good health and well being sustainable development goals essay

UNICEF Data : Monitoring the situation of children and women

GOAL 3: GOOD HEALTH AND WELL-BEING

Ensure healthy lives and promote well-being for all at all ages.

Goal 3 aims to ensure healthy lives and promote well-being for all, at all ages. Health and well-being are important at every stage of one’s life, starting from the beginning. This goal addresses all major health priorities: reproductive, maternal, newborn, child and adolescent health; communicable and non-communicable diseases; universal health coverage; and access for all to safe, effective, quality and affordable medicines and vaccines.

SDG 3 aims to prevent needless suffering from preventable diseases and premature death by focusing on key targets that boost the health of a country’s overall population. Regions with the highest burden of disease and neglected population groups and regions are priority areas. Goal 3 also calls for deeper investments in research and development, health financing and health risk reduction and management.

UNICEF’s role in contributing to Goal 3 centres on healthy pregnancies ( maternal mortality and skilled birth attendant), healthy childhoods (under-five and neonatal mortality) as well as vaccine coverage. UNICEF also contributes to monitoring elements of the universal health coverage indicator.

UNICEF is custodian for global monitoring of two indicators that measure progress towards Goal 3 as it relates to children: Indicator 3.2.1 Under-five mortality rate and Indicator 3.2.2 Neonatal mortality rate. UNICEF is also co-custodian for Indicator 3.1.2 Proportion of births attended by skilled health personnel and for Indicator 3.b.1 Proportion of the target population covered by all vaccines included in their national programme.

Child-related SDG indicators

Target 3.1 by 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births, maternal mortality ratio (number of maternal deaths per 100,000 live births).

• Indicator definition
• Computation method
• Comments & limitations

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Maternal mortality refers to deaths due to complications from pregnancy or childbirth. Accurate measurement of maternal mortality remains challenging and many deaths still go uncounted. Many countries still lack well functioning civil registration and vital statistics (CRVS) systems, and where such systems do exist, reporting errors – whether incompleteness (unregistered deaths, also known as “missing”) or misclassification of cause of death – continue to pose a major challenge to data accuracy.

The maternal mortality ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period. It depicts the risk of maternal death relative to the number of live births and essentially captures the risk of death in a single pregnancy or a single live birth.

Maternal deaths: The annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, expressed per 100,000 live births, for a specified time period.

Maternal death: The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management (from direct or indirect obstetric death), but not from accidental or incidental causes.

Pregnancy-related death: The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death. Late maternal death: The death of a woman from direct or indirect obstetric causes, more than 42 days, but less than one year after termination of pregnancy

The maternal mortality ratio can be calculated by dividing recorded (or estimated) maternal deaths by total recorded (or estimated) live births in the same period and multiplying by 100,000. Measurement requires information on pregnancy status, timing of death (during pregnancy, childbirth, or within 42 days of termination of pregnancy), and cause of death. The maternal mortality ratio can be calculated directly from data collected through vital registration systems, household surveys or other sources. There are often data quality problems, particularly related to the underreporting and misclassification of maternal deaths. Therefore, data are often adjusted in order to take these data quality issues into account. Some countries undertake these adjustments or corrections as part of specialized/confidential enquiries or administrative efforts embedded within maternal mortality monitoring programmes.

For countries with data available on maternal mortality, the expected proportion of non-HIV- related maternal deaths was based on country and regional random effects, whereas for countries with no data available, predictions were derived using regional random effects only.

Estimation of HIV-related indirect maternal deaths For countries with generalized HIV epidemics and high HIV prevalence, HIV/AIDS is a leading cause of death during pregnancy and post-delivery. There is also some evidence from community studies that women with HIV infection have a higher risk of maternal death, although this may be offset by lower fertility. If HIV is prevalent, there will also be more incidental HIV deaths among pregnant and postpartum women. When estimating maternal mortality in these countries, it is, thus, important to differentiate between incidental HIV deaths (non-maternal deaths) and HIV-related indirect maternal deaths (maternal deaths caused by the aggravating effects of pregnancy on HIV) among HIV-positive pregnant and postpartum women who have died (i.e. among all HIV-related deaths occurring during pregnancy, childbirth and puerperium).

For observed PMs, we assumed that the total reported maternal deaths are a combination of the proportion of reported non-HIV-related maternal deaths and the proportion of reported HIV- related (indirect) maternal deaths, where the latter is given by a*v for observations with a “pregnancy-related death” definition and a*v*u for observations with a “maternal death” definition.

The extent of maternal mortality in a population is essentially the combination of two factors:

1. The risk of death in a single pregnancy or a single live birth. 2. The fertility level (i.e. the number of pregnancies or births that are experienced by women of reproductive age).

The maternal mortality ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period. It depicts the risk of maternal death relative to the number of live births and essentially captures (1) above.

By contrast, the maternal mortality rate (MMRate) is calculated as the number of maternal deaths divided by person-years lived by women of reproductive age. The MMRate captures both the risk of maternal death per pregnancy or per total birth (live birth or stillbirth), and the level of fertility in the population.

In addition to the MMR and the MMRate, it is possible to calculate the adult lifetime risk of maternal mortality for women in the population. An alternative measure of maternal mortality, the proportion of deaths among women of reproductive age that are due to maternal causes (PM), is calculated as the number of maternal deaths divided by the total deaths among women aged 15–49 years.

Related Statistical measures of maternal mortality:

Maternal mortality ratio (MMR): Number of maternal deaths during a given time period per 100,000 live births during the same time period.

Maternal mortality rate (MMRate): Number of maternal deaths divided by person-years lived by women of reproductive age.

Adult lifetime risk of maternal death: The probability that a 15-year-old woman will die eventually from a maternal cause.

The proportion of deaths among women of reproductive age that are due to maternal causes (PM): The number of maternal deaths in a given time period divided by the total deaths among women aged 15–49 years.

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Skilled birth attendant – Proportion of births attended by skilled health personnel

• Sources of discrepancies

Having a skilled health care provider at the time of childbirth is an important lifesaving intervention for both women and newborns. Not having access to this key assistance is detrimental to women’s and newborns’ health because it could cause adverse health outcomes such as the death of the women and/or the newborns or long lasting morbidity. Achieving universal coverage is therefore essential for reducing maternal and newborn mortality and morbidity.

Proportion of births attended by skilled health personnel (generally doctors, nurses or midwives but can refer to other health professionals providing childbirth care) is the proportion of childbirths attended by skilled health personnel. According to the current definition (1) these are competent maternal and newborn health (MNH) professionals educated, trained and regulated to national and international standards.

They are competent to:

(i) provide and promote evidence-based, human-rights based, quality, socio-culturally sensitive and dignified care to women and newborns;

(ii) facilitate physiological processes during labour and delivery to ensure a clean and positive childbirth experience; and

(iii) identify and manage or refer women and/or newborns with complications.

Discrepancies are possible if there are national figures compiled at the health facility level. These would differ from the global figures, which are typically based on survey data collected at the household level. In terms of survey data, some survey reports may present a total percentage of births attended by a skilled health professional that does not conform to the MDG definition (e.g., total includes provider that is not considered skilled, such as a community health worker). In that case, the percentage delivered by a physician, nurse, or a midwife are totalled and entered into the global database as the MDG estimate. In some countries where skilled attendant at birth is not available, birth in a health facility (institutional births) is used instead. This is frequent among Latin American countries, where the proportion of institutional births is very high. Nonetheless, it should be noted that institutional births may underestimate the percentage of births with skilled attendant.

TARGET 3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

Under-five mortality rate.

Mortality rates among young children are a key output indicator for child health and well-being, and, more broadly, for social and economic development. This is a closely watched public health indicator because it reflects the access of children and communities to basic health interventions such as vaccination, medical treatment of infectious diseases and adequate nutrition.

Probability of dying between birth and exactly 5 years of age, expressed per 1,000 live births

The under-five mortality rate as defined here is, strictly speaking, not a rate (i.e. the number of deaths divided by the number of population at risk during a certain period of time), but a probability of death derived from a life table and expressed as a rate per 1000 live births.

The UN Inter-agency Group for Child Mortality Estimation (UN IGME) estimates are derived from national data from censuses, surveys or vital registration systems. The UN IGME does not use any covariates to derive its estimates. It only applies a curve fitting method to good-quality empirical data to derive trend estimates after data quality assessment. In most cases, the UN IGME estimates are close to the underlying data. The UN IGME aims to minimize the errors for each estimate, harmonize trends over time and produce up-to-date and properly assessed estimates. The UN IGME applies the Bayesian B-splines bias-reduction model to empirical data to derive trend estimates of under-five mortality for all countries. See references for details.

For the underlying data mentioned above, the most frequently used methods are as follows:

Civil registration: The under-five mortality rate can be derived from a standard period abridged life table using the age-specific deaths and mid-year population counts from civil registration data to calculate death rates, which are then converted into age-specific probabilities of dying.

Census and surveys: An indirect method is used based on a summary birth history, a series of questions asked of each woman of reproductive age as to how many children she has ever given birth to and how many are still alive. The Brass method and model life tables are then used to obtain an estimate of under-five and infant mortality rates. Censuses often include questions on household deaths in the last 12 months, which can be used to calculate mortality estimates.

Surveys: A direct method is used based on a full birth history, a series of detailed questions on each child a woman has given birth to during her lifetime. Neonatal, post-neonatal, infant, child and under-five mortality estimates can be derived from the full birth history module.

The UN IGME estimates are derived based on national data. Countries often use a single source as their official estimates or apply methods different from the UN IGME methods to derive estimates. The differences between the UN IGME estimates and national official estimates are usually not large if empirical data has good quality.

Many countries lack a single source of high-quality data covering the last several decades. Data from different sources require different calculation methods and may suffer from different errors, for example random errors in sample surveys or systematic errors due to misreporting. As a result, different surveys often yield widely different estimates of under-five mortality for a given time period and available data collected by countries are often inconsistent across sources. It is important to analyse, reconcile and evaluate all data sources simultaneously for each country. Each new survey or data point must be examined in the context of all other sources, including previous data. Data suffer from sampling or non-sampling errors (such as misreporting of age and survivor selection bias; underreporting of child deaths is also common). UN IGME assesses the quality of underlying data sources and adjusts data when necessary. Furthermore, the latest data produced by countries often are not current estimates but refer to an earlier reference period. Thus, the UN IGME also projects estimates to a common reference year. In order to reconcile these differences and take better account of the systematic biases associated with the various types of data inputs, the UN IGME has developed an estimation method to fit a smoothed trend curve to a set of observations and to extrapolate that trend to a defined time point. The UN IGME aims to minimize the errors for each estimate, harmonize trends over time and produce up-to-date and properly assessed estimates of child mortality. In the absence of error-free data, there will always be uncertainty around data and estimates. To allow for added comparability, the UN IGME generates such estimates with uncertainty bounds. Applying a consistent methodology also allows for comparisons between countries, despite the varied number and types of data sources. UN IGME applies a common methodology across countries and uses original empirical data from each country but does not report figures produced by individual countries using other methods, which would not be comparable to other country estimates.

Neonatal mortality rate

The neonatal mortality rate is the probability that a child born in a specific year or period will die during the first 28 completed days of life if subject to age-specific mortality rates of that period, expressed per 1000 live births.

Neonatal deaths (deaths among live births during the first 28 completed days of life) may be subdivided into early neonatal deaths, occurring during the first 7 days of life, and late neonatal deaths, occurring after the 7th day but before the 28th completed day of life.

The UN Inter-agency Group for Child Mortality Estimation (UN IGME) estimates are derived from nationally representative data from censuses, surveys or vital registration systems. The UN IGME does not use any covariates to derive its estimates. It only applies a curve fitting method to good-quality empirical data to derive trend estimates after data quality assessment. In most cases, the UN IGME estimates are close to the underlying data. The UN IGME aims to minimize the errors for each estimate, harmonize trends over time and produce up-to-date and properly assessed estimates. The UN IGME produces neonatal mortality rate estimates with a Bayesian spline regression model which models the ratio of neonatal mortality rate / (under-five mortality rate – neonatal mortality rate). Estimates of NMR are obtained by recombining the estimates of the ratio with the UN IGME-estimated under-five mortality rate. See the references for details.

Civil registration: Number of children who died during the first 28 days of life and the number of births used to calculate neonatal mortality rates.

Censuses and surveys: Censuses and surveys often include questions on household deaths in the last 12 months, which can be used to calculate mortality estimates.

Many countries lack a single source of high-quality data covering the last several decades. Data from different sources require different calculation methods and may suffer from different errors, for example random errors in sample surveys or systematic errors due to misreporting. As a result, different surveys often yield widely different estimates of neonatal mortality for a given time period and available data collected by countries are often inconsistent across sources. It is important to analyse, reconcile and evaluate all data sources simultaneously for each country. Each new survey or data point must be examined in the context of all other sources, including previous data. Data suffer from sampling or non-sampling errors (such as misreporting of age and survivor selection bias; underreporting of child deaths is also common). UN IGME assesses the quality of underlying data sources and adjusts data when necessary. Furthermore, the latest data produced by countries often are not current estimates but refer to an earlier reference period. Thus, the UN IGME also projects estimates to a common reference year. In order to reconcile these differences and take better account of the systematic biases associated with the various types of data inputs, the UN IGME has developed an estimation method to fit a smoothed trend curve to a set of observations and to extrapolate that trend to a defined time point. The UN IGME aims to minimize the errors for each estimate, harmonize trends over time and produce up-to-date and properly assessed estimates of child mortality. In the absence of error-free data, there will always be uncertainty around data and estimates. To allow for added comparability, the UN IGME generates such estimates with uncertainty bounds. Applying a consistent methodology also allows for comparisons between countries, despite the varied number and types of data sources. UN IGME applies a common methodology across countries and uses original empirical data from each country but does not report figures produced by individual countries using other methods, which would not be comparable to other country estimates.

TARGET 3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

Estimated incidence rate (new hiv infection per 1,000 uninfected population).

This indicator is used to measure progress towards ending the AIDS epidemic. The overarching goal of the global AIDS response is to reduce the number of people newly infected to fewer than 500,000 in 2020 and fewer than 200,000 in 2030. Monitoring the rate of people newly infected over time measures the progress towards achieving this goal. Disaggregation by sex, age and key populations is important to characterize how the epidemic is evolving, to monitor equity of access to services and to support the planning of programme responses in specific age groups such as children under five, adolescents and young adults, as well as key populations.

Annual number of new HIV infections per 1,000 uninfected population

Longitudinal data on individuals are the best source of data but are rarely available for large populations. Special diagnostic tests in surveys or from health facilities can be used to obtain data on HIV incidence. HIV incidence is thus modelled using the Spectrum software.

Malaria incidence per 1,000 population

This indicator is used to measure trends in malaria morbidity and to identify locations where the risk of disease is highest. With this information, programmes can respond to unusual trends, such as epidemics, and direct resources to the populations most in need. This data also serves to inform global resource allocation for malaria such as when defining eligibility criteria for Global Fund finance.

Incidence of malaria is defined as the number of new cases of malaria per 1,000 people at risk each year.

Case of malaria is defined as the occurrence of malaria infection in a person whom the presence of malaria parasites in the blood has been confirmed by a diagnostic test. The population considered is the population at risk of the disease.

Malaria incidence (1) is expressed as the number of new cases per 100,000 population per year with the population of a country derived from projections made by the UN Population Division and the total proportion at risk estimated by a country’s National Malaria Control Programme. More specifically, the country estimates what is the proportion at high risk (H) and what is the proportion at low risk (L) and the total population at risk is estimated as UN Population x (H + L).

The total number of new cases, T, is estimated from the number of malaria cases reported by a Ministry of Health which is adjusted to take into account (i) incompleteness in reporting systems (ii) patients seeking treatment in the private sector, self-medicating or not seeking treatment at all, and (iii) potential over-diagnosis through the lack of laboratory confirmation of cases. The procedure, which is described in the World malaria report 2009 (2), combines data reported by NMCPs (reported cases, reporting completeness and likelihood that cases are parasite positive) with data obtained from nationally representative household surveys on health-service use.

𝑇=( a + (𝑐 × 𝑒) ⁄ 𝑑) × (1 + h ⁄𝑔 + ((1−𝑔−h)/2) ⁄ 𝑔)

where: a is malaria cases confirmed in public sector b is suspected cases tested c is presumed cases (not tested but treated as malaria) d is reporting completeness e is test positivity rate (malaria positive fraction) = a/b f is cases in public sector, calculated by (a + (c x e))/d g is treatment seeking fraction in public sector h is treatment seeking fraction in private sector i is the fraction not seeking treatment, calculated by (1-g-h)/2 j is cases in private sector, calculated by f x h/g k is cases not in private and not in public, calculated by f x i/g T is total cases, calculated by f + j + k.

