data for years, publishing reports that explore health trends at a local level.

That’s important because data at the country level can obscure disparities within borders. Hay points to Nigeria. Taken as a whole, the country has made significant strides in under-5 mortality, he notes. But another story appears when you zoom in to 5×5 km resolution. The rural north lags significantly behind the more developed south. Armed with that knowledge, Hay says, politicians, clinicians and other stakeholders can take steps to close that gap.

The LBD team is never prescriptive with its findings, Hay stresses.

“Our job is not to tell countries what to do,” he said. “Our job is to provide the best information we can to local decision-makers so they can deploy the resources they have to maximum impact.”

Hay and the LBD team have seen their data drive real change over the years. For example, when they mapped the distribution of bed nets and malaria in Kenya, they discovered that nets were prevalent in urban areas of the country – where malaria cases were rare – but weren’t reaching other parts of the country. For policymakers, this information clarified the problem and made the solution much more apparent.

And UNICEF now uses the team’s under-5 mortality and child growth failure maps to power EQUIST, its data-driven system to identify ways to save lives.

Mapping a career

Hay at a computer

Growing up in the U.K., Hay kept all sorts of critters in his room. Alive, dead, moldy – they all fascinated him. So it was an easy leap to study zoology in school, where he became interested in parasites.

As a doctoral candidate he started to chase them. He landed a “brilliant” gig that entailed piling into a Land Rover, driving around national parks in Africa, setting traps for tsetse flies, and picking them up later in the evening.

At Oxford University he moved from the parasites to the diseases they cause, in particular malaria. Then he became a tenured professor and found himself at a crossroads.

“’Do I want to retire here, always working on malaria?’ I wasn’t sure that was ambitious enough,” Hay said. Conversations with IHME Institute Director Chris Murray and a new grant from the Bill and Melinda Gates Foundation led to an offer to bring a local dimension to the Global Burden of Disease (GBD) study, IHME’s massive effort to quantify health loss from hundreds of diseases, injuries, and risk factors. Hay and a rapidly growing team – now more 50 people – began mapping not only malaria but also diarrhea, pneumonia, HIV, tuberculosis and neglected tropical diseases.

It was ambitious enough.

“If I do this in the context of the Global Burden of Disease, and we do it well, it’s got a permanence to it,” Hay said. “It’s not just me sitting in a lab.”

The LBD team works in the world of “precision public health” – the use of data to efficiently guide health interventions. Much of the work is unglamorous, he says. A small army of data analysts – “hunter-gatherers,” he calls them – strive to get their hands on as much data as they can, including from household surveys by countries and nongovernmental organizations.  And Hay cheerfully rolls up his sleeves to number crunch with his team. “I get as excited as anyone when a new data set comes in.”

The team’s ultimate goal, Hay said, is to create these 5 by 5 maps for all the diseases, risks, and injuries covered by the GBD. “How close we will ever get to that is a work in progress. You hang around someone like Chris Murray, you get infected with optimism.”

Guest Writer: Jake Siegel

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