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
Authors: Rafael Lozano, Nancy Fullman, Degu Abate, Solomon M Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Omar Abdel-Rahman, Alireza Abdi, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Nebiyu Dereje Abebe, Zegeye Abebe, Ayenew Negesse Abejie, Semaw F Abera, Olifan Zewdie Abil, Victor Aboyans, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Niveen Me Abu-Rmeileh, Gebre Y Abyu, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Pawan Acharya, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Beyene Meressa Adhena, Tara Ballav Adhikari, Mina G Adib, Arsène Kouablan Adou, Jose C Adsuar, Mohsen Afarideh, Mahdi Afshari, Ashkan Afshin, Gina Agarwal, Sargis Aghasi Aghayan, Dominic Agius, Anurag Agrawal, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Hamid Ahmadieh, Muktar Beshir Ahmed, Sayem Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Mohammad Esmaeil Akbari, Mohammed Akibu, Rufus Olusola Akinyemi, Tomi Akinyemiju, Nadia Akseer, Fares Alahdab, Ziyad Al-Aly, Khurshid Alam, Tahiya Alam, Ammar Albujeer, Animut Alebel, Kefyalew Addis Alene, Ayman Al-Eyadhy, Samia Alhabib, Raghib Ali, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Christine A Allen, Ali Almasi, Fatma Al-Maskari, Hesham M Al-Mekhlafi, Jordi Alonso, Rajaa M Al-Raddadi, Ubai Alsharif, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Kebede Amenu, Erfan Amini, Walid Ammar, Nahla Hamed Anber, Jason A Anderson, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Hossein Ansari, Ansariadi Ansariadi, Mustafa Geleto Ansha, Carl Abelardo T Antonio, Palwasha Anwari, Lambert Tetteh Appiah, Olatunde Aremu, Habtamu Abera Areri, Johan Ärnlöv, Monika Arora, Krishna K Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Solomon Weldegebreal Asgedom, Rana Jawad Asghar, Reza Assadi, Zerihun Ataro, Suleman Atique, Sachin R Atre, Madhu Sudhan Atteraya, Marcel Ausloos, Leticia Avila-Burgos, Euripide F G A Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Henok Tadesse Ayele, Yohanes Ayele, Rakesh Ayer, Mahmoud Reza Azarpazhooh, Peter S Azzopardi, Natasha Azzopardi-Muscat, Tesleem Kayode Babalola, Arefeh Babazadeh, Hamid Badali, Alaa Badawi, Kalpana Balakrishnan, Ayele Geleto Bali, Maciej Banach, Amitava Banerjee, Joseph Adel Mattar Banoub, Amrit Banstola, Aleksandra Barac, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Lope H Barrero, Celine M Barthelemy, Quique Bassat, Arindam Basu, Sanjay Basu, Robert J Battista, Bernhard T Baune, Habtamu Wondifraw Baynes, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Bayu Begashaw Bekele, Abate Bekele Belachew, Aregawi Gebreyesus Belay, Saba Abraham Belay, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Habib Benzian, Adugnaw Berhane, Abadi Kidanemariam Berhe, Adam E Berman, Eduardo Bernabe, Robert S Bernstein, Gregory J Bertolacci, Mircea Beuran, Tina Beyranvand, Neeraj Bhala, Ashish Bhalla, Anil Bhansali, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Molly H Biehl, Ali Bijani, Boris Bikbov, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Sait Mentes Birlik, Charles Birungi, Donal Bisanzio, Tuhin Biswas, Helen Bitew, Hailemichael Bizuneh, Espen Bjertness, Eshetu Mulisa Bobasa, Soufiane Boufous, Rupert Bourne, Kayvan Bozorgmehr, Nicola Luigi Bragazzi, Michael Brainin, Luisa C Brant, Michael Brauer, Alexandra Brazinova, Nicholas J K Breitborde, Paul Svitil Briant, Gabrielle Britton, Traolach Brugha, Gene Bukhman, Reinhard Busse, Zahid A Butt, Lucero