Book review—Epic Measures: One Doctor. Seven Billion Patients.

Every so often, a development book gets published that reminds us of the value of re-examining the fundamentals of what we think we know about the world. Epic Measures: One Doctor. Seven Billion Patients. is that book.

The limitations of the data collected by the multilaterals, including the World Health Organization, are well known. In the absence of a functional civil registration and vital statistics (CRVS) system, in countries where poverty, war, corruption and disasters conspire against robust data collection, historically there was a tacit acceptance that the data produced was the best you could expect.

Dr Christopher Murray, on whom this book is based, changed that thinking, by going back to the basics of what good researchers do: he looked at the data and interrogated it. As an encouraging aside for all those at the beginning of their research careers, at the time he wasn’t the preeminent health expert he is now; Murray was writing his dissertation.

With the benefit of hindsight, that interrogation seems straight-forward. Look at the multilaterals and compare their statistics. And when doors remain stubbornly shut when you start to query the basis of the data, use some reverse engineering.

From there, Murray went on to question how we live as well as how we die, coming up with what is now a familiar concept in health and development: disability-adjusted life years (DALYs). That broadening in perception to a more holistic view of health and its elegance as a policy tool has seen it adopted globally.

Unsurprisingly, while his work brought him together with future collaborators including Alan Lopez and Paul Farmer, it also produced plenty of professional foes who saw the work as undermining decades of work on individual diseases.

The partnership with Lopez particularly shaped the lens through which we view global health, producing the Global Burden of Disease series that policymakers now heavily rely on.

So why read the book? It charts what were huge conceptual shifts in the way we view health, the ways we collect and collate health data on a global scale and reminds us of the enormous progress made since the mid-1980s. Written by a journalist, it is accessible to the broader development community. It does not seek to present a neat, linear progression; there are plenty of set-backs, data refinement and issues on both personal and professional levels.

Above all, it is an inspiring read for anyone who has wanted to make a difference in their field and felt the odds were stacked against them. It illustrates the power of rigorous, well-conceived research and analysis to change the world. And it reminds us that while change can feel incrementally slow, the research produced by academia can make an enormous contribution to the health and well-being of billions of people.

Epic Measures: One Doctor. Seven Billion Patients. by Jeremy N. Smith. Published by Harper Collins, 2015.

Review by Belinda Lawton, PhD Scholar, Crawford School of Public Policy, ANU.

Belinda Lawton

Belinda Lawton is a PhD candidate at Crawford School of Public Policy researching not-for-profit, non-government hospitals and clinics in fragile countries in Asia. Belinda is a communications specialist who has worked with several health-related NGOs in Timor-Leste, Bangladesh and Thailand.

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