Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015
Authors: Stephen S Lim, Kate Allen, Zulfiqar A Bhutta, Lalit Dandona, Mohammad H Forouzanfar, Nancy Fullman, Peter W Gething, Ellen M Goldberg, Simon I Hay, Mollie Holmberg, Yohannes Kinfu, Michael J Kutz, Heidi J Larson, Xiaofeng Liang, Alan D Lopez, Rafael Lozano, Claire R McNellan, Ali H Mokdad, Meghan D Mooney, Mohsen Naghavi, Helen E Olsen, David M Pigott, Joshua A Salomon, Theo Vos, Haidong Wang, Amanuel Alemu Abajobir, Kalkidan Hassen Abate, Cristiana Abbafati, Kaja M Abbas, Foad Abd-Allah, Abdishakur M Abdulle, Biju Abraham, Ibrahim Abubakar, Laith J Abu-Raddad, Niveen M E Abu-Rmeileh, Gebre Yitayih Abyu, Tom Achoki, Akindele Olupelumi Adebiyi, Isaac Akinkunmi Adedeji, Kossivi Agbelenko Afanvi, Ashkan Afshin, Arnav Agarwal, Anurag Agrawal, Aliasghar Ahmad Kiadaliri, Hamid Ahmadieh, Kedir Yimam Ahmed, Ali Shafqat Akanda, Rufus Olusola Akinyemi, Tomi F Akinyemiju, Nadia Akseer, Ziyad Al-Aly, Khurshid Alam, Uzma Alam, Deena Alasfoor, Fadia S AlBuhairan, Saleh Fahed Aldhahri, Robert William Aldridge, Zewdie Aderaw Alemu, Raghib Ali, Ala'a Alkerwi, Mohammad AB Alkhateeb, François Alla, Peter Allebeck, Christine Allen, Rajaa Al-Raddadi, Ubai Alsharif, Khalid A Altirkawi, Elena Alvarez Martin, Nelson Alvis-Guzman, Azmeraw T Amare, Alemayehu Amberbir, Adeladza Kofi Amegah, Heresh Amini, Walid Ammar, Stephen Marc Amrock, Hjalte H Andersen, Benjamin O Anderson, Gregory M Anderson, Carl Abelardo T Antonio, Palwasha Anwari, Johan Ärnlöv, Al Artaman, Hamid Asayesh, Rana Jawad Asghar, Suleman Atique, Euripide Frinel G Arthur Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Peter Azzopardi, Umar Bacha, Alaa Badawi, Kalpana Balakrishnan, Amitava Banerjee, Aleksandra Barac, Ryan Barber, Suzanne L Barker-Collo, Till Bärnighausen, Lope H Barrero, Tonatiuh Barrientos-Gutierrez, Sanjay Basu, Tigist Assefa Bayou, Shahrzad Bazargan-Hejazi, Justin Beardsley, Neeraj Bedi, Ettore Beghi, Yannick Béjot, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Habib Benzian, Adugnaw Berhane, Eduardo Bernabé, Oscar Alberto Bernal, Balem Demtsu Betsu, Addisu Shunu Beyene, Neeraj Bhala, Samir Bhatt, Sibhatu Biadgilign, Kelly A Bienhoff, Boris Bikbov, Agnes Binagwaho, Donal Bisanzio, Espen Bjertness, Jed Blore, Rupert R A Bourne, Michael Brainin, Michael Brauer, Alexandra Brazinova, Nicholas J K Breitborde, David M Broday, Traolach S Brugha, Rachelle Buchbinder, Zahid A Butt, Leah E Cahill, Ismael Ricardo Campos-Nonato, Julio Cesar Campuzano, Hélène Carabin, Rosario Cárdenas, Juan Jesus Carrero, Austin Carter, Daniel Casey, Valeria Caso, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Ferrán Catalá-López, Fiorella Cavalleri, Pedro Cecílio, Hsing-Yi Chang, Jung-Chen Chang, Fiona J Charlson, Xuan Che, Alan Zian Chen, Peggy Pei-Chia Chiang, Mirriam Chibalabala, Vesper Hichilombwe Chisumpa, Jee-Young Jasmine Choi, Rajiv Chowdhury, Hanne Christensen, Liliana G Ciobanu, Massimo Cirillo, Matthew M Coates, Megan Coggeshall, Aaron J Cohen, Graham S Cooke, Cyrus Cooper, Leslie Trumbull Cooper, Benjamin C Cowie, John A Crump, Solomon Abrha Damtew, Rakhi Dandona, Paul I Dargan, José das Neves, Adrian C Davis, Kairat Davletov, E Filipa de Castro, Diego De Leo, Louisa