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

Lozano R, Fullman N, Abate D, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdel-Rahman O, et al. (2018)
The Lancet 392(10159): 2091-2138.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
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Lozano, Rafael; Fullman, Nancy; Abate, Degu; Abay, Solomon M; Abbafati, Cristiana; Abbasi, Nooshin; Abbastabar, Hedayat; Abd-Allah, Foad; Abdela, Jemal; Abdelalim, Ahmed; Abdel-Rahman, Omar; Abdi, Alireza
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Abstract / Bemerkung
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 S DG 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 attaimnent 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 S DGs. 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.
Erscheinungsjahr
2018
Zeitschriftentitel
The Lancet
Band
392
Ausgabe
10159
Seite(n)
2091-2138
ISSN
0140-6736
Page URI
https://pub.uni-bielefeld.de/record/2932356

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Lozano R, Fullman N, Abate D, et al. 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. The Lancet. 2018;392(10159):2091-2138.
Lozano, R., Fullman, N., Abate, D., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., et al. (2018). 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. The Lancet, 392(10159), 2091-2138. doi:10.1016/s0140-6736(18)32281-5
Lozano, R., Fullman, N., Abate, D., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., et al. (2018). 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. The Lancet 392, 2091-2138.
Lozano, R., et al., 2018. 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. The Lancet, 392(10159), p 2091-2138.
R. Lozano, et al., “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”, The Lancet, vol. 392, 2018, pp. 2091-2138.
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Santamarina-Rubio E, Perez K, Olabarria M, Novoa AM., Accid Anal Prev 65(), 2013
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Kickbusch I, Allen L, Franz C., Lancet Glob Health 4(12), 2016
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Amos A, Greaves L, Nichter M, Bloch M., Tob Control 21(2), 2011
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Torchalla I, Okoli CT, Bottorff JL, Qu A, Poole N, Greaves L., Women Health 52(1), 2012
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Horton R, Sargent J., Lancet 391(10134), 2018
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Bottorff JL, Haines-Saah R, Kelly MT, Oliffe JL, Torchalla I, Poole N, Greaves L, Robinson CA, Ensom MH, Okoli CT, Phillips JC., Int J Equity Health 13(), 2014
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Rezaeian M., Crisis 31(1), 2010
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Boerma T, Eozenou P, Evans D, Evans T, Kieny MP, Wagstaff A., PLoS Med. 11(9), 2014
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Yusuf S, Wood D, Ralston J, Reddy KS., Lancet 386(9991), 2015
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Nishtar S, Niinisto S, Sirisena M, Vazquez T, Skvortsova V, Rubinstein A, Mogae FG, Mattila P, Ghazizadeh Hashemi SH, Kariuki S, Narro Robles J, Adewole IF, Sarr AD, Gan KY, Piukala SM, Al Owais ARBM, Hargan E, Alleyne G, Alwan A, Bernaert A, Bloomberg M, Dain K, Frieden T, Patel VH, Kennedy A, Kickbusch I; Commissioners of the WHO Independent High-Level Commission on NCDs., Lancet 392(10143), 2018
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Prasad R., Lancet 373(9657), 2009
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The economic effect of noncommunicable diseases on households and nations: a review of existing evidence.
