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

Nancy Fullman, Ryan M. Barber, Amanuel Alemu Abajobir, Kalkidan Hassen Abate, Cristiana Abbafati, Kaja M. Abbas, Foad Abd-Allah, Abdishakur M. Abdulle, Semaw Ferede Abera, Victor Aboyans, Laith J. Abu-Raddad, Niveen M.E. Abu-Rmeileh, Isaac Akinkunmi Adedeji, Olatunji Adetokunboh, Ashkan Afshin, Anurag Agrawal, Sutapa Agrawal, Aliasghar Ahmad Kiadaliri, Hamid Ahmadieh, Muktar Beshir AhmedAmani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Sneha Aiyar, Rufus Olusola Akinyemi, Nadia Akseer, Ziyad Al-Aly, Khurshid Alam, Noore Alam, Deena Alasfoor, Kefyalew Addis Alene, Reza Alizadeh-Navaei, Ala'a Alkerwi, François Alla, Peter Allebeck, Christine Allen, Rajaa Al-Raddadi, Ubai Alsharif, Khalid A. Altirkawi, Nelson Alvis-Guzman, Azmeraw T. Amare, Erfan Amini, Walid Ammar, Carl Abelardo T. Antonio, Hossein Ansari, Palwasha Anwari, Megha Arora, Al Artaman, Krishna Kumar Aryal, Hamid Asayesh, Solomon Weldegebreal Asgedom, Reza Assadi, Tesfay Mehari Atey, Sachin R. Atre, Leticia Avila-Burgos, Euripide Frinel G. Arthur Avokpaho, Ashish Awasthi, Peter Azzopardi, Umar Bacha, Alaa Badawi, Kalpana Balakrishnan, Marlena S. Bannick, Aleksandra Barac, Suzanne L. Barker-Collo, Till Bärnighausen, Lope H. Barrero, Sanjay Basu, Katherine E. Battle, Bernhard T. Baune, Justin Beardsley, Neeraj Bedi, Ettore Beghi, Yannick Béjot, Michelle L. Bell, Derrick A. Bennett, James R. Bennett, Isabela M. Bensenor, Adugnaw Berhane, Derbew Fikadu Berhe, Eduardo Bernabé, Balem Demtsu Betsu, Mircea Beuran, Addisu Shunu Beyene, Neeraj Bhala, Anil Bhansali, Samir Bhatt, Zulfiqar A. Bhutta, Boris Bikbov, Arebu I. Bilal, Charles Birungi, Stan Biryukov, Habtamu Mellie Bizuayehu, Christopher D. Blosser, Dube Jara Boneya, Dipan Bose, Ibrahim R. Bou-Orm, Michael Brauer, Nicholas J.K. Breitborde, Traolach S. Brugha, Lemma Negesa Bulto Bulto, Zahid A. Butt, Lucero Cahuana-Hurtado, Ewan Cameron, Julio Cesar Campuzano, Hélène Carabin, Rosario Cárdenas, Juan Jesus Carrero, Austin Carter, Daniel C. Casey, Carlos A. Castañeda-Orjuela, Jacqueline Castillo Rivas, Ruben Estanislao Castro, Ferrán Catalá-López, Kelly Cercy, Hsing Yi Chang, Jung Chen Chang, Fiona J. Charlson, Adrienne Chew, Vesper Hichilombwe Chisumpa, Abdulaal A. Chitheer, Hanne Christensen, Devasahayam Jesudas Christopher, Massimo Cirillo, Cyrus Cooper, Michael H. Criqui, Elizabeth A. Cromwell, John A. Crump, Lalit Dandona, Rakhi Dandona, Paul I. Dargan, José Das Neves, Dragos V. Davitoiu, Barbora De Courten, Hans De Steur, Louisa Degenhardt, Selina Deiparine, Kebede Deribe, Gabrielle A. DeVeber, Eric L. Ding, Shirin Djalalinia, Huyen Phuc Do, Klara Dokova, David Teye Doku, E. Ray Dorsey, Tim R. Driscoll, Manisha Dubey, Bruce Bartholow Duncan, Beth E. Ebel, Hedyeh Ebrahimi, Ziad Ziad El-Khatib, Ahmadali Enayati, Aman Yesuf Endries, Sergey Petrovich Ermakov, Holly E. Erskine, Babak Eshrati, Sharareh Eskandarieh, Alireza Esteghamati, Kara Estep, Emerito