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2 STATUS OF THE

HEALTH-RELATED SDGs

WHO/Hans Everts
Overview many countries, weak health systems remain an obstacle to
progress and result in deficiencies in coverage for even the
More than 50 SDG indicators, across more than 10 goals, most basic health services, as well as poor preparedness
have been selected to measure health outcomes, direct for health emergencies. Based on the latest available data,
determinants of health or health-service provision. These the global and regional situation in relation to the above
health-related indicators may be grouped into the following seven thematic areas is summarized below. Country-
seven thematic areas: specific findings by indicator, where available, are presented
graphically in Annex A and in tabular form in Annex B.
• reproductive, maternal, newborn and child health
• infectious diseases 2.1 Reproductive, maternal, newborn and
• noncommunicable diseases and mental health child health
• injuries and violence
• universal health coverage and health systems Worldwide, approximately 830 women died every single
• environmental risks day due to complications during pregnancy or childbirth
• health risks and disease outbreaks. in 2015 (1). Reducing the global maternal mortality ratio
(MMR) from 216 per 100 000 live births in 2015 to less
Available data indicate that despite the progress made than 70 per 100 000 live births by 2030 (SDG Target
during the MDG era major challenges remain in terms 3.1) will require a global annual rate of reduction of at
of reducing maternal and child mortality, improving least 7.5% – which is more than triple the annual rate of
nutrition, and making further progress in the battle against reduction that was achieved between 1990 and 2015 (2).
communicable diseases such as HIV/AIDS, tuberculosis Most maternal deaths are preventable as the necessary
(TB), malaria, neglected tropical diseases and hepatitis. medical interventions are well known. It is therefore crucially
Furthermore, the results of situation analyses provide important to increase women’s access to quality care
clear evidence of the crucial importance of addressing before, during and after childbirth. In 2016, millions of births
NCDs and their risk factors – such as tobacco use, mental globally were not assisted by a trained midwife, doctor or
health problems, road traffic injuries and environmental nurse, with only 78% of births were in the presence of a
conditions – within the sustainable development agenda. In skilled birth attendant (3).

MONITORING HEALTH FOR THE SDGs 29

In the same individual treatment and care for dracunculiasis. The global under-five mortality rate in 2015 was 43 per The greatest decrease was achieved in the WHO European 1000 live births. were an estimated 10.In 2016.1 million people died of HIV-related African trypanosomiasis and visceral leishmaniasis than illnesses. trachoma and/or onchocerciasis. In the same year. Globally. globally.6 billion people required mass or children (27 million) were found in the WHO South-East individual treatment and care for neglected tropical diseases Asia Region. with the number of indigenous cases being reduced 19 per 1000 live births – representing declines of 44% to zero in 2015. Most overweight children under the age of five increased globally of these people required mass treatment for lymphatic by 33% (7). 2. translating into an incidence rate of 94 per 1000 persons at risk – a 41% decrease from the rate in 2000.2) (13).2 million with a modern contraceptive method. a reported 1. an estimated 36. there were an estimated 212 million malaria cases 2015 was 44.4 million TB deaths. Global coverage with three age). deaths globally. WPR EUR The number of global deaths in 2015 attributable to hepatitis l l l l l l 0 20 40 60 80 100 is estimated to be in the order of 1. Both the highest prevalence of wasting (15. In 2015.3 eight countries respectively.3 per 1000 live births) despite being a treatable and curable disease. an estimated 257 million people were living with hepatitis B Globally in 2016. This finding highlights the persistence of large inequities in EMR access to high-quality diagnostic and treatment services. In 2015. with 4. In 2015.1 per 1000 adolescent girls aged 15–19 years (5). while the neonatal mortality rate was Region.4 million new TB cases and 1. However. with the heaviest burden borne by the Newborn deaths represented half or more of all deaths WHO African Region – where an estimated 92% of all among children under 5 years of age in all WHO regions in deaths occurred – and by children under 5 years of age. in 36 countries the prevalence was highest (34%) in the WHO African Region estimated coverage was less than 80% (Figure 2.1 million people were estimated to have become under surveillance for verification of elimination in 18 and newly infected with HIV in 2015. people were living with HIV. Globally.4 million deaths resulting Figure 2. only half of women in the WHO African Region did (4). by WHO region.1 from TB among HIV-positive people. 