@article{8533312,
  abstract     = {{Background: The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. 
Methods: We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 2.5th percentile estimated between 1990 and 2030, and 100 as the 97.5th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. 
Findings: Globally, the median health-related SDG index was 56.7 (IQR 31.9-66.8) in 2016 and country-level performance markedly varied, with Singapore (86.8, 95% uncertainty interval 84.6-88.9), Iceland (86.0, 84.1-87.6), and Sweden (85.6, 81.8-87.8) having the highest levels in 2016 and Afghanistan (10.9, 9.6-11.9), the Central African Republic (11.0, 8.8-13.8), and Somalia (11.3, 9.5-13.1) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. 
Interpretation: GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations.}},
  author       = {{Fullman, Nancy and Barber, Ryan M and Abajobir, Amanuel Alemu and Abate, Kalkidan Hassen and Abbafati, Cristiana and Abbas, Kaja M and Abd-Allah, Foad and Abdulle, Abdishakur M and Abera, Semaw Ferede and Aboyans, Victor and Abu-Raddad, Laith J and Abu-Rmeileh, Niveen ME and Adedeji, Isaac Akinkunmi and Adetokunboh, Olatunji and Afshin, Ashkan and Agrawal, Anurag and Agrawal, Sutapa and Kiadaliri, Aliasghar Ahmad and Ahmadieh, Hamid and Ahmed, Muktar Beshir and Aichour, Amani Nidhal and Aichour, Ibtihel and Aichour, Miloud Taki Eddine and Aiyar, Sneha and Akinyemi, Rufus Olusola and Akseer, Nadia and Al-Aly, Ziyad and Alam, Khurshid and Alam, Noore and Alasfoor, Deena and Alene, Kefyalew Addis and Alizadeh-Navaei, Reza and Alkerwi, Ala'a and Alla, Francois and Allebeck, Peter and Allen, Christine and Al-Raddadi, Rajaa and Alsharif, Ubai and Altirkawi, Khalid A and Alvis-Guzman, Nelson and Amare, Azmeraw T and Amini, Erfan and Ammar, Walid and Antonio, Carl Abelardo T and Ansari, Hossein and Anwari, Palwasha and Arora, Megha and Artaman, Al and Aryal, Krishna Kumar and Asayesh, Hamid and Asgedom, Solomon Weldegebreal and Assadi, Reza and Atey, Tesfay Mehari and Atre, Sachin R and Avila-Burgos, Leticia and Avokpaho, Euripide Frinel G. Arthur and Awasthi, Ashish and Azzopardi, Peter and Bacha, Umar and Badawi, Alaa and Balakrishnan, Kalpana and Bannick, Marlena S and Barac, Aleksandra and Barker-Collo, Suzanne L and Barnighausen, Till and Barrero, Lope H and Basu, Sanjay and Battle, Katherine E and Baune, Bernhard T and Beardsley, Justin and Bedi, Neeraj and Bejot, Yannick and Bell, Michelle L and Bennett, Derrick A and Bennett, James R and Bensenor, Isabela M and Berhane, Adugnaw and Berhe, Derbew Fikadu and Bernabe, Eduardo and Betsu, Balem Demtsu and Beuran, Mircea and Beyene, Addisu Shunu and Bhansali, Anil and Bhatt, Samir and Bhutta, Zulfiqar A and Bikbov, Boris and Bilal, Arebu I and Birungi, Charles and Biryukov, Stan and Bizuayehu, Habtamu Mellie and Blosser, Christopher D and Boneya, Dube Jara and Bose, Dipan and Bou-Orm, Ibrahim R and Brauer, Michael and Breitborde, Nicholas JK and Brugha, Traolach S and Bulto, Lemma Negesa Bulto and Butt, Zahid A and Cahuana-Hurtado, Lucero