Cahuana-Hurtado, Charlton SKH Callender, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Mate Car, Rosario Cárdenas, Juan J Carrero, Austin Carter, Félix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Franz Castro, Kate Causey, Alanur Çavlin, Kelly M Cercy, Ester Cerin, Yazan Chaiah, Julian Chalek, Hsing-Yi Chang, Jung-Chen Chang, Aparajita Chattopadhyay, Vijay Kumar Chattu, Pankaj Chaturvedi, Peggy Pei-Chia Chiang, Ken Lee Chin, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Jee-Young J Choi, Rajiv Chowdhury, Hanne Christensen, Devasahayam J Christopher, Sheng-Chia Chung, Flavia M Cicuttini, Liliana G Ciobanu, Massimo Cirillo, Rafael M Claro, Thomas Khaled Dwayne Claßen, Aaron J Cohen, Daniel Collado-Mateo, Cyrus Cooper, Leslie Trumbull Cooper, Leslie Cornaby, Monica Cortinovis, Megan Costa, Ewerton Cousin, Elizabeth A Cromwell, Christopher Stephen Crowe, Matthew Cunningham, Alemneh Kabeta Daba, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Paul I Dargan, Ahmad Daryani, Siddharth K Das, Rajat Das Gupta, José das Neves, Tamirat Tesfaye Dasa, Aditya Prasad Dash, Adrian C Davis, Dragos Virgil Davitoiu, Kairat Davletov, Anand Dayama, Barbora de Courten, Diego De Leo, Jan-Walter De Neve, Hans De Steur, Meaza Girma Degefa, Louisa Degenhardt, Tizta Tilahun Degfie, Selina Deiparine, Robert P Dellavalle, Gebre Teklemariam Demoz, Balem Demtsu, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Getenet Ayalew Dessie, Subhojit Dey, Samath D Dharmaratne, Meghnath Dhimal, Daniel Dicker, Mesfin Tadese Dinberu, Eric L Ding, Shirin Djalalinia, Huyen Phuc Do, Klara Dokova, David Teye Doku, Dirk Douwes-Schultz, Tim Robert Driscoll, Leilei Duan, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B Duncan, Andre R Duraes, Soheil Ebrahimpour, David Edvardsson, Charbel El Bcheraoui, Erika Eldrenkamp, Ziad El-Khatib, Iqbal RF Elyazar, Ahmadali Enayati, Aman Yesuf Endries, Babak Eshrati, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Kara Estep, Mahdi Fakhar, Hamed Fakhim, Jessica Fanzo, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Talha A Farid, Carla Sofia e Sá Farinha, Andrea Farioli, Andre Faro, Maryam S Farvid, Farshad Farzadfar, Mohammad Hosein Farzaei, Hossein Farzam, Ali Akbar Fazaeli, Mir Sohail Fazeli, Valery L Feigin, Andrea B Feigl, Wubalem Fekadu, Rachel Feldman, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C Fernandes, Garumma Tolu Feyissa, Daniel Obadare Fijabi, Irina Filip, Samuel Finegold, Jonas David Finger, Florian Fischer, Christina Fitzmaurice, Luisa Sorio Flor, Nataliya A Foigt, Kyle J Foreman, Tahvi D Frank, Richard Charles Franklin, Takeshi Fukumoto, Kai Fukutaki, John E Fuller, Thomas Fürst, João M Furtado, Emmanuela Gakidou, Silvano Gallus, Fortune Gbetoho Gankpe, Ron T Gansevoort, Ana Cristina Garcia, Alberto L Garcia-Basteiro, Miguel A Garcia-Gordillo, William M Gardner, Abadi Kahsu Gebre, Teshome Gebre, Gebremedhin Berhe Gebregergs, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Bereket Gebremichael, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M Geleijnse, Yilma Chisha Dea Geramo, Sefonias Getachew, Peter W Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Reza Ghadimi, Keyghobad Ghadiri, Maryam Ghasemi-Kasman, Hesam Ghiasvand, Mamata Ghimire, Aloke Gopal Ghoshal, Simona Giampaoli, Paramjit Singh Gill, Tiffany K Gill, Giorgia Giussani, Elena V Gnedovskaya, Ellen M Goldberg, Srinivas Goli, Philimon N Gona, Amador Goodridge, Sameer Vali Gopalani, Taren M Gorman, Atsushi