Sustainable Development Goals

13 Targets

  • By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

  • By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

  • By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

  • By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

  • Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

  • By 2020, halve the number of global deaths and injuries from road traffic accidents 3.7

  • By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

  • Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

  • By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

  • Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

  • Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all

  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks

The 17 Sustainable Development Goals (SDGs) of the 2030 Agenda integrate all three dimensions of sustainable development (economic, social and environmental) recognizing that eradicating poverty and inequality, creating inclusive economic growth and preserving the planet are inextricably linked. Health is centrally positioned within the 2030 Agenda, with one comprehensive goal (SDG 3) and its 13 targets covering all major health priorities, and links to targets in many of the other goals.

Health monitoring will have to look beyond the health sector and consider economic, social and environmental indicators, as well as intersectoral actions.

Strengthening country health information systems should therefore be a priority.

Millennium Development Goal (MDG) - Sustainable Development Goals (SDGs)

The 2030 Agenda differs from the MDGs in several ways, with important implications for global, regional and country health monitoring. Key differences include the broader scope of the 2030 Agenda in terms of the health targets set, as well as the emphasis placed on equity, the links between health and other sectors, and the centrality of country monitoring and review.

The SDGs cover a much broader set of topics than the MDGs, notably with regard to health. The SDG 3 targets cover virtually all major health topics, including reproductive, maternal, newborn and child health, infectious diseases, NCDs, mental health, road traffic injuries, UHC, environmental health consequences and health systems strengthening. In addition, many other SDGs include health-related targets and indicators such as targets for nutrition, water, sanitation, air quality and violence, as well as for the key determinants of health such as education and poverty.

World Health Statistics 2016 focuses on the proposed health and health-related Sustainable Development Goals (SDGs) and associated targets.

In September 2015, the United Nations General Assembly adopted the new development agenda: Transforming our world: the 2030 agenda for sustainable development.

Comprising 17 Sustainable Development Goals (SDGs), the 2030 Agenda integrates all three dimensions of sustainable development (economic, social and environmental) around the themes of people, planet, prosperity, peace and partnership. The SDGs recognize that eradicating poverty and inequality, creating inclusive economic growth and preserving the planet are inextricably linked, not only to each other, but also to population health.

Health is centrally positioned within the 2030 Agenda, with one comprehensive goal – SDG 3: Ensure healthy lives and promote well-being for all at all ages – and explicit links to many of the other goals.

Framed in very general terms, the overall health SDG is: “Ensure healthy lives and promote well-being for all at all ages”. WHO has considered several overarching indicators that might serve to monitor this goal, including: “life expectancy”; “healthy life expectancy”; and “number of deaths before age 70”.

LIFE EXPECTANCY

Life expectancy is a summary measure of mortality rates at all ages.

Global life expectancy in 2015 was 71.4 years.

Overall, female life expectancy is 73.8 years and male life expectancy is 69.1 years.

HEALTHY LIFE EXPECTANCY

Healthy life expectancy (HLE) provides an indication of overall health for a population, representing the average equivalent number of years of full health that a newborn could expect to live if they were to pass through life subject to the age-specific death rates and average age-specific levels of health states for a given period.

The gap between life expectancy and HLE are the equivalent healthy years lost through morbidity and disability.

Globally, HLE in 2015 is estimated at 63.1 years for both sexes combined.

Globally, male and female HLEs are 61.5 and 64.6 years respectively.

The main contributors to the gap between LE and HLE are musculoskeletal disorders (with back and neck pain being a major contributor), mental and substance-use disorders (particularly depression and anxiety disorders), neurological disorders, vision and hearing loss, and cardiovascular diseases and diabetes.

PREMATURE MORTALITY – focusing on deaths among those under 70 years of age

Target of reducing the number of deaths before age 70 by 40% by 2030 globally and in every country.

Numbers of deaths before age 70 is a more readily measurable indicator than life expectancy, and can decrease more rapidly than life expectancy can

increase as it is more sensitive to interventions.

Bring down mortality due to HIV, malaria, tuberculosis or child mortality, or to NCD deaths between ages 30 and 70.

Bring down MDG deaths, NCD deaths and injury-related death.

There were an estimated 30 million deaths under age 70 in 2015.

