Analysing progress on SDG 3: Good Health and Well-being
Unsurprisingly during the pandemic, the third Sustainable Development Goal is being closely monitored as it is one of the goals that is currently most impacted. Worldwide, countries are struggling to keep their health care systems up and running as they should, as now more than ever, so many people are in need of health services. The COVID-19 pandemic has shown how important it is for countries and nations to be united and work together towards fighting these struggles and finding ways to stop this virus.
SDG 3 aims to ensure healthy lives and promote well-being for all at all ages. Specifically, the targets include a reduction in maternal mortality rates to less than 70 per 100,000 live births and demise of deaths of new-borns and children under 5 that could have been prevented; extinction of epidemic of AIDS, tuberculosis, malaria and other communicable diseases and reduction of mortality due to these and promotion of mental health and well-being for those who have contracted these diseases. Additionally, these include prevention and treatment of substance abuse, reduction of deaths and/or injuries from road traffic accidents and others.
Before the COVID-19 pandemic, progress on many health areas was achieved, especially in areas such as tuberculosis, child and maternity health and HIV, but still less than half of the global population is covered by essential health services. Even though progress was seen, there was still plenty of work to be done in order to achieve the Agenda 2030.
The pandemic, however, has taken the world a step back when it comes to the acceleration of the SDG. The work that was previously done has now been fully disrupted as the pandemic has now halted or, in some cases, even reversed the progress made. It has disrupted healthcare systems by hundreds of thousands of additional under-5 deaths and has disturbed childhood immunization programmes in 70 countries meaning that illness and deaths from communicable diseases will rise and, taking malaria as an example, this would lead to an 100% increase in malaria deaths in Sub-Saharan Africa.
Infectious diseases
Aside the impacts of the pandemic, the rate of most infectious diseases measures, such as HIV, tuberculosis, malaria, hepatitis B and neglected tropical diseases, has fallen significantly. The rate of new HIV infections declined from 0.48 infections per 1,000 of uninfected population, especially in sub-Saharan Africa, which is the region with the highest number of infected. Still, due to limited access to medical services, the necessary support comes at due, presenting a major decrease in the quality of life of the infected individuals and there is little to no prevention support for the others. In 2019, the rate of tuberculosis fell globally, from 174 new and relapse cases per 100,000 population in 2000 to 130, a 25% decline. Not fast enough to meet the Agenda 2030. Also, tuberculosis remains a threat to the population as it shows to be drug-resistant in 78%, according to a study conducted in 2019. The incidence of malaria has plateaued, remaining around 57 cases per 1,000 at risk from 2015 to 2019. But, alike the current pandemic, the limitations of funding and global help towards the management of life-saving tools and medication in developing countries is falling short.
Non-communicable diseases, mental health and environmental risks
Globally, 74% of all deaths in 2019 were caused by noncommunicable diseases (NCDs), such as cancer, cardiovascular disease and diabetes. The probability of dying from one of these diseases has decreased by 19.9% in 2010 and 17.8% in 2019, still not enough to meet the targets of the SDG. The coronavirus increases the probability of severe illness or death from the disease in people who have underlying NCDs. Relatedly, the global suicide death rate declined by 29% in 2019; the total alcohol consumption decreased by 5% since 2010 and the use of tobacco declined by 11.4% since 2000 to 2018 in men and 8.2% in women.
Health Systems and Funding
Immunization, which is now very talked about, is one of the world’s most successful and cost-effective health intervention. Even though vaccination coverage in children has increased by 13% from 2000 to 2019, it is estimated that 19.7 million children did not receive essential vaccinations during the first year of their lives. The poorest of the countries are the ones who have seen the biggest progress in terms of improvement of their healthcare systems, but the pandemic has put a stop on this as now progress is being thrown back even further than before. Especially because the overall budget of healthcare has increased, which consequently impacts other essential goods, such as food and education.
The Official Development Assistance (ODA) for basic health reached $11 billion in 2019, particularly, $3.4 billion was spent on basic health case, $2.2 billion on infectious disease control and $2.2 billion on malaria control.
Health workers are in the frontline when it comes to tackling the outburst of the coronavirus and countries with limited workforce have and are still struggling the most as they cannot provide essential health services to necessity. According on data from 2013-2018, nursing or midwifery workers represent 150 per 10,000 of the population in Northern America, in comparison with sub-Saharan Africa which is 15 times less and in Northern and Southern Africa which is 8 times lower. Also, the density of medical doctors is around 25 per 10,000 of the population in Northern America, Oceania and Central Asia, whilst only 2 per 10,000 in sub-Saharan Africa.
During the pandemic, it is imperative that there is an equitable distribution of vaccines and equipment worldwide to be able to get out of this crisis. The Director-General of WHO, Tedros Adhanom Ghebreyesus refers that “our only way out is to support countries in the equitable distribution of PPE, tests, treatments and vaccines. It is not rocket science, nor charity. It is smart public health and in everyone’s best interest”. WHO, together with the International Monetary Fund, the World Bank and the World Trade Organization are working towards finding more practical ways to monitor and coordinate deliveries of supplies and vaccines to underdeveloped countries. Recently, the United Nations announced that they are supporting the development of vaccines manufacturing worldwide, especially in these countries, by creating a technology hub where manufacturers will be trained in how to produce new treatments. Once again, the Director-General underlines that this presents a step forward, “but we need manufacturers to help by sharing know-how and accelerating technology transfer.”
In all, the third SDG can be seen as the SDG that would most likely be impacted by COVID-19. Progress was being made rapidly, up until the pandemic, to achieve healthy lives and well-being for all ages, but that has regressed in the past 18 months. We have seen that countries are looking to vaccinate their way out of this pandemic, but that has created a unequal distribution of vaccines globally, with the wealthier countries vaccinating more quickly than others. The UN should look to assist with the equal distribution of vaccines, and hopefully when we are out of this pandemic, we can start to make quicker progress towards healthy lives for all, using what we have learnt from the last year.