To estimate the uncertainty around the number of cases, the test positivity rate was assumed to have a normal distribution centred on the Test positivity rate value and standard deviation defined as 0.244 × Test positivity rate 0.5547 and truncated to be in the range 0, 1.

Reporting completeness was assumed to have one of three distributions, depending on the range or value reported by the NMCP. -If the range was greater than 80% the distribution was assumed to be triangular, with limits of 0.8 and 1 and the peak at 0.8. – If the range was greater than 50% then the distribution was assumed to be rectangular, with limits of 0.5 and 0.8. -Finally, if the range was lower than 50% the distribution was assumed to be triangular, with limits of 0 and 0.5 and the peak at 0.5 (3).

If the reporting completeness was reported as a value and was greater than 80%, a beta distribution was assumed with a mean value of the reported value (maximum of 95%) and confidence intervals (CIs) of 5% round the mean value.

The proportions of children for whom care was sought in the private sector and in the public sector were assumed to have a beta distribution, with the mean value being the estimated value in the survey and the standard deviation calculated from the range of the estimated 95% confidence intervals (CI) divided by 4. The proportion of children for whom care was not sought was assumed to have a rectangular distribution, with the lower limit 0 and upper limit calculated as 1 minus the proportion that sought care in public or private sector.

Values for the proportion seeking care were linearly interpolated between the years that have a survey, and were extrapolated for the years before the first or after the last survey. Missing values for the distributions were imputed using a mixture of the distribution of the country, with equal probability for the years where values were present or, if there was no value at all for any year in the country, a mixture of the distribution of the region for that year. The data were analysed using the R statistical software.

Confidence intervals were obtained from 10000 drawns of the convoluted distributions. (Afghanistan, Bangladesh, Bolivia (Plurinational State of), Botswana, Brazil, Cambodia, Colombia, Dominican Republic, Eritrea, Ethiopia, French Guiana, Gambia, Guatemala, Guyana, Haiti, Honduras, India, Indonesia, Lao People’s Democratic Republic, Madagascar, Mauritania, Mayotte, Myanmar, Namibia, Nepal, Nicaragua, Pakistan, Panama, Papua New Guinea, Peru, Philippines, Rwanda, Senegal, Solomon Islands, Timor-Leste, Vanuatu, Venezuela (Bolivarian Republic of), Viet Nam, Yemen and Zimbabwe. For India, the values were obtained at subnational level using the same methodology, but adjusting the private sector for an additional factor due to the active case detection, estimated as the ratio of the test positivity rate in the active case detection over the test positivity rate for the passive case detection. This factor was assumed to have a normal distribution, with mean value and standard deviation calculated from the values reported in 2010. Bangladesh, Bolivia, Botswana, Brazil, Cabo Verde, Colombia, Dominican Republic, French Guiana, Guatemala, Guyana, Haiti, Honduras, Myanmar (since 2013), Rwanda, Suriname and Venezuela (Bolivarian Republic of) report cases from the private and public sector together; therefore, no adjustment for private sector seeking treatment was made.

For some high-transmission African countries the quality of case reporting is considered insufficient for the above formulae to be applied. In such cases estimates of the number of malaria cases are derived from information on parasite prevalence obtained from household surveys.

First, data on parasite prevalence from nearly 60 000 survey records were assembled within a spatiotemporal Bayesian geostatistical model, along with environmental and sociodemographic covariates, and data distribution on interventions such as ITNs, antimalarial drugs and IRS. The geospatial model enabled predictions of Plasmodium falciparum prevalence in children aged 2–10 years, at a resolution of 5 × 5 km2, throughout all malaria endemic African countries for each year from 2000 to 2016 (see http://www.map.ox.ac.uk/making-maps/ for methods on the development of maps by the Malaria Atlas Project).

Second, an ensemble model was developed to predict malaria incidence as a function of parasite prevalence.

The model was then applied to the estimated parasite prevalence in order to obtain estimates of the malaria case incidence at 5 × 5 km2 resolution for each year from 2000 to 2016.

Data for each 5 × 5 km2 area were then aggregated within country and regional boundaries to obtain both national and regional estimates of malaria cases. (Benin, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Gabon, Guinea, Kenya, Malawi, Mali, Mozambique, Niger, Nigeria, Somalia, South Sudan, Sudan, Togo and Zambia). For most of the elimination countries, the number of indigenous cases registered by the NMCPs are reported without further adjustments. (Algeria, Argentina, Belize, Bhutan, Cabo Verde, China, Comoros, Costa Rica, Democratic People’s Republic of Korea, Djibuti, Ecuador, El Salvador, Iran (Islamic Republic of), Iraq, Malaysia, Mexico, Paraguay, Republic of Korea, Sao Tome and Principe, Saudi Arabia, South Africa, Suriname, Swaziland and Thailand).

The estimated incidence can differ from the incidence reported by a Ministry of Health which can be affected by: – the completeness of reporting: the number of reported cases can be lower than the estimated cases if the percentage of health facilities reporting in a month is less than 100% – the extent of malaria diagnostic testing (the number of slides examined or RDTs performed) – the use of private health facilities which are usually not included in reporting systems. – the indicator is estimated only where malaria transmission occurs.

TARGET 3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

Adolescent birth rate (number of live births to adolescent women per 1,000 adolescent women).

Reducing adolescent fertility and addressing the multiple factors underlying it are essential for improving sexual and reproductive health and the social and economic well-being of adolescents. Preventing births very early in a woman’s life is an important measure to improve maternal health and reduce infant mortality. Furthermore, women having children at an early age experience a curtailment of their opportunities for socio-economic improvement, particularly because young mothers are unlikely to keep on studying and, if they need to work, may find it especially difficult to combine family and work responsibilities. The adolescent birth rate also provides indirect evidence on access to pertinent health services since young people, and in particular unmarried adolescent women, often experience difficulties in access to sexual and reproductive health services.

The adolescent birth rate represents the risk of childbearing among females in a particular age group. The adolescent birth rate among women aged 15-19 years is also referred to as the age-specific fertility rate for women aged 15-19

The adolescent birth rate represents the risk of childbearing among females in a particular age group. The adolescent birth rate (ABR) is also referred to as the age-specific fertility rate (ASFR) for ages 15-19 years, a designation commonly used in the context of calculation of total fertility estimates. A related measure is the proportion of adolescent fertility, measured as the percentage of total fertility contributed by women aged 15-19.

The adolescent birth rate is computed as a ratio.

Numerator – the number of live births to women aged 15-19 years Denominator – the estimate of the exposure to childbearing by women aged 15-19 years

The computation is the same for the age group 10-14 years. The numerator and the denominator are calculated differently for civil registration, survey and census data.

In the case of civil registration data, the numerator is the registered number of live births born to women aged 15-19 years during a given year, and the denominator is the estimated or enumerated population of women aged 15-19 years.

In the case of survey data, the numerator is the number of live births obtained from retrospective birth histories of the interviewed women who were 15-19 years of age at the time of the births during a reference period before the interview, and the denominator is person-years lived between the ages of 15 and 19 years by the interviewed women during the same reference period.

The reported observation year corresponds to the middle of the reference period. For some surveys without data on retrospective birth histories, computation of the adolescent birth rate is based on the date of last birth or the number of births in the 12 months preceding the survey.

With census data, the adolescent birth rate is computed on the basis of the date of last birth or the number of births in the 12 months preceding the enumeration. The census provides both the numerator and the denominator for the rates. In some cases, the rates based on censuses are adjusted for under-registration based on indirect methods of estimation.

For some countries with no other reliable data, the ‘own-children’ method of indirect estimation provides estimates of the adolescent birth rate for a number of years before the census.

For a thorough treatment of the different methods of computation, see Handbook on the Collection of Fertility and Mortality Data, United Nations Publication, Sales No. E.03.XVII.11 (publicly accessible at http://unstats.un.org/unsd/publication/SeriesF/SeriesF_92E.pdf ). Indirect methods of estimation are analyzed in Manual X: Indirect Techniques for Demographic Estimation, United Nations Publication, Sales No. E.83.XIII.2 (publicly accessible at http://www.un.org/esa/population/publications/Manual_X/Manual_X.htm ).

Discrepancies between the sources of data at the country level are common and the level of the adolescent birth rate depends in part on the source of the data selected.

For civil registration, rates are subject to limitations which depend on the completeness of birth registration, the treatment of infants born alive but that die before registration or within the first 24 hours of life, the quality of the reported information relating to age of the mother, and the inclusion of births from previous periods.

The population estimates may be subject to limitations connected to age misreporting and coverage. For survey and census data, both the numerator and denominator come from the same population. The main limitations concern age misreporting, birth omissions, misreporting the date of birth of the child, and sampling variability in the case of surveys.

With respect to estimates of the adolescent birth rate among females aged 10-14 years, comparative evidence suggests that a very small proportion of births in this age group occur to females below age 12. Other evidence based on retrospective birth history data from surveys indicates that women aged 15-19 years are less likely to report first births before age 15 than women from the same birth cohort when asked five years later at ages 20–24 years.

TARGET 3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

Proportion of the target population covered by essential health services.

Coverage of essential health services (defined as the average coverage of essential services based on tracer interventions that include reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases and service capacity and access, among the general and the most disadvantaged population).

Target 3.8 is defined as “Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”. The concern is with all people and communities receiving the quality health services they need (including medicines and other health products), without financial hardship.

Indicator 3.8.1 is for health service coverage and indicator 3.8.2 focuses on health expenditures in relation to a household’s budget to identify financial hardship caused by direct health care payments. Taken together, indicators 3.8.1 and 3.8.2 are meant to capture the service coverage and financial protection dimensions, respectively, of target 3.8. These two indicators should be always monitored jointly.

The indicator is an index reported on a unitless scale of 0 to 100, which is computed as the geometric mean of 14 tracer indicators of health service coverage.

The index of health service coverage is computed as the geometric means of 14 tracer indicators. The 14 indicators are listed below and detailed metadata for each of the components are given online ( http://www.who.int/healthinfo/universal_health_coverage/UHC_Tracer_Indicators_Metadata.pdf ) and Annex 1. The tracer indicators are as follows, organized by four broad categories of service coverage:

I. Reproductive, maternal, newborn and child health 1. Family planning: Percentage of women of reproductive age (15−49 years) who are married or in- union who have their need for family planning satisfied with modern methods 2. Pregnancy and delivery care: Percentage of women aged 15-49 years with a live birth in a given time period who received antenatal care four or more times 3. Child immunization: Percentage of infants receiving three doses of diphtheria-tetanus-pertussis containing vaccine 4. Child treatment: Percentage of children under 5 years of age with suspected pneumonia (cough and difficult breathing NOT due to a problem in the chest and a blocked nose) in the two weeks preceding the survey taken to an appropriate health facility or provider

II. Infectious diseases 5. Tuberculosis: Percentage of incident TB cases that are detected and successfully treated 6. HIV/AIDS: Percentage of people living with HIV currently receiving antiretroviral therapy 7. Malaria: Percentage of population in malaria-endemic areas who slept under an insecticide-treated net the previous night [only for countries with high malaria burden] 8. Water and sanitation: Percentage of households using at least basic sanitation facilities

III. Noncommunicable diseases 9. Hypertension: Age-standardized prevalence of non-raised blood pressure (systolic blood pressure <140 mm Hg or diastolic blood pressure <90 mm Hg) among adults aged 18 years and older 10. Diabetes: Age-standardized mean fasting plasma glucose (mmol/L) for adults aged 18 years and older 11. Tobacco: Age-standardized prevalence of adults >=15 years not smoking tobacco in last 30 days (SDG indicator 3.a.1, metadata available here)

IV. Service capacity and access 12. Hospital access: Hospital beds per capita, relative to a maximum threshold of 18 per 10,000 population 13. Health workforce: Health professionals (physicians, psychiatrists, and surgeons) per capita, relative to maximum thresholds for each cadre (partial overlap with SDG indicator 3.c.1, see metadata here) 14. Health security: International Health Regulations (IHR) core capacity index, which is the average percentage of attributes of 13 core capacities that have been attained (SDG indicator 3.d.1, see metadata here)

The index is computed with geometric means, based on the methods used for the Human Development Index. The calculation of the 3.8.1 indicator requires first preparing the 14 tracer indicators so that they can be combined into the index, and then computing the index from those values. The 14 tracer indicators are first all placed on the same scale, with 0 being the lowest value and 100 being the optimal value. For most indicators, this scale is the natural scale of measurement, e.g., the percentage of infants who have been immunized ranges from 0 to 100 percent. However, for a few indicators additional rescaling is required to obtain appropriate values from 0 to 100, as follows: – Rescaling based on a non-zero minimum to obtain finer resolution (this “stretches” the distribution across countries): prevalence of non-raised blood pressure and prevalence of non- use of tobacco are both rescaled using a minimum value of 50%. rescaled value = (X-50)/(100-50)*100 – Rescaling for a continuous measure: mean fasting plasma glucose, which is a continuous measure (units of mmol/L), is converted to a scale of 0 to 100 using the minimum theoretical biological risk (5.1 mmol/L) and observed maximum across countries (7.1 mmol/L). rescaled value = (7.1 – original value)/(7.1-5.1)*100 – Maximum thresholds for rate indicators: hospital bed density and health workforce density are both capped at maximum thresholds, and values above this threshold are held constant at 100. These thresholds are based on minimum values observed across OECD countries. rescaled hospital beds per 10,000 = minimum(100, original value / 18*100) rescaled physicians per 1,000 = minimum(100, original value / 0.9*100) rescaled psychiatrists per 100,000 = minimum(100, original value / 1*100) rescaled surgeons per 100,000 = minimum(100, original value / 14*100) Once all tracer indicator values are on a scale of 0 to 100, geometric means are computed within each of the four health service areas, and then a geometric mean is taken of those four values. If the value of a tracer indicator happens to be zero, it is set to 1 (out of 100) before computing the geometric mean. The following diagram illustrates the calculations.

Note that in countries with low malaria burden, the tracer indicator for use of insecticide-treated nets is dropped from the calculation.

These tracer indicators are meant to be indicative of service coverage, not a complete or exhaustive list of health services and interventions that are required for universal health coverage. The 14 tracer indicators were selected because they are well-established, with available data widely reported by countries (or expected to become widely available soon). Therefore, the index can be computed with existing data sources and does not require initiating new data collection efforts solely to inform the index.

TARGET 3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

Mortality rate attributed to household and ambient air pollution.

As part of a broader project to assess major risk factors to health, the mortality resulting from exposure to ambient (outdoor) air pollution and household (indoor) air pollution from polluting fuel use for cooking was assessed. Ambient air pollution results from emissions from industrial activity, households, cars and trucks which are complex mixtures of air pollutants, many of which are harmful to health. Of all of these pollutants, fine particulate matter has the greatest effect on human health. By polluting fuels is understood as wood, coal, animal dung, charcoal, and crop wastes, as well as kerosene.

Air pollution is the biggest environmental risk to health. The majority of the burden is borne by the populations in low and middle-income countries.

The mortality attributable to the joint effects of household and ambient air pollution can be expressed as: Number of deaths, Death rate. Death rates are calculated by dividing the number of deaths by the total population (or indicated if a different population group is used, e.g. children under 5 years).

Evidence from epidemiological studies have shown that exposure to air pollution is linked, among others, to the important diseases taken into account in this estimate: – Acute respiratory infections in young children (estimated under 5 years of age) – Cerebrovascular diseases (stroke) in adults (estimated above 25 years) – Ischaemic heart diseases (IHD) in adults (estimated above 25 years) – Chronic obstructive pulmonary disease (COPD) in adults (estimated above 25 years); and – Lung cancer in adults (estimated above 25 years)

The mortality resulting from exposure to ambient (outdoor) air pollution and household (indoor) air pollution from polluting fuels use for cooking was assessed. Ambient air pollution results from emissions from industrial activity, households, cars and trucks which are complex mixtures of air pollutants, many of which are harmful to health. Of all of these pollutants, fine particulate matter has the greatest effect on human health. By polluting fuels is understood kerosene, wood, coal, animal dung, charcoal, and crop wastes.