Engelgau M, Rosenhouse S, El-Saharty S, Mahal A., J Health Commun 16 Suppl 2(), 2011
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Foreman KJ, Lozano R, Lopez AD, Murray CJ., Popul Health Metr 10(), 2012
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Wilsnack RW, Vogeltanz ND, Wilsnack SC, Harris TR, Ahlstrom S, Bondy S, Csemy L, Ferrence R, Ferris J, Fleming J, Graham K, Greenfield T, Guyon L, Haavio-Mannila E, Kellner F, Knibbe R, Kubicka L, Loukomskaia M, Mustonen H, Nadeau L, Narusk A, Neve R, Rahav G, Spak F, Teichman M, Trocki K, Webster I, Weiss S., Addiction 95(2), 2000
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Newton JN, Briggs AD, Murray CJ, Dicker D, Foreman KJ, Wang H, Naghavi M, Forouzanfar MH, Ohno SL, Barber RM, Vos T, Stanaway JD, Schmidt JC, Hughes AJ, Fay DF, Ecob R, Gresser C, McKee M, Rutter H, Abubakar I, Ali R, Anderson HR, Banerjee A, Bennett DA, Bernabe E, Bhui KS, Biryukov SM, Bourne RR, Brayne CE, Bruce NG, Brugha TS, Burch M, Capewell S, Casey D, Chowdhury R, Coates MM, Cooper C, Critchley JA, Dargan PI, Dherani MK, Elliott P, Ezzati M, Fenton KA, Fraser MS, Furst T, Greaves F, Green MA, Gunnell DJ, Hannigan BM, Hay RJ, Hay SI, Hemingway H, Larson HJ, Looker KJ, Lunevicius R, Lyons RA, Marcenes W, Mason-Jones AJ, Matthews FE, Moller H, Murdoch ME, Newton CR, Pearce N, Piel FB, Pope D, Rahimi K, Rodriguez A, Scarborough P, Schumacher AE, Shiue I, Smeeth L, Tedstone A, Valabhji J, Williams HC, Wolfe CD, Woolf AD, Davis AC., Lancet 386(10010), 2015
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Gomez-Dantes H, Fullman N, Lamadrid-Figueroa H, Cahuana-Hurtado L, Darney B, Avila-Burgos L, Correa-Rotter R, Rivera JA, Barquera S, Gonzalez-Pier E, Aburto-Soto T, de Castro EF, Barrientos-Gutierrez T, Basto-Abreu AC, Batis C, Borges G, Campos-Nonato I, Campuzano-Rincon JC, de Jesus Cantoral-Preciado A, Contreras-Manzano AG, Cuevas-Nasu L, de la Cruz-Gongora VV, Diaz-Ortega JL, de Lourdes Garcia-Garcia M, Garcia-Guerra A, de Cossio TG, Gonzalez-Castell LD, Heredia-Pi I, Hijar-Medina MC, Jauregui A, Jimenez-Corona A, Lopez-Olmedo N, Magis-Rodriguez C, Medina-Garcia C, Medina-Mora ME, Mejia-Rodriguez F, Montanez JC, Montero P, Montoya A, Moreno-Banda GL, Pedroza-Tobias A, Perez-Padilla R, Quezada AD, Richardson-Lopez-Collada VL, Riojas-Rodriguez H, Rios Blancas MJ, Razo-Garcia C, Mendoza MP, Sanchez-Pimienta TG, Sanchez-Romero LM, Schilmann A, Servan-Mori E, Shamah-Levy T, Tellez-Rojo MM, Texcalac-Sangrador JL, Wang H, Vos T, Forouzanfar MH, Naghavi M, Lopez AD, Murray CJ, Lozano R., Lancet 388(10058), 2016
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Ajdacic-Gross V, Weiss MG, Ring M, Hepp U, Bopp M, Gutzwiller F, Rossler W., Bull. World Health Organ. 86(9), 2008
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Time to deliver: report of the WHO Independent High-Level Commission on NCDs.
Nishtar S, Niinisto S, Sirisena M, Vazquez T, Skvortsova V, Rubinstein A, Mogae FG, Mattila P, Ghazizadeh Hashemi SH, Kariuki S, Narro Robles J, Adewole IF, Sarr AD, Gan KY, Piukala SM, Al Owais ARBM, Hargan E, Alleyne G, Alwan A, Bernaert A, Bloomberg M, Dain K, Frieden T, Patel VH, Kennedy A, Kickbusch I; Commissioners of the WHO Independent High-Level Commission on NCDs., Lancet 392(10143), 2018
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Alcohol use on the rise in India.
Prasad R., Lancet 373(9657), 2009
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The economic effect of noncommunicable diseases on households and nations: a review of existing evidence.
Engelgau M, Rosenhouse S, El-Saharty S, Mahal A., J Health Commun 16 Suppl 2(), 2011
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Foreman KJ, Lozano R, Lopez AD, Murray CJ., Popul Health Metr 10(), 2012
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Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40.
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