Jose Aquino Faraon, Carla Sofia E Sa Farinha, André Faro, Farshad Farzadfar, Mir Sohail Fazeli, Valery L. Feigin, Andrea B. Feigl, Seyed Mohammad Fereshtehnejad, João C. Fernandes, Alize J. Ferrari, Tesfaye Regassa Feyissa, Irina Filip, Florian Fischer, Christina Fitzmaurice, Abraham D. Flaxman, Nataliya Foigt, Kyle J. Foreman, Tahvi Frank, Richard C. Franklin, Joseph Friedman, Joseph J. Frostad, Thomas Fürst, Joao M. Furtado, Emmanuela Gakidou, Alberto L. Garcia-Basteiro, Tsegaye Tewelde Gebrehiwot, Johanna M. Geleijnse, Ayele Geleto, Bikila Lencha Gemechu, Peter W. Gething, Katherine B. Gibney, Paramjit Singh Gill, Richard F. Gillum, Ababi Zergaw Giref, Melkamu Dedefo Gishu, Giorgia Giussani, Scott D. Glenn, William W. Godwin, Ellen M. Goldberg, Philimon N. Gona, Amador Goodridge, Sameer Vali Gopalani, Yevgeniy Goryakin, Max Griswold, Harish Chander Gugnani, Rajeev Gupta, Tanush Gupta, Vipin Gupta, Nima Hafezi-Nejad, Hassan Haghparast Bidgoli, Gessessew Bugssa Hailu, Randah Ribhi Hamadeh, Mouhanad Hammami, Graeme J. Hankey, Hilda L. Harb, Habtamu Abera Hareri, Mohammad Sadegh Hassanvand, Rasmus Havmoeller, Caitlin Hawley, Simon I. Hay, Jiawei He, Delia Hendrie, Nathaniel J. Henry, Ileana Beatriz Heredia-Pi, Hans W. Hoek, Mollie Holmberg, Nobuyuki Horita, H. Dean Hosgood, Sorin Hostiuc, Damian G. Hoy, Mohamed Hsairi, Aung Soe Htet, Hsiang Huang, John J. Huang, Chantal Huynh, Kim Moesgaard Iburg, Chad Ikeda, Manami Inoue, Caleb Mackay Salpeter Irvine, Kathryn H. Jacobsen, Nader Jahanmehr, Mihajlo B. Jakovljevic, Alejandra Jauregui, Mehdi Javanbakht, Panniyammakal Jeemon, Vivekanand Jha, Denny John, Catherine O. Johnson, Sarah Charlotte Johnson, Jost B. Jonas, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Ritul Kamal, André Karch, Corine Kakizi Karema, Amir Kasaeian, Nicholas J. Kassebaum, Anshul Kastor, Srinivasa Vittal Katikireddi, Norito Kawakami, Peter Njenga Keiyoro, Sefonias Getachew Kelbore, Laura Kemmer, Andre Pascal Kengne, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Ibrahim A. Khalil, Ejaz Ahmad Khan, Young Ho Khang, Ardeshir Khosravi, Jagdish Khubchandani, Christian Kieling, Daniel Kim, Jun Y. Kim, Yun Jin Kim, Ruth W. Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna A. Kissimova-Skarbek, Mika Kivimaki, Yoshihiro Kokubo, Jacek A. Kopec, Soewarta Kosen, Parvaiz A. Koul, Ai Koyanagi, Michael Kravchenko, Kristopher J. Krohn, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Xie Rachel Kulikoff, G. Anil Kumar, Michael J. Kutz, Hmwe H. Kyu, Dharmesh Kumar Lal, Ratilal Lalloo, Van C. Lansingh, Anders Larsson, Jeffrey Victor Lazarus, Paul H. Lee, James Leigh, Janni Leung, Ricky Leung, Miriam Levi, Yongmei Li, Misgan Legesse Liben, Shai Linn, Patrick Y. Liu, Shiwei Liu, Rakesh Lodha, Katharine J. Looker, Alan D. Lopez, Stefan Lorkowski, Paulo A. Lotufo, Rafael Lozano, Timothy C.D. Lucas, Raimundas Lunevicius, Mark T. Mackay, Emilie R. Maddison, Hassan Magdy Abd El Razek, Mohammed Magdy Abd El