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Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Bill & Melinda Gates Foundation.

A Development Emergency: the title of this year's Global Monitoring Report, the sixth in an annual series, could not be more apt. The global economic crisis, the most severe since the Great Depression, is rapidly turning into a human and development crisis. No region is immune. The poor countries are especially vulnerable, as they have the least cushion to withstand events. The crisis, coming on the heels of the food and fuel crises, poses serious threats to their hard-won gains in boosting economic growth and reducing poverty. It is pushing millions back into poverty and putting at risk the very survival of many. The prospect of reaching the Millennium Development Goals (MDGs) by 2015, already a cause for serious concern, now looks even more distant. A global crisis must be met with a global response. The crisis began in the financial markets of developed countries, so the first order of business must be to stabilize these markets and counter the recession that the financial turmoil has triggered. At the same time, strong and urgent actions are needed to counter the impact of the crisis on developing countries and help them restore strong growth while protecting the poor. Global Monitoring Report 2009, prepared jointly by the staff of the World Bank and the International Monetary Fund, provides a development perspective on the global economic crisis. It assesses the impact on developing countries, their growth, poverty reduction, and other MDGs. And it sets out priorities for policy response, both by developing countries themselves and by the international community. This report also focuses on the ways in which the private sector can be better mobilized in support of development goals, especially in the aftermath of the crisis.

Recently, assessments have robustly linked stabilization of global-mean temperature rise to the necessity of limiting the total amount of emitted carbon-dioxide (CO2). Halting global warming thus requires virtually zero annual CO2 emissions at some point. Policymakers have now incorporated this concept in the negotiating text for a new global climate agreement, but confusion remains about concepts like carbon neutrality, climate neutrality, full decarbonization, and net zero carbon or net zero greenhouse gas (GHG) emissions. Here we clarify these concepts, discuss their appropriateness to serve as a long-term global benchmark for achieving temperature targets, and provide a detailed quantification. We find that with current pledges and for a likely (>66%) chance of staying below 2 °C, the scenario literature suggests net zero CO2 emissions between 2060 and 2070, with net negative CO2 emissions thereafter. Because of residual non-CO2 emissions, net zero is always reached later for total GHG emissions than for CO2. Net zero emissions targets are a useful focal point for policy, linking a global temperature target and socio-economic pathways to a necessary long-term limit on cumulative CO2 emissions.

The 29th Conference of the Parties (COP 29) occurred in Baku, Azerbaijan, in November 2024. The conference’s central topic was Sustainable Development Goal 13 (Climate Action). It has been said that COP 29 developed into a “climate finance COP” to get wealthier countries to finance actions in poorer countries to remedy damage from the effects of the increasing emissions of greenhouse gases. The final agreement was not as ambitious as hoped for. In this study, the discrepancies between the fourteen regions of the countries of the world have been analyzed with a focus on Sustainable Development Goals (SDGs) 9 (Industry, Innovation, and Infrastructure), 12 (Responsible Consumption and Production), and 13 (Climate Action). The discrepancies between high-income countries (HICs) and OECD (The Organization for Economic Cooperation and Development) countries, as well as between low-income countries (LICs) and Africa, are presented. Where LICs and Africa, over the last 24-year period, virtually complied with the climate action goals (SDG 13), the HICs and OECD countries were far behind. A similar discrepancy is noted in sustainable production and consumption (SDG 12). The data show no indication that the increasing innovation in the HICs and OECD countries is reflected in increased sustainable production and consumption or increased compliance with climate action goals. One of the outcomes of the Baku COP 29 meeting was that wealthier countries should finance the remediation of the increasing effects of global temperature increase on the poorer countries, thus enabling them to continue without changing their habits.

Equilibrium among water, food, energy, and climate actions is necessary for life to exist, quality, and sustainability. This article explored how to ensure sustainability, and equilibrium in the irrigation processes by proposing irrigation equilibrium indicators (IEIs) for sustainable irrigated agriculture (SIA). The primary purpose of IEIs is to achieve a state of sustainable climate and environmental balance. The pressures driving agriculture and irrigation professionals to enhance the irrigation scheme performance are tremendous in all agricultural communities. Monitoring, assessment, and improvement of agriculture practices and irrigation schemes for enhancing the Climate, water, food, and energy (CWFE) nexus is a must. As an auspicious climate action, IEIs were developed to enhance the irrigation scheme’s efficiency, within the scope of SIA. Subsequently, water, agricultural, food, and energy productivity could be optimized. Then, the appropriate equilibrium indicators could identify the actual performance of the CWFE nexus as a whole and the performance of each component. The effective irrigation scheme is the backbone of SIA. IEIs could measure the degree of achieving the overall and specific objectives and designated irrigation processes. The ultimate measure of equilibrium is optimizing sustainable agricultural yields and productivity, ensuring environmental balance, strengthening life quality, and maximizing economic returns.