Degenhardt, Liana C Del Gobbo, Kebede Deribe, Sarah Derrett, Don C Des Jarlais, Aniruddha Deshpande, Gabrielle A deVeber, Subhojit Dey, Samath D Dharmaratne, Preet K Dhillon, Eric L Ding, E Ray Dorsey, Kerrie E Doyle, Tim R Driscoll, Leilei Duan, Manisha Dubey, Bruce Bartholow Duncan, Hedyeh Ebrahimi, Aman Yesuf Endries, Sergey Petrovich Ermakov, Holly E Erskine, Babak Eshrati, Alireza Esteghamati, Saman Fahimi, Talha A Farid, Carla Sofia e Sa Farinha, André Faro, Maryam S Farvid, Farshad Farzadfar, Valery L Feigin, Manuela Mendonca Felicio, Seyed-Mohammad Fereshtehnejad, Jefferson G Fernandes, Joao C Fernandes, Alize J Ferrari, Florian Fischer, Joseph R A Fitchett, Christina Fitzmaurice, Nataliya Foigt, Kyle Foreman, F Gerry R Fowkes, Elisabeth Barboza Franca, Richard C Franklin, Maya Fraser, Joseph Friedman, Joseph Frostad, Thomas Fürst, Belinda Gabbe, Alberto L Garcia-Basteiro, Teshome Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Alemseged Aregay Gebru, Bradford D Gessner, Richard F Gillum, Ibrahim Abdelmageem Mohamed Ginawi, Ababi Zergaw Giref, Maurice Giroud, Melkamu Dedefo Gishu, Giorgia Giussani, William Godwin, Philimon Gona, Amador Goodridge, Sameer Vali Gopalani, Carolyn C Gotay, Atsushi Goto, Hebe N Gouda, Nicholas Graetz, Karen Fern Greenwell, Max Griswold, Harish Gugnani, Yuming Guo, Rahul Gupta, Rajeev Gupta, Vipin Gupta, Reyna A Gutiérrez, Bishal Gyawali, Juanita A Haagsma, Annie Haakenstad, Nima Hafezi-Nejad, Demewoz Haile, Gessessew Bugssa Hailu, Yara A Halasa, Randah Ribhi Hamadeh, Samer Hamidi, Mouhanad Hammami, Graeme J Hankey, Hilda L Harb, Josep Maria Haro, Mohammad Sadegh Hassanvand, Rasmus Havmoeller, Ileana Beatriz Heredia-Pi, Hans W Hoek, Masako Horino, Nobuyuki Horita, H Dean Hosgood, Damian G Hoy, Aung Soe Htet, Guoqing Hu, Hsiang Huang, Kim Moesgaard Iburg, Bulat T Idrisov, Manami Inoue, Farhad Islami, Troy A Jacobs, Kathryn H Jacobsen, Nader Jahanmehr, Mihajlo B Jakovljevic, Peter James, Henrica A F M Jansen, Mehdi Javanbakht, Sudha P Jayaraman, Achala Upendra Jayatilleke, Sun Ha Jee, Panniyammakal Jeemon, Vivekanand Jha, Ying Jiang, Tariku Jibat, Ye Jin, Jost B Jonas, Zubair Kabir, Yogeshwar Kalkonde, Ritul Kamal, Haidong Kan, Amit Kandel, André Karch, Corine Kakizi Karema, Chante Karimkhani, Palitha Karunapema, Amir Kasaeian, Nicholas J Kassebaum, Anil Kaul, Norito Kawakami, Jeanne Françoise Kayibanda, Peter Njenga Keiyoro, Laura Kemmer, Andrew Haddon Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Abdur Rahman Khan, Ejaz Ahmad Khan, Gulfaraz Khan, Young-Ho Khang, Tawfik Ahmed Muthafer Khoja, Ardeshir Khosravi, Jagdish Khubchandani, Christian Kieling, Cho-il Kim, Daniel Kim, Sungroul Kim, Yun Jin Kim, Ruth W Kimokoti, Niranjan Kissoon, Miia Kivipelto, Luke D Knibbs, Yoshihiro Kokubo, Dhaval Kolte, Soewarta Kosen, Georgios A Kotsakis, Parvaiz A Koul, Ai Koyanagi, Michael Kravchenko, Hans Krueger, Barthelemy Kuate Defo, Ricardo S Kuchenbecker, Ernst J Kuipers, Xie Rachel Kulikoff, Veena S Kulkarni, G Anil Kumar, Gene F Kwan, Hmwe H Kyu, Aparna Lal, Dharmesh Kumar Lal, Ratilal Lalloo, Hilton Lam, Qing Lan, Sinead M Langan, Anders Larsson, Dennis Odai Laryea, Asma Abdul Latif, Janet L Leasher, James Leigh, Mall Leinsalu, Janni Leung, Ricky Leung, Miriam