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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 Publisher Pubmed



Lozano R1, 3, 705 ; Fullman N1 ; Abate D22 ; Abay SM25 ; Abbafati C32 ; Abbasi N52, 57 ; Abbastabar H40 ; Abdallah F60 ; Abdela J20 ; Abdelalim A60 ; Abdelrahman O61, 65 ; Abdi A75 ; Abdollahpour I84, 85 ; Abdulkader RS86 Show All Authors
Authors
  1. Lozano R1, 3, 705
  2. Fullman N1
  3. Abate D22
  4. Abay SM25
  5. Abbafati C32
  6. Abbasi N52, 57
  7. Abbastabar H40
  8. Abdallah F60
  9. Abdela J20
  10. Abdelalim A60
  11. Abdelrahman O61, 65
  12. Abdi A75
  13. Abdollahpour I84, 85
  14. Abdulkader RS86
  15. Abebe ND30
  16. Abebe Z92
  17. Abejie AN98
  18. Abera SF221, 243
  19. Abil OZ265, 274
  20. Aboyans V275, 276
  21. Abraha HN111
  22. Abrham AR18
  23. Aburaddad LJ277
  24. Aburmeileh NM278
  25. Abyu GY199, 279
  26. Accrombessi MMK283
  27. Acharya D284, 285
  28. Acharya P287
  29. Adamu AA288, 291
  30. Adebayo OM295
  31. Adedeji IA296
  32. Adedoyin RA297
  33. Adekanmbi V298
  34. Adetokunboh OO288, 291
  35. Adhena BM221
  36. Adhikari TB299, 300
  37. Adib MG301
  38. Adou AK302
  39. Adsuar JC303
  40. Afarideh M45
  41. Afshari M305
  42. Afshin A1, 2
  43. Agarwal G306
  44. Aghayan SA308, 309
  45. Agius D310
  46. Agrawal A312, 313
  47. Agrawal S318, 319
  48. Ahmadi A66
  49. Ahmadi M323
  50. Ahmadieh H329, 331
  51. Ahmed MB336
  52. Ahmed S342, 345
  53. Akalu TY88
  54. Akanda AS351
  55. Akbari ME326
  56. Akibu M352
  57. Akinyemi RO354
  58. Akinyemiju T355
  59. Akseer N358
  60. Alahdab F359, 360
  61. Alaly Z361, 362
  62. Alam K366
  63. Alam T1
  64. Albujeer A367
  65. Alebel A96
  66. Alene KA93, 369
  67. Aleyadhy A372
  68. Alhabib S374
  69. Ali R375, 378
  70. Alijanzadeh M381
  71. Alizadehnavaei R388
  72. Aljunid SM395, 396
  73. Alkerwi A397
  74. Alla F398
  75. Allebeck P350, 399
  76. Allen CA1
  77. Almasi A67
  78. Almaskari F400, 401
  79. Almekhlafi HM402, 404
  80. Alonso J405, 406
  81. Alraddadi RM407
  82. Alsharif U410
  83. Altirkawi K373
  84. Alvisguzman N411, 412
  85. Amare AT282, 413
  86. Amenu K24
  87. Amini E43
  88. Ammar W418, 421
  89. Anber NH422, 423
  90. Anderson JA1
  91. Andrei CL428
  92. Androudi S429
  93. Animut MD431
  94. Anjomshoa M41
  95. Ansari H432
  96. Ansariadi A433
  97. Ansha MG353
  98. Antonio CAT434
  99. Anwari P436
  100. Appiah LT437, 438
  101. Aremu O439
  102. Areri HA29
  103. Arnlov J348, 440
  104. Arora M315, 441
  105. Aryal KK442
  106. Asayesh H443
  107. Asfaw ET177
  108. Asgedom SW210
  109. Asghar RJ444
  110. Assadi R446
  111. Ataro Z17
  112. Atique S447, 448
  113. Atre SR450, 456
  114. Atteraya MS458
  115. Ausloos M460
  116. Avilaburgos L11
