Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

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dc.contributor.authorLozano R
dc.contributor.authorFullman N
dc.contributor.authorAbate D
dc.contributor.authorAbay SM
dc.contributor.authorAbbafati C
dc.contributor.authorAbbasi N
dc.contributor.authorAbbastabar H
dc.contributor.authorAbd-Allah F
dc.contributor.authorAbdela J
dc.contributor.authorAbdelalim A
dc.contributor.authorAbdel-Rahman O
dc.contributor.authorAbdi A
dc.contributor.authorAbdollahpour I
dc.contributor.authorAbdulkader RS
dc.contributor.authorAbebe ND
dc.contributor.authorAbebe Z
dc.contributor.authorAbejie AN
dc.contributor.authorAbera SF
dc.contributor.authorAbil OZ
dc.contributor.authorAboyans V
dc.contributor.authorAbraha HN
dc.contributor.authorAbrham AR
dc.contributor.authorAbu-Raddad LJ
dc.contributor.authorAbu-Rmeileh NM
dc.contributor.authorAbyu GY
dc.contributor.authorAccrombessi MMK
dc.contributor.authorAcharya D
dc.contributor.authorAcharya P
dc.contributor.authorAdamu AA
dc.contributor.authorAdebayo OM
dc.contributor.authorAdedeji IA
dc.contributor.authorAdedoyin RA
dc.contributor.authorAdekanmbi V
dc.contributor.authorAdetokunboh OO
dc.contributor.authorAdhena BM
dc.contributor.authorAdhikari TB
dc.contributor.authorAdib MG
dc.contributor.authorAdou AK
dc.contributor.authorAdsuar JC
dc.contributor.authorAfarideh M
dc.contributor.authorAfshari M
dc.contributor.authorAfshin A
dc.contributor.authorAgarwal G
dc.contributor.authorAghayan SA
dc.contributor.authorAgius D
dc.contributor.authorAgrawal A
dc.contributor.authorAgrawal S
dc.contributor.authorAhmadi A
dc.contributor.authorAhmadi M
dc.contributor.authorAhmadieh H
dc.contributor.authorAhmed MB
dc.contributor.authorAhmed S
dc.contributor.authorAkalu TY
dc.contributor.authorAkanda AS
dc.contributor.authorAkbari ME
dc.contributor.authorAkibu M
dc.contributor.authorAkinyemi RO
dc.contributor.authorAkinyemiju T
dc.contributor.authorAkseer N
dc.contributor.authorAlahdab F
dc.contributor.authorAl-Aly Z
dc.contributor.authorAlam K
dc.contributor.authorAlam T
dc.contributor.authorAlbujeer A
dc.contributor.authorAlebel A
dc.contributor.authorAlene KA
dc.contributor.authorAl-Eyadhy A
dc.contributor.authorAlhabib S
dc.contributor.authorAli R
dc.contributor.authorAlijanzadeh M
dc.contributor.authorAlizadeh-Navaei R
dc.contributor.authorAljunid SM
dc.contributor.authorAlkerwi A
dc.contributor.authorAlla F
dc.contributor.authorAllebeck P
dc.contributor.authorAllen CA
dc.contributor.authorAlmasi A
dc.contributor.authorAl-Maskari F
dc.contributor.authorAl-Mekhlafi HM
dc.contributor.authorAlonso J
dc.contributor.authorAl-Raddadi RM
dc.contributor.authorAlsharif U
dc.contributor.authorAltirkawi K
dc.contributor.authorAlvis-Guzman N
dc.contributor.authorAmare AT
dc.contributor.authorAmenu K
dc.contributor.authorAmini E
dc.contributor.authorAmmar W
dc.contributor.authorAnber NH
dc.contributor.authorAnderson JA
dc.contributor.authorAndrei CL
dc.contributor.authorAndroudi S
dc.contributor.authorAnimut MD
dc.contributor.authorAnjomshoa M
dc.contributor.authorAnsari H
dc.contributor.authorAnsariadi A
dc.contributor.authorAnsha MG
dc.contributor.authorAntonio CAT
dc.contributor.authorAnwari P
dc.contributor.authorAppiah LT
dc.date.accessioned2019-03-07T23:50:48Z
dc.date.available2019-03-07T23:50:48Z
dc.date.issued2018en
dc.date.updated2019-01-28T22:40:55Z
dc.description.abstract© 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Funding: Bill & Melinda Gates Foundation.en
dc.identifier.doihttps://doi.org/10.1016/S0140-6736(18)32281-5
dc.identifier.issn0140-6736
dc.identifier.issn1474-547X
dc.identifier.urihttp://hdl.handle.net/10092/16560
dc.languageEnglish
dc.language.isoen
dc.rightsCreative Commons Attribution License (CC BY) This article is available under the terms of the Creative Commons Attribution License (CC BY). You may copy and distribute the article, create extracts, abstracts and new works from the article, alter and revise the article, text or data mine the article and otherwise reuse the article commercially (including reuse and/or resale of the article) without permission from Elsevier. You must give appropriate credit to the original work, together with a link to the formal publication through the relevant DOI and a link to the Creative Commons user license above. You must indicate if any changes are made but not in any way that suggests the licensor endorses you or your use of the work.en
dc.subjectGBD 2017 SDG Collaboratorsen
dc.subject.anzsrcField of Research::11 - Medical and Health Sciencesen
dc.titleMeasuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017en
dc.typeJournal Articleen
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