Abstract
SummaryBackgroundIn 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).MethodsWe 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.FindingsIn 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.InterpretationGBD 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.FundingBill & Melinda Gates Foundation.
Highlights
In September, 2015, the UN General Assembly adopted “Transforming our World: The 2030 Agenda for Sustainable Development”, a resolution outlining a new framework to form the cornerstone of the sustainable development agenda for the period leading up to 2030.1 This new framework replaced the Millennium Development Goal (MDG) framework that expired in 2015, establishing 17 universal goals and 169 targets referred to as the Sustainable Development Goals (SDGs)
For universal health coverage (UHC) tracer interventions, we developed an index based on the geometric mean of the coverage of a set of UHC tracer interventions: met need with modern contraception; antenatal care; skilled birth attendance coverage; in-facility delivery rates; vaccination coverage; tuberculosis case detection rate; coverage of antiretroviral therapy for populations living with HIV, and coverage of insecticide-treated nets for malariaendemic countries
Health-related SDG, health-related MDG, and healthrelated non-MDG indices To identify broad patterns and more track general progress, we developed an overall health-related SDG index that is a function of the 33 health-related SDG indicators
Summary
In September, 2015, the UN General Assembly adopted “Transforming our World: The 2030 Agenda for Sustainable Development”, a resolution outlining a new framework to form the cornerstone of the sustainable development agenda for the period leading up to 2030.1 This new framework replaced the Millennium Development Goal (MDG) framework that expired in 2015, establishing 17 universal goals and 169 targets referred to as the Sustainable Development Goals (SDGs). The SDGs substantially broaden the development agenda beyond the MDGs and are expected to frame UN member state policies over the 15 years. To measure progress towards achieving the goals, the UN Statistical Commission created the Inter-Agency and Expert Group on Sustainable Development Goal Indicators (IAEG-SDGs) with a mandate to draft an indicator framework that aligns with the targets. The IAEG-SDGs announced a total of 230 indicators to measure achievement of the 169 targets.[2] Health is a core dimension of the SDGs; goal 3 aims to “ensure healthy lives and promote wellbeing for all at all ages”. Health-related indicators—ie, indicators directly pertaining to health services, health outcomes, and environmental, occupational, behavioural, or metabolic www.thelancet.com Vol 388 October 8, 2016
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