Razek, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Rajesh Malhotra, Deborah Carvalho Malta, Abdullah A. Mamun, Helena Manguerra, Lorenzo G. Mantovani, Tsegahun Manyazewal, Chabila C. Mapoma, Guy B. Marks, Randall V. Martin, Jose Martinez-Raga, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Manu Raj Mathur, Mohsen Mazidi, Colm McAlinden, Madeline McGaughey, John J. McGrath, Martin McKee, Suresh Mehata, Man Mohan Mehndiratta, Toni Meier, Kidanu Gebremariam Meles, Ziad A. Memish, Walter Mendoza, Melkamu Merid Mengesha, Mubarek Abera Mengistie, George A. Mensah, Gert B.M. Mensink, Seid Tiku Mereta, Atte Meretoja, Tuomo J. Meretoja, Haftay Berhane Mezgebe, Renata Micha, Anoushka Millear, Ted R. Miller, Shawn Minnig, Mojde Mirarefin, Erkin M. Mirrakhimov, Awoke Misganaw, Shiva Raj Mishra, Philip B. Mitchell, Karzan Abdulmuhsin Mohammad, Kedir Endris Mohammed, Shafiu Mohammed, Murali B.V. Mohan, Ali H. Mokdad, Sarah K. Mollenkopf, Lorenzo Monasta, Julio Cesar Montañez Hernandez, Marcella Montico, Maziar Moradi-Lakeh, Paula Moraga, Lidia Morawska, Shane D. Morrison, Mark W. Moses, Cliff Mountjoy-Venning, Ulrich O. Mueller, Kate Muller, Gudlavalleti Venkata Satyanarayana Murthy, Kamarul Imran Musa, Mohsen Naghavi, Aliya Naheed, Kovin S. Naidoo, Vinay Nangia, Gopalakrishnan Natarajan, Ionut Negoi, Ruxandra Irina Negoi, Cuong Tat Nguyen, Grant Nguyen, Minh Nguyen, Quyen Le Nguyen, Trang Huyen Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Marika Nomura, Vuong Minh Nong, Ole F. Norheim, Jean Jacques N. Noubiap, Carla Makhlouf Obermeyer, Felix Akpojene Ogbo, In Hwan Oh, Olanrewaju Oladimeji, Andrew Toyin Olagunju, Tinuke Oluwasefunmi Olagunju, Pedro R. Olivares, Helen E. Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin Ong, Eyal Oren, Alberto Ortiz, Mayowa O. Owolabi, P. A. Mahesh, Adrian Pana, Basant Kumar Panda, Songhomitra Panda-Jonas, Christina Papachristou, Eun Kee Park, George C. Patton, Katherine Paulson, David M. Pereira, David Norberto Perico, Konrad Pesudovs, Max Petzold, Michael Robert Phillips, David M. Pigott, Julian David Pillay, Christine Pinho, Michael A. Piradov, Farhad Pishgar, Richie G. Poulton, Farshad Pourmalek, Mostafa Qorbani, Amir Radfar, Anwar Rafay, Puja C. Rao, Vafa Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Rajesh Kumar Rai, Sasa Rajsic, Usha Ram, Chhabi Lal Ranabhat, Salman Rawaf, Patrick Reidy, Robert C. Reiner, Nikolas Reinig, Marissa B. Reitsma, Giuseppe Remuzzi, Andre M.N. Renzaho, Serge Resnikoff, Satar Rezaei, Maria Jesus Rios Blancas, Kedir Teji Roba, David Rojas-Rueda, Mohammad Bagher Rokni, Gholamreza Roshandel, Gregory A. Roth, Ambuj Roy, Enrico Rubagotti, Nafis Sadat, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Joseph Salama, Joshua A. Salomon, Abdallah M. Samy, Juan Ramon Sanabria, Damian Santomauro, Itamar S. Santos, João Vasco Santos, Milena M. Santric Milicevic, Benn Sartorius, Maheswar Satpathy, Monika Sawhney, Sonia Saxena, Mete I. Saylan, Shreya