18. with an additional 0. there that year – almost double the global rate (6). The WHO African Region 30 WORLD HEALTH STATISTICS: 2017 . human year. The WHO African Region also had the Tuberculosis (TB) remains a major global health problem. and the WHO South-East Asia Region. While nine out of 10 people living with HIV were on antiretroviral therapy by women in the WHO Western Pacific Region had their family mid 2016 (8). soil-transmitted helminthiases.0 billion people in 2010. SEAR The WHO European Region had the highest incidence rate AMR of multidrug. the adolescent birth rate in In 2015. 52 million wasted (too light for their height) and doses of hepatitis B vaccine (a priority intervention) reached 41 million overweight (too heavy for their height). highest under-five mortality rate (81. planning need satisfied. the number of (NTDs) – down from 2. schistosomiasis.4% of adults married or in-union had their family planning need met aged 15–49 years living with HIV.7 million ever before (14).3%) and number of wasted In 2015. there were 155 million children under virus infection. This figure Mortality rate (per 1000 live births) includes deaths from acute hepatitis.3 million (11). The progress made in reducing the number of people requiring mass treatment 2. liver cancer due to hepatitis and cirrhosis due to hepatitis.1). the TB case Under-five mortality rates by age at death. 77% of women of reproductive age who were remains the most severely affected. Between 2000 and 2016. an estimated 1. fewer people required new infections per 1000 uninfected people. filariasis. At the end of 2015.2 Infectious diseases has been driven in large part by the fact that lymphatic filariasis and trachoma have either been eliminated or are Globally.or rifampicin-resistant TB (MDR/RR-TB) at 14 per 100 000 population (10). and 71 million people were living with the age of five who were stunted (too short for their hepatitis C virus infection (12). There were an estimated 429 000 malaria and 37% respectively compared to the rates in 2000. Stunting 84% among infants in 2015. who 2015 with the exception of the WHO African Region where accounted for more than 70% of all deaths (9). one third of under-five deaths occurred after the first month of life (Figure 2. representing a rate of 0. 2015 fatality rate (calculated as mortality divided by incidence) Neonatal Post-neonatal varied widely – from under 5% in some countries to more AFR than 20% in most countries in the WHO African Region.

they remain far Low. 17.and middle-income countries (LMIC). accounting for 70% of the overall total of 56 million High-income countries deaths. while mortality rates from the other 0– main NCDs have fallen at a slower pace.3) (11). 250 – 3.4 litres of pure alcohol per person aged 15 years or older.and middle-income countries higher than rates in high-income countries (Figure 2. namely: cardiovascular disease. or 59%) Not applicable 0 750 1500 3000 Kilometres 2. 1.6 million deaths 200 – (4%). an estimated 40 million deaths occurred due to Cancers Chronic respiratory diseases NCDs. The majority of such deaths were caused by the four 350 – main NCDs. 2000–2015 Cardiovascular diseases Diabetes mellitus In 2015. The risk of dying from any one of the four main 150 – NCDs between ages 30 and 70 decreased from 23% in 2000 to 19% in 2015. 100 – standardized cardiovascular mortality rates have declined 50 – rapidly in recent years. or 16%) 80–89 (35 countries.7 million 300 – deaths (accounting for 45% of all NCD deaths). l l l l standardized cardiovascular mortality rates and chronic 2000 2005 2010 2015 respiratory mortality rates have improved substantially in low. and diabetes. though further work is needed to improve the measurement of such coverage.3 Noncommunicable diseases and mental Figure 2.2 Hepatitis B third-dose (HepB3) immunization coverage among one-year olds (%). In high-income countries. or 5%) ≥90 (114 countries. 200 – Available data indicate that treatment coverage for alcohol 150 – and drug-use disorders is inadequate. 2015 Coverage (%) <50 (6 countries. Age-standadized mortality rate (per 100 000 population) 8. with considerable variation between WHO regions (15). cancer. or 3%) 50–79 (30 countries. by country income groups. The WHO Framework Convention on MONITORING HEALTH FOR THE SDGs 31 . age. more than 1. chronic respiratory disease.3 health Global trends in age-standardized mortality rate by NCD cause.1 billion people smoked tobacco.8 million deaths (22%).9 million deaths (10%). or 18%) Data not available/HepB not introduced (9 countries. 350 – 300 – The worldwide level of alcohol consumption in 2016 was Age-standadized mortality rate (per 100 000 population) 250 – 6. Although age.Figure 2. 0– with far more males than females currently engaging in l l l l 2000 2005 2010 2015 this behaviour (16). 100 – 50 – In 2015.