Attributable mortality is calculated by first combining information on the increased (or relative) risk of a disease resulting from exposure, with information on how widespread the exposure is in the population (e.g. the annual mean concentration of particulate matter to which the population is exposed, proportion of population relying primarily on polluting fuels for cooking).

This allows calculation of the ‘population attributable fraction’ (PAF), which is the fraction of disease seen in a given population that can be attributed to the exposure (e.g in that case of both the annual mean concentration of particulate matter and exposure to polluting fuels for cooking).

Applying this fraction to the total burden of disease (e.g. cardiopulmonary disease expressed as deaths), gives the total number of deaths that results from exposure to that particular risk factor (in the example given above, to ambient and household air pollution).

To estimate the combined effects of risk factors, a joint population attributable fraction is calculated, as described in Ezzati et al (2003).

The mortality associated with household and ambient air pollution was estimated based on the calculation of the joint population attributable fractions assuming independently distributed exposures and independent hazards as described in (Ezzati et al, 2003).

The joint population attributable fraction (PAF) were calculated using the following formula: PAF=1-PRODUCT (1-PAFi) where PAFi is PAF of individual risk factors.

The PAF for ambient air pollution and the PAF for household air pollution were assessed separately, based on the Comparative Risk Assessment (Ezzati et al, 2002) and expert groups for the Global Burden of Disease (GBD) 2010 study (Lim et al, 2012; Smith et al, 2014).

For exposure to ambient air pollution, annual mean estimates of particulate matter of a diameter of less than 2.5 um (PM25) were modelled as described in (WHO 2016, forthcoming), or for Indicator 11.6.2.

For exposure to household air pollution, the proportion of population with primary reliance on polluting fuels use for cooking was modelled (see Indicator 7.1.2 [polluting fuels use=1-clean fuels use]). Details on the model are published in (Bonjour et al, 2013).

The integrated exposure-response functions (IER) developed for the GBD 2010 (Burnett et al, 2014) and further updated for the GBD 2013 study (Forouzanfar et al, 2015) were used. The percentage of the population exposed to a specific risk factor (here ambient air pollution, i.e. PM2.5) was provided by country and by increment of 1 ug/m3; relative risks were calculated for each PM2.5 increment, based on the IER. The counterfactual concentration was selected to be between 5.6 and 8.8 ug/m3, as described elsewhere (Ezzati et al, 2002; Lim et al, 2012). The country population attributable fraction for ALRI, COPD, IHD, stroke and lung cancer were calculated using the following formula :

PAF=SUM(Pi(RR-1)/(SUM(RR-1)+1)

where i is the level of PM2.5 in ug/m3, and Pi is the percentage of the population exposed to that level of air pollution, and RR is the relative risk.

The calculations for household air pollution are similar, and are explained in detailed elsewhere (WHO 2014a).

An approximation of the combined effects of risk factors is possible if independence and little correlation between risk factors with impacts on the same diseases can be assumed (Ezzati et al, 2003). In the case of air pollution, however, there are some limitations to estimate the joint effects: limited knowledge on the distribution of the population exposed to both household and ambient air pollution, correlation of exposures at individual level as household air pollution is a contributor to ambient air pollution, and non- linear interactions (Lim et al, 2012; Smith et al, 2014). In several regions, however, household air pollution remains mainly a rural issue, while ambient air pollution is predominantly an urban problem. Also, in some continents, many countries are relatively unaffected by household air pollution, while ambient air pollution is a major concern. If assuming independence and little correlation, a rough estimate of the total impact can be calculated, which is less than the sum of the impact of the two risk factors.

TARGET 3.b Support the research and development of vaccines and medicines for the communicable and non‑communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all

Proportion of the target population covered by all vaccines included in their national programme.

This indicator aims to measure access to vaccines, including the newly available or underutilized vaccines, at the national level. In the past decades all countries added numerous new and underutilised vaccines in their national immunization schedule and there are several vaccines under final stage of development to be introduced by 2030. For monitoring diseases control and impact of vaccines it is important to measure coverage from each vaccine in national immunization schedule and the system is already in place for all national programmes, however direct measurement for proportion of population covered with all vaccines in the programme is only feasible if the country has a well-functioning national nominal immunization registry, usually an electronic one that will allow this coverage to be easily estimated. While countries will develop and strengthen immunization registries it is a need for an alternative measurement.

Coverage of DTP containing vaccine (3rd dose): Percentage of surviving infants who received the 3 doses of diphtheria and tetanus toxoid with pertussis containing vaccine in a given year.

Coverage of Measles containing vaccine (2nd dose): Percentage of children who received two dose of measles containing vaccine according to nationally recommended schedule through routine immunization services in a given year.

Coverage of Pneumococcal conjugate vaccine (last dose in the schedule): Percentage of surviving infants who received the nationally recommended doses of pneumococcal conjugate vaccine in a given year.

Coverage of HPV vaccine (last dose in the schedule): Percentage of 15 years old girls received the recommended doses of HPV vaccine. Currently performance of the programme in the previous calendar year based on target age group is used.

In accordance with its mandate to provide guidance to Member States on health policy matters, WHO provides global vaccine and immunization recommendations for diseases that have an international public health impact. National programmes adapt the recommendations and develop national immunization schedules, based on local disease epidemiology and national health priorities. National immunization schedules and number of recommended vaccines vary between countries, with only DTP polio and measles containing vaccines being used in all countries.

The target population for given vaccine is defined based on recommended age for administration. The primary vaccination series of most vaccines are administered in the first two years of life.

Coverage of DTP containing vaccine measure the overall system strength to deliver infant vaccination. Coverage of Measles containing vaccine ability to deliver vaccines beyond first year of life through routine immunization services. Coverage of Pneumococcal conjugate vaccine: adaptation of new vaccines for children Coverage of HPV vaccine: life cycle vaccination

WHO and UNICEF jointly developed a methodology to estimate national immunization coverage form selected vaccines in 2000. The methodology has been refined and reviewed by expert committees over time. The methodology was published and reference is available under the reference section. Estimates time series for WHO recommended vaccines produced and published annually since 2001.

The methodology uses data reported by national authorities from countries administrative systems as well as data from immunization or multi indicator household surveys.

The rational to select a set of vaccines reflects the ability of immunization programmes to deliver vaccines over the life cycle and to adapt new vaccines. Coverage for other WHO recommended vaccines are also available and can be provided.

Given that HPV vaccine is relatively new and vaccination schedule varies from countries to country coverage estimate will be made for girls vaccinated by ag 15 and at the moment data is limited to very few countries therefore reporting will start later.

To ensure healthy lives and promote the well-being of all children, UNICEF has four key asks that encourage all governments to:

• Strengthen primary healthcare systems to reach every child
• Focus on maternal, newborn and child survival
• Prioritize child and adolescent health and well-being, including mental health
• Support responses to reduce the impact on children and families of natural disasters, complex emergencies and demographic shifts

Learn more about  UNICEF’s key asks for implementing Goal 3

See more Sustainable Development Goals

ZERO HUNGER

GOOD HEALTH AND WELL-BEING

QUALITY EDUCATION

GENDER EQUALITY

CLEAN WATER AND SANITATION

AFFORDABLE AND CLEAN ENERGY

DECENT WORK AND ECONOMIC GROWTH

REDUCED INEQUALITIES

CLIMATE ACTION

PEACE, JUSTICE AND STRONG INSTITUTIONS

PARTNERSHIPS FOR THE GOALS

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Healthy Lives and Well-being for Everyone: Why SDG 3 matters and how we can achieve it

Creating a sustainable world—and reaching economic, environmental and social goals—depends on having a thriving and healthy human population. We explore how Sustainable Development Goal 3 plans to achieve that.

Creating a sustainable world—and reaching economic, environmental and social goals—depends on having a thriving and healthy human population.

However, even the most cursory glance at figures pertaining to human health reveals a world where grave inequalities result in massive disparities when it comes to access to basic health care, and where easily treatable diseases still claim far too many lives in many corners of the globe.

Let’s start at birth. In 2015, there were approximately 303,000 maternal deaths worldwide, most from preventable causes. Maternal health conditions were also the leading cause of death among girls aged 15-19 in that year.

Infant mortality rates—along with many other health-related issues—can also expose inequalities within nations. In Canada, for example, while the average mortality rate is around 5 deaths per 1,000 live births, it reaches as high as 16 deaths per 1,000 live births in Nunavut—a region where 85 per cent of the population is Indigenous.

Around the world, more than 6 million children still die before their fifth birthday each year, with four out of five of those deaths occurring in sub-Saharan Africa and Southern Asia. Rates of poverty and the level of the mother’s education are key factors that affect the likelihood of a child making it past the age of five.

When it comes to communicable diseases, at the end of 2013, there were an estimated 35 million people living with HIV worldwide. In fact, 240,000 children were newly infected with the disease that year.

While the rates of malaria are falling globally, the recent resurgence of ailments such as measles and the Zika virus reminds us that there are always potential health crises around the corner for which we may not be equipped—with the Global South often most at risk.

A Global Approach to Worldwide Problems

When world leaders adopted the Sustainable Development Goals, they signed on to a goal (SDG 3) that aims to "ensure healthy lives and promote well-being for all at all ages."

The Millennium Development Goals (MDGs), which provided a global framework for development from 2000-2015, and dedicated a hefty 3 out of 10 goals to global health issues (child mortality; maternal health; HIV/AIDS, malaria and other diseases).

The targets under SDG 3 have an even greater scope than those three MDGs combined. Furthermore, given the integrated nature of the sustainable development approach, many of the other SDGs, such as Goal 1 (“end poverty”), Goal 2 (“end hunger”) and Goal 6 (“ensure access to water”), are strongly tied to—and have an impact on—human health issues.

The recent resurgence of ailments such as measles and the Zika virus reminds us that there are always potential health crises around the corner for which we may not be equipped—with the Global South often most at risk.

Many of the SDG 3 targets are dedicated to tackling pressing issues surrounding maternal health and child mortality rates, which continue to affect much of the Global South in particular. The ambition of those targets reflects the urgency of the work at hand, and the desire of the international community to continue their work on the unfinished business in the MDGs. By 2030, Target 3.2 aims to “end preventable deaths of newborns and children under 5 years of age,” and Target 3.1 is to “reduce the global maternal mortality ratio to less than 70 per 100,000 live births.”

Other targets reflect the universal nature of the SDGs. They touch on everything from universal health coverage and tobacco control to reducing the number of deaths due to road traffic accidents and substance abuse—issues that are widespread in countries at all stages of development.

Both developed and developing countries have work to do to ensure healthy lives and promote well-being for all of their citizens, including addressing policies on universal access to health coverage and populations’ relationships with alcohol and narcotics.

Towards a Healthier Future

The global community has already made significant progress in key areas of human health. Despite the still-high figures of maternal mortality, the United Nations reports it has actually fallen by almost 50 percent since 1990. In Northern Africa and Southern and Eastern Asia, maternal mortality has also been reduced by around two-thirds.

17,000 fewer children die each day than in 1990—some of which can be attributed to increased access to vaccinations. For example, since 2000, the United Nations reports that measles vaccines have prevented almost 15.6 million deaths globally.

When it comes to treating HIV, at the end of 2014, 13.6 million had access to antiretroviral therapy, and new HIV infections in 2013 were estimated at 2.1 million—38 per cent lower than in 2001.

These achievements point to the value of international goals—the MDGs—in focusing global efforts on shared objectives. The SDGs continue, and widen the scope of actors and efforts, in order to ensure that no one is left behind due to lack of access to health care and healthy lifestyle options.  

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Sustainable Development Goal 3

Ensure healthy lives and promote well-being for all at all ages.

Sustainable Development Goal 3 is to “ensure healthy lives and promote well-being for all at all ages”, according to the United Nations .

The visualizations and data below present the global perspective on where the world stands today and how it has changed over time.

The UN has defined 13 targets and 28 indicators for SDG 3. Targets specify the goals and indicators represent the metrics by which the world aims to track whether these targets are achieved. Below we quote the original text of all targets and show the data on the agreed indicators.

Target 3.1 Reduce maternal mortality

Sdg indicator 3.1.1 maternal mortality ratio.

Definition of the SDG indicator: Indicator 3.1.1 is the “maternal mortality ratio” in the UN SDG framework .

The maternal mortality ratio refers to the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.

Data for this indicator is shown in the interactive visualization.

Target: By 2030 “reduce the global maternal mortality ratio to less than 70 per 100,000 live births” per year.

More research: The Our World in Data topic page on Maternal Mortality gives a long-run perspective over the last centuries and presents research on the causes and consequences of the deaths of mothers.

Additional charts

• Number of maternal deaths by region
• Number of maternal deaths by country

SDG Indicator 3.1.2 Skilled birth attendance

Definition of the SDG indicator: Indicator 3.1.2 is the “proportion of births attended by skilled health personnel” in the UN SDG framework .

This indicator is measured as the ratio of the births attended by skilled health personnel (generally doctors, nurses, or midwives) who are trained in providing quality obstetric care, to the number of live births in the same period.

More research: Research, discussed in the Our World in Data topic page on Maternal Mortality , shows that skilled staff can reduce maternal mortality.

Target 3.2 End all preventable deaths under 5 years of age

Sdg indicator 3.2.1 under-5 mortality rate.

Definition: Indicator 3.2.1 is the “under-5 mortality rate” in the UN SDG framework .

The under-5 mortality rate measures the probability per 1,000 that a newborn baby will die before reaching age five, if subject to age-specific mortality rates of the specified year.

Target: By 2030, “end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.”

More research: Child mortality is covered more broadly, and with a longer-term perspective in the Our World in Data topic page on Child Mortality .

• Number of under-five deaths
• Number of under-five deaths by region
• Child mortality rate by sex

SDG Indicator 3.2.2 Neonatal mortality rate

Definition of the SDG indicator: Indicator 3.2.2 is the “neonatal mortality rate” in the UN SDG framework .

The neonatal mortality rate is defined as the probability per 1,000 that a child born in a given year will die during the first 28 days of life, if subject to the age-specific mortality rates of that period.

Data on this indicator is shown in the interactive visualization.

More research: The Our World in Data topic page on Child Mortality includes a section on neonatal mortality.

• Number of neonatal deaths
• Number of neonate deaths by region

Target 3.3 Fight communicable diseases

Sdg indicator 3.3.1 hiv incidence.

Definition of the SDG indicator: Indicator 3.3.1 is the “number of new HIV infections per 1,000 uninfected population, by sex, age and key populations” in the UN SDG framework .

Data for this indicator is shown in the interactive visualization, by age group in the first chart and for the 15-49 age group in the second chart. You can change the country shown in the first chart by clicking the “Change country” button in the upper left hand corner.

Target: The target for 2030 is to “end the epidemic of AIDS” across all countries. 1

The targeted level of reduction is defined by UNAIDS as a 90% reduction in new HIV infections over 2010 levels. For all age groups combined, this would imply a target of around .03 per 1,000, or 3 new infections for every 100,000 uninfected people.

More research: HIV is covered in detail by the Our World in Data topic page on HIV/AIDS .

• Share of population infected with HIV
• HIV/AIDS death rates
• Number of HIV/AIDS deaths

SDG Indicator 3.3.2 Tuberculosis incidence

Definition of the SDG indicator: Indicator 3.3.2 is “tuberculosis incidence per 100,000 population” in the UN SDG framework .

Tuberculosis incidence is the number of new and relapse cases of tuberculosis (TB) per 100,000 people, including all forms of TB.

Target: The 2030 target is to “end the epidemic of tuberculosis” in all countries. 1

The World Health Organization's End TB Strategy defines this targeted level of reduction as a decrease in incidence of 80% over 2015 levels. This would imply a target of around 28 cases per 100,000 population globally.

• Tuberculosis death rates
• Number of tuberculosis deaths

SDG Indicator 3.3.3 Malaria incidence

Definition of the SDG indicator: Indicator 3.3.3 is “malaria incidence per 1,000 population” in the UN SDG framework .

Malaria incidence is the number of new cases of malaria in one year per 1,000 people at risk.

Target: By 2030 “end the epidemic of malaria” in all countries. 1

To achieve this target, the WHO Global Technical Strategy has set a target of reducing incidence by 90% by 2030 from 2015 levels. This would imply a target of 6 or fewer cases of malaria per 1,000 people globally in 2030.

More research: More information on global and national trends in malaria prevalence, deaths and interventions can be found at the Our World in Data topic page on Malaria .

