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 E. 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 Kutz, Heidi J. Larson, Xiaofeng Liang, Alan D Lopez, Rafael Lozano, Claire R. McNellan, Ali H. Mokdad, Meghan Mooney, Mohsen Naghavi, Helen Elizabeth Olsen, David M. Pigott, Joshua A. Salomon, Theo Vos, Haidong Wang, Amanuel Alemu Abajobir, Kalkidan Hassen Abate, Cristiana Abbafati, Kaja Abbas, Foad Abd-Allah, Abdishakur Abdulle, Biju Abraham, Ibrahim Abubakar, Laith J. Abu‐Raddad, Niveen M. E. Abu-Rmeileh, Gebre Yitayih Abyu, Tom Achoki, Akindele O. Adebiyi, Isaac Akinkunmi Adedeji, Kossivi Agbélénko Afanvi, Ashkan Afshin, Arnav Agarwal, Anurag Agrawal, Ali Kiadaliri, Hamid Ahmadieh, Kedir Y. Ahmed, A. S. Akanda, Rufus Akinyemi, Tomi Akinyemiju, Nadia Akseer, Ziyad Al‐Aly, Khurshid Alam, Uzma Alam, Deena Alasfoor, Fadia AlBuhairan, Saleh Fahed Aldhahri, Robert W Aldridge, Zewdie Aderaw Alemu, Raghib Ali, Ala’a Alkerwi, Mohammad AB Alkhateeb, François Alla, Peter Allebeck, Christine A. Allen, Rajaa Al‐Raddadi, Ubai Alsharif, Khalid A Altirkawi, Elena Álvarez Martín, Nelson Alvis‐Guzmán, Azmeraw T. Amare, Alemayehu Amberbir, A. Kofi Amegah, Heresh Amini, Walid Ammar, Stephen M. Amrock, Hjalte Holm 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 Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Peter Azzopardi, Umar Bacha, Alaa Badawi, Kalpana Balakrishnan, Amitava Banerjee, Aleksandra Barać, Ryan M Barber, Suzanne Barker‐Collo, Till Bärnighausen, Lope H. Barrero, Tonatiuh Barrientos‐Gutiérrez, Sanjay Basu, Tigist Assefa Bayou, Shahrzad Bazargan‐Hejazi, Justin Beardsley, Neeraj Bedi, Ettore Beghi, Yannick Béjot, Michelle L. Bell, Aminu K. Bello, Derrick Bennett, Isabela M. Benseñor, Habib Benzian, Adugnaw Berhane, Eduardo Bernabé, Oscar Alberto Bernal, Balem Demtsu Betsu, Addisu Shunu Beyene, Neeraj Bhala, Samir Bhatt, Sibhatu Biadgilign, Kelly Bienhoff, Boris Bikbov, Agnès Binagwaho, Donal Bisanzio, Espen Bjertness, Jed D Blore, Rupert Bourne, Michael Brainin, Michael Bräuer, Alexandra Bražinová, Nicholas J. K. Breitborde, David M. Broday, Traolach Brugha, Rachelle Buchbinder, Zahid A Butt, Leah E. Cahill, Ismael Campos‐Nonato, Julio César Campuzano, Hélène Carabin, Rosario Cárdenas, Juan Jesús 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 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 Círillo, Matthew M Coates, Megan Coggeshall, Aaron J. Cohen, Graham Cooke, Cyrus Cooper, Leslie T. Cooper, Benjamin C Cowie, John Crump, Solomon Abrha Damtew, Rakhi Dandona, Paul I. Dargan, José das Neves, Adrian Davis, Kairat Davletov, E. Castro, Diego De Leo, Louisa Degenhardt, Liana C. Del Gobbo, Kebede Deribe, Sarah Derrett, Don C. Des Jarlais, Aniruddha Deshpande, Gabrielle deVeber, Subhojit Dey, Samath Dhamminda Dharmaratne, Preet K. Dhillon, Eric L. Ding, E. Ray Dorsey, Kerrie Doyle, Tim 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 Farid, Carla Sofia e Sá Farinha, André Faro, Maryam S. Farvid, Farshad Farzadfar, Valery L. Feigin, Manuela Felício, Seyed‐Mohammad Fereshtehnejad, Jefferson Gomes Fernandes, João Carlos Fernandes, Alize J Ferrari, Florian Fischer, Joseph R A Fitchett, Christina Fitzmaurice, Nataliya A Foigt, Kyle J Foreman, F. Gerry