  117. Avokpaho EFGA283, 461
  118. Awasthi A318, 463
  119. Quintanilla BPA467, 468
  120. Ayele HT56, 469
  121. Ayele Y20
  122. Ayer R470
  123. Azarpazhooh MR476
  124. Azzopardi PS414, 477
  125. Azzopardimuscat N311, 478
  126. Babalola TK479, 481
  127. Babazadeh A483
  128. Badali H383
  129. Badawi A356, 485
  130. Balakrishnan K486
  131. Bali AG21
  132. Banach M487, 488
  133. Banerjee A494
  134. Banoub JAM496, 497
  135. Banstola A498
  136. Barac A499, 501
  137. Barboza MA504, 506
  138. Barkercollo SL508
  139. Barnighausen TW511, 514
  140. Barrero LH521
  141. Barthelemy CM1
  142. Bassat Q522, 526
  143. Basu A527
  144. Basu S529
  145. Battista RJ530
  146. Baune BT531
  147. Baynes HW94
  148. Bazarganhejazi S532, 533
  149. Bedi N403, 534
  150. Beghi E536
  151. Behzadifar M544, 548
  152. Behzadifar M544, 548
  153. Bejot Y550, 551
  154. Bekele BB93
  155. Belachew AB221, 552
  156. Belay AG144
  157. Belay SA554
  158. Belay YA97
  159. Bell ML556
  160. Bello AK557
  161. Bennett DA378
  162. Bensenor IM560
  163. Benzian H566
  164. Berhane A30
  165. Berhe AK567, 568
  166. Berman AE569, 570
  167. Bernabe E572
  168. Bernstein RS576, 578
  169. Bertolacci GJ1
  170. Beuran M427
  171. Beyranvand T547
  172. Bhala N579, 580
  173. Bhalla A581
  174. Bhansali A584
  175. Bhattarai S591, 592
  176. Bhaumik S594
  177. Bhutta ZA357, 595
  178. Biadgo B87
  179. Biehl MH1
  180. Bijani A604
  181. Bikbov B538
  182. Bililign N607
  183. Sayeed MSB368, 608
  184. Birlik SM610, 611
  185. Birungi C495, 613
  186. Bisanzio D614, 615
  187. Biswas T617
  188. Bitew H210
  189. Bizuneh H619
  190. Bjertness E622
  191. Bobasa EM340, 624
  192. Boufous S632
  193. Bourne R633
  194. Bozorgmehr K634
  195. Bragazzi NL635
  196. Brainin M636
  197. Brant LC641
  198. Brauer M1, 643
  199. Brazinova A645
  200. Breitborde NJK647, 648
  201. Briant PS1
  202. Britton G649, 652
  203. Brugha T459
  204. Bukhman G515, 653
  205. Busse R409
  206. Butt ZA643, 654
  207. Cahuanahurtado L11
  208. Callender CSKH1
  209. Camposnonato IR16
  210. Rincon JCC16, 655
  211. Cano J586
  212. Car J656, 662
  213. Car M660, 665
  214. Cardenas R666
  215. Carrero JJ346
  216. Carter A1
  217. Carvalho F667, 670
  218. Castanedaorjuela CA673, 676
  219. Rivas JC503, 505
  220. Castro F651
  221. Causey K1
  222. Cavlin A678
  223. Cercy KM1
  224. Cerin E679, 682
  225. Chaiah Y684
  226. Chalek J1
  227. Chang HY686
  228. Chang JC687
  229. Chattopadhyay A688
  230. Chattu VK693, 694
  231. Chaturvedi P695
  232. Chiang PPC696
  233. Chin KL698
  234. Chisumpa VH702, 703
  235. Chitheer A704
  236. Choi JYJ705
  237. Chowdhury R706
  238. Christensen H708
  239. Christopher DJ712
  240. Chung SC490, 713