and Cameron, Ewan and Cesar Campuzano, Julio and Cardenas, Rosario and Carrero, Juan Jesus and Carter, Austin and Casey, Daniel C and Castaneda-Orjuela, Carlos A and Castillo Rivas, Jacqueline and Estanislao Castro, Ruben and Catala-Lopez, Ferran and Cercy, Kelly and Chang, Hsing-Yi and Chang, Jung-Chen and Charlson, Fiona J and Chew, Adrienne and Chisumpa, Vesper Hichilombwe and Chitheer, Abdulaal A and Christensen, Hanne and Christopher, Devasahayam Jesudas and Cirillo, Massimo and Cooper, Cyrus and Criqui, Michael H and Cromwell, Elizabeth A and Crump, John A and Dandona, Lalit and Dandona, Rakhi and Dargan, Paul I and das Neves, Jose and Davitoiu, Dragos V and de Courten, Barbora and De Steur, Hans and Degenhardt, Louisa and Deiparine, Selina and Deribe, Kebede and deveber, Gabrielle A and Ding, Eric L and Djalalinia, Shirin and Huyen Phuc Do, Huyen Phuc Do and Dokova, Klara and Doku, David Teye and Dorsey, E Ray and Driscoll, Tim R and Dubey, Manisha and Duncan, Bruce Bartholow and Ebel, Beth E and Ebrahimi, Hedyeh and El-Khatib, Ziad Ziad and Enayati, Ahmadali and Endries, Aman Yesuf and Ermakov, Sergey Petrovich and Erskine, Holly E and Eshrati, Babak and Eskandarieh, Sharareh and Esteghamati, Alireza and Estep, Kara and Faraon, Emerito Jose Aquino and E Sa Farinha, Carla Sofia and Faro, Andre and Farzadfar, Farshad and Fazeli, Mir Sohail and Feigin, Valery L and Feigl, Andrea B and Fereshtehnejad, Seyed-Mohammad and Fernandes, Joao C and Ferrari, Alize J and Feyissa, Tesfaye Regassa and Filip, Irina and Fischer, Florian and Fitzmaurice, Christina and Flaxman, Abraham D and Foigt, Nataliya and Foreman, Kyle J and Frank, Tahvi and Franklin, Richard C and Friedman, Joseph and Frostad, Joseph J and Furst, Thomas and Furtado, Joao M and Gakidou, Emmanuela and Garcia-Basteiro, Alberto L and Gebrehiwot, Tsegaye Tewelde and Geleijnse, Johanna M and Geleto, Ayele and Gemechu, Bikila Lencha and Gething, Peter W and Gibney, Katherine B and Gill, Paramjit Singh and Gillum, Richard F and Giref, Ababi Zergaw and Gishu, Melkamu Dedefo and Giussani, Giorgia and Glenn, Scott D and Godwin, William W and Goldberg, Ellen M and Gona, Philimon N and Goodridge, Amador and Gopalani, Sameer Vali and Goryakin, Yevgeniy and Griswold, Max and Gugnani, Harish Chander and Gupta, Rajeev and Gupta, Tanush and Gupta, Vipin and Hafezi-Nejad, Nima and Bidgoli, Hassan Haghparast and Hailu, Gessessew Bugssa and Hamadeh, Randah Ribhi and Hammami, Mouhanad and Hankey, Graeme J and Harb, Hilda L and Hareri, Habtamu Abera and Hassanvand, Mohammad Sadegh and Havmoeller, Rasmus and Hawley, Caitlin and Hay, Simon I and He, Jiawei and Hendrie, Delia and Henry, Nathaniel J and Beatriz Heredia-Pi, Ileana and Hoek, Hans W and Holmberg, Mollie and Horita, Nobuyuki and Hosgood, H Dean and Hostiuc, Sorin and Hoy, Damian G and Hsairi, Mohamed and Htet, Aung Soe and Huang, Hsiang and Huang, John J and Huynh, Chantal and Iburg, Kim Moesgaard and Ikeda, Chad and Inoue, Manami and Irvine, Caleb Mackay Salpeter and Jacobsen, Kathryn H and Jahanmehr, Nader