GAPMINDER: for a fact-based worldview

by Barbara Schimmer (EPIET Cohort 10, RIVM, NL)

During the IMED conference in Vienna (13-16 February) I was fortunate to listen to an extraordinary inspiring lecture ‘Dynamic trends in Global Health’ by a rather ordinary looking Swedish professor in international health Hans Rosling. Although I read about him before, l was so impressed by his plenary lecture which captivated the whole audience, everyone sat on the tip of their chair. He starts off by telling about how he taught global health to a group of medical students at Karolinska University in Sweden. He made a pre-test to test the students knowledge by asking them to indicate which of two mentioned countries have the highest child mortality rate. The students scored really badly, and he cynically concluded that his medical students were significantly more stupid than chimpanzees (as they scored less than half of the questions right), and the professors who did the same test did just as well as the chimpanzees. As he goes on, he challenges his audience to change their complete view on the world, as we all still seem to have the traditional and polarized view of developed and developing countries in our minds, a concept that runs at least 50 years behind. He encourages the audience to never use this ancient divide anymore, but instead use high-income, middle income and low income countries, as this is far more factual. In order to show us, he opens an open-access programme called ‘Gapminder’, unveiling the beauty of statistics for a fact-based worldview.

A screen full of bubbles appears in different colours (for continents) and sizes, each bubble representing a country. Big and small bubbles move over the screen, through time using different data on x- and y axis, such as child mortality, life expectancy, AIDS or gross domestic product. Also the range within countries is shown. Rosling captivates his audience pointing at the animated screen with an old-fashioned pointing stick, as Al Gore in his film the Inconvenient Truth. He pleads convincingly that the world will be helped if we would get a realistic view of the world we are living in, instead of being fixated on post-colonial ideas from the 1950s, and better divide the world into low, middle and high income countries.

After his presentation, I will try to never use the terms developed and developing countries anymore, as this rigid dichotomy does not exist anymore. For a more fact-based worldview, we need to be aware of our preconceived ideas such as ‘They can never live like us’ and realise that we live in a dynamic world where the interrelationships between and within countries are always changing. Gapminder is open-source software which Rosling developed with his son. There is a long list of available indicators ranging from health expenditure per capita, literacy rate, measles immunisation rates, urban population growth, people living with HIV and forest surface area (in square kilometres) The tool is also very relevant for infectious diseases and can aid decision making.

By combining basic health parameters such as live expectancy at birth, child and maternal mortality with socio-economical parameters, such as income per person, population growth and family size, he easily visualises for example that Sweden would never have reached the Millennium Development Goals compared to countries such as Brazil, Egypt and Bangladesh which have faster improved, so we need to be a bit humble to these countries. During the IMED conference, several speakers were inspired and adapted their presentations the next days after having heard the lecture by Professor Rosling. It is a website that is definitely worth a visit for everyone interested in global health.

Online:
Gapminder website: www.gapminder.org. It is a dynamic website with video’s, tutorials and a blog. You can upload your time series into moving bubbles in the free Google Gadget called Motion Chart.

About Hans Rosling in Wikipedia: en.wikipedia.org/wiki/Hans_Rosling

The Gapminder World Chart 2006 compares all countries and territories by income and health.
For the complete list of Gapminder’s downloadable charts and material, see: http://www.gapminder.org/downloads/