  241. Cicuttini FM700
  242. Ciobanu LG714
  243. Cirillo M718
  244. Claro RM639
  245. Claen TKD719, 720
  246. Cohen AJ1, 722
  247. Colladomateo D304, 724
  248. Cooper C726, 727
  249. Cooper LT728
  250. Cornaby L1
  251. Cortinovis M537
  252. Costa M729, 730
  253. Cousin E732
  254. Cromwell EA1, 3
  255. Crowe CS9
  256. Cunningham M1
  257. Daba AK733
  258. Dadi AF93, 736
  259. Dandona L1, 318
  260. Dandona R1, 318
  261. Dang AK737
  262. Dargan PI574, 739
  263. Daryani A393
  264. Das SK740
  265. Das Gupta R741
  266. Das Neves J668, 669
  267. Dasa TT19
  268. Dash AP743
  269. Davis AC492, 661
  270. Davitoiu DV425, 744
  271. Davletov K745
  272. Dayama A746
  273. De Courten B699, 747
  274. De Leo D748
  275. Neve JWD511
  276. De Steur H750
  277. Degefa MG166
  278. Degenhardt L1, 628
  279. Degfie TT753
  280. Deiparine S1
  281. Dellavalle RP754, 755
  282. Demoz GT31, 756
  283. Demtsu B232
  284. Denovagutierrez E12
  285. Deribe K30, 758
  286. Dervenis N759, 760
  287. Dessie GA96
  288. Dey S761
  289. Dharmaratne SD1, 762
  290. Dhimal M763
  291. Dicker D1
  292. Dinberu MT352
  293. Ding EL516
  294. Djalalinia S765
  295. Do HP737
  296. Dokova K767
  297. Doku DT769, 771
  298. Douwesschultz D1
  299. Driscoll TR774
  300. Duan L777
  301. Dubey M779
  302. Dubljanin E501
  303. Duken EE254, 339
  304. Duncan BB732
  305. Duraes AR781, 782
  306. Ebrahimpour S483
  307. Edvardsson D466, 783
  308. El Bcheraoui C3
  309. Eldrenkamp E1
  310. Elkhatib Z2, 350
  311. Elyazar IRF784
  312. Enayati A392
  313. Endries AY785
  314. Eshrati B764
  315. Eskandarieh S51
  316. Esteghamati A45
  317. Esteghamati S45
  318. Estep K1
  319. Fakhar M394
  320. Fakhim H786
  321. Fanzo J449, 787
  322. Faramarzi M606
  323. Fareed M788
  324. Farhadi F547
  325. Farid TA790
  326. Farinha CSES791
  327. Farioli A609
  328. Faro A792
  329. Farvid MS516
  330. Farzadfar F52
  331. Farzaei MH72, 79
  332. Farzam H83
  333. Fazaeli AA795
  334. Fazeli MS530
  335. Feigin VL1, 796
  336. Feigl AB514, 797
  337. Fekadu W27, 280
  338. Feldman R1
  339. Fentahun N281
  340. Fereshtehnejad SM58, 349
  341. Fernandes E671
  342. Fernandes JC798
  343. Feyissa GT337
  344. Fijabi DO799, 800
  345. Filip I616, 801
  346. Finegold S1
  347. Finger JD802
  348. Fischer F721
  349. Fitzmaurice C1, 8
  350. Flor LS803, 804
  351. Foigt NA805
  352. Foreman KJ1
  353. Frank TD1
  354. Franklin RC806
  355. Fukumoto T807, 808
  356. Fukutaki K1
  357. Fuller JE1
  358. Furst T809, 810
  359. Furtado JM564
  360. Gakidou E1
  361. Gallus S535
  362. Gankpe FG462, 811
  363. Gansevoort RT812
  364. Garcia AC814, 815
  365. Garciabasteiro AL523, 525
  366. Garciagordillo MA723