and Jakovljevic, Mihajlo B and Jauregui, Alejandra and Javanbakht, Mehdi and Jeemon, Panniyammakal and Jha, Vivekanand and John, Denny and Johnson, Catherine O and Johnson, Sarah Charlotte and Jonas, Jost B and Jurisson, Mikk and Kabir, Zubair and Kadel, Rajendra and Kahsay, Amaha and Kamal, Ritul and Karch, Andre and Karema, Corine Kakizi and Kasaeian, Amir and Kasaeian, Amir and Kassebaum, Nicholas J and Kastor, Anshul and Katikireddi, Srinivasa Vittal and Kawakami, Norito and Keiyoro, Peter Njenga and Kelbore, Sefonias Getachew and Kemmer, Laura and Kengne, Andre Pascal and Kesavachandran, Chandrasekharan Nair and Khader, Yousef Saleh and Khalil, Ibrahim A and Khan, Ejaz Ahmad and Khang, Young-Ho and Khosravi, Ardeshir and Khubchandani, Jagdish and Kieling, Christian and Kim, Daniel and Kim, Jun Y and Kim, Yun Jin and Kimokoti, Ruth W and Kinfu, Yohannes and Kisa, Adnan and Kissimova-Skarbek, Katarzyna A and Kivimaki, Mika and Kokubo, Yoshihiro and Kopec, Jacek A and Kosen, Soewarta and Koul, Parvaiz A and Koyanagi, Ai and Kravchenko, Michael and Krohn, Kristopher J and Defo, Barthelemy Kuate and Bicer, Burcu Kucuk and Kulikoff, Xie Rachel and Kumar, G Anil and Kutz, Michael J and Kyu, Hmwe H and Lal, Dharmesh Kumar and Lalloo, Ratilal and Lansingh, Van C and Larsson, Anders and Lazarus, Jeffrey Victor and Lee, Paul H and Leigh, James and Leung, Janni and Leung, Ricky and Levi, Miriam and Li, Yongmei and Liben, Misgan Legesse and Linn, Shai and Liu, Patrick Y and Liu, Shiwei and Lodha, Rakesh and Looker, Katharine J and Lopez, Alan D and Lorkowski, Stefan and Lotufo, Paulo A and Lozano, Rafael and Lucas, Timothy CD and Mackay, Mark T and Maddison, Emilie R and Abd el Razek, Hassan Magdy and Abd el Razek, Mohammed Magdy and Majdan, Marek and Majdzadeh, Reza and Majeed, Azeem and Malekzadeh, Reza and Malhotra, Rajesh and Malta, Deborah Carvalho and Mamun, Abdullah A and Manguerra, Helena and Mantovani, Lorenzo G and Manyazewal, Tsegahun and Mapoma, Chabila C and Marks, Guy B and Martin, Randall V and Martins-Melo, Francisco Rogerlandio and Martopullo, Ira and Mathur, Manu Raj and Mazidi, Mohsen and McAlinden, Colm and McGaughey, Madeline and McGrath, John J and Mckee, Martin and Mehata, Suresh and Mehndiratta, Man Mohan and Meier, Toni and Meles, Kidanu Gebremariam and Memish, Ziad A and Mendoza, Walter and Mengesha, Melkamu Merid and Mengistie, Mubarek Abera and Mensah, George A and Mensink, Gert BM and Mereta, Seid Tiku and Meretoja, Atte and Meretoja, Tuomo J and Mezgebe, Haftay Berhane and Micha, Renata and Millear, Anoushka and Miller, Ted R and Minnig, Shawn and Mirarefin, Mojde and Mirrakhimov, Erkin M and Misganaw, Awoke and Mishra, Shiva Raj and Mitchell, Philip B and Mohammad, Karzan Abdulmuhsin and Mohammed, Kedir Endris and Mohammed, Shafiu and Mohan, Murali BV and Mokdad, Ali H and Mollenkopf, Sarah K and Monasta, Lorenzo and Montanez Hernandez, Julio Cesar and Montico, Marcella and Moradi-Lakeh, Maziar and Moraga, Paula and Morawska, Lidia and Morrison, Shane D and Moses, Mark W and