• Malaria death rates
• Number of malaria deaths

SDG Indicator 3.3.4 Hepatitis B incidence

Definition of the SDG indicator: Indicator 3.3.4 is “Hepatitis B incidence per 100,000 population” in the UN SDG framework .

Hepatitis B incidence is the number of new cases of hepatitis B in one year per 100,000 people in a given population. This is measured indirectly as the share of children under 5 years of age with an active Hepatitis B infection, as measured by an Hepatitis B surface antigen test.

Target: By 2030 “combat hepatitis” in all countries with a focus on hepatitis B. 1 The targeted level of reduction, however, is not defined.

• Hepatitis death rates

SDG Indicator 3.3.5 Neglected tropical diseases

Definition of the SDG indicator: Indicator 3.3.5 is the “number of people requiring interventions against neglected tropical diseases” in the UN SDG framework .

This is defined as the number of people who require interventions (treatment and care) for any of the 20 neglected tropical diseases (NTDs) identified by the WHO NTD Roadmap and World Health Assembly resolutions. Treatment and care is broadly defined to allow for preventive, curative, surgical or rehabilitative treatment and care.

Target: By 2030 “end the epidemic of neglected tropical diseases (NTDs)” in all countries. 1

The associated WHO target is a 90% reduction in the number of people requiring interventions against NTDs from 2010 baseline levels. This implies a target of 219 million people needing interventions against NTDs in 2030.

• Number of people requiring interventions for NTDs by region

Target 3.4 Reduce mortality from non-communicable diseases and promote mental health

Sdg indicator 3.4.1 mortality rate from non-communicable diseases.

Definition of the SDG indicator: Indicator 3.4.1 is the “mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease” in the UN SDG framework .

This is defined as the percent of 30-year-old-people who would die before their 70th birthday from cardiovascular disease, cancer, diabetes, or chronic respiratory disease, assuming that they would experience current mortality rates at every age and would not die from any other cause of death (e.g. injuries or HIV/AIDS).

Target: By 2030 “reduce by one third premature mortality from non-communicable diseases through prevention and treatment” in all countries. 2

More research: Further data and research on non-communicable diseases can be found at the Our World in Data topic pages on Causes of Death , Burden of Disease , and Cancer .

• Cancer death rates
• Cardiovascular disease (CVD) death rates
• Stroke death rates

SDG Indicator 3.4.2 Suicide rate

Definition of the SDG indicator: Indicator 3.4.2 is the “suicide mortality rate” in the UN SDG framework .

The suicide mortality rate is the number of deaths from suicide measured per 100,000 people in a given population.

Target: By 2030 “promote mental health and wellbeing”. 2 There is no defined target level of reduction for this indicator.

More research: Further data and research on suicide, mental health and wellbeing can be found at the Our World in Data topic pages on Suicide , Mental Health and Happiness and Life Satisfaction .

• Number of suicide deaths
• Share of population with depression

Target 3.5 Prevent and treat substance abuse

Sdg indicator 3.5.1 coverage of treatment interventions for substance use disorders.

Definition of the SDG indicator: Indicator 3.5.1 is the “coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders” in the UN SDG framework .

This is the share of people with substance use disorders in a given year who receive treatment in the form of pharmacological, psychosocial, rehabilitation or aftercare services. Data coverage in household surveys of substance use disorders is limited in many countries, and efforts are currently in progress to better estimate this indicator.

Data for this indicator is shown in the interactive visualizations. The first chart shows the share of the population with an alcohol use disorder in each country, and the second chart shows coverage of treatment interventions for certain types of substance use disorder for the countries where this data is available.

Target: By 2030 “strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol” across all countries. However, there is no defined target level for this indicator.

More research: The Our World in Data topic page on Substance Use provides data on substance use disorder prevalence and as well as more limited data coverage of treatment interventions.

SDG Indicator 3.5.2 Alcohol consumption per capita

Definition of the SDG indicator: Indicator 3.5.2 is the “harmful use of alcohol, defined according to the national context as alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol” in the UN SDG framework .

More research: Further data and research on alcohol consumption and alcohol use disorders can be found at the Our World in Data topic page on Alcohol Consumption .

• Share of population with alcohol use disorders
• Share of population with drug use disorders
• Prevalence of substance use disorders by sex

Target 3.6 Reduce road injuries and deaths

Sdg indicator 3.6.1 halve the number of road traffic deaths.

Definition of the SDG indicator: Indicator 3.6.1 is the “death rate due to road traffic injuries” in the UN SDG framework .

Road traffic deaths include vehicle drivers, passengers, motorcyclists, cyclists and pedestrians.

Data for this indicator is shown in the first chart in the series of interactive visualizations. The second chart shows the absolute number of road traffic deaths for additional context.

Target: By 2020 “halve the number of global deaths and injuries from road traffic accidents.”

While most SDG targets are set for 2030, this was set to be achieved for 2020.

Note that the SDG Indicator is the rate of road deaths while the target is set for the absolute number of road deaths. Because of this, the interactive visualization shows, in the first chart, the road traffic death rate, and in the second chart, the number of road traffic deaths.

• Road traffic deaths by user

Target 3.7 Universal access to sexual and reproductive care, family planning and education

Sdg indicator 3.7.1 family planning needs.

Definition of the SDG indicator: Indicator 3.7.1 is the “proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods” in the UN SDG framework .

This indicator incorporates two components, the prevalence of modern methods of contraception, and the share of women of reproductive age who want to stop or delay childbearing but are not using any method of contraception.

It is measured as the percent of women of reproductive age (15-49 years) who are currently using at least one modern contraceptive method, out of the total population of women who have demand for contraceptive methods (defined as those using contraception of any form or who have unmet need for contraception).

Target: By 2030 “ensure universal access to sexual and reproductive healthcare services, including for family planning, information and education.” 3

More research: Further data and research can be found at the Our World in Data topic page on Fertility Rate .

• Unmet need for contraception
• Contraception prevalence, any methods

SDG Indicator 3.7.2 Adolescent birth rate

Definition of the SDG indicator: Indicator 3.7.2 is the “adolescent birth rate (aged 10–14 years; aged 15–19 years) per 1,000 women in that age group” in the UN SDG framework .

Data for this indicator is shown in the interactive visualizations, which show, in the first chart, adolescent birth rates per 1,000 women aged 10-14 years old, and in the second chart, women aged 15-19 years old.

Target: By 2030 “ensure universal access to sexual and reproductive healthcare services, including for family planning.” 3

Target 3.8 Achieve universal health coverage

Sdg indicator 3.8.1 coverage of essential health services.

Definition of the SDG indicator: Indicator 3.8.1 is “coverage of essential health services” in the UN SDG framework .

Coverage of essential health services is defined as the average coverage of essential services based on tracer interventions that include reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases and service capacity and access, among the general and the most disadvantaged population.

The Universal Health Coverage (UHC) Service Coverage Index is used to track progress on this indicator. The index is on a scale from 0 to 100, where 100 is the optimal value, and calculated from the geometric mean of 14 indicators measuring the coverage of essential services including reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases and service capacity and access.

Target: By 2030 “achieve universal health coverage including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”

More research: Further data and research can be found at the Our World in Data topic page on Financing Healthcare .

SDG Indicator 3.8.2 Household expenditures on health

Definition of the SDG indicator: Indicator 3.8.2 is the “proportion of population with large household expenditures on health as a share of total household expenditure or income” in the UN SDG framework .

Two thresholds are used for defining large household expenditures: greater than 10% or 25% of total household expenditure or income.

The interactive visualizations show data for the 25 and 10 percent thresholds.

Target: By 2030 “achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”

• Out-of-pocket expenditure on healthcare
• Risk of catastrophic expenditure for surgical care
• Risk of impoverishing expenditure for surgical care

Target 3.9 Reduce illnesses and deaths from hazardous chemicals and pollution

Sdg indicator 3.9.1 mortality rate from air pollution.

Definition of the SDG indicator: Indicator 3.9.1 is the “mortality rate attributed to household and ambient air pollution” in the UN SDG framework .

This is measured as the number of deaths attributed to indoor and outdoor air pollution per 100,000 people, accounting for differences in the age structure of different populations.

Data for this indicator is shown in the series of interactive visualizations, first for household and ambient air pollution combined, then for each separately, and then with a comparison of the two types of pollution in the final chart.

Target: By 2030 “substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.” There is, however, not a defined target level for this indicator.

More research: Further data and research can be found at the Our World in Data topic pages on Air Pollution and Indoor Air Pollution .

• Mortality rate from ambient particulate air pollution
• Number of deaths from outdoor air pollution
• Mortality rate from indoor air pollution
• Number of deaths from indoor air pollution

SDG Indicator 3.9.2 Mortality rate from unsafe water, sanitation, hygiene (WASH)

Definition of the SDG indicator: Indicator 3.9.2 is the “mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene” in the UN SDG framework .

This indicator is defined as the number of deaths per 100,000 people that are attributed to unsafe water, unsafe sanitation, and lack of hygiene (defined as exposure to unsafe Water, Sanitation, and Hygiene for All (WASH) services). This definition includes deaths from diarrhoea, intestinal nematode infections, malnutrition and acute respiratory infections.

Target: By 2030 “substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.” There is, however, not a defined quantified target level for this indicator.

More research: Further data and research can be found at the Our World in Data topic page on Water Access, Resources and Sanitation .

• Mortality rate attributable to unsafe water
• Mortality rate attributable to unsafe sanitation

SDG Indicator 3.9.3 Mortality rate from unintentional poisoning

Definition of the SDG indicator: Indicator 3.9.3 is the “mortality rate attributed to unintentional poisoning” in the UN SDG framework .

This measures the annual number of deaths per 100,000 people that are attributed to unintentional poisonings.

Target 3.a Implement the WHO framework convention on tobacco control

Sdg indicator 3.a.1 prevalence of tobacco use.

Definition of the SDG indicator: Indicator 3.a.1 is the “age-standardized prevalence of current tobacco use among persons aged 15 years and older” in the UN SDG framework .

This measures the share of people aged 15 and older who currently use any tobacco product, whether smoked or smokeless tobacco. This includes both people who use tobacco on a daily basis as well as those who use it on a non-daily basis but have used it at some point in the last 30 days before the survey. Age-standardization accounts for differences in age distributions between countries.

Target: By 2030 “strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.” There is no specified target level of tobacco use for this indicator.

More research: Further data and research can be found at the Our World in Data topic page on Smoking .

• Daily smoking in people aged 10 or older
• Share of men who smoke
• Share of women who smoke
• Death rate from tobacco smoking
• Deaths attributed to smoking and secondhand smoke

Target 3.b Support research, development and access to affordable vaccines and medicines

Sdg indicator 3.b.1 vaccine coverage.

Definition of the SDG indicator: Indicator 3.b.1 is the “proportion of the target population covered by all vaccines included in their national programme” in the UN SDG framework .

The UN currently includes the four following vaccines in this indicator: three-dose diphtheria, pertussis, and tetanus (DPT3); second-dose measles vaccine; recommended dose of pneumococcal conjugate vaccine (PCV3) and recommended dose of human papillomavirus vaccine.

Data on this indicator is shown across the four interactive visualizations.

Target: By 2030 “provide access to affordable essential medicines and vaccines.” 4

For this indicator, this means universal coverage of the vaccines noted above (if included in national vaccination programmes) must be achieved by 2030.

SDG Indicator 3.b.2 Development assistance to medical research & basic healthcare

Definition: Indicator 3.b.2 is the “total net official development assistance (ODA) to medical research and basic health sectors” in the UN SDG framework .

This indicator is measured as disbursements of official development assistance (ODA) and other official flows to the medical research and basic health sectors.

Official development assistance refers to flows to countries and territories on the Organization for Economic Co-operation and Development’s Development Assistance Committee (DAC) and to multilateral institutions which meet a set of criteria related to the source of the funding, the purpose of the transaction, and the concessional nature of the funding.

Data for this indicator is shown for recipient countries.

Target: By 2030 “support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, [and] provide access to affordable essential medicines and vaccines.” 4

SDG Indicator 3.b.3 Availability of essential medicines

Definition: Indicator 3.b.3 is the “proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis” in the UN SDG framework .

This indicator measures the share of surveyed healthcare facilities that had essential medicines available for purchase at prices, such that no extra daily wages would be needed for the lowest paid unskilled government sector worker to purchase a monthly dose treatment of this medicine after fulfilling their basic needs represented by the national poverty line.

The list of 32 essential medicines used in calculation is from the 2017 Model List of Essential Medicines from the WHO Expert Committee on Selection and Use of Essential Medicines, which updates its list of essential medicines every two years. Availability and affordability of specific medicines are weighted in the overall calculation based on the regional burden of disease.

Target: By 2030 “provide access to affordable essential medicines for all.” 4

Target 3.c Increase health financing and support health workforce in developing countries

Sdg indicator 3.c.1 health worker density.

Definition: Indicator 3.c.1 is “health worker density and distribution” in the UN SDG framework .

Health worker density is the size of the health workforce per 1,000 people. It is measured here based on the density of physicians, surgeons, nurses and midwives, dentistry and pharmaceutical personnel.

Target: By 2030 “substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries.”

• Nurses and midwives (per 1,000 people)
• Surgical workforce (per 100,000 people)
• Dentistry personnel (per 1,000 people)
• Pharmaceutical personnel (per 1,000 people)

Target 3.d Improve early warning systems for global health risks

Sdg indicator 3.d.1 health emergency preparedness.

Definition: Indicator 3.d.1 is the “International Health Regulations (IHR) capacity and health emergency preparedness” in the UN SDG framework .

The IHR Core capacity index is measured in terms of 15 capacities, where each capacity is measured as the average implementation score across a set of indicators. Countries self-report progress in the following 15 capacities: (1) Policy, legal and normative instruments to implement IHR; (2) IHR Coordination and National Focal Point Functions; (3) Financing; (4) Laboratory; (5) Surveillance; (6) Human resources; (7) Health emergency management (8) Health Service Provision; (9) Infection Prevention and Control; (10) Risk communication and community engagement; (11) Points of entry and border health; (12) Zoonotic diseases; (13) Food safety; (14) Chemical events; (15) Radiation emergencies.

Target: By 2030 “strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.”

SDG Indicator 3.d.2 Bloodstream infections due to antimicrobial-resistant organisms

Definition of the SDG indicator: Indicator 3.d.2 is the “percentage of bloodstream infections due to selected antimicrobial-resistant organisms” in the UN SDG framework .

This is measured as the share of people who are found to have a bloodstream infection due to certain antimicrobial-resistant organisms (methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli resistant to 3rd-generation cephalosporin), among those seeking care whose blood sample is collected and tested.

Data for this indicator is shown in the interactive visualizations.

Full text: “By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.”

Full text: “By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.”

Full text:” By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.”

Full text: “Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.”

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Article Contents

Introduction, sources of data, areas of agreement, areas of controversy, growing points, areas timely for developing research, conflict of interest statement.

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Sustainable Development Goals (SDGs), and their implementation: A national global framework for health, development and equity needs a systems approach at every level

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Stephen Morton, David Pencheon, Neil Squires, Sustainable Development Goals (SDGs), and their implementation: A national global framework for health, development and equity needs a systems approach at every level, British Medical Bulletin , Volume 124, Issue 1, December 2017, Pages 81–90, https://doi.org/10.1093/bmb/ldx031

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The Sustainable Development Goals (SDGs) are a set of global goals for fair and sustainable health at every level: from planetary biosphere to local community. The aim is to end poverty, protect the planet and ensure that all people enjoy peace and prosperity, now and in the future.

The UN has established web-sites to inform the implementation of the SDGs and an Inter-Agency and Expert Group on an Indicator Framework. We have searched for independent commentaries and analysis.

The goals represent a framework that is scientifically robust, and widely intuitive intended to build upon the progress established by the Millennium Development Goals (MDGs). There is a need for system wide strategic planning to integrate the economic, social and environmental dimensions into policy and actions.

Many countries have yet to understand the difference between the MDGs and the SDGs, particularly their universality, the huge potential of new data methods to help with their implementation, and the systems thinking that is needed to deliver the vision. The danger is that individual goals may be prioritized without an understanding of the potential positive interactions between goals.

There is an increasing understanding that sustainable development needs a paradigm shift in our understanding of the interaction between the real economy and quality of life. There would be many social, environmental and economic benefits in changing our current model.

We need to develop systems wide understanding of what supports a healthy environment and the art and science of making change.

