A perennial feature of the Covid-19 pandemic has been the guessing game of whether things are getting better or worse—and how policy approaches (masks, shutdowns) and changes in the weather will affect the coronavirus. Dozens of research institutes have published educated guesses about what’s coming next, but none have had the impact or reach of the University of Washington’s Institute for Health Metrics and Evaluation.
In the early days of the pandemic, the IHME projected a far less severe outbreak than other models, which drew the attention of Donald Trump, who was eager to downplay the danger. At a
March 31 press briefing, the White House’s coronavirus response coordinator, Debbie Birx, with the president at her side, used IHME charts to show that the pandemic was rapidly winding down.
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“Throughout April, millions of Americans were falsely led to believe that the epidemic would be over by June because of IHME’s projections,” the data scientist Youyang Gu noted in his review of the institute’s work. “I think that a lot of states reopened based on their modeling.”
The IHME brushed aside the widespread criticism that emerged—“Many people do not understand how modeling works,” its director, Chris Murray, explained in a
Los Angeles Times op-ed—and continued to push
headline-grabbing projections that drew alarm from its peers. For example, while many researchers limit their projections to a few weeks into the future, Murray used his regular appearances on
CNN to chart the course of the pandemic many months in advance, putting the IHME’s highly contested estimates in a position to guide policy-making ahead of other models.
“It seems to be a version of the playbook Trump follows,” says Sam Clark, a demographer at Ohio State University. “Absolutely nothing negative sticks, and the more exposure you get, the better, no matter what. It’s really stunning, and I don’t know any other scientific personality or organization that is able to pull it off quite like IHME.”
The institute’s uncanny resilience, unconventional methods, and media savvy have long made it controversial in the global health community, where scholars have watched its meteoric rise over the past decade with a mix of awe and concern. Years before Covid, the IHME gained outsize influence by tracking hundreds of diseases across the planet and producing some of the most cited studies in all of science.
But it has also spawned a legion of detractors who call the IHME a monopoly and a juggernaut and charge the group has surrounded itself with a constellation of high-profile allies that have made it too big to peer review, the traditional method of self-regulation in science. Fueled by more than $600 million in funding from the Bill & Melinda Gates Foundation—a virtually unheard-of sum for an academic research institute—the IHME has outgrown and overwhelmed its peers, most notably the World Health Organization (WHO), which previously acted as the global authority for health estimates.
Today the IHME’s sprawling estimates have become the gold standard for understanding an increasingly broad array of topics related to health and development—particularly in the data-poor developing world, where record keeping is sparse. Its website offers interactive maps that allow users to drill down to virtually any village in sub-Saharan Africa, for example, to find out how many years of education people have; how malaria, HIV, and lower respiratory infections are changing over time; who has access to piped water; or how many men are circumcised. These estimates—educated guesses, really—help guide billions of dollars in aid spending and tell health ministers, charities, researchers, and journalists where things are getting better or worse.
“In a relatively short period of time, the IHME has exerted a certain kind of hegemony or dominance on global health metrics production,” says Manjari Mahajan, a professor of international studies at the New School. “It’s a kind of monopoly of knowledge production, of how to know global health trends in the world. And that produces a concentration of…power that should make anybody uncomfortable.
Thanks to the Microsoft founder’s support, the IHME can make its own rules about how to track global health. That’s a problem.