Globally, 4 / 1000 population

WPR, 2.8 / 1000 population

Universal Health Coverage at the Center of Health Goal

Under SDG 3, UHC is also assigned the specific Target 3.8: “Achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all”.

The goal of UHC (all people and communities receiving the needed quality services, including health protection, promotion, prevention, treatment, rehabilitation and palliation without financial hardship) is relevant to all countries and offers an unprecedented opportunity to increase coherence in health-related actions and initiatives.

The framework focuses on the two core components of UHC: coverage of the population with quality, essential health services; and coverage of the

population with financial protection, the key to which is reducing dependence on payment for health services out-of-pocket (OOP) at the time of use.

The proposed indicators are a “coverage index” of essential services, disaggregated by key stratifiers where possible, and a measure of the lack of financial protection against the costs of health services.

These two indicators need to be interpreted together to assess the state of UHC, both nationally and globally.

UHC coverage index of essential health services – a new summary measure

The set of tracer indicators for service coverage are grouped into four main categories, each with four indicators (Table 4.1):

(1) reproductive, maternal, newborn and child health; (2) infectious diseases; (3) NCDs; and (4) service capacity and access, and health security.

Reproductive, maternal, newborn and child health

Family planning coverage

Antenatal and delivery care

Full child immunization

Health-seeking

behaviour for child pneumonia

Infectious diseases

Tuberculosis effective treatment

HIV antiretroviral treatment

ITN coverage for malaria prevention

Improved water source and adequate sanitation

Noncommunicable diseases

Prevalence of raised blood pressure

Prevalence of raised

blood glucose Cervical cancer screening

Tobacco (non-use)

Service capacity and access

Basic hospital access

Health-worker density

Access to essential medicines

Health security: IHR compliance

Inequalities in coverage – towards an integrated assessment

OOP (out-of-pocket) payments are judged to be catastrophic when they exceed a given proportion (25%) of the total household budget or of the capacity to pay (40%).

They are labelled impoverishing when OOP payments push a household’s other spending below a minimum socially recognized living standard

such as that identified by a poverty line.

Equity

Equity is at the heart of the SDGs, which are founded on the concept of “leaving no one behind”. SDG 3 calls for healthy lives for all at all ages, positioning equity as a core cross-cutting theme, while SDG 10 calls for the reduction of inequality within and between countries.

Equity is also a key consideration with regard to UHC, which as noted earlier is both central to the health goal and founded on the principle of equal access to health services without risk of financial hardship.

Health inequalities within countries are associated with a variety of factors, several of which are encountered uniformly across all countries. Examples include sex, age, economic status, education and place of residence.

Sex – major differences between men and women for many indicators

Age – data should cover the full life course

SDG 3 aims for health and well-being for all at all ages. It is thus vital to monitor health developments using age-disaggregated data. In some areas, such monitoring is already improving.

For example, newborn care became a health priority when evidence emerged that rates of child mortality during the neonatal period were declining

much more slowly than those during subsequent periods.

Adolescent health is also receiving more attention because of alarming data regarding risk factors such as tobacco use, harmful use of alcohol, HIV incidence and obesity prevalence.

Older people do not figure prominently in he 2030 Agenda for Sustainable Development, but their numbers are rapidly increasing and evidence is emerging that much more can be done to promote their well-being.

Socioeconomic inequalities – major disadvantages for the poorest and the least educated

Place of residence – focus on geographical differences within countries

Migrants and minorities – requiring special efforts

Health targets – 13 targets and 26 proposed indicators

MATERNAL MORTALITY

SDG Target 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births

Indicator 3.1.1: Maternal mortality ratio

BIRTHS ATTENDED BY SKILLED HEALTH PERSONNEL

Indicator 3.1.2: Proportion of births attended by skilled health personnel

CHILD MORTALITY

SDG Target 3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-five mortality to at least as low as 25 per 1000 live births

Indicator 3.2.1: Under-five mortality rate

Indicator 3.2.2: Neonatal mortality rate

HIV

SDG Target 3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

Indicator 3.3.1: Number of new HIV infections per 1000 uninfected population, by sex, age and key populations