Summary of the UN’s 17 Sustainable Development Goals, linked to the five Areas of Critical Importance (5P’s)

Examples of targets and indicators (for Goal 2) 26

UN Graphical Illustration of the 17 SDGs.

The Sustainable Development Goals (adopted by the United Nations General Assembly in September 2015) run from 2016 to 2030 and are formally the goals of the United Nations’ ‘Transforming our world; the 2030 Agenda for Sustainable Development’, an agenda which sets out the vision, principles and commitments to a fairer and more sustainable world for all. The practical and political importance of the SDGs, and the challenges associated with them, can only truly be appreciated by understanding what preceded them. The Millennium Development Goals (MDGs) were in place from 2000 to 2015 and consisted of eight international development goals. The first three goals covered poverty, education and gender equality; the next three goals addressed ‘health outcomes’ covering child mortality, maternal health and ‘HIV/AIDS, malaria and other diseases’. The remaining two goals addressed environmental sustainability and global partnership for development. These eight MDGs were supported by a total of 21 individual targets.

The MDGs, although a move in the right direction, were subject to certain criticisms. One was that there was insufficient analysis to justify why these goals were selected as priorities and insufficient information available to be able to compare performance, especially in tackling inequalities within countries. 1 This highlighted the perennial challenge in such initiatives of balancing political consensus with scientific validity. Nevertheless, based on data compiled by the Inter-Agency and Expert Group on MDG indicators, 2 the UN could demonstrate considerable success on some goals, especially on reducing extreme poverty (numbers of people living on less than $1.25 per day), reducing both child and maternal mortality, increasing access for people living with HIV to antiretroviral treatment and reducing new HIV infections. However, the report recognized that ‘progress has been uneven across regions and countries’ in the implementation of the MDGs.

Perhaps most importantly, the Millennium Development Goals focussed primarily on the needs of developing countries reinforcing a binary view of rich and poorer countries, of donors and recipients and implying that the global challenge is a problem of development which international aid can help address, rather than a set of shared problems which only collective action globally can resolve.

The 17 Sustainable Development Goals (SDGs) with 169 targets are broader in scope and go further than the MDGs by addressing the root causes of poverty and the universal need for development that works for all people. The goals cover the three dimensions of sustainable development: economic growth, social inclusion and environmental protection.

Building on the success and momentum of the MDGs, the new global goals cover more ground, with ambitions to address inequalities, economic growth, decent jobs, cities and human settlements, industrialization, oceans, ecosystems, energy, climate change, sustainable consumption and production, peace and justice.

The new Goals are universal and apply to all countries, whereas the MDGs were intended for action in developing countries only.

A core feature of the SDGs is their strong focus on means of implementation: the mobilization of financial resources; capacity-building and technology; as well as data and institutions.

The new Goals recognize that tackling climate change is essential for sustainable development and poverty eradication. SDG 13 aims to promote urgent action to combat climate change and its impacts.

The UN resolution refers to five ‘areas of critical importance’; sometimes known as the 5 ‘P’s, these are People, Planet, Prosperity, Peace and Partnerships (see Table 1 ). The goals were launched with the strap-line of ‘Ensuring that no-one is left behind’ with its implication that development and levelling up will be the keys to progress by 2030. How this aspiration is reconciled with maintaining ecosystems and tackling climate change will be a challenge in itself. However, the SDGs do have a clear goal on climate action (Goal 13), which has been strengthened subsequently by the Paris Agreement of the 21st Conference of Parties (COP21) to the United Nations Framework Convention on Climate Change (UNFCCC). However, the SDGs are voluntary commitments by governments in contrast to the formal Paris Agreement which is legally binding now that it has been signed by 55% of parties and that those who have signed are responsible for more than 55% of greenhouse gas emissions. Also adopted in March 2015, and with a similar timescale, was the Sendai Framework for Disaster Risk Reduction (2015–30) which succeeded the Hyogo Framework for Action (2005–15); the Sendai Framework was agreed by 187 countries and was endorsed by the UN General Assembly in June 2015.

There is a wealth of published material on sustainable development in general and on the SDGs in particular from the UN, from international non-governmental organizations, and from many other concerned and committed organizations and individuals more locally. It is easy to get lost in all of this so we have been selective in the sources we have used. Most importantly, there is a widely held view that much more innovative ways to both collecting data and using data, from crowd sourcing to the use of big data, need to be used if the mechanisms for implementing and delivering the SDGs are to take full advantage of the data revolution.

There is a dedicated United Nations website on sustainable development ( http://www.un.org/sustainabledevelopment/ ) as well as a sustainable development knowledge platform ( https://sustainabledevelopment.un.org/ ) with updates on the High Level Political Forum, on individual topics and milestones, and a directory of resources including recent publications. Both sites have much supporting material on the SDGs and also on the challenge of integrating the three dimensions of sustainable development (economic, social and environmental).

The formal resolution adopted by the UN General Assembly in September 2015 was published on 21 October 2015. 3 In the same year the United Nations Statistical Commission created an Inter-Agency and Expert Group on SDG Indicators (IAEG-SDGs), which will coordinate proposals of a global indicator framework. 4 This should be properly recognized by all countries and associated organizations who are working towards consistent methods of tracking progress so that duplication can be avoided, gaps identified, and resources directed most effectively. While work continues on international action to support the SDGs, all countries are ‘expected to take ownership and establish a national framework for achieving the 17 goals’. The UN states that countries have the ‘primary responsibility for follow-up and review’ and this ‘will require quality, accessible and timely data collection’. In the UK, for example, the Office for National Statistics (ONS), has been working with the UK Stakeholders for Sustainable Development (UKSSD) to consult on national indicators for the SDGs. And some countries (notably Sweden, Germany, Colombia, the Philippines and Czechia) already have national institutional arrangements. 5

There is general agreement on the breadth and depth of the goals. There are clear obligations and responsibilities for all member states (for which they will be held to account) and a recognition that cross systems approaches to implementation will be needed. This is a significant change from the MDG process and requires explicit contributions from every country, particularly in developing and aligning the complex analytical tools to assess progress and assist decision making. The UN report on ‘critical milestones’ 6 refers to ‘an overarching vision and framework’. Getting accountability structures fit for purpose is already a key challenge. 7 A recent review in Nature 8 identifies that this requires a ‘new coherent way of thinking’ and that while it is implicit in the SDG logic that the goals depend on each other, no-one has specified exactly how. To help, different models have been developed, 9 including both scenario analysis and quantitative modelling. Some of these can be used as top-down macro-framework level tools and some as sectoral models for option level impact analysis. This independent review 7 of 16 countries who volunteered for national review (by the High Level Political Forum) noted a range of different approaches to deal with the complexity of the implementation process. Some countries with existing national sustainable development strategies have built on these and tried to align existing objectives with the new goals. Other countries have developed new national SDG Implementation Plans. Some have linked the SDGs to financial planning for sustainable development or sought to integrate SDGs either in sectoral planning (nutrition, education etc.) or in local government planning frameworks.

Other areas of agreement include the need to integrate the three dimensions of sustainable development (economic, social and environmental), 10 , 11 the importance of raising awareness and creating ownership and the need for stakeholder engagement. 7 , 8 This is especially important to address the widespread misbelief that sustainable development concerns only the environmental dimension and conflicts with necessary ‘economic growth’. No strategy, not even one agreed by all member states of the United Nations, can immediately address historical cultures; yet, it remains one of the most fundamental challenges (and opportunities) for us all to address. The reality is that addressing all three dimensions collaboratively will yield the greatest benefits, whilst the alternative—addressing them separately and in competitive isolation—will deliver much less and with greater risks.

The agreement on the need for ‘systems thinking’, and integration across the three dimensions, is welcome, but the difficulties inherent in this approach should not be under-estimated. This has been illustrated by recent worked examples and case studies.

One worked example 8 concludes that action on the route to zero hunger in sub-Saharan Africa interacts positively with Goal 1 (poverty), Goal 3 (health and well-being), and Goal 4 (quality education). However, it also notes that food production has a more complex interaction with Goal 13 (climate change mitigation). This is because agriculture contributes 20–35% of global greenhouse gases, so climate mitigation constrains some types of food production (particularly meat). Additionally, food production (Goal 2) can compete with renewable energy production (Goal 7) and eco-system protection (Goals 14 and 15). Conversely, climate stability (Goal 13) and preventing ocean acidification (Goal 14) will support sustainable food production and fisheries (Goal 2).

Similarly, the UN paper on mainstreaming the three dimensions 11 highlights water as a nexus of integration and describes how water and sanitation (Goal 6) underpin other areas such as health (Goal 3), food (Goal 2), energy (Goal 7), elimination of poverty (Goal 1), economic productivity (Goal 8), equity (Goal 10) and access to education (Goal 4).

Perhaps the biggest single controversy, particularly because simplicity and logic favour collaborative and system wide implementation, is the high number of goals, targets and supporting actions that have been agreed. This raises concerns about whether governments and international agencies have sufficient skills in ‘whole systems thinking’ 12 to implement the goals without the risk of ‘unintended consequences’ and ‘perverse outcomes’. 8 Early mapping exercises 8 , 11 , 12 have demonstrated the important interconnections between achieving goals but experience suggests that government departments and international negotiations do not always have the mandate or skills to realistically address what might at first appear to be inconvenient and politically contentious trade-offs 8 and unintended consequences.

Deciding which goals to prioritize and then assessing the positive (or negative impacts) on other goals, is a crucial step. There is scope for concern if governments, corporations or agencies were to prioritize energy production (to meet Goal 7), agricultural output (to meet Goal 2) or development of business and infrastructure (to meet Goals 8 and 9), without considering impacts on climate (Goal 13), water (Goal 14) or land (Goal 15). The root cause of this problem is the failure to imagine better ways of addressing energy, agricultural output and what defines success of a business in the 21st century. It is rarely more of what has gone before. The SDGs are the formal stimulus for us to innovate collectively at scale and pace; and to think and act better not bigger. For instance, we need to be more open to the increasing evidence of the many potential positive interactions between different Goals. More equitable and sustainable food systems would help to meet Goal 2, produce ecological benefits (Goals 13–15) and help tackle problems such as obesity and non-communicable disease (Goal 3). 8 , 12

Interestingly, although the SDGs and supporting targets make little mention of tackling world population growth, there are several studies illustrating how coordinated, whole system approaches to the SDGs are already stabilizing the global population. One paper 13 looks at how the SDG targets on mortality, reproductive health and education for girls will directly and indirectly influence future demographic trends. Another paper, 14 looking from the opposite perspective, describes how reductions in fertility in Africa could reduce dependency ratios (the proportion of population not economically active) and thus help tackle poverty (Goal 1), increase productivity (Goal 8), and improve education and gender equality (Goals 4 and 5).

It should be clear that each country will pursue these Global Goals differently, and that a key benefit of the SDG approach is a degree of local flexibility. However, there are certain goals which require urgent collective action, where the clock is ticking on the world’s ability to tackle changes that are already significantly impacting on planetary health. 15 This means that international collaboration must give primacy to action on climate change (Goal 13) and the need to make economic policy subservient to the minimization of environmental impact (see Goal 12: Responsible consumption and production). This is of increasing importance with the recent expressions of electoral judgements in some western countries. The danger is that electorates are seduced into abandoning collective responsibility for the three dimensions of sustainable development in the hope that this will produce short-term benefits for individual countries while ignoring the wider longer term environmental, social and economic costs, knowingly leaving these to be borne by future generations.

A significant risk of allowing countries to take unilateral and apparently self-interested approaches by opting out of multi-state arrangements and economic agreements is the threat of a ‘race to the bottom’ where a country adopts low taxation, relaxed labour laws and reduced regulation as a deceptively attractive way to avoid economic crises. This approach risks increasing health inequity alongside continued restraints on social assistance and environmental protection, with negative impacts on many of the SDGs. Alternatively, a country, region or state could seek to build an economy which is directed at realizing the combined economic, social and environmental benefits associated with implementing the SDGs, with a focus on renewable energy, sustainable food and agriculture and environmentally sustainable technology (recycling, energy conservation and the like). This may also provide a model of sustaining prosperity given the demographic changes and likely labour shortages if countries, such as the UK, shift away from an economic model which depends on a migrant labour force for continued growth.

Given that it took 21 years of annual conferences of parties to the United Nations Framework Convention on Climate Change before a substantial agreement for action (the Paris Agreement) was achieved in December 2015, there could well be international controversy if reneging on key global commitments weakens the collective resolve. If we accept the fact that human health, and its future survival and prosperity, depend on a liveable earth, we would argue therefore that a refocus of population health to ecological 16 and planetary health 15 is the golden thread which binds the SDGs together as a systems approach. 1 This brings us to a fundamental challenge for governments, businesses, consumers and communities.

To what extent can we seek to implement the SDGs by improvements in current systems and at what point do we need a paradigm shift in our outlook and aspirations? This subject has been explored in relation to health and food systems 17 and in relation to regional trade agreements and health related SDGs. 18 However, it has also been clearly addressed by the United Nations Environment Programme’s ‘Inquiry into the design of a sustainable financial system’. 19 This inquiry points out that ‘failure of the financial system to take adequate account of climate change could result in extensive damage to financial assets globally, may well threaten the stability of the financial system itself, and most importantly could impose irreversible damage to the underlying state of the real economy and the quality of life for those who depend on it for their livelihoods’, a point that has been repeatedly echoed by some of the most powerful financial organizations and people globally. It is not enough to simply wait until action is obviously needed. As Mark Carney, the Governor of the Bank of England, says: ‘…once climate change becomes a defining issue for financial stability, it may already be too late’. 20

The existing macroeconomic model had already been challenged by a report prepared for the UK’s Sustainable Development Commission in 2009 21 and developed further by their Economics Commissioner. 22 Essentially, this is a challenge to a global economic model, which sees wealth creation based on rising production to meet ever increased demand as the basis of development. This continued consumption based model would be unsustainable even if the world’s population was stable but is compounded by the projected increase from 6 billion people in 2000 to potentially 9 billion by 2050; the consequences in terms of resources consumed, waste generated and boundaries exceeded will be an unprecedented planetary emergency. 23

However, before we despair completely, some of these reports are also clear that there would be many social, environmental and economic benefits in changing our current model and that ‘transitioning to a green economy opens us to many opportunities as well as posing many challenges’. 19 , 21 The fundamental challenge is aligning the three dimensions across all 17 SDGs and that will challenge many current sectoral interests.

The UK Stakeholders for Sustainable Development recently coordinated an open letter, 24 from over 80 UK businesses, to the Prime Minister, asking her to highlight the UK’s commitment to the SDGs at the 2017 World Economic Forum in Davos. This included not just many UK ethical environmental businesses but also many more traditional major multinational companies such as Coca Cola, Tesco, HSBC, Nestle, Land Rover, KPMG and Standard Chartered. It would seem that large corporations are more aware of the need to fundamentally re-shape the economy than many political parties.

The last two centuries have seen huge advances in our understanding of what causes diseases in individuals. There has been far less progress in understanding systematically exactly what causes health in populations: from a village level or a planetary level. The challenge for this generation is to synthesize our knowledge into creating those conditions that foster health and protect us from poverty as much as they protect us from polio. If we continue to devote resources disproportionately to finding ever more detailed causes of disease without considering the solutions to some of the obvious problems we have created for ourselves and others, we will be breaking the implicit contract we have with future generations, with those people who have no voice or choice; that is the agreement that we make every effort to leave the world in a better place than we found it. Without understanding how we collectively protect and improve all those conditions that make life worth living for all, we will be forever remembered as the generation who knew too much and did too little. The art and science of making change is fraught with more human and cultural barriers than with technical or knowledge barriers. The SDGs provide perhaps the last best hope we have of being honest about why and how we should implement the evidence we already have. The number of challenges and opportunities we face, from demographic transitions to new models of economic activity and workforce development makes it essential that we embrace clear and systematic frameworks for action that are measurable and monitorable and for which we should all be held accountable and responsible. Every generation in history has faced global challenges. ‘We Are the First Generation that Can End Poverty, the Last that Can End Climate Change’. 25

The authors have no potential conflicts of interest.

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‘ Breaking the Tragedy of the Horizon – climate change and financial stability ’ Speech given by Mark Carney Governor of the Bank of England Chairman of the Financial Stability Board Lloyd’s of London 29 September 2015. http://www.bankofengland.co.uk/publications/Documents/speeches/2015/speech844.pdf (17 February 2017, date last accessed).

