published by The Lancet represent a big undertaking and are not without controversy. IHME has been ambitiously radical in some of its methods. In the absence of death registries or medical records, they have been willing, for instance, to take evidence from verbal autopsies – deciding the cause of death by an interview with the family. The most startling result has been the malaria figure, released earlier in 2012. IHME said 1.2 million die of the disease every year – twice as many as previously thought. The big increase is in adult deaths. Conventional wisdom has it that malaria kills mostly children under five. “The way I was taught as a doctor and everybody else is taught is that, in malarial areas, you become semi-immune as an adult,” said Dr Christopher Murray, IHME Director and one of the founders of the Global Burden of Disease project. “We originally went with the prevailing opinion but there has been a shift as we have become more empirical. African doctors write on hospital records that adults are dying of malaria a lot.” But, he adds, their fever could be something else. The findings have prompted further studies. Although Margaret Chan, Director General of the World Health Organization, gave the IHME study a warm official welcome, some of the staff are cautious. “We need to be very careful in assessing the validity [of the figures],” said Colin