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Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study INTRODUCTION Future health scenarios that are likely, or probable, or merely possible can have an important role in shaping public-health policy. Studies on health projections1–3 provide an indication of the strong interest shown by scientific and public-health communities in the definition and quantification of scenarios of future health. There have, however, been few comprehensive efforts to project health scenarios for a population4 and none for the entire world or for major regions. In this paper, the last of four on the Global Burden of Disease Study (GBD) (see Lancet 1997; 349: 1269–76; 1347–52; and 1436–42) we describe how we created three scenarios of future mortality and disability by cause, which may have important public policy implications. Our scenarios were based on future health status as a function of projected changes in key socioeconomic variables, which influence he...