Levi, Yichong Li, Yongmei Li, Margaret Lind, Shai Linn, Steven E Lipshultz, Patrick Y Liu, Shiwei Liu, Yang Liu, Belinda K Lloyd, Loon-Tzian Lo, Giancarlo Logroscino, Paulo A Lotufo, Robyn M Lucas, Raimundas Lunevicius, Mohammed Magdy Abd El Razek, Carlos Magis-Rodriguez, Mahdi Mahdavi, Marek Majdan, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Chabila C Mapoma, David Joel Margolis, Randall V Martin, Jose Martinez-Raga, Felix Masiye, Amanda J Mason-Jones, João Massano, Richard Matzopoulos, Bongani M Mayosi, John J McGrath, Martin McKee, Peter A Meaney, Alem Mehari, Alemayehu B Mekonnen, Yohannes Adama Melaku, Peter Memiah, Ziad A Memish, Walter Mendoza, Gert B M Mensink, Atte Meretoja, Tuomo J Meretoja, Yonatan Moges Mesfin, Francis Apolinary Mhimbira, Renata Micha, Ted R Miller, Edward J Mills, Mojde Mirarefin, Awoke Misganaw, Philip B Mitchell, Charles N Mock, Alireza Mohammadi, Shafiu Mohammed, Lorenzo Monasta, Jonathan de la Cruz Monis, Julio Cesar Montañez Hernandez, Marcella Montico, Maziar Moradi-Lakeh, Lidia Morawska, Rintaro Mori, Ulrich O Mueller, Michele E Murdoch, Brighton Murimira, Joseph Murray, Gudlavalleti Venkata Satyanarayana Murthy, Srinivas Murthy, Kamarul Imran Musa, Jean B Nachega, Gabriele Nagel, Kovin S Naidoo, Luigi Naldi, Vinay Nangia, Bruce Neal, Chakib Nejjari, Charles R Newton, John N Newton, Frida Namnyak Ngalesoni, Peter Nguhiu, Grant Nguyen, Quyen Le Nguyen, Muhammad Imran Nisar, Patrick Martial Nkamedjie Pete, Sandra Nolte, Marika Nomura, Ole F Norheim, Bo Norrving, Carla Makhlouf Obermeyer, Felix Akpojene Ogbo, In-Hwan Oh, Olanrewaju Oladimeji, Pedro R Olivares, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, John Nelson Opio, Eyal Oren, Alberto Ortiz, Richard H Osborne, Erika Ota, Mayowa O Owolabi, Mahesh PA, Eun-Kee Park, Hye-Youn Park, Charles D Parry, Mahboubeh Parsaeian, Tejas Patel, Vikram Patel, Angel J Paternina Caicedo, Snehal T Patil, Scott B Patten, George C Patton, Deepak Paudel, João Mário Pedro, David M Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael Robert Phillips, Frédéric B Piel, Julian David Pillay, Christine Pinho, Farhad Pishgar, Suzanne Polinder, Richie G Poulton, Farshad Pourmalek, Mostafa Qorbani, Rynaz H S Rabiee, Amir Radfar, Vafa Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Sajjad Ur Rahman, Rajesh Kumar Rai, Sasa Rajsic, Murugesan Raju, Usha Ram, Saleem M Rana, Chhabi Lal Ranabhat, Kavitha Ranganathan, Puja C Rao, Amany H Refaat, Marissa B Reitsma, Giuseppe Remuzzi, Serge Resnikoff, Antonio L Ribeiro, Maria Jesus Rios Blancas, Hirbo Shore Roba, Bayard Roberts, Alina Rodriguez, David Rojas-Rueda, Luca Ronfani, Gholamreza Roshandel, Gregory A Roth, Dietrich Rothenbacher, Ambuj Roy, Nobhojit Roy, Ben Benasco Sackey, Rajesh Sagar, Muhammad Muhammad Saleh, Juan R Sanabria, João Vasco Santos, Damian F Santomauro, Itamar S Santos, Rodrigo Sarmiento-Suarez, Benn Sartorius, Maheswar Satpathy, Miloje Savic, Monika Sawhney, Susan M Sawyer, Josef Schmidhuber, Maria Inês Schmidt, Ione J C Schneider, Aletta E Schutte, David C Schwebel, Soraya Seedat, Sadaf G Sepanlou, Edson E Servan-Mori, Katya Shackelford, Amira Shaheen, Masood Ali Shaikh, Teresa Shamah Levy, Rajesh Sharma, Jun She, Sara Sheikhbahaei, Jiabin Shen, Kevin N