United NationsDepartamento de Asuntos Económicos y Sociales Desarrollo Sostenible
Objetivos
3

Garantizar una vida sana y promover el bienestar de todos a todas las edades

Targets and Indicators

Target

3.1

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

3.1.1

Maternal mortality ratio

3.1.2

Proportion of births attended by skilled health personnel

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

3.2.1

Under-five mortality rate

3.2.2

Neonatal mortality rate

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

3.3.1

Number of new HIV infections per 1,000 uninfected population, by sex, age and key populations

3.3.2

Tuberculosis incidence per 1,000 population

3.3.3

Malaria incidence per 1,000 population

3.3.4

Hepatitis B incidence per 100,000 population

3.3.5

Number of people requiring interventions against neglected tropical diseases

Target

3.4

By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

3.4.1

Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease

3.4.2

Suicide mortality rate

Target

3.5

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

3.5.1

Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders

3.5.2

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

Target

3.6

By 2020, halve the number of global deaths and injuries from road traffic accidents

3.6.1

Death rate due to road traffic injuries

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

3.7.1

Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods

3.7.2

Adolescent birth rate (aged 10-14 years; aged 15-19 years) per 1,000 women in that age group

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

3.8.1

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)

3.8.2

Proportion of population with large household expenditures on health as a share of total household expenditure or income

Target

3.9

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

3.9.1

Mortality rate attributed to household and ambient air pollution

3.9.2

Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (exposure to unsafe Water, Sanitation and Hygiene for All (WASH) services)

3.9.3

Mortality rate attributed to unintentional poisoning

Target

3.a

Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

3.a.1

Age-standardized prevalence of current tobacco use among persons aged 15 years and older

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

3.b.1

Proportion of the population with access to affordable medicines and vaccines on a sustainable basis

3.b.2

Total net official development assistance to medical research and basic health sectors

Target

3.c

Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

3.c.1

Health worker density and distribution

Target

3.d

Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks

3.d.1

International Health Regulations (IHR) capacity and health emergency preparedness

Progress and Info

Before the COVID-19 pandemic, progress had been made in many health areas, including improving maternal and children health, increasing immunization coverage, and reducing communicable diseases, albeit not fast enough to meet the SDG 3 targets by 2030. The disruption caused by the pandemic has now halted or even reversed progress made. A recent survey shows that substantial disruptions persist over one year into the pandemic, with about 90% of countries still reporting one or more disruptions to essential health services. Among the most extensively affected health services are those for mental, neurological and substance use disorders; neglected tropical diseases; tuberculosis; HIV and hepatitis B and C; cancer screening, services for other noncommunicable diseases including hypertension and diabetes; family planning and contraception; urgent dental care; malnutrition; immunization and malaria.

Reproductive, maternal and child health

Globally, based on data from 2014-2020, 83% of births were assisted by skilled health professionals, including medical doctors, nurses and midwives, which represents an increase from 71% in 2007-2013. The COVID-19 pandemic may reverse gains made in coverage of skilled childbirth care and interruptions to maternity services.

The world has made substantial progress toward the goal of ending preventable child deaths— the global under-5 mortality rate was 38 deaths per 1,000 live birth in 2019, falling from 76 in 2000. The global neonatal mortality rate fell from 30 to 17 between 2000 and 2019. Even with that progress, 5.2 million children died before reaching their fifth birthday in 2019, with almost half of those deaths, 2.4 million, occurring in the first month of life. While the total impact of COVID-19 pandemic on child survival is not yet known, significant disruptions to the continued provision of life saving interventions could stagnate or even reverse this progress

The proportion of women of reproductive age (15-49 years) who have their need for family planning satisfied with modern contraceptive methods has stagnated at around 77% from 2015 to 2021, reaching only 56% in sub-Saharan Africa and 52% in Oceania (excluding Australia and New Zealand). The ongoing COVID-19 pandemic may lead to reductions in the proportion of women who have their needs for family planning satisfied by modern methods as a result of supply-chain disruptions and decreased access to family planning services, while fertility intentions and family planning needs among women of reproductive age may also change.

The adolescent birth rate has fallen worldwide from 56 births per 1,000 adolescents aged 15-19 years in 2000 to 45 in 2015 and 41 in 2020. Declines varied considerably across regions, with the largest declines occurring in Central Asia and Southern Asia, from 70 in 2000 to 24 births per 1,000 adolescent women in 2020.

Infectious diseases

While the rate of new HIV infections declined from 0.48 infections per 1,000 uninfected population among adults (aged 15 to 49 years) to 0.37 between 2010 and 2019, it was still far 8 higher than the global targets for 2020. The largest decrease was in sub-Saharan Africa, the region with the highest numbers of people living with HIV. Major inequalities remain in access to HIV prevention, testing and treatment services across regions, countries and sub-populations within countries. Evidence suggests COVID-19 has caused considerable disruptions to HIV services including testing, initiation of treatment, voluntary medical male circumcision and preexposure prophylaxis.

In 2019, an estimated 10 million people fell ill with tuberculosis (56% were adult men, 32% adult women, 12% children, and 8.2% were people living with HIV) -- the top killer from a single infectious agent. Globally, tuberculosis incidence declined from 174 new and relapse cases per 100,000 population in 2000 to 130 in 2019 (a 25% decline in the 19-year period) and the tuberculosis mortality rate among HIV-negative people fell by 45% in the same period. Although the burden is falling, large gaps in detection and treatment persist and the current pace of progress is not fast enough to meet the SDG target of ending tuberculosis by 2030. Drugresistant tuberculosis is a continuing threat: in 2019, there were 465,000 new cases with resistance to rifampicin, the most effective first-line drug, of which 78% had multidrug-resistant tuberculosis. An estimated 1.4 million fewer people received necessary care for tuberculosis during 2020 compared with 2019 due to COVID-19, a reduction in treatment of 21%.