provide the first comparable set of SDG monitoring figures for developing an index for use as a measure of financial During the period 2011–2015.a.1 and 3.8 on UHC began in February 2017. the global annual average protection. As a result. 32 WORLD HEALTH STATISTICS: 2017 . This measure indicates the level of Around 1. health and social aged 15–29 years and disproportionately affect vulnerable protection).2 since 2005.1 per 100 000 systems population) and lowest in the WHO Eastern Mediterranean Region (3.4 Injuries and violence Eastern Mediterranean Region to 13.4 acute conditions. the current landscape of health research and development (see section 1. global coverage of three doses of diphtheria- four fifths of all homicide victims being male. corresponding to around 0. Regionally.8 per 100 000 population) (11). maternal. SDG indicator 3. This estimate does not include control laws and regulations or have adopted new ones. respectively – will partner sexual violence at some point in their life (19). 12 times 2007–2014 show that the median availability of selected the rate among men in the WHO Western Pacific Region essential medicines in the public sector was only 60% in (Figure 2. during the period 2000–2015 there selected low-income countries and 56% in selected lower- was a marked decline (19%) in homicide rates (11). was 86% (13).2 on the proportion of total government traffic injuries are the main cause of death among people spending on essential services (education. newborn and child health.1 – Coverage of essential health services – is defined as the average 5— coverage of essential services based on tracer interventions that include reproductive. estimates Latest estimates indicate that globally almost one quarter of the SDG indicators 3. Globally. as a proxy for full WHO Region of the Americas suffered the highest rate of immunization among children.8. Men in the tetanus-pertussis (DTP3) vaccine. Homicide rates by sex. Access to medicines for chronic conditions and NCDs is even worse than that for Figure 2. The WHO Western Pacific Region had with 50% of countries having at least one data source for the highest rate at 0. Between 2000 and 2013 the number of road traffic deaths Consultations with WHO Member States on estimating globally increased by approximately 13% (17).8. In 2015.6% in the WHO Region of the Americas (20). middle-income countries (21).5 deaths per 100 000 population (11). services (11).5) is Mortality rate (per 100 000 population) 30 — insufficiently aligned with global health demands and needs. Tobacco Control has now been ratified by 180 Parties It is estimated that in 2015. Suicide mortality rates 2.8. with up to 50 million people sustaining non-fatal for public sector operations in a country. by WHO region and globally. Once completed. poor nutrition and collapse of health Almost 800 000 deaths by suicide occurred in 2015. there were an estimated 468 000 murders. making it the second leading cause of death by injury after road traffic injuries. WHO regions 15 — with the highest burden of disease expressed in disability- 10 — 1 SDG indicator 3. More than 80% in wars and conflicts. 152 000 people were killed representing 90% of the global population.8% in the WHO 2.3% of of Parties have either strengthened their existing tobacco all global deaths that year. and is part of injuries as a result of road traffic collisions or crashes.7% in 2014. Data from homicide deaths at 32. As shown in Figure 2. cyclists and motorcyclists.5. road users.5 Universal health coverage and health are highest in the WHO European Region (14. deaths due to the indirect effects of war and conflict on the spread of diseases. noncommunicable diseases 0— and service capacity and access. Despite improvements in recent decades.9 per 100 000 population. countries have data since 2010 for death rate due to natural disasters was 0. 25 — Health workforce densities are also distributed unevenly 20 — across the globe.8. namely pedestrians.4). infectious diseases. The average national percentage of total government expenditure devoted to health was 11.1 100 000 population.3 deaths per around 70% of tracer indicators within SDG indicator 3. such average ranged from 8.25 million people died from road traffic injuries government spending on health within the total expenditure in 2013.2 – coverage of essential of adults (23%) suffered physical abuse as a child (18) health services. with In 2015. among the general and the most disadvantaged AFR AMR SEAR EUR EMR WPR Global populations. Men are almost twice as likely as women to die as a result of suicide. 2015 the development of innovative new products remains Male Female focused away from the health needs of those living in 35 — developing countries. the SDG indicators needed to monitor SDG Target 3. Road SDG indicator 1.1.8. and the proportion of population with and about one third (35%) of women experienced either large household expenditures on health as a share of physical and/or sexual intimate partner violence or non. total household expenditure or income. On average.