  367. Gardner WM1
  368. Gebre AK210
  369. Gebre T816
  370. Gebregergs GB221
  371. Gebrehiwot TT336
  372. Gebremedhin AT338, 817
  373. Gebremichael B23
  374. Gebremichael TG210
  375. Gelano TF22
  376. Geleijnse JM818
  377. Geramo YCD430
  378. Getachew S26, 819
  379. Gething PW376
  380. Gezae KE122
  381. Ghadami MR81
  382. Ghadimi R601
  383. Ghadiri K83
  384. Ghasemikasman M601
  385. Ghiasvand H821
  386. Ghimire M823
  387. Ghoshal AG824, 825
  388. Giampaoli S826, 827
  389. Gill PS89
  390. Gill TK714
  391. Giussani G536
  392. Gnedovskaya EV829
  393. Goldberg EM1
  394. Goli S692, 830
  395. Gona PN832
  396. Goodridge A650
  397. Gopalani SV833, 834
  398. Gorman TM1
  399. Goto A835
  400. Goulart AC558, 565
  401. Goulart BNG732
  402. Grada A836
  403. Griswold MG1
  404. Grosso G837
  405. Gugnani HCC838, 839
  406. Guillemin F840
  407. Guimaraes ALS841
  408. Guo Y700
  409. Gupta PC519, 842
  410. Gupta R843, 844
  411. Gupta R843, 844
  412. Gupta T847, 849
  413. Ha GH737
  414. Haagsma JA850
  415. Hachinski V475, 851
  416. Hafezinejad N53, 455
  417. Bidgoli HH493
  418. Hagos TB99
  419. Haile MT618
  420. Hailegiyorgis TT22
  421. Hailu GB100
  422. Hajmirzaian A42
  423. Hajmirzaian A42
  424. Hamadeh RR852
  425. Hamidi S853
  426. Hankey GJ365, 854
  427. Harb HL856
  428. Harikrishnan S858
  429. Haririan H862
  430. Haro JM863, 864
  431. Hasan M741
  432. Hassankhani H862, 865
  433. Hassen HY552, 866
  434. Havmoeller R867
  435. Hawley CN1
  436. Hay SI1, 3
  437. He Y1
  438. Hedayatizadehomran A394
  439. Hegazy MI60
  440. Heibati B540
  441. Heidari B868
  442. Heidari M869
  443. Hendrie D817
  444. Henok A553
  445. Herediapi I11
  446. Herteliu C870
  447. Heydarpour B871
  448. Heydarpour F76
  449. Heydarpour S83
  450. Hibstu DT734
  451. Hijar M16, 872
  452. Hoek HW813, 873
  453. Hoffman DJ875
  454. Hole MK876
  455. Homaie Rad E877, 878
  456. Hoogar P879
  457. Horita N880, 884
  458. Hosgood HD848
  459. Hosseini SM39
  460. Hosseinzadeh M886, 887
  461. Hostiuc M425, 888
  462. Hostiuc S426, 889
  463. Hotez PJ314
  464. Hoy DG775
  465. Hsairi M890
  466. Hsiao T1
  467. Hu G891
  468. Huang JJ555
  469. Hughes C892
  470. Huynh CK1
  471. Igumbor EU893, 894
  472. Ikeda CT1
  473. Ilesanmi OS895
  474. Iqbal U897
  475. Irvani SSN52, 332
  476. Irvine CMS1
  477. Islam SMS773, 900
  478. Islami F902
  479. Ivers RQ593
  480. Izadi N328
  481. Jacobsen KH903
  482. Jahangiry L861
  483. Jahanmehr N333, 334
  484. Jain SK904
  485. Jakovljevic M1, 905
  486. Jalu MT22
  487. Jamal AA370
  488. James SL1
  489. Jassal SK363, 906
  490. Javanbakht M907
  491. Jayatilleke AU908, 909
  492. Jeemon P857
  493. Jha RP910
  494. Jha V380, 594