The Sustainable Development Goals (SDGs) differ from the MDGs in purpose, concept, and politics. This article focuses on the gender agenda in the SDGs as a reflection on the shifts from the MDGs to the SDGs. It argues that the SDGs address several of the key shortcomings of the MDGs and incorporate a broader and more transformative agenda that more adequately reflects the complex challenges of the 21st century, and the need for structural reforms in the global economy. The SDGs also reverse the MDG approach to global goal setting and the misplaced belief in the virtues of simplicity, concreteness, and quantification. While the SDGs promise the potential for a more transformative agenda, implementation will depend on continued advocacy on each of the targets to hold authorities to account.

Food, energy, and water (collectively referred to as ‘FEW’) security forms the key to human survival as well as socioeconomic development. However, the security of these basic resources is increasingly threatened due to growing demand. Beyond the widespread implications on public health, Coronavirus disease (COVID-19) has further raised additional challenges for FEW security, particularly for urban populations, as they mainly outsource their FEW demands from rural areas outside their physical boundaries. In light of that, this study reviews existing literature on FEW security to highlight the growing relevance of urban–rural linkages for realizing FEW security, especially against the backdrop of the COVID-19 pandemic. To achieve this, relevant research documents have been identified through Elsevier’s Scopus database and other sources (by applying search equations). The authors have accordingly underlined the necessity of shifting the conventional urban-centric approach to city region-centric development planning for the post-COVID-19 era. To this end, a framework has been suggested for translating physical urban–rural linkages to a partnership enhancing a collective response. The major elements of this framework are the conceptualization of national-level policies to support urban–rural linkages. The framework can play the role of a science–policy–action interface to redesign the FEW system in city regions.

In an evolving world, effectively managing human–natural systems under uncertainty becomes paramount, particularly when targeting the United Nations 2030 Agenda for Sustainable Development Goals (SDGs). The complexity in multi-actor decision-making and multi-sectoral settings, coupled with intricate relationships and potential conflicting management approaches, makes understanding the local implications of progressing towards the global SDGs challenging. We used a transdisciplinary approach for knowledge co-production with local stakeholders to assess the impact of local action to boost sustainability in the Goulburn–Murray region, Victoria, Australia, and its alignment with global action towards the SDGs. Together, we co-developed 11 local actions geared towards achieving four locally important environmental and socioeconomic SDGs, with a particular emphasis on addressing potential ‘spillovers’—unintended effects that influence SDGs across scales. Through system dynamics modelling, we evaluated the interplay between these local actions and global scenarios, emphasising their synergies, trade-offs, and the resulting impact on SDG indicators. Key findings indicate a predominant synergy between global and local actions across most SDG indicators. However, certain areas like dairy production, riverine algal blooms, and agricultural profit displayed trade-offs. Local actions significantly impacted indicators, such as crop production, dairy output, agricultural land use, and agricultural profitability. Findings highlighted the need for complementary actions in areas, such as water availability management, skilled workforce, and salinity control. This study underscored the importance of harmonising local initiatives with global sustainability objectives and can inspire local governance to champion resilience policies that harmoniously integrate local actions with global sustainability goals, adapting to evolving uncertainty scenarios.

On 25 September 2015, the United Nations (UN) member countries adopted an ambitious 17 Sustainable Development Goals (SDGs) aiming to ‘transform the world’ in the next 15 years. [...]

The article is aimed at identifying the main areas of regional policy with reference to ensuring economic security. It is proved that the state regional policy is an integral part of the state policy aimed at providing the spatial organization of a region, maintaining balance, eliminating regional differentiation. The mechanism of regional policy provision is considered. The powers of regional policy actors in Ukraine are apecified. The global and local goals of regional policy are characterized, the goal hierarchy is created with respect to ensuring regional economic security. Estimates of the local goals of regional policy on achieving the strategic goal of regional policy are defined. The main global goals of regional policy are highlighted, in particular: territorial integrity, socio-economic integration and spatial development, sustainable development of the region’s diversified competitive economy, development of rural territories and territories adjacent to cities, development of human capital and life quality, effective regional development management. It is determined that the following local goals are estimated highest for achieving the strategic goal of regional policy: protection of regional interests, territorial unity, prevention of deepening imbalances in regional development, rationalization of agricultural production pattern aimed at increasing its productivity, development of a competitive industrial sector.