“Evidence before this study
“Measuring country progress on the UN’s Sustainable Development Goals (SDGs) has been an important international priority since the SDGs were introduced in 2015. The UN, the Sustainable Development Solutions Network, WHO, and the World Bank also report on the SDGs, but their analyses do not consistently measure indicators for each location and year. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2015 estimated 33 health-related SDG indicators and the overall health-related SDG index from 1990 to 2015 for 188 countries. In GBD 2016, the number of indicators included was expanded to 37, and projections of health-related SDG achievement in 2030 were estimated for the first time. The ability of decision makers, particularly at the national level, to adequately monitor progress on the health-related SDGs and budget and plan for the future is potentially hampered by the scarcity of disaggregated data, such as by subnational unit, sex, and socioeconomic level. Complete estimates of SDG progress at these levels are needed to identify, and target programmes to, the populations that are most at risk of falling behind.

“Added value of this study
“GBD 2017 provides consistent, comparably generated estimates of the health-related SDG indicators for 195 countries and territories from 1990 to 2017. Additionally, GBD 2017 provides, for the first time, estimates of health-related SDGs at the subnational level for select countries and by sex. Newly estimated indicators in GBD 2017 include health worker density per 1000 population (SDG indicator 3.c.1), sexual violence by non-intimate partners (SDG indicator 5.2.2), and population census status (SDG indicator 17.19.2a), as well as disaggregation of SDG indicator 16.1.3 into prevalence of physical violence (SDG indicator 16.1.3a) and sexual violence (SDG indicator 16.1.3c) following the March, 2018, refinements accepted by the UN Statistical Commission. Measurement improvements included reporting on prevalence of current smoking rather than of daily smoking to better align with the UN’s definition and internally consistent, systematic estimation of adolescent birth rates within the broader GBD study. We used a forecasting platform that systematically captures the effects of independent drivers of population health into the future to generate projections through 2030. On the basis of past trends, we assessed country-level probabilities of attainment for SDG indicators with defined targets. We also calculated the rates of change required to meet defined SDG targets at the global level from 2015 to 2030, and then compared them to annualised rates of change observed at the country level from 1990 to 2015; this analysis provided a way of benchmarking the pace of progress needed to meet ambitious SDG aims with what the world has achieved in the past. We then applied the mean percentile of the global required rates of change to all SDG indicators, providing a historically grounded foundation to evaluate progress for indicators without explicit targets and the relative feasibility of current ones.

“Implications of all the available evidence
“Most countries were projected to improve their health-related SDG index scores by 2030, although our results revealed gaps in potential progress at and beyond the national level. This information is urgently needed to inform strategies for attaining SDG targets, which for many countries will require rates of progress that are faster than rates achieved in the recent past. Most countries already have national action plans in place for, and are in a better position to meet indicator targets that have origins in, the Millennium Development Goals, whereas the SDGs have not been similarly operationalised in many national policies. In the remaining years of the SDG era, it is crucial that governments and international institutions invest in and implement SDG-related programmes and continue to monitor inequalities in the health-related SDGs within populations to truly deliver on the promise of leaving no one behind.”

Source: GBD 2017 SDG Collaborators. “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.” Lancet (London, England) vol. 392,10159 (2018): 2091-2138. doi:10.1016/S0140-6736(18)32281-5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6227911/