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New Data on the Global Burden of Disease and SDG Progress

Title page of The Lancet issue including the GBD Study 2019.

New Data on the Global Burden of Disease and Progress Towards Targets of the Sustainable Development Goals

At Global 2030, we compile newly published data by the Global Burden of Disease (GBD) study to address major global challenges that result from limited access to vital resources such as food, clean air or health care. We utilize the study in topics covered by our data-driven review on the most important global challenges.

Additionally, we use the new data to assess trends towards major targets of the Sustainable Development Goals (SDGs) that the members of the United Nations (UN) committed to in 2015 for 2030. Indicators are similar to the official UN indicators.

There are several global challenges that despite posing significant health impacts do not have a time-bound global target. Despite this, these challenges still require a concerted global effort to reduce associated preventable deaths and health losses.

In the following, we present new GBD data on life expectancy and major global challenges in the order of the related numbers of deaths.

Is the world on track to meet the targets?

First, new data by the Global Burden of Disease Study indicates that global life expectancy at birth has increased from 67.2 years in 2000 to 73.5 years in 2019 (source: 1).

Health risks from outdoor air pollution were related to 4.14 million deaths worldwide in 2019. The UN members pledged in SDG target 3.9: "By 2030, substantially reduce the number of deaths and illnesses from ... air pollution". The trend is diverting from the target: deaths increased by 7.0% from 2015 to 2019, according to the new GBD study (2 – from here on, most sources include a trend diagram).

Child and maternal malnutrition led to at least 2.94 million deaths globally in 2019. SDG target 2.1 states: "By 2030, end hunger". However, despite this pledge, the incidence of different nutritional deficiencies changed between +19 and −9.9% globally between 2015 and 2019, which is vastly insufficient to meet the target (3).

Lower respiratory infections – primarily pneumonia – claimed a death toll of 2.49 million lives in 2019. Pneumonia is by far the top killer among infectious diseases. The WHO supports countries to "reduce mortality from pneumonia in children less than 5 years of age to fewer than 3 per 1000 live births" by 2025. Twenty countries exceeded this level in 2010, and ten countries in 2019 – meaning we are not on track to meet the target by 2025 (4).

Indoor air pollution, resulting from burning solid fuels for cooking and heating, was linked to 2.31 million deaths in 2019. SDG target 3.9 strives to "substantially reduce" the number of deaths from air pollution by 2030. Deaths attributable to indoor air pollution from solid fuels decreased by 10.5% from 2015 to 2019, which would result in a 33% reduction by 2030. Consideration of whether this is on or off track depends on the interpretation of "substantially" (5).

Neonatal disorders claimed the lives of 1.88 million newborns in 2019. SDG target 3.2 aspires for "all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births" by 2030. Despite public health efforts, countries exceeding that number only decreased from 69 in 2015 to 65 in 2019, which is clearly not on track (6).

Unsafe water sources, unsafe sanitation facilities and a lack of access to handwashing facilities were related to 1.66 million deaths in 2019. SDG target 6.1 declares: "By 2030, achieve ... universal access to safe ... drinking water for all". Despite a 9.7% drop in related deaths between 2015 to 2019, the GBD data suggests that we are not on track to meet the target (7).

Second-hand smoke was connected to 1.30 million deaths in 2019. Unfortunately, this number has increased by 12.8% since 2010. This trend is not in line with the general WHO target to reduce smoking (8).

Occupational diseases and accidents led to 1.22 million deaths in 2019. SDG 8.8 of the UN aims to "promote safe and secure working environments for all workers" (not time-bound). However, the number of deaths rose by 3.8% from 2015 to 2019, indicating that we are heading in the opposite direction of achieving the target (9).

Road accidents claimed 1.20 million lives in 2019. SDG target 3.6 pledges: "By 2020, halve the number of global deaths and injuries from road traffic accidents". Between 2015 and 2019, deaths decreased slightly (0.32%) and injuries increased by 9.0%, so the 2020 target is likely to be missed (10).

Tuberculosis killed 1.18 million people in 2019. This is the second-highest death toll among infectious diseases. SDG target 3.3 by the UN stipulates: "By 2030, end the epidemics of ... tuberculosis ..." Between 2015 and 2019, new cases increased by 1.6% and deaths decreased by 7.0%, meaning neither figure is on track to meet the target (11).