R. Fowkes, Elisabeth Barboza França, Richard C. Franklin, Maya Fraser, Joseph Friedman, Joseph Frostad, Thomas Fürst, Belinda J. Gabbe, Alberto L. García‐Basteiro, Teshome Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Alemseged Aregay Gebru, Bradford D. Gessner, Richard F Gillum, Ibrahim Ginawi, Ababi Zergaw Giref, Maurice Giroud, Melkamu Dedefo Gishu, Giorgia Giussani, William Godwin, Philimon Gona, Amador Goodridge, Sameer Vali Gopalani, Carolyn Gotay, Atsushi Goto, Hebe Gouda, Nicholas Graetz, Karen Fern Greenwell, Max Griswold, H. C. Gugnani, Yuming Guo, Rahul Gupta, Rajeev Gupta, Vipin Gupta, Reyna Alma Gutiérrez, Bishal Gyawali, Juanita A. Haagsma, Annie Haakenstad, Nima Hafezi‐Nejad, Demewoz Haile, Gessessew Bugssa Hailu, Yara A. Halasa, Randah R Hamadeh, Samer Hamidi, Mouhanad Hammami, Graeme J Hankey, Hilda L Harb, Josep María Haro, Mohammad Sadegh Hassanvand, Rasmus Havmoeller, Ileana Heredia-Pi, Hans W. Hoek, Masako Horino, Nobuyuki Horita, Hung Chak Ho, Damian G Hoy, Aung Soe Htet, Guoqing Hu, Hsiang Huang, Kim Moesgaard Iburg, Bulat Idrisov, Manami Inoue, Farhad Islami, Troy Jacobs, Kathryn H. Jacobsen, Nader Jahanmehr, Mihajlo Jakovljević, Peter James, Henrica A. F. M. Jansen, Mehdi Javanbakht, Sudha 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 Karema, Chanté Karimkhani, Palitha Karunapema, Amir Kasaeian, Nicholas J Kassebaum, Anil Kaul, Norito Kawakami, Jeanne Françoise Kayibanda, Peter Njenga Keiyoro, Laura Kemmer, Andrew H. Kemp, André Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Khader, Abdur Rahman Khan, Ejaz Ahmad Khan, Gulfaraz Khan, Young‐Ho Khang, Tawfik 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, Barthélémy Kuate Defo, Ricardo Kuchenbecker, Ernst J. Kuipers, Xie Rachel Kulikoff, Veena S. Kulkarni, G Anil Kumar, Gene F. Kwan, Hmwe Hmwe Kyu, Aparna Lal, Dharmesh Kumar Lal, Ratilal Lalloo, Hilton Y. Lam, Qing Lan, Sinéad Langan, Anders Larsson, Dennis Odai Laryea, Asma Latif, Janet L Leasher, James Leigh, Mall Leinsalu, Janni Leung, Ricky Leung, Miriam Levi, Li Y, Yongmei Li, Margaret L. Lind, Shai Linn, Steven E. Lipshultz, Patrick Y Liu, Shiwei Liu, Yang Liu, Belinda Lloyd, Loon-Tzian Lo, Giancarlo Logroscino, Paulo A. Lotufo, Robyn Lucas, Raimundas Lunevičius, Mohammed Magdy Abd El Razek, Carlos Magis‐Rodríguez, Mahdi Mahdavi, Marek Majdán, Azeem Majeed, Reza Malekzadeh, Déborah Carvalho Malta, Chabila C Mapoma, David Joel Margolis, Randall V. Martin, José Martı́nez-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 Mekonnen, Yohannes Adama Melaku, Peter Memiah, Ziad A. Memish, Walter Mendoza, Gert Mensink, Atte Meretoja, Tuomo J Meretoja, Yonatan Moges Mesfin, Francis Mhimbira, Renata Micha, Ted R. Miller, Edward J Mills, Mojde Mirarefin, Awoke Misganaw, Philip B. Mitchell, Charles Mock, Alireza Mohammadi, Shafiu Mohammed, Lorenzo Monasta, Jonathan de la Cruz Monis, Julio Cesar Montañez Hernandez, Marcella Montico, Maziar Moradi‐Lakeh, Lídia Morawska, Rintaro Mori, Ulrich Müeller, Michele E Murdoch, Brighton Murimira, Joseph Murray, Gudlavalleti Venkata Satyanarayana Murthy, Srinivas Murthy, Kamarul Imran Musa, Jean B. Nachega, Gabriele Nagel, Kovin Naidoo, Luigi Naldi, Vinay Nangia, Bruce Neal, Chakib Nejjari, Charles R. Newton, John