Mountjoy-Venning, Cliff and Mueller, Ulrich O and Muller, Kate and Murthy, Gudlavalleti Venkata Satyanarayana and Musa, Kamarul Imran and Naghavi, Mohsen and Naheed, Aliya and Naidoo, Kovin S and Nangia, Vinay and Natarajan, Gopalakrishnan and Negoi, Ionut and Negoi, Ruxandra Irina and Cuong Tat Nguyen, Cuong Tat Nguyen and Grant Nguyen, Grant Nguyen and Minh Nguyen, Minh Nguyen and Quyen Le Nguyen, Quyen Le Nguyen and Trang Huyen Nguyen, Trang Huyen Nguyen and Nichols, Emma and Ningrum, Dina Nur Anggraini and Nomura, Marika and Vuong Minh Nong, Vuong Minh Nong and Norheim, Ole F and Noubiap, Jean Jacques N and Obermeyer, Carla Makhlouf and Ogbo, Felix Akpojene and Oh, In-Hwan and Oladimeji, Olanrewaju and Olagunju, Andrew Toyin and Olagunju, Tinuke Oluwasefunmi and Olivares, Pedro R and Olsen, Helen E and Olusanya, Bolajoko Olubukunola and Olusanya, Jacob Olusegun and Ong, Kanyin and Oren, Eyal and Ortiz, Alberto and Owolabi, Mayowa O and Pa, Mahesh and Pana, Adrian and Panda, Basant Kumar and Panda-Jonas, Songhomitra and Papachristou, Christina and Park, Eun-Kee and Patton, George C and Paulson, Katherine and Pereira, David M and Perico, David Norberto and Pesudovs, Konrad and Petzold, Max and Phillips, Michael Robert and Pigott, David M and Pillay, Julian David and Pinho, Christine and Piradov, Michael A and Pishgar, Farhad and Poulton, Richie G and Pourmalek, Farshad and Qorbani, Mostafa and Radfar, Amir and Rafay, Anwar and Rao, Puja C and Rahimi-Movaghar, Vafa and Rahman, Mahfuzar and Rahman, Mohammad Hifz Ur and Rahman, Muhammad Aziz and Rai, Rajesh Kumar and Rajsic, Sasa and Ram, Usha and Ranabhat, Chhabi Lal and Rawaf, Salman and Reidy, Patrick and Reiner, Robert C, Jr and Reinig, Nikolas and Reitsma, Marissa B and Remuzzi, Giuseppe and Renzaho, Andre MN and Resnikoff, Serge and Rezaei, Satar and Rios Blancas, Maria Jesus and Roba, Kedir Teji and Rojas-Rueda, David and Rokni, Mohammad Bagher and Roshandel, Gholamreza and Roth, Gregory A and Roy, Ambuj and Rubagotti, Enrico and Sadat, Nafis and Safdarian, Mahdi and Safi, Sare and Safiri, Saeid and Sagar, Rajesh and Salama, Joseph and Salomon, Joshua A and Samy, Abdallah M and Ramon Sanabria, Juan and Santomauro, Damian and Santos, Itamar S and Santos, Joao Vasco and Milicevic, Milena M Santric and Sartorius, Benn and Satpathy, Maheswar and Sawhney, Monika and Saxena, Sonia and Saylan, Mete I and Shirude, Shreya and Schmidt, Maria Ines and Schneider, Ione JC and Schneider, Matthew T and Schottker, Ben and Schutte, Aletta E and Schwebel, David C and Schwendicke, Falk and Seedat, Soraya and Sepanlou, Sadaf G and Servan-Mori, Edson E and Shackelford, Katya Anne and Shaheen, Amira and Shahraz, Saeid and Shaikh, Masood Ali and Shamsipour, Mansour and Shamsizadeh, Morteza and Islam, Sheikh Mohammed Shariful and Sharma, Jayendra and Sharma, Rajesh and She, Jun and Shi, Peilin and Shibuya, Kenji and Shields, Chloe and Shiferaw, Mekonnen Sisay and Shigematsu, Mika and Shin, Min-Jeong and Shiri, Rahman and Shirkoohi, Reza and Shishani, Kawkab and Shoman, Haitham and