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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
by
Herteliu, Claudiu
,
Ghiasvand, Hesam
,
Minnig, Shawn P
in
Aggression
,
Air pollution
,
Alcoholic beverages
2018
Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment.
We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator.
The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030.
The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
Bill & Melinda Gates Foundation.
Journal Article
The legacy of punishment in international law
\"The Legacy of Punishment in International Law illustrates how 17th and 18th century rationales for the use of force in support of piracy and colonialism have been transformed into progressive features of contemporary International Law. The classic practice of international punishment was a part of the jus ad bellum, and was the fig leaf for intra-European violence, and for the European conquest of the Americas. It has been transformed, however, into the basis for the assertion of a set of unconditionally, universally binding rules of international law, and for universal jurisdiction over perpetrators of crimes against humanity and war crimes\"-- Provided by publisher.
Exile, ostracism, and democracy
2005,2009,2006
This book explores the cultural and political significance of ostracism in democratic Athens. In contrast to previous interpretations, Sara Forsdyke argues that ostracism was primarily a symbolic institution whose meaning for the Athenians was determined both by past experiences of exile and by its role as a context for the ongoing negotiation of democratic values.
The first part of the book demonstrates the strong connection between exile and political power in archaic Greece. In Athens and elsewhere, elites seized power by expelling their rivals. Violent intra-elite conflict of this sort was a highly unstable form of \"politics that was only temporarily checked by various attempts at elite self-regulation. A lasting solution to the problem of exile was found only in the late sixth century during a particularly intense series of violent expulsions. At this time, the Athenian people rose up and seized simultaneously control over decisions of exile and political power. The close connection between political power and the power of expulsion explains why ostracism was a central part of the democratic reforms.
Forsdyke shows how ostracism functioned both as a symbol of democratic power and as a key term in the ideological justification of democratic rule. Crucial to the author's interpretation is the recognition that ostracism was both a remarkably mild form of exile and one that was infrequently used. By analyzing the representation of exile in Athenian imperial decrees, in the works of Herodotus, Thucydides, Plato, Aristotle, and in tragedy and oratory, Forsdyke shows how exile served as an important term in the debate about the best form of rule.
Crimes Against The State
2011,2016
In the post-2001 context of economic and political conflict, this book presents a timely and detailed examination of the role of the criminal law in the protection of the existing order from political dissent and destabilization. It reviews offences such as rebellion, treason, mutiny, espionage, sedition, terrorism, riot and unlawful assembly in the UK, US, Canada and Australia from a comparative perspective and investigates leading cases in their historical and political contexts. Also examining the impact on human rights and civil liberties, this book covers a neglected area of English-derived law and will encourage debate about crimes against states and governments.
Dr Michael Head, B.Juris, LL.B. (Hons) (Monash), LLM (Columbia), Ph.D. (UWS), is Associate Professor in law at the University of Western Sydney. He is an established name in the fields of law and civil liberties. Over the past ten years, he has had a substantial range of publications in leading law journals. Head is also the author of Calling out the Troops - The Australian Military and Civil Unrest (Federation Press 2008), Administrative Law: Context and Critique (Federation Press, 2nd ed, 2008), Evgeny Pashukanis: A Critical Reappraisal (Routledge-Cavendish, 2008) and co-author with Dr Scott Mann of Law in Perspective: Ethics, society and critical thinking (UNSW Press, 2nd ed, 2008) and Domestic Deployment of the Armed Forces: Military Powers, Law and Human Rights (Ashgate 2009).
The hidden history of crime, corruption, and states
Renowned historical sociologist Charles Tilly wrote many years ago that \"banditry, piracy, gangland rivalry, policing, and war-making all belong on the same continuum.\" This volume pursues the idea by revealing how lawbreakers and lawmakers have related to one another on the shadowy terrains of power over wide stretches of time and space. Illicit activities and forces have been more important in state building and state maintenance than conventional histories have acknowledged. Covering vast chronological and global terrain, this book traces the contested and often overlapping boundaries between these practices in such very different polities as the pre-modern city-states of Europe, the modern nation-states of France and Japan, the imperial power of Britain in India and North America, Africa's and Southeast Asia's postcolonial states, and the emerging postmodern regional entity of the Mediterranean Sea. Indeed, the contemporary explosion of transnational crime raises the question of whether or not the relationship of illicit to licit practices may be mutating once more, leading to new political forms beyond the nation-state.