Abstract
Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8–61·8) and varied widely by country, ranging from 85·5 (84·2–86·5) in Iceland to 20·4 (15·4–24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0–10·4), and gains on the MDG index (a median change of 10·0 [6·7–13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1–8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs. Funding Bill & Melinda Gates Foundation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1813-1850 |
| Number of pages | 38 |
| Journal | The Lancet |
| Volume | 388 |
| Issue number | 10053 |
| DOIs | |
| State | Published - Oct 8 2016 |
Funding
Bruce Bartholow Duncan and Maria In\u00EAs Schmidt have received additional funding from the Brazilian Ministry of Health (Process number 25000192049/2014-14). Itamar S Santos reports grants from FAPESP (Brazilian public agency) outside the submitted work. Rafael Tabar\u00E9s-Seisdedos was supported in part by grant PROMETEOII/2015/021 from Generalitat Valenciana and the national grand PI14/00894 from ISCIII-FEDER. Ai Koyanagi's work is supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII\u2014General Branch Evaluation and Promotion of Health Research\u2014and the European Regional Development Fund (ERDF-FEDER). Benjamin C Cowie acknowledges funding support from the Australian Government Department of Health and the Royal Melbourne Hospital Research Funding Program. Elisabeth Barboza Franca acknowledges funding from the Brazilian Ministry of Health (Project number 25000192049/2014-14). Aletta E Schutte is funded by the Medical Research Council of South Africa, and the South African Research Chair Initiative by the National Research Foundation. Amador Goodridge acknowledges funding from Sistema Nacional de Investigadores de Panam\u00E1-SNI. Jos\u00E9 das Neves was supported in his contribution to this work by a Fellowship from Funda\u00E7\u00E3o para a Ci\u00EAncia e a Tecnologia, Portugal (SFRH/BPD/92934/2013). Thomas F\u00FCrst has received financial support from the Swiss National Science Foundation (SNSF; project number P300P3-154634). Jost B Jonas reports personal fees from being a consultant for Mundipharma and a patent holder with Biocompatibles UK (title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or anti-angiogenic factor; patent number: 20120263794), and has applied for patent with University of Heidelberg (title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europ\u00E4ische Patentanmeldung 15\u2008000 771.4) outside the submitted work. Stefanos Tyrovolas's work is supported by the Foundation for Education and European Culture (IPEP), the Sara Borrell postdoctoral programme (reference number CD15/00019) from the Instituto de Salud Carlos III (ISCIII), Spain, and the Fondos Europeo de Desarrollo Regional (FEDER). Beatriz Paulina Ayala Quintanilla acknowledges the institutional support of PRONABEC (National Program of Scholarship and Educational Loan), provided by the Peruvian Government, while studying for her doctoral course at the Judith Lumley Centre of La Trobe University funded by PRONABEC. Manami Inoue is the beneficiary of a financial contribution from the AXA Research fund as chair holder of the AXA Department of Health and Human Security, Graduate School of Medicine, The University of Tokyo from Nov 1, 2012; the AXA Research Fund has no role in this work. Olanrewaju Oladimeji is an African Research Fellow at Human Sciences Research Council (HSRC) and a Doctoral Candidate at the University of KwaZulu-Natal (UKZN), South Africa, and acknowledges the institutional support by leveraging on the existing organisational research infrastructure at HSRC and UKZN. Sun Ha Jee has been funded by a grant of the Korean Health Technology R&D project (HI14C2686), South Korea. Dan J Stein reports personal fees from Lundbeck, Novartis, AMBRF, Biocodex, Sevier, SUN, and CIPLA; and grants from NRGF and MRC outside the submitted work. Mayowa O Owolabi's work is supported by U54 HG007479 from the US National Institutes of Health. All other authors declare no competing interests.
ASJC Scopus subject areas
- General Medicine