health workforce required to deliver much-needed health drugs.5 million deaths (11.6 Global mortality rate due to unintentional poisonings. Even in higher among men than among women across all age countries with higher national health worker densities. with preliminary estimates of 68% coverage in urban areas and only 20% in rural areas (30.0 — information provided on cause of death (11.6) (11). crop wastes. accounting for 60% of process involved the use of a self-assessment questionnaire all deaths attributed to such pollution (25).0 — above). 0– l l l l l l l l l 0 100 200 300 400 500 600 700 800 An estimated 108 000 deaths were caused by unintentional Disability-adjusted life years (per 1000 population) poisonings in 2015.5 — States register at least 80% of deaths. indoor and outdoor air pollution caused an estimated 1 Includes deaths from diarrhoea. with an estimated 871 000 associated deaths occurring in 2012. unsafe sanitation and lack of hygiene also Regional health workforce density. using wood. intestinal nematode infections and protein-energy 6. Jointly. The use of such inefficient fuels and technologies leads to high levels of household air pollution. sent to States Parties to assess the implementation status of 13 core capacities. Data from 2005–2015 show that around 40% of home. Mortality rates are also and midwifery personnel per 1000 population (23). with rural and hard-to-reach areas tending to be understaffed compared Figure 2. WHO estimates that only half of its 194 Member Mortality rate (per 100 000 population) 3. 40 – WPR Around one third of the world population (32%) did not have EMR access to improved sanitation facilities in 2015. 2005–2015.6 Environmental risks 0.5 — 0— 0–4 5–14 15–29 30–59 60+ Around 3 billion people still heat their homes and cook Age (years) using solid fuels (that is. In addition. 92% of the world population was living in places States Parties) responded to the monitoring questionnaire.0 — information. kerosene.6 billion people used an improved drinking-water source (per 100 000 population) AMR 80 – in 2015 the coverage of safely managed drinking-water 60 – services remains low. pesticides.3 million deaths globally. the groups (Figure 2.5 — 1. The number deaths attributed to this cause are countries have less than one physician per 1000 population highest among children under 5 years of age and among and around half of all countries have less than three nursing adults aged 60  years or older. 24).5 Unsafe water. estimated to have caused 3 million deaths worldwide in 2012. 129 States Parties (66% of all In 2014. Women and children are at particularly high risk of disease caused by The International Health Regulations (IHR) monitoring exposure to household air pollution. workforce is often inequitably distributed. 33).5 — data-quality problems further limit the use of such 2. household chemicals and carbon monoxide are all common causes of such poisoning. Some 87% of these deaths occurred in LMIC (26). Male Female In the area of monitoring and evaluation (see section 1. Although Skilled health professionals density 6. In high-income countries. 2. malnutrition attributable to lack of access to WASH services. The average core capacity scores of all reporting countries Outdoor air pollution in both cities and rural areas was in 2016 was 76% (32. charcoal.Figure 2.1 Such deaths 120 – disproportionately occur in low-income communities and EUR 100 – among children under 5 years of age (28. In LMIC. 29). MONITORING HEALTH FOR THE SDGs 33 . 31).0 — 2. by age and sex. such household air 2. and estimated total burden of disease.1 4. coal or dung) in open fires and leaky stoves. In 2012. the adjusted life years (22) also have the lowest densities of substances involved primarily include carbon monoxide. 2010 remain important causes of death.7 Health risks and disease outbreaks pollution caused 4. including 20 – SEAR AFR 946 million people who practised open defecation (30). and cleaning and personal-care products in the services. with associated 3. 1. In 2016. where WHO air quality guideline standards were not met. 2015 to capital cities and other urban areas.6% of all global deaths) in 2012 (27).