  495. Ji JS912
  496. Johnson CO1
  497. Johnson SC1
  498. Jonas JB510, 914
  499. Jonnagaddala J631, 915
  500. Shushtari ZJ822
  501. Joshi A916
  502. Jozwiak JJ921, 922
  503. Jungari SB923
  504. Jurisson M924
  505. Madhanraj K1157
  506. Kabir Z926
  507. Kadel R571
  508. Kahsay A166
  509. Kahssay M927
  510. Kalani R5
  511. Kapil U871
  512. Karami M794
  513. Matin BK77
  514. Karanikolos M585, 928
  515. Karimi N385, 390
  516. Karimi SM929
  517. Karimisari H930, 933
  518. Kasaeian A46, 47
  519. Kassa DH96
  520. Kassa GM95
  521. Kassa TD111
  522. Kassa ZY735
  523. Kassebaum NJ1, 934
  524. Katikireddi SV935
  525. Kaul A936, 937
  526. Kawakami N473
  527. Kazemi Z766
  528. Karyani AK77
  529. Kazi DS938, 939
  530. Prakash KC770
  531. Kebede S940
  532. Keiyoro PN941
  533. Kemmer L1
  534. Kemp GR1, 944
  535. Kengne AP947, 948
  536. Keren A952, 953
  537. Kesavachandran CN954
  538. Khader YS955
  539. Khafaei B956
  540. Khafaie MA321
  541. Khajavi A327
  542. Khalid N957
  543. Khalil IA1, 3
  544. Khan EA958
  545. Khan MS959, 960
  546. Khan MA964, 966
  547. Khang YH967, 968
  548. Khanna T831, 969
  549. Khater MM59
  550. Khatony A83
  551. Khazaeipour Z33
  552. Khazaie H71
  553. Khoja AT453, 789
  554. Khosravi A766
  555. Khosravi MH931, 973
  556. Khubchandani J974
  557. Kiadaliri AA975
  558. Kiarie HW977
  559. Kibret GD97
  560. Kiirithio DN978, 979
  561. Kim D980
  562. Kim JY1
  563. Kim YE981
  564. Kim YJ982
  565. Kimokoti RW983
  566. Kinfu Y984
  567. Kinra S590
  568. Kisa A620, 985
  569. Kissimovaskarbek K986
  570. Kissoon N642
  571. Kivimaki M489, 988
  572. Kocarnik JM1, 990
  573. Kochhar S2, 850
  574. Kokubo Y991
  575. Kolola T353
  576. Kopec JA644, 992
  577. Kosek MN454
  578. Kosen S993
  579. Koul PA994
  580. Koyanagi A863
  581. Kravchenko MA829
  582. Krishan K995
  583. Krohn KJ1
  584. Defo BK996, 997
  585. Kucuk Bicer B677, 998
  586. Kudom AA768
  587. Kulikoff XR1
  588. Kumar GA318
  589. Kumar M491, 943
  590. Kumar P692
  591. Kutz MJ1
  592. Kyu HH1, 3
  593. Lachat C751
  594. Lad DP581
  595. Lad SD582
  596. Lafranconi A999
  597. Lagat AK1000, 1002
  598. Lal DK318
  599. Lalloo R626
  600. Lam H882
  601. Lami FH1003
  602. Lamichhane P901
  603. Lan Q1004
  604. Lang JJ484
  605. Lansingh VC1005, 1006
  606. Lansky S1007
  607. Larson HJ1, 588
  608. Larsson AO1008, 1009
  609. Laryea DO1010
  610. Lassi ZS716
  611. Latifi A1011
  612. Lau KMM1
  613. Laxmaiah A971
  614. Lazarus JV522
  615. Leasher JL1013
  616. Lebedev G1014, 1017
  617. Ledesma JR1
  618. Lee JB1
  619. Lee PH1018
  620. Leever AT1
  621. Leigh J772
  622. Leinsalu M1019, 1020
  623. Leshargie CT97
  624. Leung J627
  625. Lewycka S376, 1021
