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UK fifth in world for health-related sustainable development goals

But doing relatively poorly on HIV, smoking, alcohol, suicide, obesity and pollution targets

Louise Prime

Thursday, 22 September 2016

Although the UK is ranked fifth overall in the world in making progress towards the United Nations’ health-related sustainable development goals (SDG), it is doing relatively poorly on some of the indicators – notably those relating to HIV, smoking, alcohol, suicide, overweight and air pollution.

The UN General Assembly established the SDGs in September 2015, to replace the millennium development goal (MDG) framework that expired last year; the SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. The authors of the latest assessment* of progress, published today in The Lancet, have compared 33 health-related SDG indicators across 188 countries.

They reported that on many measures – such as reducing under-5 and neonatal mortality, family planning, and the rollout of universal health care – good progress has been made since 2000 towards some of the health-related SDGs. But improvement is not universal. Hepatitis B incidence rates have improved only minimally; and childhood overweight, intimate partner violence, and harmful alcohol consumption have worsened.

They also found that, largely, a country’s health-related SDGs are well predicted by its sociodemographic index (a combination of income per capita, educational attainment, and overall fertility rate). However, some countries had considerably lower SDG index scores than would be predicted by their sociodemographic index alone. The US is ranked only 28th overall, just above Estonia and New Zealand (its worst performing indicators were violence, HIV and self-harm), Russia 119th (its worst measures were for alcohol consumption, self-harm and violence) and India 143rd (hygiene, malaria and particulate matter pollution).

Taking into account progress on all 33 health-related SDGs, the UK was ranked fifth in the world, with an overall score of 82 (out of a maximum possible 100); but against certain SDG measures, it did relatively poorly, scoring only 51 for HIV, 55 for smoking, 57 for alcohol, 64 each for suicide and overweight, and 65 for particulate matter pollution.

The study authors said their findings showed that although income, education, and fertility are important drivers for health improvement globally, investments in these areas alone will not be sufficient. They also pointed out that that gains made on the health-related MDG indicators will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets.

They concluded: “These results should ideally be used as the basis for review and action at the country level. We hope that this collaboration is a major contribution to creating a culture of accountability for the SDGs. Other actors, especially governments, civil society organisations, donors, and global development institutions, need to participate in the process of using this information to enhance accountability through open and transparent review and action.”

However, in her accompanying comment**, Devi Sridhar, professor of global health at the University of Edinburgh, questioned whether the SDG index is even relevant and useful to donors, academics, governments in middle- and low-income countries, and poor communities. She said that donors such as the US, UK and the Gates Foundation, like to see that money invested in health has directly improved progress. But she argued that for poor communities themselves the answer is probably not, as they may prefer to determine their own health priorities based on their values and needs.

She concluded: “Whether we like it or not, the SDGs have been agreed on. The best we can do is to acknowledge … that they are mostly vague, largely immeasurable, somewhat attainable, and definitely relevant, and then put together the smartest minds and resources to communicate their importance through one index.”

* GBD 2015 SDG Collaborators. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. The Lancet, published online 21 September 2016. DOI: 10.1016/S0140-6736(16)31467-2

** Sridhar D. Making the SDGs useful: a Herculean task. The Lancet, published online 21 September 2016. DOI: 10.1016/S0140-6736(16)31635-X

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