3 GOOD HEALTH AND WELL-BEING

Since 2000, impressive advancements have been made on many health fronts. However, to meet the Sustainable Development Goals health targets by 2030, progress must be accelerated, in particular in regions with the highest burden of disease.

Reproductive, maternal, newborn and child health

• In 2015, the global maternal mortality ratio stood at 216 maternal deaths per 100,000 live births. Achieving the target of less than 70 maternal deaths by 2030 requires an annual rate of reduction of at least 7.5 per cent, more than double the annual rate of progress achieved from 2000 to 2015. Most maternal deaths can be prevented. In 2016, 78 per cent of live births worldwide benefited from skilled care during delivery, compared to 61 per cent in 2000. In sub-Saharan Africa, however, the rate in 2016 was only 53 per cent of live births.
• The mortality rate for children under 5 years of age globally was 43 deaths per 1,000 live births in 2015. That rate represents a 44 per cent reduction since 2000. Mortality among children under 5 years of age remains high in sub-Saharan Africa, with a rate of 84 deaths per 1,000 live births in 2015.
• Children are most vulnerable in the first 28 days of life (the neonatal period). In 2015, the global neonatal mortality rate was 19 deaths per 1,000 live births, a decrease from 31 deaths per 1,000 live births in 2000. Neonatal mortality is highest in Central and Southern Asia and in sub-Saharan Africa, at 29 deaths per 1,000 live births in each of those regions in 2015.
• Preventing unintended pregnancies and reducing adolescent childbearing through universal access to sexual and reproductive health care is crucial to the health and well-being of women, children and adolescents. In 2017, 78 per cent of women of reproductive age (15 to 49 years of age) worldwide who were married or in union had their need for family planning satisfied with modern methods, up from 75 per cent in 2000. Progress has been substantial in the least developed countries, with a rise of 18 percentage points from 2000 to 2017.
• Globally, the adolescent birth rate among females aged 15 to 19 declined by 21 per cent from 2000 to 2015; in Northern America and Southern Asia, it dropped by more than 50 per cent. However, the adolescent birth rate remains high in two thirds of all countries, with more than 20 births per 1,000 adolescent girls in 2015.

Infectious diseases

• Major advances have been made in combating infectious diseases. Globally in 2015, there were 0.3 new HIV (human immunodeficiency virus) infections per 1,000 uninfected people; among children under 15 years of age, there were 0.08 new HIV infections. That data represents a decline of 45 per cent and 71 per cent, respectively, since 2000. The incidence of HIV infection remained highest in sub-Saharan Africa, with 1.5 new infections per 1,000 uninfected people in 2015.
• In 2015, 10.4 million new cases of tuberculosis were reported worldwide, which represents 142 new cases per 100,000 people, or a decline of 17 per cent since 2000. The global malaria incidence rate in 2015 was 94 per 1,000 people at risk, a 41 per cent decrease since 2000. In 2015, 1.6 billion people required mass or individual treatment and care for neglected tropical diseases, a 21 per cent decline from 2010.
• Around 1.34 million deaths were attributed to hepatitis in 2015, including 0.9 million deaths owing to hepatitis B. Hepatitis B can be prevented through vaccinations; global coverage of vaccinations for that disease among children 1 year of age increased from 29 per cent in 2000 to 84 per cent in 2015.
• A major risk factor for infectious diseases and mortality is the lack of safe water, sanitation and hygiene (WASH) services, which disproportionately affects sub-Saharan Africa and Central/Southern Asia. Death rates owing to the lack of WASH services in those two regions were 46 and 23 per 100,000 people, respectively, compared to 12 per 100,000 people globally in 2012.

Non-communicable diseases and mental health

• Premature deaths (before 70 years of age) owing to cardiovascular disease, cancer, chronic respiratory disease or diabetes totalled about 13 million in 2015, accounting for 43 per cent of all premature deaths globally. From 2000 to 2015, the risk of dying between 30 and 70 years of age from one of those four causes decreased from 23 per cent to 19 per cent, falling short of the rate required to meet the 2030 target of a one-third reduction.
• Such mental disorders as depression can lead to suicide. Nearly 800,000 suicides occurred worldwide in 2015, with men about twice as likely to commit suicide as women.
• Tobacco and alcohol use contributes to the burden of non-communicable diseases. The World Health Organization (WHO) Framework Convention on Tobacco Control has been ratified by 180 parties, which represent 90 per cent of the global population. Still, more than 1.1 billion people, mostly men, consumed tobacco in 2015. The prevalence of smoking among those individuals 15 years of age and older dropped from 23 per cent in 2007 to 21 per cent in 2013. In 2016, the average consumption of pure alcohol was 6.4 litres per year per person among those individuals 15 years of age or older.
• Indoor and ambient air pollution is the greatest environmental health risk. Globally in 2012, household air pollution from cooking with unclean fuels or inefficient technologies led to an estimated 4.3 million deaths, while ambient air pollution from traffic, industrial sources, waste burning or residential fuel combustion resulted in an estimated 3 million deaths.

Other health risks

• In 2013, about 1.25 million people died from road traffic injuries, the leading cause of death among males between 15 and 29 years of age. Road traffic deaths have increased by about 13 per cent globally since 2000.
• Worldwide in 2015, an estimated 108,000 people died as a result of unintentional poisoning. That figure represents 1.5 deaths per 100,000 people, a 33 per cent decrease since 2000.

Health systems and funding

• In 2015, total official flows for medical research and basic health from all donor countries and multilateral organizations amounted to $9.7 billion, an increase in real terms of 30 per cent since 2010. Of that amount, the member countries of the Development Assistance Committee of OECD contributed $4.3 billion.
• Available data from 2005 to 2015 indicate that over 40 per cent of all countries have less than one physician per 1,000 people, and around half have fewer than three nurses or midwives per 1,000 people. Almost all least developed countries have less than one physician and fewer than three nurses or midwives per 1,000 people.