Beyond counts: a common unit for human suffering

WSI is building and testing a common experimental language for human suffering. Each series starts with public source data and then adds explicit assumptions about intensity and duration. The aim is to learn when this common framework adds useful information and when simpler indicators are enough.

A USU expresses modeled intensity-time burden relative to a specified six-hour kidney-stone pain trajectory. The reference makes the scale concrete. It does not by itself prove that different harms are fully comparable.

No. The reference defines the reporting scale. Whether pain, hunger, fear, illness, and other experiences can be compared on that scale remains a research question. The pilot reports therefore show their assumptions and mapping maturity.

No. Dengue reports cumulative burden across reported 2025 episodes. Acute food insecurity and child wasting report one-day equivalent burden rates. The populations, sources, coverage, geography, and mapping maturity also differ. The three results form a research portfolio, not a cross-domain ranking.

It is the span between the approved low and high mapping scenarios. It shows how the experimental result changes when the provisional intensity or duration assumptions change. It is not a statistical confidence interval and does not capture every source of uncertainty.

P1 means an early illustrative mapping defined for transparent testing. P2 means the mapping is informed by relevant empirical or clinical evidence. Neither level means that the mapping has been fully calibrated or validated. Later maturity levels would require external review or direct empirical evaluation.

No. The current pilot standard covers experienced suffering during lived time. Deaths are reported separately when the source provides a comparable mortality measure. WSI does not convert death into USU in these pilot series.

The source data, state mappings, time basis, and comparison rules would need stronger validation. Results would also need to remain stable under reasonable alternative assumptions and show value beyond simpler indicators. The current pilots are research demonstrations, not decision rules.

WSI can help public-health agencies, humanitarian organizations, researchers, and funders compare documented burden within a clearly defined topic. It can support priority discussions, track changes over time, show whether population size or severity drives a result, improve public communication, and reveal where better data are needed. WSI is intended to inform judgment, not replace it.

WSI is the applied research project. It produces focused series on diseases, humanitarian conditions, and other documented harms. USU is the experimental reporting framework used in those series: it combines the number of people or episodes, a modeled intensity, and a duration, then expresses the result relative to a defined reference episode.

Renal colic is intense, time-bounded, commonly assessed on clinical pain scales, and supported by published clinical data. WSI uses a specified six-hour renal-colic trajectory to define the reporting scale. This is a calibration convention, not a claim that kidney-stone pain is the most important form of suffering. Alternative references can be tested.

Physical pain is one form of suffering, but serious negative experience can also involve breathlessness, nausea, fatigue, hunger, panic, fear, grief, or disruption of basic living conditions. USU is intended to represent experienced suffering more broadly. Each non-pain state still needs a clear definition, an evidence basis, and a stated mapping maturity.

Case counts show how many people or episodes were reported, but they do not show how intense or prolonged the experience may have been. Death counts remain essential and are reported separately. DALYs and QALYs are established health measures with different purposes. WSI adds an experimental experienced-suffering perspective and keeps the original indicators visible beside it.

A focused series can keep the source, definitions, time period, and model consistent across all included locations. That is cleaner than adding a different mixture of available harms for every country. Over time, many focused series can form a broader evidence library without forcing them prematurely into one total score.

Each published pilot shows the source evidence, the modeled states, the cumulative or daily-equivalent time basis, the central experimental USU estimate, the deterministic mapping range, the mapping maturity, and the main interpretation limits. Mortality is reported separately when a comparable source measure exists. Public briefs, full reports, and research methods provide different levels of detail.

Total burden reflects the aggregate modeled burden in the included population. A per-capita or per-analyzed-population value reflects concentration relative to a stated denominator. The two views can produce different orderings, so WSI keeps them separate and identifies the denominator used.

Each modeled state receives low, central, and high assumptions that are documented in a mapping note. P1 mappings are early illustrative assumptions; P2 mappings are informed by relevant empirical or clinical evidence. Duration is taken from the source or supporting evidence when possible. Snapshot-based series use a one-day equivalent rather than assuming that a state persisted for an entire season or year.

WSI primarily uses official public-health, humanitarian, demographic, and research sources. Each series identifies its source, reporting period, geographic scope, and release version. Source data remain separate from the assumptions introduced by the WSI model.

Absence does not mean absence of suffering. A country may fall outside the source coverage, use an incompatible definition, have a different reporting period, or lack enough data for the stated analysis. Each series defines its source universe and explains important exclusions.

The current pilot standard uses approved low, central, and high mapping scenarios. The resulting deterministic range shows how the estimate changes under those assumptions; it is not a confidence interval. Full reports also describe source limitations and other uncertainty that the range does not capture. More advanced probabilistic analyses may be used in later studies when they add value.

Psychological suffering can be modeled only when the state is clearly defined and supported by credible evidence. Physical and psychological suffering are not assumed to be identical. Any mapping for anxiety, depression, grief, trauma, or fear would be context-specific and would require explicit assumptions and further validation. None of the first three pilots provides a general psychological-suffering mapping.

The current pilot standard does not apply an overlap adjustment. Categories within one model must be mutually exclusive or made exclusive before calculation. Separate series are not added into one country total when the same people and time periods may overlap. Future work may examine overlap when person-level evidence supports it.

The source counts are observed or estimated by the source organization; the USU mapping adds judgment about intensity and sometimes duration. WSI makes those choices visible through low, central, and high scenarios, mapping-maturity labels, and source-versus-model disclosures. Readers can therefore see which conclusions come from the evidence and which depend on provisional assumptions.

WSI estimates modeled experienced suffering associated with the states included in a specific series. It does not measure a person's worth, dignity, rights, productivity, or overall value of life. Mortality, long-term effects, caregiver burden, and other excluded outcomes remain separate unless a future series models them explicitly.

DALYs and QALYs summarize health loss or health-adjusted time. HDI summarizes dimensions of human development. Other indices may combine economic, political, or security indicators. WSI asks a different question: what modeled intensity-time burden is associated with a defined condition or event? These measures can be used together because they describe different aspects of a problem.

Possibly, but not until a broad set of series has sufficiently comparable coverage, time bases, mappings, and treatment of overlap. The immediate product is a library of focused research series. A wider country-level view would be introduced only if it becomes stable, interpretable, and more useful than showing the component series separately.

The intensity-over-time structure may be relevant to animal-welfare research, but the present USU reference and WSI programme are human-centered. A non-human application would need species-specific behavioral and physiological evidence, animal-welfare expertise, and separate validation. Human and non-human estimates would not be combined by default.

WSI welcomes help with data sourcing, domain expertise, state mapping, quantitative review, replication, visualization, and critical assessment. Researchers can also test alternative assumptions, propose improved mappings, or examine whether a simpler source indicator is sufficient for a particular series.