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Disease Burden and Simulation

Improving global understanding of the disease burden associated with catastrophic childhood illness and strengthening data for evidence-based decision-making.


The Global Disease Burden and Simulation (DBS) Unit is a multidisciplinary program that aims to provide and strengthen key data on pediatric cancer and catastrophic blood diseases for clinicians, health administrators and health policy stakeholders to enable the best possible decisions. The team includes faculty, staff and global collaborators external to St. Jude with expertise in statistics, decision sciences, cancer survivorship, health economics and epidemiology.


Program Initiatives


Functioning as the epidemiology and health economics program within St. Jude Global, the DBS Unit emphasizes building collaborative partnerships to synergize global efforts and leverage diverse expertise across relevant multidisciplinary fields.  


The program’s projects span various topics, including novel methods development, the innovative application of methods to answer new questions, and direct data collection and analyses to increase equity within existing or planned global health policies. Our research agenda is broad but includes the following:

  • Developing novel methods of enumerating and estimating multimorbidities across diverse cohorts. 
  • Designing microsimulation analyses to support pre-clinical and health policy decision-making. 
  • Constructing costing tools and cost-effectiveness models to guide budget allocation. 
  • Establishing standardized methodologies for assessing family economic burden to support benchmarking and evidence-based interventions. 
  • Integrating hospital-based cancer registry to inform quality improvement surveillance and design. 
  • Developing normative standards for cancer classification and outcome assessments. 

Many projects undertaken by the DBS team originate within the core program. However, the program also administers key strategic partnerships with global agencies and academic institutions to improve the estimation of childhood cancer burden. Examples include:

  • In 2017, St. Jude and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington began a formal partnership to advance knowledge and understanding of the global childhood cancer burden. This collaboration combines institutional expertise in health metrics, global health, epidemiology and disease burden estimation to provide more accurate estimates of the global burden of childhood cancer. 
  • In 2020, St. Jude and the International Agency for Research on Cancer launched a bilateral initiative, Targeting Childhood Cancer through the Global Initiative for Cancer Registry Development (ChildGICR), with the primary aim of improving data quality and availability on cancer in children, particularly in countries with limited resources. This collaboration unifies expertise in cancer registration and data standards, disease classification, epidemiology, global implementation science, education and health economics. 
  • In 2023, the DBS program partnered with the CONCORD Programme at the London School of Hygiene and Tropical Medicine to provide technical expertise in childhood cancer to support world surveillance of trends in cancer survival, using population-based registry data. 

Projects encompass diverse subject matters and strategies across these collaborations and within the DBS program, with cross-specialty engagement. The ultimate goal of this work is to generate evidence that allows all stakeholders — including policymakers, health advocates and the public health and global health communities — to improve outcomes for childhood cancer patients worldwide.


Our Team


Nickhill Bhakta, MD, MPH

Director, Disease Burden and Simulation Program

Director, Sub-Saharan Africa Regional Program

Co-Director, ARIA Program

Associate Member, St. Jude Faculty

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Nancy Sobhy Bolous, MD, M.A., M.Sc.

Senior Research Scientist, Health Economics

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Julie Ritter, MPH

Program Manager, Disease Burden and Simulation Program

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Program Manager, ARIA Program 

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Amirah Anderson, MPH

Project Coordinator, Disease Burden and Simulation Program

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To learn more about the Disease Burden and Simulation Unit, email