Goto, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Max G Griswold, Giuseppe Grosso, Harish Chander C Gugnani, Francis Guillemin, Andre Luiz Sena Guimaraes, Yuming Guo, Prakash C Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Giang Hai Ha, Juanita A Haagsma, Vladimir Hachinski, Nima Hafezi-Nejad, Hassan Haghparast Bidgoli, Tekleberhan B Hagos, Michael Tamene Haile, Tewodros Tesfa Hailegiyorgis, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Graeme J Hankey, Hilda L Harb, Sivadasanpillai Harikrishnan, Hamidreza Haririan, Josep Maria Haro, Mehedi Hasan, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Caitlin N Hawley, Simon I Hay, Yihua He, Akbar Hedayatizadeh-Omran, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Mohsen Heidari, Delia Hendrie, Andualem Henok, Ileana Heredia-Pi, Claudiu Herteliu, Behzad Heydarpour, Fatemeh Heydarpour, Sousan Heydarpour, Desalegn T Hibstu, Martha Híjar, Hans W Hoek, Daniel J Hoffman, Michael K Hole, Enayatollah Homaie Rad, Praveen Hoogar, Nobuyuki Horita, H Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J Hotez, Damian G Hoy, Mohamed Hsairi, Thomas Hsiao, Guoqing Hu, John J Huang, Caitlyn Hughes, Chantal K Huynh, Ehimario U Igumbor, Chad Thomas Ikeda, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Sheikh Mohammed Shariful Islam, Farhad Islami, Rebecca Q Ivers, Neda Izadi, Kathryn H Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Moti Tolera Jalu, Amr A Jamal, Spencer L James, Simerjot K Jassal, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Catherine O Johnson, Sarah C Johnson, Jost B Jonas, Jitendra Jonnagaddala, Zahra Jorjoran Shushtari, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Madhanraj K, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Molla Kahssay, Rizwan Kalani, Umesh Kapil, Manoochehr Karami, Behzad Karami Matin, Marina Karanikolos, Narges Karimi, Seyed M Karimi, Hamidreza Karimi-Sari, Amir Kasaeian, Dessalegn H Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Zemenu Yohannes Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Norito Kawakami, Zhila Kazemi, Ali Kazemi Karyani, Dhruv Satish Kazi, Prakash KC, Seifu Kebede, Peter Njenga Keiyoro, Laura Kemmer, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young-Ho Khang, Tripti Khanna, Mona M Khater, Alireza Khatony, Zahra Khazaeipour, Habibolah Khazaie, Abdullah T Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A Kiadaliri, Helen W Kiarie, Getiye D Kibret, Daniel N Kiirithio, Daniel Kim, Jun Y Kim, Young-Eun Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Sanjay Kinra, Adnan Kisa, Katarzyna Kissimova-Skarbek, Niranjan Kissoon, Mika Kivimäki, Jonathan M Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A Kopec, Margaret N Kosek, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Michael A Kravchenko, Kewal Krishan, Kristopher J Krohn, Barthelemy Kuate Defo, Burcu Kucuk Bicer, Andreas A Kudom, Xie Rachel Kulikoff, G Anil Kumar, Manasi Kumar, Pushpendra Kumar, Michael J Kutz, Hmwe Hmwe Kyu, Carl Lachat, Deepesh P Lad, Sheetal D Lad, Alessandra Lafranconi, Abraham K Lagat, Dharmesh Kumar Lal, Ratilal Lalloo, Hilton Lam, Faris Hasan Lami, Prabhat Lamichhane, Qing Lan, Justin J Lang, Van C Lansingh, Sonia Lansky, Heidi J Larson, Anders O Larsson, Dennis Odai Laryea, Zohra S Lassi, Arman Latifi, Kathryn Mei-Ming Lau, Avula Laxmaiah, Jeffrey V Lazarus, Janet L Leasher, Georgy Lebedev, Jorge R Ledesma, James B Lee, Paul H Lee, Andrew T Leever, James Leigh, Mall Leinsalu, Cheru Tesema Leshargie, Janni Leung, Sonia