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Sustainable Development Goals: 17 Goals to Transform our World​

• Introduction

The Sustainable Development Goals are a universal call to action to end poverty, protect the planet and improve the lives and prospects of everyone, everywhere.

The Goals were adopted by all United Nations Member States in September 2015 as part of the 2030 Agenda for Sustainable Development which sets out a 15-year plan to achieve the Goals and their related targets. Never before had world leaders pledged common action across such a broad and universal policy agenda.

The 17 Goals are interconnected, apply to all countries, and need to be carried out by all stakeholders – governments, the private sector, civil society, the United Nations system and others – in a collaborative partnership.

This year marks the midpoint of SDG implementation. However, on its current course, the world may miss many Sustainable Development Goals targets by 2030. For the first time in decades, development progress has stalled and even reversed under the combined weight of climate disasters, conflict, economic downturn and the lingering aftermath of COVID-19. The SDG Summit, held on 18 to 19 September 2023 at the UN Headquarters in New York is a unique opportunity for the world to pivot from crisis to development and deliver the breakthroughs needed to achieve the Goals.

This exhibit illustrates the Sustainable Development Goals through photos from around the world, bringing to life what the 17 Goals mean for people on the planet.

This exhibit was produced by the UN Department of Global Communications.

End poverty in all its forms everywhere

In 2020, the number of people living in extreme poverty  (living on less than USD 2.15 a day) rose to 724 million. Those living in extreme poverty struggle to fulfill the most basic needs (health, education, access to water and sanitation).

Recovery from the pandemic has been slow and uneven, with extreme poverty dropping from 9.3 per cent in 2020 to 8.8 per cent in 2021. The conflict in Ukraine has disrupted global trade, leading to increased living costs that are disproportionately impacting the poor. Furthermore, climate change poses substantial threats to poverty reduction. 

By the end of 2022, nowcasting suggests that 8.4 per cent of the world’s population, or as many as 670 million people, could still be living in extreme poverty.

Poverty affects developed countries as well. Right now, 30 million children are growing up poor in the world's richest countries.

Eradicating poverty in all its forms remains one of the greatest challenges facing humanity. While the number of people living in extreme poverty dropped by more than half between 1990 and 2015 – from 1.9 billion to 731 million – too many are still struggling for the most basic human needs.

A surge in action and investment to enhance economic opportunities, improve education and extend social protection to all, particularly the most excluded, is crucial to delivering on the central commitment to end poverty and leave no one behind.

End hunger, achieve food security and improved nutrition and promote sustainable agriculture

In 2022, about 9.2 per cent of the world population was facing chronic hunger, equivalent to about 735 million people - 122 million more than in 2019. Hunger and malnutrition are barriers to sustainable development because hungry people are less productive, more prone to disease, and less able to improve their livelihoods.

To nourish today’s 735 million hungry people and the additional 2 billion people expected by 2050, a profound change of the global food and agriculture system is needed.

To achieve zero hunger by 2030, urgent coordinated action and policy solutions are imperative to address entrenched inequalities, transform food systems, invest in sustainable agricultural practices, and reduce and mitigate the impact of conflict and the pandemic on global nutrition and food security.

Ensure healthy lives and promote well-being for all at all ages

Great strides have been made in improving people’s health in recent years. 146 out of 200 countries or areas have already met or are on track to meet the SDG target on under-5 mortality. Effective HIV treatment has cut global AIDS-related deaths by 52 per cent since 2010 and at least one neglected tropical disease has been eliminated in 47 countries.

However, inequalities in health care access still persist. The COVID-19 pandemic and other ongoing crises have impeded progress towards Goal 3. Childhood vaccinations have experienced the largest decline in three decades, and tuberculosis and malaria deaths have increased compared with pre-pandemic levels.

The Sustainable Development Goals (SDGs) make a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. The aim is to achieve universal health coverage, and provide access to safe and affordable medicines and vaccines for all.

To overcome these setbacks and address long-standing health care shortcomings, increased investment in health systems is needed to support countries in their recovery and build resilience against future health threats.

Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all

Progress towards quality education was already slower than required before the pandemic, but COVID-19 has had devastating impacts on education, causing learning losses in four out of five of the 104 countries studied.

Without additional measures, an estimated 84 million children and young people will stay out of school and approximately 300 million students will lack the basic numeracy and literacy skills necessary for success in life.

In addition to free primary and secondary schooling for all boys and girls by 2030, the aim is to provide equal access to affordable vocational training, eliminate gender and wealth disparities, and achieve universal access to quality higher education.

Education is the key that will allow many other Sustainable Development Goals (SDGs) to be achieved. When people are able to get quality education they can break from the cycle of poverty.

Education helps to reduce inequalities and to reach gender equality. It also empowers people everywhere to live more healthy and sustainable lives. Education is also crucial to fostering tolerance between people and contributes to more peaceful societies.

Achieve gender equality and empower all women and girls

Women and girls represent half of the world’s population and therefore also half of its potential. But gender inequality persists everywhere and stagnates social progress.

On average, women in the labor market still earn 23 percent less than men globally. On average, women spend about three times as many hours in unpaid domestic and care work as men.

Sexual violence and exploitation, the unequal division of unpaid care and domestic work, and discrimination in public office, all remain huge barriers. All these areas of inequality have been exacerbated by the COVID-19 pandemic: there has been a surge in reports of sexual violence, women have taken on more care work due to school closures, and 70% of health and social workers globally are women.

At the current rate, it will take an estimated 300 years to end child marriage, 286 years to close gaps in legal protection and remove discriminatory laws, 140 years for women to be represented equally in positions of power and leadership in the workplace, and 47 years to achieve equal representation in national parliaments.

Political leadership, investments and comprehensive policy reforms are needed to dismantle systemic barriers to achieving Goal 5. Gender equality is a cross-cutting objective and must be a key focus of national policies, budgets and institutions.

Gender equality is not only a fundamental human right, but a necessary foundation for a peaceful, prosperous and sustainable world.

Ensure availability and sustainable management of water and sanitation for all

Access to water, sanitation and hygiene is a human right. Yet billions are still faced with daily challenges accessing even the most basic of services.

Water scarcity is projected to increase with the rise of global temperatures as a result of climate change. In 2020, 2.4 billion people lived in water-stressed countries.

In 2022, 2.2 billion people still lacked safely managed drinking water, including 703 million without a basic water service; 3.5 billion people lacked safely managed sanitation, including 1.5 billion without basic sanitation services; and 2 billion lacked a basic handwashing facility, including 653 million with no handwashing facility at all.

There has been positive progress. Between 2015 and 2022, the proportion of the world's population with access to safely managed drinking water increased from 69 per cent to 73 per cent.

Investments in infrastructure and sanitation facilities; protection and restoration of water-related ecosystems; and hygiene education are among the steps necessary to ensure universal access to safe and affordable drinking water for all by 2030.

But we are still not on track to reach Goal 6 by 2030. To get back on track, key strategies include increasing sector-wide investment and capacity-building, promoting innovation and evidence-based action, enhancing cross-sectoral coordination and cooperation among all stakeholders, and adopting a more integrated and holistic approach to water management.

Ensure access to affordable, reliable, sustainable and modern energy for all

Our everyday life depends on reliable and affordable energy. And yet the consumption of energy is the dominant contributor to climate change, accounting for around 60 percent of total global greenhouse gas emissions.

From 2015 to 2021, the proportion of the global population with access to electricity has increased from 87 per cent to 91 per cent. In 2021, developing countries installed a record-breaking 268 watts per capita of renewable energy-generating capacity. And yet, in 2021 there were still 675 million people around the world with no access to electricity.

Ensuring universal access to affordable electricity by 2030 means investing in clean energy sources such as solar, wind and thermal. Expanding infrastructure and upgrading technology to provide clean energy in all developing countries is a crucial goal that can both encourage growth and help the environment.

To ensure access to energy for all by 2030, we must accelerate electrification, increase investments in renewable energy, improve energy efficiency and develop enabling policies and regulatory frameworks.

Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all

Multiple crises are placing the global economy under serious threat. Global real GDP per capita growth is forecast to slow down in 2023 and with ever increasing challenging economic conditions, more workers are turning to informal employment.

Globally, labour productivity has increased and the unemployment rate has decreased. However, more progress is needed to increase employment opportunities, especially for young people, reduce informal employment and labour market inequality (particularly in terms of the gender pay gap), promote safe and secure working environments, and improve access to financial services to ensure sustained and inclusive economic growth.

The global unemployment rate declined significantly in 2022, falling to 5.4 per cent from a peak of 6.6 per cent in 2020 as economies began recovering from the shock of the COVID-19 pandemic. This rate was lower than the pre-pandemic level of 5.5 per cent in 2019.

A persistent lack of decent work opportunities, insufficient investments and under-consumption contribute to the erosion of the basic social contract: that all must share in progress. The creation of quality jobs remain a major challenge for almost all economies.

Achieving Goal 8 will require a wholesale reform of the financial system to tackle rising debts, economic uncertainty and trade tensions, while promoting equitable pay and decent work for young people.

Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation

The manufacturing industry's recovery from COVID-19 is incomplete and uneven. Global manufacturing growth slowed down to 3.3 per cent in 2022, from 7.4 per cent in 2021.

The share of manufacturing in Least Developed Countries (LDCs) remains low, posing a serious challenge to the target of doubling industry’s share of GDP by 2030. However, medium-high and high-technology industries demonstrated robust growth rates.

As of 2022, 95 per cent of the world’s population was within reach of a mobile broadband network, but some areas remain underserved.

Investments in infrastructure – transport, irrigation, energy and information and communication technology – are crucial to achieving sustainable development and empowering communities in many countries.

To achieve Goal 9 by 2030, it is also essential to support LDCs, invest in advanced technologies, lower carbon emissions and increase mobile broadband access.

Reduce inequality within and among countries

Inequality threatens long-term social and economic development, harms poverty reduction and destroys people’s sense of fulfillment and self-worth.

The incomes of the poorest 40 per cent of the population had been growing faster than the national average in most countries. But emerging yet inconclusive evidence suggests that COVID-19 may have put a dent in this positive trend of falling within-country inequality.

The pandemic has caused the largest rise in between-country inequality in three decades.

Reducing both within- and between-country inequality requires equitable resource distribution, investing in education and skills development, implementing social protection measures, combating discrimination, supporting marginalized groups and fostering international cooperation for fair trade and financial systems.

Make cities and human settlements inclusive, safe, resilient and sustainable

Half of the world’s population live in cities. This is projected to reach 70 per cent by 2050.

In the developing world, the rapid growth of cities, along with the increasing rural to urban migration, has led to a boom in mega-cities. In 1990, there were ten mega-cities with 10 million inhabitants or more. In 2014, there are 28 mega-cities, home to a total of 453 million people.

This rapid urbanization outpaces the development of housing, infrastructure and services, which led to a rise in slums or slum-like conditions.  In 2020, an estimated 1.1 billion urban residents lived in slums or slum-like conditions. Over the next 30 years, an additional 2 billion people are expected to live in such settlements.

Sustainable development cannot be achieved without significantly transforming the way urban spaces are built and managed.

Making cities safe and sustainable means ensuring access to safe and affordable housing, upgrading slum settlements, investing in public transport, creating green spaces, and improving urban planning and management in a way that is both participatory and inclusive.

Ensure sustainable consumption and production patterns

If the global population reaches 9.8 billion by 2050, the equivalent of almost three planets will be required to provide the natural resources needed to sustain current lifestyles.

Global crises triggered a resurgence in fossil fuel subsidies, nearly doubling from 2020 to 2021.

In 2021, governments spent an estimated $732 billion on subsidies for coal, oil and gas, nearly doubling the $375 billion spent in 2020.

In 2021, although 828 million people were facing hunger, 13.2 per cent of the world's food was lost after harvest along the supply chain from farm to consumer.

The trend towards sustainability reporting is on the rise, with around 70 per cent of monitored companies publishing sustainability reports in 2021.

In 2022, 67 national governments reported to the United Nations Environment Programme on the implementation of sustainable public procurement policies and action plans, a 50 per cent increase from 2020.

Support should be provided to developing countries to move towards more sustainable patterns of consumption by 2030.

Take urgent action to combat climate change and its impacts

Climate change affects every country on every continent. It is caused by human activities and threatens the future of our planet. With rising greenhouse gas emissions, climate change is occurring at rates much faster than anticipated and its effects are clearly felt world-wide.

The impacts include changing weather patterns, rising sea level, and more extreme weather events. If left unchecked, climate change will undo a lot of the progress made over the past years in development. It will also provoke mass migrations that will lead to instability and wars.

Between 2010 and 2020, highly vulnerable regions, home to approximately 3.3–3.6 billion people, experienced 15 times higher human mortality rates from floods, droughts and storms compared to regions with very low vulnerability.

Sea levels continued to rise in 2022, reaching a new record since satellite measurements in 1993.

Affordable, scalable solutions are now available to enable countries to leapfrog to cleaner, more resilient, and low-carbon economies.

Climate change is a global challenge that requires coordinated international cooperation.

Conserve and sustainably use the oceans, seas and marine resources for sustainable development

Oceans cover three-quarters of the Earth’s surface, contain 97 percent of the Earth’s water, and represent 99 percent of the living space on the planet by volume.

The world’s oceans provide key natural resources including food, medicines, biofuels and other products; help with the breakdown and removal of waste and pollution; and their coastal ecosystems act as buffers to reduce damage from storms.

However, marine pollution is reaching alarming levels, with over 17 million metric tons clogging the ocean in 2021, a figure set to double or triple by 2040.

Currently, the ocean’s average pH is 8.1, about 30 per cent more acidic than in pre-industrial times. Ocean acidification threatens the survival of marine life, disrupts the food web, and undermines vital services provided by the ocean and our own food security.

Careful management of this essential global resource is a key feature of a sustainable future. This includes increasing funding for ocean science, intensifying conservation efforts, and urgently turning the tide on climate change to safeguard the planet's largest ecosystem.

Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, halt and reverse land degradation, and halt biodiversity loss

Terrestrial ecosystems are vital for sustaining human life, contributing to over half of global GDP and encompassing diverse cultural, spiritual, and economic values.

Global forest coverage decreased from 31.9 per cent in 2000 (4.2 billion hectares) to 31.2 per cent (4.1 billion hectares) in 2020.

In 2021, Official Development Assistance (ODA) in support of biodiversity increased by 26.2 per cent from $7.7 billion  in 2020 to $9.8 billion.

In 2022,  21 per cent of reptile species are threatened.

Between 2015 and 2019, at least 100 million hectares of healthy and productive land were degraded every year, impacting the lives of 1.3 billion people.

Halting deforestation and restoring the use of terrestrial ecosystems is necessary to reduce the loss of natural habitats and biodiversity which are part of our common heritage.

Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels

People everywhere should be free of fear from all forms of violence and feel safe as they go about their lives whatever their ethnicity, faith or sexual orientation.

Civilian deaths directly related to 12 of the world’s deadliest conflicts increased by 53 per cent between 2021 and 2022, marking the first rise since the adoption of the 2030 Agenda in 2015.  The year 2022 witnessed a more than 50 per cent increase in conflict-related civilian deaths.

High levels of armed violence and insecurity have a destructive impact on a country’s development.

Sexual violence, crime, exploitation and torture are prevalent where there is conflict or no rule of law, and countries must take measures to protect those who are most at risk.

As of the end of 2022, 108.4 million people were forcibly displaced worldwide – an increase of 19 million compared with the end of 2021 and two and a half times the number of a decade ago.

In 2021, there were approximately 458,000 intentional homicides – the highest number in the past two decades.

Governments, civil society and communities need to work together to find lasting solutions to conflict and insecurity. Strengthening the rule of law and promoting human rights is key to this process, as is reducing the flow of illicit arms, combating corruption, and ensuring inclusive participation at all times.

Strengthen the means of implementation and revitalize the global partnership for sustainable development

The 2030 Agenda for Sustainable Development is universal and calls for action by all countries – developed and developing – to ensure no one is left behind. It requires partnerships between governments, the private sector, and civil society.

The Sustainable Development Goals can only be realized with a strong commitment to global partnership and cooperation.

The total external debt of low- and middle-income countries reached $9 trillion in 2021, recording a 5.6 per cent increase from 2020.

In 2022, global exports increased sharply by 12.3 per cent, and global trade reached a record $32 trillion.

In 2022, net ODA flows by member countries of the Development Assistance Committee (DAC) reached $206 billion.