Newton, Frida Ngalesoni, Peter Nguhiu, Grant Nguyen, Quyen Le Nguyen, Muhammad Imran Nisar, Patrick Martial Nkamedjie Pete, Sandra Nolte, Marika Nomura, Ole Frithjof Norheim, Bo Norrving, Carla Makhlouf Obermeyer, Felix Akpojene Ogbo, In‐Hwan Oh, Olanrewaju Oladimeji, Pedro R. Olivares, Bolajoko O. Olusanya, Jacob Olusegun Olusanya, John Nelson Opio, Eyal Oren, Alberto Ortíz, Richard H. Osborne, Erika Ota, Mayowa Owolabi, P A Mahesh, Eun‐Kee Park, Hye-Youn Park, Charles Parry, Mahboubeh Parsaeian, Tejas Patel, Vikram Patel, Angel J Paternina Caicedo, Snehal T Patil, Scott B. Patten, George Patton, Deepak Paudel, João Mário Pedro, David M. Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael Phillips, Frédéric B. Piel, Julian David Pillay, Christine Pinho, Farhad Pishgar, Suzanne Polinder, Richie 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, Saša Rajšić, Murugesan Raju, Usha Ram, Saleem M Rana, Chhabi Lal Ranabhat, Kavitha Ranganathan, Puja C Rao, Amany Refaat, Marissa B Reitsma, Giuseppe Remuzzi, Serge Resnikoff, Antônio Luiz Pinho Ribeiro, María Jesús Ríos-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 Sanabria, João Vasco Santos, Damian Santomauro, Itamar S Santos, Rodrigo Sarmiento-Suárez, Benn Sartorius, Maheswar Satpathy, Miloje Savic, Monika Sawhney, Susan M. Sawyer, Josef Schmidhuber, María Inês Schmidt, Ione Jayce Ceola Schneider, Aletta E. Schutte, David C. Schwebel, Soraya Seedat, Sadaf G Sepanlou, Edson Serván‐Mori, Katya Anne 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 Dóra Sigfúsdóttir, Naris Silpakit, Diego Augusto Santos Silva, Jonathan I. Silverberg, Edgar P. Simard, Shireen Sindi, Abhishek Singh, Gitanjali 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 Sunguya, Patrick John Sur, Soumya Swaminathan, Bryan L. Sykes, Cassandra Szoeke, Rafael Tabarés‐Seisdedos, Karen M. Tabb, Roberto Tchio Talongwa, Mohammed Rasoul Tarawneh, Mohammad Tavakkoli, Bineyam Taye, Hugh R. Taylor, Bemnet Tedla, Worku Tefera, Teketo Kassaw Tegegne, Dejen Yemane, Girma Temam Shifa, Abdullah Sulieman Terkawi, Gizachew Assefa Tessema, JS Thakur, A. J. Thomson, Andrew Thorne‐Lyman, Amanda G. Thrift, George D. Thurston, Taavi Tillmann, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topór-Mądry, Fotis Topouzis, Bach Xuan Tran, Thomas Truelsen, Zacharie Tsala Dimbuene, Abera Kenay Tura, E. 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, Lennert Veerman, Narayanaswamy Venketasubramanian, Raj Kumar Verma, Francesco Saverio Violante, Vasily Vlassov, Patricia Volkow-Fernández, Stein Emil Vollset, Gregory R. Wagner, Mitchell T. Wallin, Linhong Wang, Valentine Wanga, David Watkins, Scott Weichenthal, Elisabete Weiderpass, Robert G Weintraub, Daniel J. Weiss, Andrea Werdecker, Ronny Westerman, Harvey Whiteford, James D. Wilkinson, Charles Shey Wiysonge, Charles 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 - The Lancet 2016 cited by 625

BACKGROUND: In 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). METHODS: We 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. FINDINGS: =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. INTERPRETATION: GBD 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. FUNDING: Bill & Melinda Gates Foundation.