TUBERCULOSIS

Indicator 3.3.2: Tuberculosis incidence per 1000 population

MALARIA

Indicator 3.3.3: Malaria incidence per 1000 population

HEPATITIS

Indicator 3.3.4: Hepatitis B incidence per 100 000 population

NEGLECTED TROPICAL DISEASES

Indicator 3.3.5: Number of people requiring interventions against neglected tropical diseases

NONCOMMUNICABLE DISEASES

SDG Target 3.4 By 2030, reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being

Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease

SUICIDE

Indicator 3.4.2: Suicide mortality rate

SUBSTANCE ABUSE

SDG Target 3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

Indicator 3.5.1: Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance-use disorders

Indicator 3.5.2: Harmful use of alcohol, defined according to the national context as alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol

ROAD TRAFFIC INJURIES

SDG Target 3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents

Indicator 3.6.1: Death rate due to road traffic injuries

SEXUAL AND REPRODUCTIVE HEALTH

SDG Target 3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

Indicator 3.7.1: Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods Indicator 3.7.2: Adolescent birth rate (aged 10–14 years; aged 15–19 years) per 1000 women in that age group

MORTALITY DUE TO AIR POLLUTION

SDG Target 3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

Indicator 3.9.1: Mortality rate attributed to household and ambient air pollution

MORTALITY DUE TO UNSAFE WATER, UNSAFE SANITATION AND LACK OF HYGIENE

SDG Target 3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

Indicator 3.9.2: Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (exposure to unsafe WASH services)

MORTALITY DUE TO UNINTENTIONAL POISONING

Indicator 3.9.3: Mortality rate attributed to unintentional poisoning

TOBACCO USE

SDG Target 3.a Strengthen the implementation of the WHO Framework Convention on Tobacco Control in all countries, as appropriate

Indicator 3.a.1: Age-standardized prevalence of current tobacco use among persons aged 15 years and older

SDG Target 3.b Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all Indicator 3.b.1: Proportion of the population with access to affordable medicines and vaccines on a sustainable basis Indicator 3.b.2: Total net official development assistance to medical research and basic health sectors

HEALTH WORKFORCE

SDG Target 3.c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least-developed countries and small-island developing States

NATIONAL AND GLOBAL HEALTH RISKS

SDG Target 3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks Indicator 3.d.1: International Health Regulations (IHR) capacity and health emergency preparedness index

CHILD STUNTING

SDG Target 2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons Indicator 2.2.1: Prevalence of stunting (height for age < -2 standard deviation from the median of the WHO Child Growth Standards) among children under 5 years of age

CHILD WASTING AND OVERWEIGHT

SDG Target 2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons Indicator 2.2.2: Prevalence of malnutrition (weight for height > +2 or < -2 standard deviation from the median of the WHO Child Growth Standards) among children under 5 years of age, by type (wasting and overweight)

DRINKING-WATER SERVICES

SDG Target 6.1 By 2030, achieve universal and equitable access to safe and affordable drinking-water for all Indicator 6.1.1: Proportion of population using safely managed drinking-water services

SANITATION

SDG Target 6.2 By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations Indicator 6.2.1: Proportion of population using safely managed sanitation services, including a hand-washing facility with soap and water

CLEAN HOUSEHOLD ENERGY

SDG Target 7.1 By 2030, ensure universal access to affordable, reliable and modern energy services Indicator 7.1.2: Proportion of population with primary reliance on clean fuels and technology

AMBIENT AIR POLLUTION

SDG Target 11.6 By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management Indicator 11.6.2: Annual mean levels of fine particulate matter in cities (population weighted)

NATURAL DISASTERS

SDG Target 13.1 Strengthen resilience and adaptive capacity to climate-related hazards and natural disasters in all countries1 Indicator 13.1.2: Number of deaths, missing and persons affected by disaster per 100 000 people2

HOMICIDE

SDG Target 16.1 Significantly reduce all forms of violence and related death rates everywhere Indicator 16.1.1: Number of victims of intentional homicide per 100 000 population, by sex and age

CONFLICTS

SDG Target 16.1 Significantly reduce all forms of violence and related death rates everywhere Indicator 16.1.2: Conflict-related deaths per 100 000 population, by sex, age and cause

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