  626. Li S700
  627. Li X1022
  628. Li Y1023
  629. Liang J1024, 1025
  630. Liang X778
  631. Liben ML927
  632. Lim LL1026, 1027
  633. Limenih MA93
  634. Linn S1028
  635. Liu S1029
  636. Liu Y577
  637. Lodha R919
  638. Logroscino G1030, 1031
  639. Lopez AD1, 1036
  640. Lorkowski S1037, 1038
  641. Lotufo PA561
  642. Lucchesi LR1
  643. Lyons RA1039
  644. Macarayan ERK435, 512
  645. Mackay MT1033, 1041
  646. Maddison ER1
  647. Madotto F999
  648. Maghavani DP1042
  649. Magisrodriguez C674
  650. Mahotra NB1043
  651. Majdan M1044
  652. Majdzadeh R37, 50
  653. Majeed A660
  654. Malekzadeh R44, 1045
  655. Malta DC637
  656. Mamun AA623
  657. Manda AL1046
  658. Mandaranofilho LG559
  659. Mangalam S1047, 1048
  660. Manguerra H1
  661. Mansournia MA39
  662. Mapoma CC702
  663. Maravilla JC623
  664. Marcenes W573
  665. Marks A1
  666. Martin RV1049
  667. Martins SCO731, 1050
  668. Martinsmelo FR1051
  669. Martopullo I1
  670. Mashambathompson TP479
  671. Massenburg BB9
  672. Mathur MR318, 489
  673. Maulik PK594, 629
  674. Mazidi M1052
  675. Mcalinden C1053
  676. Mcgrath JJ625, 1054
  677. Mckee M587
  678. Mcmahon BJ4, 1055
  679. Mehata S1056
  680. Mehndiratta MM1057
  681. Mehrotra R1058
  682. Mehta KM938
  683. Mehta V1059
  684. Mejiarodriguez F16
  685. Mekonen T280
  686. Mekonnen TCC1063
  687. Meles HG232
  688. Melese A1064
  689. Melku M93
  690. Memiah PTN1065
  691. Memish ZA684, 1060
  692. Mendoza W1066
  693. Mengistu DT188
  694. Mengistu G20, 1062
  695. Mensah GA881, 948
  696. Mensink GBM802
  697. Mereta ST335
  698. Meretoja A1034, 1068
  699. Meretoja TJ989, 1067
  700. Mestrovic T1069, 1070
  701. Mezgebe HB1071
  702. Miazgowski B1073, 1075
  703. Miazgowski T1072
  704. Millear AI1
  705. Miller TR817, 1076
  706. Millerpetrie MK1, 925
  707. Milne GJ364
  708. Mini GK857
  709. Minnig SP1077, 1078
  710. Mirabi P600
  711. Mirarefin M1079
  712. Mirrakhimov EM1080, 1081
  713. Misganaw AT1, 3
  714. Mitchell PB630
  715. Moazen B511, 1082
  716. Moghadamnia AA347, 606
  717. Mohajer B51, 52
  718. Mohammad KA1083, 1084
  719. Mohammadi M387
  720. Mohammadifard N1085
  721. Mohammadniaafrouzi M599
  722. Mohammed MA775, 1086
  723. Mohammed S511, 1089
  724. Mohan MBV1090
  725. Mohan V1091
  726. Mohebi F48, 52
  727. Moitra M1
  728. Mokdad AH1, 3
  729. Molokhia M574
  730. Monasta L1092
  731. Montanez JC685
  732. Moosazadeh M389
  733. Moradi G1093, 1094
  734. Moradi M73
  735. Moradilakeh M546
  736. Moradinazar M80
  737. Moraga P1095
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Source: The Lancet Published:2018


Abstract

Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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