org/sites/default/files/ FULLREPORT_EN. int/neglected_diseases/preventive_chemotherapy/databank/ 2015 (http://www. World Health Organization. New York (NY): United Nations. accessed 22 March 2017). Global Health Observatory (GHO) data.int/phe/publications/air-pollution-global-assessment/en/.who. Preventive chemotherapy and transmission control (PCT) UNICEF. Global. S0140673615008387.html.int/violence_injury_ prepared for estimates by WHO region. Population Division.un.who. World Bank Group and the United Nations databank. 2015 (http://www. Geneva: World Health Organization. Millennium Development Goal 8: taking stock of the global www. 2017 update 17.int/malaria/publications/world-malaria. Gemmill et Geneva: World Health Organization (http://www. Estimates by WHO region were calculated by WHO. 2016 (http://www. but it can be.who. Global hepatitis report. accessed 23 March 2017). int/iris/bitstream/10665/204717/1/9789241565233_eng. accessed 22 March 2017). Geneva: World Sept_15. Estimates and projections of family planning indicators 2016. 2016. World Bank and United Nations.pdf . Levels & Trends in Child Mortality. country and by region.who.shtml. 2. 2015 (http://apps. London School of Hygiene & Tropical Social Affairs.int/reproductivehealth/publications/ Estimation. Report 2015.int/healthinfo/global_ 25. Lancet. Population Division.who. New York (NY): United Nations. am/10665/250441/1/9789241565394-eng. United Nations Office on Drugs and Social Affairs. partnership for development.int/healthinfo/mortality_data/en/) as of 12 October 11. media_asset/AIDS-by-the-numbers-2016_en. accessed 18 April 2016). accessed 22 March 2017). United Nations Children’s Fund. burden_disease/estimates/en/index1. accessed 22 March 2017). accessed 23 March 2017). age. with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality 16. Geneva: World Health Organization (http://who.pdf. WHO Global Health Workforce Statistics.who.who. 9. 7. 2016 (see: http:// 13. and national levels and trends in maternal alcohol/en/).html.int/reproductivehealth/publications/ en/).pdf. 3. 2015 (www. Geneva: World Health Organization.who. sex. World Population Prospects. New York (NY): United Nations. 2016 (http://apps. 2000–2015.who. Global Health Estimates 2015: DALYs by cause. 22. 24. WHO/UNICEF estimates of national immunization coverage. Trends in maternal mortality: 1990 to 2015. 2017 (http:// 21. accessed 23 March 2017). Geneva: World Health Organization (http://www.who.who. accessed 23 March 2017). Department of Economic and 19. 2016 (http://apps.pdf. 2015 (http://esa.int/hepatitis/publications/global- hepatitis-report2017/en/. Neglected tropical diseases [online database]. Chou D.who.int/immunization/monitoring_ accessed 23 March 2017). WHO global database on maternal health indicators. 2017. and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non- 6. Geneva: World Health Organization. accessed 13 April 2016). 2014 update [online 10. Geneva: World Health Organization. estimates/en/index2. 74 (http://www. Global status report on road safety 2015. Geneva: World Health Organization. accessed 23 March 2017). UNFPA.un.int/healthinfo/global_burden_disease/ 2016 (http://www. Burning opportunity: clean household energy for health.int/nutgrowthdb/database/en). Global en/development/desa/population/theme/family-planning/cp_ status report on violence prevention 2014. Global Health Observatory (GHO) data. accessed 23 March 2017). accessed 17 April 2017).int/nha/database/Select/ Indicators/en. Global database on child growth and malnutrition [online database]. 2015 (http://www.thelancet.int /iris/bitstre hrh/statistics/hwfstats/en/). monitoring/maternal-mortality-2015/en/. New York (NY): United Nations Children’s Fund.who. Zhang S.387(10017):462– 2015. Unweighted averages of country-specific data from WHO Global publications/files/Child_Mortality_Report_2015_Web_9_ Health Expenditure Database [online database]. surveillance/routine/coverage/en/index4. Organization. Estimates partner sexual violence. age. Health Organization (http://apps.int/gho/maternal_health/en/). 