Shrime, Mark G and Santos Silva, Diego Augusto and Silva, Joao Pedro and Alves Silveira, Dayane Gabriele and Singh, Jasvinder A and Singh, Virendra and Sinha, Dhirendra Narain and Skiadaresi, Eirini and Slepak, Erica Leigh and Sligar, Amber and Smith, Alison and Smith, David L and Smith, Mari and Sobaih, Badr HA and Sobngwi, Eugene and Soljak, Michael and Soneji, Samir and Sorensen, Reed JD and Sposato, Luciano A and Sreeramareddy, Chandrashekhar T and Srinivasan, Vinay and Stanaway, Jeffrey D and Stein, Dan J and Steinke, Sabine and Stokes, Mark Andrew and Strub, Bryan and Sufiyan, Muawiyyah Babale and Abdulkader, Rizwan Suliankatchi and Sunguya, Bruno F and Sur, Patrick J and Swaminathan, Soumya and Sykes, Bryan L and Sylte, Dillon O and Szoeke, Cassandra EI and Tabares-Seisdedos, Rafael and Tadakamadla, Santosh Kumar and Tandon, Nikhil and Tao, Tianchan and Tarekegn, Yihunie L and Tavakkoli, Mohammad and Taveira, Nuno and Tegegne, Teketo Kassaw and Shifa, Girma Temam and Terkawi, Abdullah Sulieman and Tessema, Gizachew Assefa and Thakur, JS and Thankappan, Kavumpurathu Raman and Thrift, Amanda G and Tiruye, Tenaw Yimer and Tobe-Gai, Ruoyan and Topor-Madry, Roman and Torre, Anna and Tortajada, Miguel and Tran, Bach Xuan and Troeger, Christopher and Truelsen, Thomas and Tsoi, Derrick and Tuem, Kald Beshir and Tuzcu, Emin Murat and Tyrovolas, Stefanos and Ukwaja, Kingsley N and Uneke, Chigozie Jesse and Updike, Rachel and Uthman, Olalekan A and van Boven, Job FM and van Donkelaar, Aaron and Varughese, Santosh and Vasankari, Tommi and Venketasubramanian, Narayanaswamy and Vidavalur, Ramesh and Violante, Francesco S and Vladimirov, Sergey K and Vlassov, Vasiliy Victorovich and Vollset, Stein Emil and Vos, Theo and Wadilo, Fiseha and Wakayo, Tolassa and Wallin, Mitchell T and Wang, Yuan-Pang and Weichenthal, Scott and Weiderpass, Elisabete and Weintraub, Robert G and Weiss, Daniel J and Werdecker, Andrea and Westerman, Ronny and Whiteford, Harvey A and Wijeratne, Tissa and Wiysonge, Charles Shey and Woldeyes, Belete Getahun and Wolfe, Charles DA and Woodbrook, Rachel and Xavier, Denis and Xu, Gelin and Yadgir, Simon and Yakob, Bereket and Yan, Lijing L and Yano, Yuichiro and Yaseri, Mehdi and Ye, Pengpeng and Yimam, Hassen Hamid and Yip, Paul and Yonemoto, Naohiro and Yoon, Seok-Jun and Yotebieng, Marcel and Younis, Mustafa Z and Zaidi, Zoubida and Zaki, Maysaa El Sayed and Zavala-Arciniega, Luis and Zhang, Xueying and Zipkin, Ben and Zodpey, Sanjay and Lim, Stephen S and Murray, Christopher JL}},
  issn         = {{0140-6736}},
  journal      = {{LANCET}},
  keywords     = {{DEVELOPMENT ASSISTANCE,PREPAID PRIVATE,COVERAGE,MORTALITY,CARE,40-PERCENT,GOVERNMENT,SYSTEMS,MEXICO,CHINA}},
  language     = {{eng}},
  number       = {{10100}},
  pages        = {{1423--1459}},
  title        = {{Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries : an analysis from the Global Burden of Disease Study 2016}},
  volume       = {{390}},
  year         = {{2017}},
}

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