Post-COVID-19 health inequalities: Estimates of the potential loss in the evolution of the health-related SDGs indicators.

Abstract

This study delves into the global evolution of 43 Sustainable Development Goals (SDG) indicators, spanning 7 major health themes across 185 countries to evaluate the potential progress loss due to the COVID-19 pandemic. Both the cross-country and temporal variability of the dataset are employed to estimate an empirical model based on an extended version of the Preston curve, which links well-being to income levels and other key socioeconomic health determinants. The approach reveals significant global evolution trends operating in each SDG indicator assessed. We extrapolate the model yearly between 2020 and 2030 using the IMF's pre-COVID-19 economic growth projections to show how each country in the dataset are expected to evolve in these health topics throughout the decade, assuming no other external shocks. The results of this baseline scenario are contrasted with a post-COVID-19 scenario, where most of the pandemic costs were already known. The study reveals that economic growth losses are, on average, estimated as 42% and 28% for low- and lower middle-income countries, and of 15% and 7% in high- and upper middle-income countries, respectively, according to the IMF's projections. These disproportional figures are shown to exacerbate global health inequalities revealed by the curves. The expected progress loss in infectious diseases in low-income countries, for instance, is an average of 34%, against a mean of 6% in high-income countries. The theme of Infectious diseases is followed by injuries and violence; maternal and reproductive health; health systems coverage; and neonatal and infant health as those with worse performance. Low-income countries can expect an average progress loss of 16% across all health indicators assessed, whereas in high-income countries the estimated loss is as low as 3%. The disparity across countries is even more pronounced, with cases where the estimated progress loss is as high as nine times worse than the average loss of 8%. Conversely, countries with greater fiscal capacity are likely to fare much better under the circumstances, despite their worse death count, in many cases. Overall, these findings support the critical importance of integrating the fight against inequalities into the global development agendas.