To be successful, everyone will need to mobilize both existing and additional resources, and developed countries will need to fulfill their official development assistance commitments.

Now is the time for change. A confluence of multiple global crises have upended our lives. The way we work, the way we interact, the way we move about. This can be a turning point. Let's seize the moment and change course - toward more sustainable lifestyles. Small changes in your daily life can save you money, improve your health and help cut harmful pollution.

The 2030 Agenda for Sustainable Development is guided by the purposes and principles of the Charter of the United Nations and is grounded in the Universal Declaration of Human Rights.

As such, the Agenda's Sustainable Development Goals aim not only to achieve sustainable development in its three dimensions – economic, social and environmental – but also to foster peaceful, just and inclusive societies, realizing the human rights of all.

They offer a blueprint for tackling the defining issues of our time, such as climate change, which requires urgent and transformative action that leaves no one behind.

The United Nations and its agencies, funds and programmes are working with Member States, civil society, the private sector and other stakeholders to accelerate progress toward the Goals, in a spirit of global solidarity, focused in particular on the needs of the poorest and most vulnerable.

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This exhibit was launched in September 2020 and updated in August 2023

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SDG 3: Good Health & Well-Being

Sustainable Development Goal 3 (SDG 3) is one of the 17 Sustainable Development Goals established by the United Nations in 2015. The official wording of SDG 3 is: “To ensure healthy lives and promote well-being for all at all ages.” SDG 3 research focuses on key targets like: reducing maternal mortality, ending all preventable deaths for children under five, fighting communicable diseases, reducing mortality from non-communicable diseases, and promoting mental health — all with the aim of stopping needless suffering from preventable diseases and premature death.

Breaking Barriers for Gender and Health Equity Through Research

After the success of the 2022 Nature Conference on “Breaking Barriers for gender equity through research”, we continue our exploration of gender equity by putting the spotlight on gender and health equity.

This global virtual conference comprising a combination of keynote talks, fireside chats and panel discussions, will explore some of the key challenges at the intersection of the UN's Sustainable Development Goal 10 “Reduced inequalities", Goal 5 “Gender equality”, and Goal 3 “Good Health and Well-being”.

A key aspect of this conference will be breaking barriers and making connections across genders, between early and late careers, and between researchers, policymakers and health practitioners. The conference will also feature a mentorship programme.

September 10 - 11, 2024  |  2 days  |  Free virtual event

Find out more & register today!

Featured journals.

Explore a few hand-picked journals below and find many more >>>   journals and article collections on the dedicated website.

Topical Collections & Special Issues relevant to SDG3

Special Issues and Collections open for submission

Mind the submission deadline

- One Health for Headache (The Journal of Headache and Pain)

-  Ethical considerations in decision-making for gender-affirming care   (BMC Medical Ethics)

-  Stigma and mental health in infectious diseases   (BMC Global and Public Health)

Ongoing Topical Collections - Read papers and contribute yours

-  Long-term Impact of COVID in Cancer Patients  (multiple journals)

-  Cancer Disparities (multiple journals)

-  Global climate change: the defining issue of our time for our children’s health (Pediatric Research)

-  Impact of climate change on non-communicable diseases (multiple journals)

-  Elimination of infectious diseases of poverty as a key contribution to achieving the SDGs  (multiple journals)

-  Disparities in access to sexual and reproductive health services ( BMC Women's Health & BMC Pregnancy and Childbirth )

-  Quality improvement in maternal and reproductive health services   (BMC Pregnancy and Childbirth and BMC Women's Health)

-  Progress towards the Sustainable Development Goals (multiple journals)

See more Collections

The Sustainable Development Goals Series

Discover the latest SDG3-related books published in Springer Nature’s Sustainable Development Goals Series.  The Series features research on each of the SDGs, addressing the urgent global challenges facing humanity. The books published in the Series feature impactful contributions that support the efforts to make the SDGs a reality.  

Browse the entire book series

Key topics in SDG 3

Suicide Prevention

Explore a compilation of multidisciplinary research on suicide prevention. Learn more about this devastating global challenge.

Mental Health

An exclusive collection of the latest research from across disciplines and imprints that highlight how mental health and well-being are impacted by social, cultural and environmental disparities.

Our Nurses. Our Future

We are proud to support the nursing community with a global nursing and midwifery program. Read inspiring blogs and highlighted articles and book chapters.

Migration and Health

...and much more. Discover our curated collection on all topics related to the burning issue of migration including ‘Migration and Health’.

Climate Change & Health

The reality of climate change is inextricable from human health. Springer Nature has published a broad range of scholarship on these topics, which will help guide policy to address these challenges.

Health Humanities

Explore multidisciplinary research at the intersection of humanities, health, medicine and well-being.

Springer Nature's SDG OA Book Collection

Why publish SDG research as an open access (OA) book? 

Because OA’s enhanced and equitable visibility means that research can reach the broader audience, and findings can be translated into actionable strategy. Explore OA books that support sustainable development and learn more about publishing your book OA - including funding options.

Explore OA books & publishing options

Your work here: information for authors.

You can add impact and power to your SDG-related research when you publish it at Springer Nature, and alongside leading research (like the examples above). Research published OA at Springer Nature gets more exposure . For example, research published in fully OA Springer Nature journals are downloaded over 7,000 times on average (up to 5x more than competitors) and cited 7.39 times on average.

Publishing with Springer Nature gives you:

• A range of journals , from Nature, Springer, and BMC, both hybrid and OA. The journals with SDG content curated above are a small selection of journals you can publish in. Clicking through on them will give you the information — including journal metrics, submission guidelines and more — that you need to plan your next submission.
• The world’s leading scholarly book program, including the option to publish your book OA. ᐅ SDG 3 OA Books
• Support in finding funding for OA. Many funders and institutions now cover open access (OA) journal article publishing costs for affiliated researchers, as part of an OA agreement with Springer Nature.  Find out more about OA agreements and whether you may be entitled to publish OA journal articles with your fees covered. The OA funding support service can help you find and access other OA publishing funds — for journal articles and books — to which you may be entitled.  ᐅ OA Agreements    ᐅ Funding Support Service   ᐅ The impact of OA
• Support in writing and publishing your work — both free, including tutorials and paid research solutions services, including editing, translation, and more.  ᐅ Author Services   ᐅ Research Solutions
• An easy way to get started on a book . Even if it is only a germ of an idea, by filling in this form , you will be put in touch with an editor who can help you grow it into a fully formed book.  ᐅ Submit your book idea

Committed to the SDGs and open access

News, insights, and stories on the UN Sustainable Development Goals, open access (OA), accessibility and knowledge transfer.

Open for Progress

Stefan von Holtzbrinck and Frank Vrancken Peeters introduce Springer Nature's latest Sustainable Business report, Open for Progress.

Life In Research

Advancing inclusive practices in research publishing and solutions at Springer Nature

From providing knowledge to improving products and services.

Open research

Why is Open Science and Open Access central to who we are at Springer Nature?

Our CPO Harsh Jegadeesan disucsses our latest OA report and the role of open science.

Supporting sustainable development at a crucial milestone moment

Joyce Lorigan reflects on Springer Nature’s work to support the sustainable development goals (SDGs), as the halfway point of the goals is marked by the UN.

Blogs related to SDG3

Meet the SDG 3 Researcher Blog Series . 

In this series , we interview academics and practitioners working in diverse fields to achieve SDG 3. Particular focus is on researchers based in, or working in settings in the Global South, minorities, and female scientists, and whose work is bridging gaps between disciplines, countries, and basic and applied research.

How Will the Monkeypox Outbreak Affect the Hajj and World Cup – And What Can Be Done About It?

Ashwaq M Al-Nazawi and Ernest Tambo look at how the Monkeypox outbreak will affect the Hajj and World Cup, as well as what ca be done to help mitigate its effects.

How much would it cost to provide maternity leave to working mothers in Indonesia’s informal sector?

New research reveals that the annual cost to provide maternity cash transfers to women working in Indonesia’s informal sector would be a worthwhile investment. 

The importance of gender justice and equality in global education

Professor Leona M. English talks to us about gender justice and equality in global education.

Telehealth during COVID-19: the impact on services for people with substance use disorder

This describe the experiences and COVID-19 induced challenges pivoting to telehealth faced by projects funded under the Health Resources and Services Administration’s (HRSA’s) Rural Communities Opioid Response Program (RCORP).

Biodiversity and sustainability’s role in preventing pandemics

Globalisation and lack of environmental sustainability are the cause of the increased spread of zoonoses, such as Covid-19. While finding a vaccine may bring this current crisis to an end, to avoid new pandemics we must address the root cause of these outbreaks and build more sustainable societies.

A Personalized Approach to HIV

In this blog, Andrea Savarino focuses on some of the efforts aimed at finding a therapeutic vaccine, and, in particular, on a novel wave of research, to which he's participated and which recently resulted in a clinical trial giving proof of concept for personalized immunization strategy based on highly conserved portions of HIV.

More Information

Research Highlights >>>  Read and explore your interests from  over 60 subject areas . Find highlighted journals and books from across our imprints, curated by our Editors.

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SDG 3: Ensure healthy lives and promote well-being for all at all ages

Sdg compass.

• Business Tools
• Business Indicators

The role of business

Health is a fundamental human right and a key indicator of sustainable development. Poor health threatens the rights of children to education, limits economic opportunities for men and women and increases poverty within communities and countries around the world. In addition to being a cause of poverty, health is impacted by poverty and strongly connected to other aspects of sustainable development, including water and sanitation, gender equality, climate change and peace and stability.

In recent years, notable progress has been made, but significant challenges remain. Women around the world continue to lack access to sexual and reproductive health care; thousands of new cases of HIV/AIDS continue to occur each day, billions of people are left without access to essential medicines, millions of adults and children will suffer from undernourishment this year, and the global amount of waste is estimated to triple in the coming year, with severe effects on health Further, with an increase in economic integration, mobility and political instability new health challenges and risks are emerging, threatening livelihoods in both the global North and South.

In order to accelerate progress and address new health challenges, all actors, including the private sector need to partner to develop health care solutions that work for people, families, communities and nations. At minimum business has a responsibility to respect all human rights, including the right to health. Small, medium and large companies can both benefit from and contribute to achieving healthy societies. The SDGs provide a new opportunity for the private sector to support the delivery of health needs around the world through their products, services and business activities including value chains and distribution networks, communication activities, occupational health and safety practices and provision of employee benefits. By ensuring that workers have safe working conditions and access to health services, companies establish healthier staff and better relationships which in many cases has positive effects on productivity.

Key business themes addressed by this SDG

• Occupational health and safety
• Access to medicines
• Access to quality essential health care services
• Air quality
• Water quality

Examples of key business actions and solutions

The below examples are non-exhaustive and some may be more relevant to certain industries than to others.

• Align human resources policies with principles of human rights, including policies for HIV/AIDS. Use already existing resources for guidance (e.g. from the ILO, WHO, etc.).
• Partner with health care NGOs and public clinics to raise awareness and increase access to targeted health services for women and men workers and their families.
• Make investments in health a priority in business operations.
• Facilitate and invest in affordable medicine and health care for low-income populations.
• Leverage corporate resources (e.g. R&D, distribution, cold chains) to support health care delivery by public and international organizations.

Examples of key business indicators

• Access to Medicine Index, C.III.1: Portion of financial R&D investments dedicated to Index Diseases out of the company’s total R&D expenditures
• CEO Water Mandate’s Corporate Water Disclosure Guidelines: % of facilities adhering to relevant water quality standard(s)
• GRI G4 Sustainability Reporting Guidelines, G4-LA6: Type of injury and rates of injury, occupational diseases, lost days, and absenteeism, and total number of work-related fatalities, by region and by gender
• Oxfam Poverty Footprint, PF - 14.4 (B): Where the Company has set up health services for workers, does it make the service available to the family and community members? If yes, how many people have benefited from this service?

The complete overview of business indicators can be found at Business Indicators

Examples of key business tools

• Social Hotspots Database/Portal (SHDB)
• UN Global Compact-Oxfam Poverty Footprint Tool
• Corporate Human Rights Benchmark (CHRB)

The complete overview of business tools can be found at Business Tools

The SDG targets

3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

3.2 By 2030, end preventable deaths of newborns and under-five children

3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases

3.4 By 2030, reduce by one-third pre-mature mortality from non-communicable diseases (NCDs) through prevention and treatment, and promote mental health and wellbeing

3.5 Strengthen prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

3.6 By 2020, halve global deaths and injuries from road traffic accidents

3.7 By 2030, ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs

3.8 Achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all

3.9 By 2030 substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination

3.a. Strengthen implementation of the Framework Convention on Tobacco Control in all countries as appropriate

3.b. Support research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration which affirms the right of developing countries to use to the full the provisions in the TRIPS agreement regarding flexibilities to protect public health and, in particular, provide access to medicines for all

3.c. Increase substantially health financing and the recruitment, development and training and retention of the health workforce in developing countries, especially in LDCs and SIDS

3.d. Strengthen the capacity of all countries, particularly developing countries, for early warning, risk reduction, and management of national and global health risks

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Essay on Sustainable Development: Samples in 250, 300 and 500 Words

• Updated on  
• Nov 18, 2023

On 3rd August 2023, the Indian Government released its Net zero emissions target policy to reduce its carbon footprints. To achieve the sustainable development goals (SDG) , as specified by the UN, India is determined for its long-term low-carbon development strategy. Selfishly pursuing modernization, humans have frequently compromised with the requirements of a more sustainable environment.

As a result, the increased environmental depletion is evident with the prevalence of deforestation, pollution, greenhouse gases, climate change etc. To combat these challenges, the Ministry of Environment, Forest and Climate Change launched the National Clean Air Programme (NCAP) in 2019. The objective was to improve air quality in 131 cities in 24 States/UTs by engaging multiple stakeholders.

‘Development is not real until and unless it is sustainable development.’ – Ban Ki-Moon

The concept of Sustainable Development in India has even greater relevance due to the controversy surrounding the big dams and mega projects and related long-term growth. Since it is quite a frequently asked topic in school tests as well as competitive exams , we are here to help you understand what this concept means as well as the mantras to drafting a well-written essay on Sustainable Development with format and examples.

This Blog Includes:

What is sustainable development, 250-300 words essay on sustainable development, 300 words essay on sustainable development, 500 words essay on sustainable development, introduction, conclusion of sustainable development essay, importance of sustainable development, examples of sustainable development.

As the term simply explains, Sustainable Development aims to bring a balance between meeting the requirements of what the present demands while not overlooking the needs of future generations. It acknowledges nature’s requirements along with the human’s aim to work towards the development of different aspects of the world. It aims to efficiently utilise resources while also meticulously planning the accomplishment of immediate as well as long-term goals for human beings, the planet as well and future generations. In the present time, the need for Sustainable Development is not only for the survival of mankind but also for its future protection. 

Looking for ideas to incorporate in your Essay on Sustainable Development? Read our blog on Energy Management – Find Your Sustainable Career Path and find out!

To give you an idea of the way to deliver a well-written essay, we have curated a sample on sustainable development below, with 250-300 words:

To give you an idea of the way to deliver a well-written essay, we have curated a sample on sustainable development below, with 300 + words:

Must Read: Article Writing

To give you an idea of the way to deliver a well-written essay, we have curated a sample on sustainable development below, with 500 + words:

Essay Format

Before drafting an essay on Sustainable Development, students need to get familiarised with the format of essay writing, to know how to structure the essay on a given topic. Take a look at the following pointers which elaborate upon the format of a 300-350 word essay.

Introduction (50-60 words) In the introduction, students must introduce or provide an overview of the given topic, i.e. highlighting and adding recent instances and questions related to sustainable development. Body of Content (100-150 words) The area of the content after the introduction can be explained in detail about why sustainable development is important, its objectives and highlighting the efforts made by the government and various institutions towards it.  Conclusion (30-40 words) In the essay on Sustainable Development, you must add a conclusion wrapping up the content in about 2-3 lines, either with an optimistic touch to it or just summarizing what has been talked about above.

How to write the introduction of a sustainable development essay? To begin with your essay on sustainable development, you must mention the following points:

• What is sustainable development?
• What does sustainable development focus on?
• Why is it useful for the environment?

How to write the conclusion of a sustainable development essay? To conclude your essay on sustainable development, mention why it has become the need of the hour. Wrap up all the key points you have mentioned in your essay and provide some important suggestions to implement sustainable development.