Sheth, Muki Shey, Peilin Shi, Kenji Shibuya, Mika Shigematsu, Min-Jeong Shin, Rahman Shiri, Kawkab Shishani, Ivy Shiue, Inga Dora Sigfusdottir, Naris Silpakit, Diego Augusto Santos Silva, Jonathan I Silverberg, Edgar P Simard, Shireen Sindi, Abhishek Singh, Gitanjali M Singh, Jasvinder A Singh, Om Prakash Singh, Prashant Kumar Singh, Vegard Skirbekk, Amber Sligar, Samir Soneji, Kjetil Søreide, Reed J D Sorensen, Joan B Soriano, Sergey Soshnikov, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Hans-Christian Stahl, Jeffrey D Stanaway, Vasiliki Stathopoulou, Nadine Steckling, Nicholas Steel, Dan J Stein, Caitlyn Steiner, Heidi Stöckl, Saverio Stranges, Mark Strong, Jiandong Sun, Bruno F Sunguya, Patrick Sur, Soumya Swaminathan, Bryan L Sykes, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Karen M Tabb, Roberto Tchio Talongwa, Mohammed Rasoul Tarawneh, Mohammad Tavakkoli, Bineyam Taye, Hugh R Taylor, Bemnet Amare Tedla, Worku Tefera, Teketo Kassaw Tegegne, Dejen Yemane Tekle, Girma Temam Shifa, Abdullah Sulieman Terkawi, Gizachew Assefa Tessema, J S Thakur, Alan J Thomson, Andrew L Thorne-Lyman, Amanda G Thrift, George D Thurston, Taavi Tillmann, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Fotis Topouzis, Bach Xuan Tran, Thomas Truelsen, Zacharie Tsala Dimbuene, Abera Kenay Tura, Emin Murat Tuzcu, Stefanos Tyrovolas, Kingsley Nnanna Ukwaja, Eduardo A Undurraga, Chigozie Jesse Uneke, Olalekan A Uthman, Aaron van Donkelaar, Yuri Y Varakin, Tommi Vasankari, Ana Maria Nogales Vasconcelos, J Lennert Veerman, Narayanaswamy Venketasubramanian, Raj Kumar Verma, Francesco S Violante, Vasiliy Victorovich Vlassov, Patricia Volkow, Stein Emil Vollset, Gregory R Wagner, Mitchell T Wallin, Linhong Wang, Valentine Wanga, David A Watkins, Scott Weichenthal, Elisabete Weiderpass, Robert G Weintraub, Daniel J Weiss, Andrea Werdecker, Ronny Westerman, Harvey A Whiteford, James D Wilkinson, Charles Shey Wiysonge, Charles D A Wolfe, Ingrid Wolfe, Sungho Won, Anthony D Woolf, Shimelash Bitew Workie, Mamo Wubshet, Gelin Xu, Ajit Kumar Yadav, Bereket Yakob, Ayalnesh Zemene Yalew, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Pengpeng Ye, Paul Yip, Naohiro Yonemoto, Seok-Jun Yoon, Mustafa Z Younis, Chuanhua Yu, Zoubida Zaidi, Maysaa El Sayed Zaki, Carlos Zambrana-Torrelio, Tomas Zapata, Elias Asfaw Zegeye, Yi Zhao, Maigeng Zhou, Sanjay Zodpey, David Zonies, Christopher J L Murray
Journal: The Lancet (2016)

BackgroundIn September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015).MethodsWe applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices.FindingsIn 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8–61·8) and varied widely by country, ranging from 85·5 (84·2–86·5) in Iceland to 20·4 (15·4–24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r2=0·88) and the MDG index (r2=0·92), whereas the non-MDG index had a weaker relation with SDI (r2=0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0–10·4), and gains on the MDG index (a median change of 10·0 [6·7–13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1–8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened.InterpretationGBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs.FundingBill & Melinda Gates Foundation.