Shirude, Maria Inês Schmidt, Ione J.C. Schneider, Matthew T. Schneider, Ben Schöttker, Aletta E. Schutte, David C. Schwebel, Falk Schwendicke, Soraya Seedat, Sadaf G. Sepanlou, Edson E. Servan-Mori, Katya Anne Shackelford, Amira Shaheen, Saeid Shahraz, Masood Ali Shaikh, Mansour Shamsipour, Morteza Shamsizadeh, Sheikh Mohammed Shariful Islam, Jayendra Sharma, Rajesh Sharma, Jun She, Peilin Shi, Kenji Shibuya, Chloe Shields, Mekonnen Sisay Shiferaw, Mika Shigematsu, Min Jeong Shin, Rahman Shiri, Reza Shirkoohi, Kawkab Shishani, Haitham Shoman, Mark G. Shrime, Donald H. Silberberg, Diego Augusto Santos Silva, João Pedro Silva, Dayane Gabriele Alves Silveira, Jasvinder A. Singh, Virendra Singh, Dhirendra Narain Sinha, Eirini Skiadaresi, Erica Leigh Slepak, Amber Sligar, Alison Smith, David L. Smith, Mari Smith, Badr H.A. Sobaih, Eugene Sobngwi, Michael Soljak, Samir Soneji, Reed J.D. Sorensen, Luciano A. Sposato, Chandrashekhar T. Sreeramareddy, Vinay Srinivasan, Jeffrey D. Stanaway, Dan J. Stein, Caitlyn Steiner, Sabine Steinke, Mark Andrew Stokes, Bryan Strub, Muawiyyah Babale Sufiyan, Rizwan Suliankatchi Abdulkader, Bruno F. Sunguya, Patrick J. Sur, Soumya Swaminathan, Bryan L. Sykes, Dillon O. Sylte, Cassandra E.I. Szoeke, Rafael Tabarés-Seisdedos, Santosh Kumar Tadakamadla, Nikhil Tandon, Tianchan Tao, Yihunie L. Tarekegn, Mohammad Tavakkoli, Nuno Taveira, Teketo Kassaw Tegegne, Girma Temam Shifa, Abdullah Sulieman Terkawi, Gizachew Assefa Tessema, J. S. Thakur, Kavumpurathu Raman Thankappan, Amanda G. Thrift, Tenaw Yimer Tiruye, Ruoyan Tobe-Gai, Roman Topor-Madry, Anna Torre, Miguel Tortajada, Bach Xuan Tran, Christopher Troeger, Thomas Truelsen, Derrick Tsoi, Kald Beshir Tuem, Emin Murat Tuzcu, Stefanos Tyrovolas, Kingsley N. Ukwaja, Chigozie Jesse Uneke, Rachel Updike, Olalekan A. Uthman, Job F.M. Van Boven, Aaron Van Donkelaar, Santosh Varughese, Tommi Vasankari, Narayanaswamy Venketasubramanian, Ramesh Vidavalur, Francesco S. Violante, Sergey K. Vladimirov, Vasiliy Victorovich Vlassov, Stein Emil Vollset, Theo Vos, Fiseha Wadilo, Tolassa Wakayo, Mitchell T. Wallin, Yuan Pang Wang, Scott Weichenthal, Elisabete Weiderpass, Robert G. Weintraub, Daniel J. Weiss, Andrea Werdecker, Ronny Westerman, Harvey A. Whiteford, Tissa Wijeratne, Charles Shey Wiysonge, Belete Getahun Woldeyes, Charles D.A. Wolfe, Rachel Woodbrook, Denis Xavier, Gelin Xu, Simon Yadgir, Bereket Yakob, Lijing L. Yan, Yuichiro Yano, Mehdi Yaseri, Pengpeng Ye, Hassen Hamid Yimam, Paul Yip, Naohiro Yonemoto, Seok Jun Yoon, Marcel Yotebieng, Mustafa Z. Younis, Zoubida Zaidi, Maysaa El Sayed Zaki, Luis Zavala-Arciniega, Xueying Zhang, Ben Zipkin, Sanjay Zodpey, Stephen S. Lim, Christopher J.L. Murray

    Research output: Contribution to journalArticlepeer-review

    145 Scopus citations

    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

    ASJC Scopus subject areas

    • Medicine(all)

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