Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries

An analysis from the Global Burden of Disease Study 2016

GBD 2016 SDG Collaborators

    Research output: Contribution to journalArticle

    Abstract

    Background: The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. Methods: We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 25th percentile estimated between 1990 and 2030, and 100 as the 975th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. Findings Globally, the median health-related SDG index was 567 (IQR 319-668) in 2016 and country-level performance markedly varied, with Singapore (868, 95% uncertainty interval 846-889), Iceland (860, 841-876), and Sweden (856, 818-878) having the highest levels in 2016 and Afghanistan (109, 96-119), the Central African Republic (110, 88-138), and Somalia (113, 95-131) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. Interpretation GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations.

    Original languageEnglish (US)
    Pages (from-to)1423-1459
    Number of pages37
    JournalThe Lancet
    Volume390
    Issue number10100
    DOIs
    StatePublished - Sep 16 2017

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    Population Growth
    Conservation of Natural Resources
    Health
    Universal Coverage
    Central African Republic
    Global Burden of Disease
    Health Services
    Equatorial Guinea
    Lesotho
    Somalia
    Laos
    Rwanda
    Cambodia
    Iceland
    Afghanistan
    Mortality
    United Nations
    Maternal Mortality
    Quality of Health Care
    Singapore

    ASJC Scopus subject areas

    • Medicine(all)

    Cite this

    @article{a4736e323bb948a6a8ab959e2910aa04,
    title = "Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: An analysis from the Global Burden of Disease Study 2016",
    abstract = "Background: The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of {"}leaving no one behind{"}. Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. Methods: We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 25th percentile estimated between 1990 and 2030, and 100 as the 975th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. Findings Globally, the median health-related SDG index was 567 (IQR 319-668) in 2016 and country-level performance markedly varied, with Singapore (868, 95{\%} uncertainty interval 846-889), Iceland (860, 841-876), and Sweden (856, 818-878) having the highest levels in 2016 and Afghanistan (109, 96-119), the Central African Republic (110, 88-138), and Somalia (113, 95-131) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60{\%} of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5{\%} of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. Interpretation GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations.",
    author = "{GBD 2016 SDG Collaborators} and Nancy Fullman and Barber, {Ryan M.} and Abajobir, {Amanuel Alemu} and Abate, {Kalkidan Hassen} and Cristiana Abbafati and Abbas, {Kaja M.} and Foad Abd-Allah and Abdishakur Abdulle and Abera, {Semaw Ferede} and Victor Aboyans and Abu-Raddad, {Laith J.} and Abu-Rmeileh, {Niveen M.E.} and Adedeji, {Isaac Akinkunmi} and Olatunji Adetokunboh and Ashkan Afshin and Anurag Agrawal and Sutapa Agrawal and Kiadaliri, {Aliasghar Ahmad} and Hamid Ahmadieh and Ahmed, {Muktar Beshir} and Aichour, {Amani Nidhal} and Ibtihel Aichour and Aichour, {Miloud Taki Eddine} and Sneha Aiyar and Akinyemi, {Rufus Olusola} and Nadia Akseer and Ziyad Al-Aly and Khurshid Alam and Noore Alam and Deena Alasfoor and Alene, {Kefyalew Addis} and Reza Alizadeh-Navaei and Ala'a Alkerwi and Fran{\cc}ois Alla and Peter Allebeck and Christine Allen and Rajaa Al-Raddadi and Ubai Alsharif and Altirkawi, {Khalid A.} and Nelson Alvis-Guzman and Amare, {Azmeraw T.} and Erfan Amini and Walid Ammar and Antonio, {Carl Abelardo T.} and Hossein Ansari and Palwasha Anwari and Megha Arora and Al Artaman and Aryal, {Krishna Kumar} and Hamid Asayesh",
    year = "2017",
    month = "9",
    day = "16",
    doi = "10.1016/S0140-6736(17)32336-X",
    language = "English (US)",
    volume = "390",
    pages = "1423--1459",
    journal = "The Lancet",
    issn = "0140-6736",
    publisher = "Elsevier Limited",
    number = "10100",

    }

    TY - JOUR

    T1 - Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries

    T2 - An analysis from the Global Burden of Disease Study 2016

    AU - GBD 2016 SDG Collaborators

    AU - Fullman, Nancy

    AU - Barber, Ryan M.

    AU - Abajobir, Amanuel Alemu

    AU - Abate, Kalkidan Hassen

    AU - Abbafati, Cristiana

    AU - Abbas, Kaja M.

    AU - Abd-Allah, Foad

    AU - Abdulle, Abdishakur

    AU - Abera, Semaw Ferede

    AU - Aboyans, Victor

    AU - Abu-Raddad, Laith J.

    AU - Abu-Rmeileh, Niveen M.E.

    AU - Adedeji, Isaac Akinkunmi

    AU - Adetokunboh, Olatunji

    AU - Afshin, Ashkan

    AU - Agrawal, Anurag

    AU - Agrawal, Sutapa

    AU - Kiadaliri, Aliasghar Ahmad

    AU - Ahmadieh, Hamid

    AU - Ahmed, Muktar Beshir

    AU - Aichour, Amani Nidhal

    AU - Aichour, Ibtihel

    AU - Aichour, Miloud Taki Eddine

    AU - Aiyar, Sneha

    AU - Akinyemi, Rufus Olusola

    AU - Akseer, Nadia

    AU - Al-Aly, Ziyad

    AU - Alam, Khurshid

    AU - Alam, Noore

    AU - Alasfoor, Deena

    AU - Alene, Kefyalew Addis

    AU - Alizadeh-Navaei, Reza

    AU - Alkerwi, Ala'a

    AU - Alla, François

    AU - Allebeck, Peter

    AU - Allen, Christine

    AU - Al-Raddadi, Rajaa

    AU - Alsharif, Ubai

    AU - Altirkawi, Khalid A.

    AU - Alvis-Guzman, Nelson

    AU - Amare, Azmeraw T.

    AU - Amini, Erfan

    AU - Ammar, Walid

    AU - Antonio, Carl Abelardo T.

    AU - Ansari, Hossein

    AU - Anwari, Palwasha

    AU - Arora, Megha

    AU - Artaman, Al

    AU - Aryal, Krishna Kumar

    AU - Asayesh, Hamid

    PY - 2017/9/16

    Y1 - 2017/9/16

    N2 - Background: The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. Methods: We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 25th percentile estimated between 1990 and 2030, and 100 as the 975th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. Findings Globally, the median health-related SDG index was 567 (IQR 319-668) in 2016 and country-level performance markedly varied, with Singapore (868, 95% uncertainty interval 846-889), Iceland (860, 841-876), and Sweden (856, 818-878) having the highest levels in 2016 and Afghanistan (109, 96-119), the Central African Republic (110, 88-138), and Somalia (113, 95-131) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. Interpretation GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations.

    AB - Background: The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. Methods: We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 25th percentile estimated between 1990 and 2030, and 100 as the 975th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. Findings Globally, the median health-related SDG index was 567 (IQR 319-668) in 2016 and country-level performance markedly varied, with Singapore (868, 95% uncertainty interval 846-889), Iceland (860, 841-876), and Sweden (856, 818-878) having the highest levels in 2016 and Afghanistan (109, 96-119), the Central African Republic (110, 88-138), and Somalia (113, 95-131) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. Interpretation GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations.

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    U2 - 10.1016/S0140-6736(17)32336-X

    DO - 10.1016/S0140-6736(17)32336-X

    M3 - Article

    VL - 390

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    JO - The Lancet

    JF - The Lancet

    SN - 0140-6736

    IS - 10100

    ER -