Hepatitis B and C claimed 1.10 million lives in 2019. This death toll is the only major infectious disease that continues to increase. SDG 3.3 outlines: "By 2030, ... combat hepatitis", and WHO members agreed to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030. Whilst the trends are varied, they are not on track to meet the targets (12).

Lead pollution was related to 902,000 deaths in 2019. SDG target 3.9 aims: "By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution". However, deaths attributable to lead pollution increased by 5.5% between 2015 and 2019, diverting away from the target (13).

HIV/AIDS resulted in the death of 864,000 people in 2019, including deaths from tuberculosis co-infection. SDG target 3.3 claims: "By 2030, end the epidemics of AIDS ..." Between 2015 and 2019, the number of HIV infected people increased by 9.6%, new cases and deaths decreased by 11% and 16%, respectively. Despite these decreases and huge efforts, none of these trends is on track (14).

Malaria killed 643,000 people in 2019, predominantly children. SDG target 3.3 stipulates: "By 2030, end the epidemics of ... malaria ..." From 2015 to 2019, prevalent and new cases rose by 20% and 3.5%, respectively, while malarial deaths went down by 8.5%. No trend is on track to achieve the target (15).

Maternal disorders claimed the lives of 196,000 women and girls in 2019. The UN has agreed upon SDG target 3.1: "By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births". The ratio was reduced by 3.2% from 150 maternal deaths per 100,000 live births in 2015 to 145 in 2019. While a small reduction has been achieved through the promotion of maternal and reproductive health, we are clearly not on track to meet this target (16).

Antimicrobial resistance killed at least 139,000 people in 2019. This number is a decrease compared to 2015 (multidrug-resistant tuberculosis including extensive drug resistance and HIV co-infection). This decrease fits the WHO members goal to reduce antimicrobial resistance (which is not time-bound) (17).

A lack of patient safety or the adverse effects of medical treatment (medical errors, side effects, unsafe injections etc.) led to 106,000 deaths in 2019, representing an increase of 7.9% since 2010, states the GBD study. The topic lacks a time-bound target (18).

Intimate partner violence killed 86,500 women and girls in 2019. SDG 5.2 aims to "Eliminate all forms of violence against all women and girls in the public and private spheres" (not time-bound). If the estimated 14% decrease of related deaths between 2015 and 2019 were to continue, the goal may be reached by 2035 in terms of mortality (19).

Measles resulted in the death of 83,400 people in 2019, mainly children. Successful vaccination campaigns have accomplished a 60.4% reduction since 2010. However, this success is not sufficient for the 2012-2020 strategy by WHO members to eliminate measles in 4 of 6 world regions (20).

Armed conflicts including terrorism claimed 63,000 lives in 2019. The SDGs aim to "redouble our efforts to resolve or prevent conflict" (ß 35) and to "Significantly reduce all forms of violence and related death rates everywhere" (goal 16.1) (neither are time-bound). Mortality rates due to armed conflicts decreased from 2015 to 2019 by 64% and are currently in accordance with the goal (21).

Natural disasters killed at least 6,000 people in 2019. It is stipulated in SDG target 11.5: "By 2030, significantly reduce the number of deaths ... caused by disasters". Whilst these figures vary greatly depending on the occurrence of mega-disasters, such as the magnitude 7 earthquake in Haiti in 2010, the number of deaths from natural disasters decreased by 61% in the period 2015 to 2019 and can so far be viewed as on track (22).

The COVID-19 pandemic, which has already killed more than 1 million people in 2020, is likely to result in deteriorating trends for many of the global health challenges assessed in the GBD study 2019 (23).

We compiled data by the new GBD study for the largest global challenges that result from limited access to vital resources. Of 12 related time-bound and quantifiable SDG targets, only 1-2 are on track for 2030. Five years after being established, and with most major targets not on track, the SDGs need an additional push, just as the MDGs needed – and received – after five years. Without the UN 2005 World Summit and the financial commitments it achieved, the MDG targets would have lacked success, as the SDG targets do currently (24).

 

Chloë Mills and Lars Vogelsang
Global2030

(All data produced by the Institute for Health Metrics and Evaluation [IHME], published in The Lancet Medical Journal. Conclusions are our own.)

 

Suggested citation:
Global2030: New Data on the Global Burden of Disease and Progress Towards Targets of the Sustainable Development Goals. Editors: ChloŽ Mills and Lars Vogelsang. Berlin, Global Challenges Initiative e.V., 10 November 2020. (global2015.net/news/1604934000-new-data-on-GBD.html).