2016 (http://www. Moller A-B. 23. MDG Gap Task Force Report 2015. regional. the 2015 Revision (DVD edition). Department of Economic and 18. by country and by region.pdf?ua=1. report-2016/report/en/. mortality between 1990 and 2015.int/violence_injury_ www. 15. accessed 23 March 2017). July who. Population Division. Global Health Estimates 2015: Deaths by cause.com/pb/assets/raw/Lancet/pdfs/ int/iris/bitstream/10665/156262/1/9789241564922_eng. accessed 22 March 2017). accessed 23 March 2017).org/ Crime and United Nations Development Programme.unicef. Geneva: World Health [online database]. Geneva: World Health model.int/gho/neglected_diseases/en/). Geneva: World Health database]. Global wpp/Download/Standard/Fertility/.who.who. and the 1.who. WHO Global Information System on Alcohol and Health (GISAH) [online database]. 2015 (http://www. Geneva: World Health Organization (http://www. Estimates by WHO. prevention/road_safety_status/2015/en/. Ambient air pollution: a global assessment of exposure and burden of disease. Geneva: World Health Organization. sex.pdf. accessed 22 March 2017). Geneva: World Health Organization (http:// Organization. AIDS by the numbers: AIDS is not over. World Health Organization. Geneva: development/desa/policy/mdg_gap/mdg_gap2015/2015GAP_ UNAIDS. 26.html. Hogan D. Global tuberculosis report 2016.org/ 20. Geneva: World Health Organization. accessed 22 March sustainable development.who. World Health violence/9789241564625/en/.who.int/ Organization. 2015 (see: http://www. 2014 (see: http://www. Alkema L.org/unpd/ Medicine and South African Medical Research Council.org/en/ 8. 4. Special tabulations were Organization. 2017 (http://www. Geneva: World Health Organization. 34 WORLD HEALTH STATISTICS: 2017 .unaids. World Malaria Report 2016.References 14.pdf. 2016 revision (http://www. Geneva: World Health Organization.int/gho/ al. Geneva: World Health Organization. 2000–2015. and wellbeing of women and children. prevention/violence/status_report/2014/en/. developed by the UN Inter-agency Group for Child Mortality 2013 (http://www.un. 12. WHO global report on trends in prevalence of tobacco smoking Estimation Inter-Agency Group. 2017).who. by 2016. Based on data reported to the WHO Mortality Database (http:// www. 5. accessed 22 March 2017).

New York (NY): UNICEF. 30. Progress on sanitation and drinking water – 2015 update and MDG assessment. and Geneva: World Health Organization. A global assessment of the burden of disease from environmental risks. International Health Regulations (2005) Monitoring Framework Geneva: World Health Organization. data/view. 28.int/gho/ accessed 23 March 2017). Preventing disease through healthy environments. pdf?ua=1&ua=1. Preventing diarrhoea through better water. sanitation and hygiene.who. Hutton. The costs of meeting the 2030 Sustainable Observatory (GHO) data. 29.who.main. Geneva: World Health Organization (http://www.int/gho/ hygiene. G.SDGAIRBODREGv?lang=en. Washington (DC): World Bank.27.int/iris/ bitstream/10665/177752/1/9789241509145_eng. 2015 (http://apps.int/gho/phe/en/ and http://apps. Public health and environment [online database]. States Parties to the International Health Regulations (2005) Exposures and impacts in low. accessed 10 Aprié worldbank. 2016 (http://documents. Geneva: World Health Organization Development Goals targets on drinking water. accessed 23 March 2017).who. sanitation and (http://www.pdf.and middle-income countries. iris/bitstream/10665/204585/1/9789241565196_eng.who. Global Health 31. Geneva: World Health Organization (http://www. accessed 10 April 2017). int/ihr/legal_issues/states_parties/en/. 32. accessed 24 April 2017). 33.pdf?ua=1. MONITORING HEALTH FOR THE SDGs 35 . accessed 23 March 2017). ihr/en/). int/iris/bitstream/10665/150112/1/9789241564823_eng.who. 2014 (http://apps.who. Global Health Observatory (GHO) data.who. Geneva: World Health Organization.int/ [online database]. 2016 (http://apps. [website].pdf?ua=1.org/curated/en/415441467988938343/pdf/103171- 2017) PUB-Box394556B-PUBLIC-EPI-K8543-ADD-SERIES. Varughese M.