The incidence rate of malaria had plateaued, staying around 57 cases per 1,000 people at risk from 2015 to 2019. The WHO 2020 target for reductions in malaria case incidence will be missed by 37%. In 2019, the global tally of malaria cases was 229 million and the disease claimed some 409,000 lives. Gaps in funding and in access to life-saving tools are undermining global efforts to curb the disease, and the COVID-19 pandemic is expected to set back the fight even further.

The use of hepatitis B vaccine in infants has considerably reduced the incidence of new chronic hepatitis B virus infections. The proportion of children under five years of age who became chronically infected fell from 4.7% in the pre-vaccination era to 0.9% in 2020. Worldwide the 2020 target of 1% seroprevalence in children under 5 years of age has been reached. Additional efforts in increasing coverage are needed to reach the 2030 SDG target of 0.1%.

In 2019, 1.74 billion people were reported to require mass or individual treatment and care for neglected tropical diseases (NTDs), down from 2.19 billion in 2010, and about 12 million people fewer than reported in 2018. The smaller number of people requiring interventions is largely due to due to the elimination of at least one NTD since 2010 in 42 countries.

Non-communicable diseases, mental health and environmental risks

Globally, 74% of all deaths in 2019 were caused by noncommunicable diseases (NCDs). The probability of dying from any of the four main NCDs (cardiovascular disease, cancer, diabetes or chronic respiratory disease) between age 30 and 70 declined from 19.9% in 2010 to 17.8% in 2019. This rate of decline is insufficient to meet SDG target. The COVID-19 pandemic underscores the need for further attention to NCD interventions as people with underlying NCD conditions have higher risks of severe illness and death from the coronavirus.

About 700,000 suicide deaths occurred in 2019. Global suicide death rate declined by 29% from 13.0 deaths per 100 000 population in 2000 to 9.2 - in 2019.

In 2019, alcohol consumption in the world, measured in litres of pure alcohol per person of 15 years of age or older, was 5.8 litres, which is a 5% relative decrease from 6.1 litres in 2010.

The global mortality rate due to road traffic injuries declined by 8.3% from 18.1 deaths per 100,000 population in 2010 to 16.7 in 2019. Still, road traffic crashes killed about 1.3 million people worldwide in 2019 with 75% of these occurring among boys and men. The death rate was over 3.5 times higher in low-income countries than in high-income countries despite lower rates of vehicle ownership in low-income countries. Road traffic injuries was the leading cause of death among young people aged 15-29 years worldwide.

The global prevalence of tobacco uses among men declined from 50.0% in 2000 to 38.6% in 2018, and among women from 16.7% in 2000 to 8.5% in 2018. Even so, the number of people dying from a tobacco-related illness was estimated to be over 8.1 million in 2017.

Unintentional poisonings were responsible for more than 84,000 deaths in 2019. Although the number of deaths from unintentional poisonings has steadily declined since 2000, mortality rates continue to be relatively high in low-income countries (over two times the global average). A third of all deaths from unintentional poisonings occurred in sub-Saharan Africa.

Health Systems and Funding

Immunization is as one of the world’s most successful and cost-effective health interventions. While vaccination coverage among infants increased from 72% in 2000 to 85% in 2015 and 2019, when an estimated 19.7 million children did not receive the essential vaccines during the first year of life. In addition, global coverage levels of pneumococcal conjugate vaccine with potential to significantly reduce pneumonia is yet to reach 50% coverage. Measles is a highly contagious disease and the 71% coverage of 2-dose vaccine in 2019 is insufficient to prevent measles outbreaks.

Improvements in essential health services, measured by universal health coverage service coverage index, increased from a global average of 45 (of 100) in 2000 to 66 in 2017. Lowincome countries had experienced the greatest progress, mainly driven by interventions for infectious diseases. However, the pace of progress has slowed since 2010, and the poorest countries and those affected by conflict generally lag furthest behind. The COVID-19 pandemic is throwing progress even further off track.

Prior to the COVID-19 pandemic, an estimated 927 million people, or 12.7% of the global population made out-of-pocket healthcare payments of more than 10% of their household budgets, and for 209 million, or 3%, the healthcare spending share exceeded 25%, posing an even greater threat to spending on other essential goods like food and education.

ODA for basic health from all official donors increased by 59% in real terms since 2010 and reached $11 billion in 2019. The Global Fund, GAVI and the United States accounted for more than half of this total, providing, $2.4 billion, $1.9 billion and $1.8 billion respectively. In 2019, about $3.4 billion was spent on basic health care, $2.2 billion on infectious disease control, excluding HIV/AIDS and $2.2 billion on malaria control.

Health workers are at the frontline of the COVID-19 pandemic response. Countries, especially those with limited health workforce, are further decapacitated with regards to delivery of essential health services. Based on data from 2013-2018, the density of nursing and midwifery personnel in Northern America is over 150 per 10,000 population, which is over 15 times that in sub-Saharan African and 8 times that in Northern Africa and Southern Asia. The density of medical doctors in Northern America, Oceania, and Central Asia remain around 25 per 10,000 population, compared to 2 per 10,000 population in sub-Saharan African.

Source: Advance unedited copy of 2021 report of the Secretary-General on Progress towards the Sustainable Development Goals