 

Sources:

  1. Life expectancy: www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30977-6/fulltext (The Lancet article of 17 October 2020)
  2. Outdoor air pollution (ambient particulate matter pollution): ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/d06b1c47c69fe9550ab512bfcaaa54b7 (online tool by the IHME) (all percent changes own calculations, e.g.
    (4140971 − 3870691) / 3870691 = 0.070 = 7.0 / 100 = 7.0%)
    (for target quotes, see note 25)
  3. Hunger: www.healthdata.org/results/gbd_summaries/2019/child-and-maternal-malnutrition-level-2-risk (child and maternal malnutrition), ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/fb7dc0cb75e90a8b5426e7b35b2502be (nutritional deficiencies)
  4. Lower respiratory infections (primarily pneumonia): www.healthdata.org/results/gbd_summaries/2019/lower-respiratory-infections-level-3-cause (global deaths), ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/82ab4036db705951aca2b463608da258 (country-level mortality rates – displayed per 100,000, so the target level of 3 per 1000 live births is equivalent to 300 per 100,000; values are in column VAL, double-click on the header to view figures in descending order, then count all incidences above 300 per 100,000 for YEAR 2010 and 2019)
  5. Indoor air pollution (household air pollution from solid fuels): ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/8dd5e91a4153764e76b32b73a137c8f3
  6. Neonatal disorders: www.healthdata.org/results/gbd_summaries/2019/neonatal-disorders-level-3-cause (global deaths), ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/e1197f17a5d03e9a52cb9af04ee7da85 (country-level mortality rates – displayed per 100,000, so the target level of 12 per 1000 live births is equivalent to 1200 per 100,000; values are in column VAL, download the data to personal spreadsheet software, or organize column VAL for descending figures by double-clicking on its header, then count all incidences above 1200 per 100,000 for YEAR 2015 and 2019)
  7. Unsafe water sources, unsafe sanitation facilities and lack of access to handwashing facilities: ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/d7404e976e239317d41be4fb60c161af
  8. Second-hand smoke: www.healthdata.org/results/gbd_summaries/2019/secondhand-smoke-level-3-risk
  9. Occupational diseases and accidents (occupational risks): ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/7949169d1cb8bab45c36b23f35ca47b1
  10. Road traffic accidents: ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/3319cb923edb99984014f5f6197dbad9
  11. Tuberculosis: ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/bef7541602dc287f43ea05a879eecf01
  12. Hepatitis B and C: ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/753d509b13dc0b40b85351f2895d4313
  13. Lead pollution (lead exposure): ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/9d54244a0549af7d52019ce151c799ff
  14. HIV/AIDS: ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/bef8cb47b4770903010e5149abbd7d34
  15. Malaria: ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/ac47fa307ed25414cc0aa19c5c3ec18b
  16. Maternal disorders: www.healthdata.org/results/gbd_summaries/2019/maternal-disorders-level-3-cause (deaths), ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/9eddac00978dd9d2b72279cfb933787d (mortality rate)
  17. Antimicrobial resistance: ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/c3194af3330970994e6ee329be87cc12
  18. Adverse effects of medical treatment: www.healthdata.org/results/gbd_summaries/2019/adverse-effects-of-medical-treatment-level-3-cause
  19. Intimate partner violence: ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/8df400411d266af4f0be659ce7994f0c
  20. Measles: www.healthdata.org/results/gbd_summaries/2019/measles-level-3-cause (see the map there for achievements on the WHO target)
  21. Armed conflicts: www.healthdata.org/results/gbd_summaries/2019/conflict-and-terrorism-level-3-cause (deaths), ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/2abb297caf798d6fef00289fb950df5b (mortality rate)
  22. Natural disasters (exposure to forces of nature): ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/62569f715c05d0dd3281b9c27fc6fcb1
  23. COVID-19 impacts: www.healthdata.org/news-release/lancet-latest-global-disease-estimates-reveal-perfect-storm-rising-chronic-diseases-and (press release of 15 October 2020)
  24. MDG trends before/after 2005 (assessment by Global2030, based on data by the UN and academia): global2030.org/file/global2030mdg_targets.pdf
  25. SDGs (UN General Assembly resolution): www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E

 

 

  Title page of The Lancet issue including the GBD Study 2019.