Lewycka, Shanshan Li, Xiaohong Li, Yichong Li, Juan Liang, Xiaofeng Liang, Misgan Legesse Liben, Lee-Ling Lim, Miteku Andualem Limenih, Shai Linn, Shiwei Liu, Yang Liu, Rakesh Lodha, Giancarlo Logroscino, Alan D Lopez, Stefan Lorkowski, Paulo A Lotufo, Lydia R Lucchesi, Ronan A Lyons, Erlyn Rachelle King Macarayan, Mark T Mackay, Emilie R Maddison, Fabiana Madotto, Dhaval P Maghavani, Carlos Magis-Rodriguez, Narayan Bahadur Mahotra, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, 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Mustafa, Saravanan Muthupandian, Ashraf F Nabhan, Jean B Nachega, Ahamarshan Jayaraman Nagarajan, Gabriele Nagel, Mohsen Naghavi, Aliya Naheed, Azin Nahvijou, Kovin Naidoo, Gurudatta Naik, Nitish Naik, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, Haseeb Nawaz, Nahid Neamati, Ionut Negoi, Ruxandra Irina Negoi, Subas Neupane, Charles Richard James Newton, Frida N Ngalesoni, Josephine W Ngunjiri, Anh Nguyen, Grant Nguyen, Ha Nguyen, Huong Lan Thi Nguyen, Huong Thanh Nguyen, Minh Nguyen, Emma Nichols, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Yirga Legesse Nirayo, Muhammad Imran Nisar, Molly R Nixon, Nomonde Nolutshungu, Marika Nomura, Ole F Norheim, Mehdi Noroozi, Bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Peter S Nyasulu, Carla Makhlouf Obermeyer, Richard Ofori-Asenso, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Anselm Okoro, Kelechi E Oladimeji, Olanrewaju Oladimeji, Andrew T Olagunju, Tinuke O Olagunju, Pedro R Olivares, Helen Elizabeth Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin L Ong, Sok King Ong, Anu Mary Oommen, John Nelson Opio, Eyal Oren, Andrei Oros, Doris D V Ortega-Altamirano, Alberto Ortiz, Justin R Ortiz, Eduardo Ortiz-Panozo, Erika Ota, Stanislav S Otstavnov, Mayowa Ojo Owolabi, Mahesh P A, Smita Pakhale, Abhijit P Pakhare, Wen-Harn Pan, Adrian Pana, Basant Kumar Panda, Songhomitra Panda-Jonas, Jeyaraj Durai Pandian, Nikolaos Papantoniou, Eun-Kee Park, Charles D H Parry, Hadi Parsian, Shanti Patel, Sanghamitra Pati, Ajay Patle, George C Patton, Vishnupriya Rao Paturi, Deepak Paudel, Katherine R Paulson, Neil Pearce, Emmanuel K Peprah, David M Pereira, Norberto Perico, Aslam Pervaiz, Konrad Pesudovs, William A Petri, Max Petzold, Michael R Phillips, David M Pigott, Julian David Pillay, Meghdad Pirsaheb, Martin Pletcher, Constance Dimity Pond, Maarten J Postma, Akram Pourshams, Hossein 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Sabde, Perminder S Sachdev, Basema Saddik, Ehsan Sadeghi, Hosein Safari, Yahya Safari, Roya Safari-Faramani, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Haniye Sadat Sajadi, Nasir Salam, Joseph S Salama, Payman Salamati, Raphael de Freitas Saldanha, Zikria Saleem, Yahya Salimi, Hamideh Salimzadeh, Joshua A Salomon, Sundeep Santosh Salvi, Inbal Salz, Evanson Zondani Sambala, Abdallah M Samy, Juan Sanabria, Maria Dolores Sanchez-Niño, Itamar S Santos, Milena M Santric Milicevic, Bruno Piassi Sao Jose, Mayank Sardana, Abdur Razzaque Sarker, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Miloje Savic, Arundhati R Sawant, Monika Sawhney, Sonia Saxena, Mete Saylan, Mehdi Sayyah, Elke Schaeffner, Maria Inês Schmidt, Ione J C Schneider, Ben Schöttker, Aletta Elisabeth Schutte, David C Schwebel, Falk Schwendicke, Soraya Seedat, Mario Sekerija, Sadaf G Sepanlou, Edson Serván-Mori, Seyedmojtaba 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Filho, Badr Hasan Sobaih, Soheila Sobhani, Michael Soljak, Moslem Soofi, Masoud