The importance of sustainable development is that it meets the needs of the present generations without compromising on the needs of the coming future generations. Sustainable development teaches us to use our resources in the correct manner. Listed below are some points which tell us the importance of sustainable development.

• Focuses on Sustainable Agricultural Methods – Sustainable development is important because it takes care of the needs of future generations and makes sure that the increasing population does not put a burden on Mother Earth. It promotes agricultural techniques such as crop rotation and effective seeding techniques.
• Manages Stabilizing the Climate – We are facing the problem of climate change due to the excessive use of fossil fuels and the killing of the natural habitat of animals. Sustainable development plays a major role in preventing climate change by developing practices that are sustainable. It promotes reducing the use of fossil fuels which release greenhouse gases that destroy the atmosphere.
• Provides Important Human Needs – Sustainable development promotes the idea of saving for future generations and making sure that resources are allocated to everybody. It is based on the principle of developing an infrastructure that is can be sustained for a long period of time.
• Sustain Biodiversity – If the process of sustainable development is followed, the home and habitat of all other living animals will not be depleted. As sustainable development focuses on preserving the ecosystem it automatically helps in sustaining and preserving biodiversity.
• Financial Stability – As sustainable development promises steady development the economies of countries can become stronger by using renewable sources of energy as compared to using fossil fuels, of which there is only a particular amount on our planet.

Mentioned below are some important examples of sustainable development. Have a look:

• Wind Energy – Wind energy is an easily available resource. It is also a free resource. It is a renewable source of energy and the energy which can be produced by harnessing the power of wind will be beneficial for everyone. Windmills can produce energy which can be used to our benefit. It can be a helpful source of reducing the cost of grid power and is a fine example of sustainable development. 
• Solar Energy – Solar energy is also a source of energy which is readily available and there is no limit to it. Solar energy is being used to replace and do many things which were first being done by using non-renewable sources of energy. Solar water heaters are a good example. It is cost-effective and sustainable at the same time.
• Crop Rotation – To increase the potential of growth of gardening land, crop rotation is an ideal and sustainable way. It is rid of any chemicals and reduces the chances of disease in the soil. This form of sustainable development is beneficial to both commercial farmers and home gardeners.
• Efficient Water Fixtures – The installation of hand and head showers in our toilets which are efficient and do not waste or leak water is a method of conserving water. Water is essential for us and conserving every drop is important. Spending less time under the shower is also a way of sustainable development and conserving water.
• Sustainable Forestry – This is an amazing way of sustainable development where the timber trees that are cut by factories are replaced by another tree. A new tree is planted in place of the one which was cut down. This way, soil erosion is prevented and we have hope of having a better, greener future.

Related Articles

The Sustainable Development Goals (SDGs) are a set of 17 global goals established by the United Nations in 2015. These include: No Poverty Zero Hunger Good Health and Well-being Quality Education Gender Equality Clean Water and Sanitation Affordable and Clean Energy Decent Work and Economic Growth Industry, Innovation, and Infrastructure Reduced Inequality Sustainable Cities and Communities Responsible Consumption and Production Climate Action Life Below Water Life on Land Peace, Justice, and Strong Institutions Partnerships for the Goals

The SDGs are designed to address a wide range of global challenges, such as eradicating extreme poverty globally, achieving food security, focusing on promoting good health and well-being, inclusive and equitable quality education, etc.

India is ranked #111 in the Sustainable Development Goal Index 2023 with a score of 63.45.

Hence, we hope that this blog helped you understand the key features of an essay on sustainable development. If you are interested in Environmental studies and planning to pursue sustainable tourism courses , take the assistance of Leverage Edu ’s AI-based tool to browse through a plethora of programs available in this specialised field across the globe and find the best course and university combination that fits your interests, preferences and aspirations. Call us immediately at 1800 57 2000 for a free 30-minute counselling session

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Health Environment and Sustainable Development

Pilar aparicio-martínez.

1 Grupo Investigación Epidemiológica en Atención Primaria (GC-12), Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, Menedez Pidal, University of Cordoba, 14071 Cordoba, Spain; se.ocu@pampa23n

María Pilar Martinez-Jimenez

2 Departamento de Física Aplicada, Radiología y Medicina Física, Campus de Rabanales, Universidad de Córdoba, 14071 Cordoba, Spain

Alberto-Jesús Perea-Moreno

Although there are multiple definitions of sustainability, it can be defined as the balance of a species and the resources of its environment [ 1 ]. Globally, the diverse definitions of the term embedded the concept of improving and maintaining an individual’s well-being in the long term by recovering, adjusting, or preserving environmental systems [ 2 , 3 ]. Sustainability is based on simultaneous benefits regarding economic, social, and environmental factors. Among all the factors contributing to sustainability, innovational and technological advances have become the most relevant elements defining a population’s health [ 4 ].

These elements connected to sustainability have been described in different reports and recommendations, such as the Brundtland Report [ 5 , 6 ]. This report is the beginning of the Sustainable Development Goals (SDGs), establishing an agenda for 2030 to minimize emissions and reduce climate change. This agenda includes 17 SDGs with 169 targets, with a high interest in sustainability, including health systems, human health, the social environment, social equality, and education in sustainability. Some goals integrate the environment and health, such as Goal 3, known as “Good Health and Well-being”, and those related to the environment (Goal 13 focused on Climate Action, Goal 14: “Underwater: conservation of marine fauna”, and Goal 15: “Life on land: conservation of terrestrial ecosystems”) since they directly affect people’s health and quality of life. Moreover, one goal is integrated transversal to achieve other goals, with this being Goal 4, “Quality Education”. This goal integrates the necessity of achieving sustainable education, which is related to Goal 1, “No Poverty”, and education on sustainability that bases on creating environmental awareness. Furthermore, as with Goal 6: “Ensure access to water and sanitation for all” or Goal 7: “Ensure access to affordable, reliable, sustainable, and modern energy”, the idea is that these goals are integrated with each other making them more inclusive [ 7 , 8 ].

1. Integration of Developments Sustainable Goals: Technology, Education, and Health

The United Nations indicated that to achieve these SDGs is necessary to incorporate new technologies and innovative tools in all fields [ 9 , 10 ]. Most of the innovations focused on integrating such technologies in the process to achieve the ideal of sustainability. The institutionalization inside the structure of diverse systems implies the integration of diverse technologies in making decisions, protocols, and policies that ultimately modify health care quality, from the diagnosis to the organization of care [ 11 , 12 , 13 ].

Besides, there are other areas that have integrated sustainability in their structural pillar, from creation and design up to marketing, such as the automotive industry, resulting in the concept of industry 4.0. The objective of improving all these different areas to achieve individual wellbeing is sometimes lost within technological advances since some of these technologies also contribute to health problems, from musculoskeletal issues to mental health [ 14 , 15 ]. Simultaneously, several economic, social, or organizational interests utilize the novel advances despite the sustainability and, therefore, the population’s well-being [ 16 , 17 ].

Based on this, two concepts have arisen during the last two decades, the sustainability of healthcare innovations and social sustainability. Both concepts are based on the adequation of the technologies; first, to the environment and resources and, later, to adapt them to the community [ 18 , 19 , 20 ].

Meanwhile, via the endorsements of the world of the 2030 Agenda for Sustainable Development Goals, this structured agenda is aimed at making education accessible to all and creating the foundation for sustainable development and peace. In this sense, UNESCO coordinates the international community’s action to achieve education of quality, sustainable and accessible to all people regardless of gender, ethnic background, or socioeconomic status. Education is the tool for social transformation, whose fundamental role is to generate change and guide personal and collective action. The Education for Sustainable Development (ESD) is UNESCO’s education sector’s response to the urgent and dramatic challenges facing the planet, like multiresistant bacteria, water pollution and microplastics. ESD for UNESCO’s 2030 Education Agenda aims to achieve the personal and social transformation needed to change the course of the current climate change and unbalance environment [ 21 , 22 ].

Finally, it is also important to highlight how the concept of e-health is currently evolving in parallel with that of smart cities, which also aims to introduce the widespread use of ICTs in cities to improve the quality of life of their inhabitants, considering important concepts, such as sustainability, energy efficiency, healthy mobility, health, and social sustainability. Smart cities make extensive use of sensors of all kinds that can be used to improve the health of their citizens, giving rise to the concept of smart health [ 23 ].

This Special Issue aims to advance the contribution of a Health Environment and Sustainable Development. Leading authors have published important publications in this field, with the most relevant and frequent areas analyzed being “social sustainability”, “work safety”, “environmental science “, and “healthcare facilities”, among others less common, such as “social relations” or “computer science” ( Figure 1 ).

Word cloud of most relevant and frequent terms from the researchers in the Special Issue.

In this sense, Yasaman Parsia and Shahryar Sorooshian proposed a decision-making algorithm for the rearchitecting of healthcare facilities to minimize nosocomial infection risks. The algorithm was validated by implementing an HF as a case study, reaching good results.

Meanwhile, Manuel Vaquero Alvarez, Pilar Aparicio-Martinez, Francisco Javier Fonseca Pozo, Joaquín Valle Alonso, Isabel María Blancas Sánchez, and Manuel Romero-Saldaña validated the NIM-MetS test, previously used in the adult population, for the early and sustainable detection of MetS in children and adolescents. They concluded that this method shows high diagnostic accuracy, with high sensitivity, specificity, and clinic concordance with the reference test (NCEP ATP III).

Sepehr Hendiani, Huchang Liao, Morteza Bagherpour, Manuela Tvaronavičienė, Audrius Banaitis, and Jurgita Antucheviciene proposed a new benchmark approach that aims at measuring the current level of sustainability in manufacturing systems, identifying the weak points that harm the overall sustainability level and enhancing the efficiency of weak points to uplift the overall sustainability index subsequently.

Mila Cascajares, Alfredo Alcayde, Esther Salmerón-Manzano, and Francisco Manzano-Agugliaro carried out a bibliometric analysis to assess the status of medicine and environmental sciences in the scientific world through their publications. The leading countries in publications within these fields are China, USA, and Spain.

Zia Ullah, Mohammed Ali Bait Ali Sulaiman, Syed Babar Ali, Naveed Ahmad, Miklas Scholz, and Heesup Han studied the importance of occupational safety in improving social sustainability in public hospitals. Within this study, data were collected from 431 healthcare professionals in a public hospital in the city of Lahore, Pakistan and analyzed using structural equation modeling.

Jihan Muhaidat, Aiman Albatayneh, Mohammed N. Assaf, Adel Juaidi, Ramez Abdallah, and Francisco Manzano-Agugliaro analyzed new strategies to reduce the energy demand associated with cooling in residential buildings in different climates. For this purpose, the authors proposed movable window shading and night ventilation.

Johanna Andrea Navarro-Espinosa, Manuel Vaquero-Abellán, Alberto-Jesús Perea-Moreno, Gerardo Pedrós-Pérez, Maria del Pilar Martínez-Jiménez, and Pilar Aparicio-Martínez analyzed the positive and negative effects that can be derived from the use of gamification in higher educational institutions. In this study, the authors argue that gamification produces motivation and performance improvement among students and is a fundamental tool for creating sustainable higher educational institutions.

Yingyi Zhang evaluated a parametric form-based code for the sustainable development of urban communities. For this purpose, leadership methods in energy and environmental design for neighborhood development were used.

Mihaela-Roberta Stanef-Puică, Liana Badea, George-Laurențiu Șerban-Oprescu, Anca-Teodora Șerban-Oprescu, Laurențiu-Gabriel Frâncu, and Alina Crețu analyzed scientific publications dealing with the topic of “green jobs” over the last five years in order to detect global trends and associated terms.

Based on the articles, it could be determined that this Special Issue has reflected how SDGs have been analyzed from different fields, from the industry and education to healthcare systems. Besides, an interesting topic has arisen from work published, the use of models and algorithms based on significant technologies, such as artificial intelligence, to minimize the climate change impact, improve the sustainability of systems, and the decision-making of important actors in creating a viable future.

2. List of Contributions

• Parsia, Y.; Sorooshian, S. A Decision-Making Algorithm for Rearchitecting of Healthcare Facilities to Minimize Nosocomial Infections Risks. Int. J. Environ. Res. Public Health 2020 , 17 , 855.
• Vaquero Alvarez, M.; Aparicio-Martinez, P.; Fonseca Pozo, F.J.; Valle Alonso, J.; Blancas Sánchez, I.M.; Romero-Saldaña, M. A Sustainable Approach to the Metabolic Syndrome in Children and Its Economic Burden. Int. J. Environ. Res. Public Health 2020 , 17 , 1891.
• Hendiani, S.; Liao, H.; Bagherpour, M.; Tvaronavičienė, M.; Banaitis, A.; Antucheviciene, J. Analyzing the Status of Sustainable Development in the Manufacturing Sector Using Multi-Expert Multi-Criteria Fuzzy Decision-Making and Integrated Triple Bottom Lines. Int. J. Environ. Res. Public Health 2020 , 17 , 3800.
• Cascajares, M.; Alcayde, A.; Salmerón-Manzano, E.; Manzano-Agugliaro, F. The Bibliometric Literature on Scopus and WoS: The Medicine and Environmental Sciences Categories as Case of Study. Int. J. Environ. Res. Public Health 2021 , 18 , 5851.
• Ullah, Z.; Sulaiman, M.A.B.A.; Ali, S.B.; Ahmad, N.; Scholz, M.; Han, H. The Effect of Work Safety on Organizational Social Sustainability Improvement in the Healthcare Sector: The Case of a Public Sector Hospital in Pakistan. Int. J. Environ. Res. Public Health 2021 , 18 , 6672.
• Muhaidat, J.; Albatayneh, A.; Assaf, M.N.; Juaidi, A.; Abdallah, R.; Manzano-Agugliaro, F. The Significance of Occupants’ Interaction with Their Environment on Reducing Cooling Loads and Dermatological Distresses in East Mediterranean Climates. Int. J. Environ. Res. Public Health 2021 , 18 , 8870.
• Navarro-Espinosa, J.A.; Vaquero-Abellán, M.; Perea-Moreno, A.-J.; Pedrós-Pérez, G.; Martínez-Jiménez, M.d.P.; Aparicio-Martínez, P. Gamification as a Promoting Tool of Motivation for Creating Sustainable Higher Education Institutions. Int. J. Environ. Res. Public Health 2022 , 19 , 2599.
• Zhang, Y. Evaluating Parametric Form-Based Code for Sustainable Development of Urban Communities and Neighborhoods. Int. J. Environ. Res. Public Health 2022 , 19 , 7983.
• Stanef-Puică, M.-R.; Badea, L.; Șerban-Oprescu, G.-L.; Șerban-Oprescu, A.-T.; Frâncu, L.-G.; Crețu, A. Green jobs—a literature review. Int. J. Environ. Res. Public Health 2022 , 19 , 7998.

Funding Statement

This research received no external funding.

Author Contributions

Conceptualization, P.A.-M., M.P.M.-J. and A.-J.P.-M.; methodology, P.A.-M., M.P.M.-J. and A.-J.P.-M.; validation, P.A.-M., M.P.M.-J. and A.-J.P.-M.; formal analysis, P.A.-M., M.P.M.-J. and A.-J.P.-M.; writing—review and editing, P.A.-M., M.P.M.-J. and A.-J.P.-M. All authors have read and agreed to the published version of the manuscript.

Conflicts of Interest

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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SDG 3: Good health and well-being

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AI Application in Achieving Sustainable Development Goal Targeting Good Health and Well-Being: A New Holistic Paradigm

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Artificial intelligence is a field of engineering, science, and technology mainly based on computational comprehension with the creation of artifacts for better diagnosis, detection, and treatment of medical emergencies. Such computing advances in past decades catalyzed the integration of digitalized techniques with medicine along with clinical nutrition and mental health. Several AI-based devices and prediction models provide clinical help to various self-management tools. AI application in the healthcare sector targets good health management and well-being of individuals. Such technologies can perform healthcare tasks with better patient engagement and adherence. Still, it is crucial to validate such computational tools with a traditional clinical trial. These AI systems thus should be initially approved and standardized as well as provision of updating should be there.

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Vyas, S., Kumari, A. (2024). AI Application in Achieving Sustainable Development Goal Targeting Good Health and Well-Being: A New Holistic Paradigm. In: George, V.I., Santhosh, K.V., Lakshminarayanan, S. (eds) Control and Information Sciences. CISCON 2018. Lecture Notes in Electrical Engineering, vol 1140. Springer, Singapore. https://doi.org/10.1007/978-981-99-9554-7_6

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