Soosaraei, Reed J D Sorensen, Joan B Soriano, Sergey Soshnikov, Ireneous N Soyiri, Angela Spinelli, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Raghavendra Guru Srinivasan, Vinay Srinivasan, Jeffrey D Stanaway, Vladimir I Starodubov, Vasiliki Stathopoulou, Nadine Steckling, Dan J Stein, Leo G Stewart, Leo Stockfelt, Mark A Stokes, Kurt Straif, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Bruno F Sunguya, Patrick John Sur, Ipsita Sutradhar, Bryan L Sykes, P N Sylaja, Dillon O Sylte, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Santosh Kumar Tadakamadla, Koku Sisay Tamirat, Nikhil Tandon, Frank C Tanser, Aberash Abay Tassew, Segen Gebremeskel Tassew, Mohammad Tavakkoli, Nuno Taveira, Nega Yimer Tawye, Arash Tehrani-Banihashemi, Tigist Gashaw Tekalign, Merhawi Gebremedhin Tekle, Habtamu Temesgen, Mohamad-Hani Temsah, Omar Temsah, Abdullah Sulieman Terkawi, Manaye Yihune Teshale, Destaw Fetene Teshome, Belay Tessema, Mebrahtu Teweldemedhin, Jarnail Singh Thakur, Kavumpurathu Raman Thankappan, Andrew Theis, Sathish Thirunavukkarasu, Laura Anne Thomas, Nihal Thomas, Alan J Thomson, Amanda G Thrift, Binyam Tilahun, Quyen G To, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Anna E Torre, Miguel Tortajada-Girbés, Marcos Roberto Tovani-Palone, Jeffrey A Towbin, Bach Xuan Tran, Khanh Bao Tran, Tung Thanh Tran, Srikanth Prasad Tripathy, Christopher E Troeger, Thomas Clement Truelsen, Afewerki Gebremeskel Tsadik, Lorainne Tudor Car, E Murat Tuzcu, Hayley D Tymeson, Kingsley N Ukwaja, Irfan Ullah, Rachel L Updike, Muhammad Shariq Usman, Olalekan A Uthman, Muthiah Vaduganathan, Afsane Vaezi, Gaurang Vaidya, Pascual R Valdez, Aaron van Donkelaar, Elena Varavikova, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Ramesh Vidavalur, Santos Villafaina, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Sebastian Vollmer, Stein Emil Vollset, Theo Vos, Kia Vosoughi, Isidora S Vujcic, Gregory R Wagner, Fasil Shiferaw Wagnew, Yasir Waheed, Judd L Walson, Yanping Wang, Yuan-Pang Wang, Molla Mesele Wassie, Elisabete Weiderpass, Robert G Weintraub, Jordan Weiss, Fitsum Weldegebreal, Kidu Gidey Weldegwergs, Andrea Werdecker, Adhena Ayaliew Werkneh, T Eoin West, Ronny Westerman, Joanna L Whisnant, Harvey A Whiteford, Justyna Widecka, Katarzyna Widecka, Tissa Wijeratne, Lauren B Wilner, Andrea Sylvia Winkler, Alison B Wiyeh, Charles Shey Wiysonge, Haileab Fekadu Wolde, Charles D A Wolfe, Shouling Wu, Denis Xavier, Gelin Xu, Rixing Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Bereket Yakob, Tomohide Yamada, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Pengpeng Ye, Jamal A Yearwood, Alex Yeshaneh, Ebrahim M Yimer, Paul Yip, Biruck Desalegn Yirsaw, Engida Yisma, Naohiro Yonemoto, Gerald Yonga, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Sojib Bin Zaman, Mohammad Zamani, Zohreh Zare, Luis Zavala-Arciniega, Desalegn Tegabu Zegeye, Elias Asfaw Zegeye, Ayalew Jejaw Zeleke, Kazem Zendehdel, Taddese Alemu Zerfu, Anthony Lin Zhang, Xueying Zhang, Maigeng Zhou, Jun Zhu, Stephanie R M Zimsen, Sanjay Zodpey, Leo Zoeckler, Inbar Zucker, Liesel Joanna J Zuhlke, Stephen S Lim, Christopher J L Murray
Journal: The Lancet (2018)

BackgroundEfforts 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.MethodsWe 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.FindingsThe 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.InterpretationThe 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.FundingBill & Melinda Gates Foundation.