Ensuring healthy lives and promoting well-being at all ages is essential to sustainable development. Currently, the world is facing a global health crisis unlike any other — COVID-19 is spreading human suffering, destabilizing the global economy and upending the lives of billions of people around the globe.
Before the pandemic, major progress was made in improving the health of millions of people. Significant strides were made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality. But more efforts are needed to fully eradicate a wide range of diseases and address many different persistent and emerging health issues. By focusing on providing more efficient funding of health systems, improved sanitation and hygiene, and increased access to physicians, significant progress can be made in helping to save the lives of millions.
Health emergencies such as COVID-19 pose a global risk and have shown the critical need for preparedness. The United Nations Development Programme highlighted huge disparities in countries’ abilities to cope with and recover from the COVID-19 crisis. The pandemic provides a watershed moment for health emergency preparedness and for investment in critical 21st century public services.
Major progress has been made in improving the health of millions of people, increasing life expectancy, reducing maternal and child mortality and fighting against leading communicable diseases. However, progress has stalled or is not happening fast enough with regard to addressing major diseases, such as malaria and tuberculosis, while at least half the global population does not have access to essential health services and many of those who do suffer undue financial hardship, potentially pushing them into extreme poverty. Concerted efforts are required to achieve universal health coverage and sustainable financing for health, to address the growing burden of non-communicable diseases, including mental health, and to tackle antimicrobial resistance and determinants of health such as air pollution and inadequate water and sanitation.
Reproductive, maternal, newborn and child health
- An estimated 303,000 women around the world died due to complications of pregnancy and childbirth in 2015. Almost all of these deaths occurred in low- and middle-income countries, and almost two thirds of those were in sub-Saharan Africa. These deaths are preventable with appropriate management and care. Globally in 2018, 81 per cent of births took place with the assistance of a skilled birth attendant, a significant improvement from 69 per cent in 2012. Coverage of skilled birth attendants in 2018 was only 59 per cent in sub-Saharan Africa.
- The under-5 mortality rate fell to 39 deaths per 1,000 live births in 2017, a 6.7 per cent reduction from 42 deaths in 2015, and an overall reduction of 49 per cent from 77 deaths per 1,000 live births in 2000. The total number of under-5 deaths dropped to 5.4 million in 2017 from 9.8 million in 2000. Still, most of these deaths were from preventable causes and almost half, or 2.5 million, occurred in the first month of life – the most crucial period for child survival. The global neonatal mortality rate has continued to decline after a long downward trend from 31 deaths per 1,000 live births in 2000 to 18 in 2017, a 41 per cent reduction.
- Immunization saves millions of lives and is widely recognized as one of the world’s most successful and cost-effective health interventions. Coverage of the required three doses of the vaccine that prevents diphtheria, tetanus and pertussis increased from 72 per cent in 2000 to 85 per cent in 2015 and has remained unchanged between 2015 and 2017. An estimated 19.9 million children did not receive the vaccines during the first year of life, putting them at serious risk of these potentially fatal diseases. The global coverage of pneumococcal conjugate vaccine, which has the potential to significantly reduce deaths in children under age of 5, has yet to reach 50 per cent. Two doses of the measles vaccine are required to prevent the disease and the illnesses, disabilities and deaths caused by complications associated with it. Coverage with the second dose of measles vaccine increased from 59 per cent in 2015 to 67 per cent in 2017, but that is still insufficient to prevent this highly contagious disease.
- Expanding access to modern contraceptive methods is essential to ensuring universal access to sexual and reproductive health-care services. Globally, the proportion of women of reproductive age (15 to 49 years old) who have their need for family planning satisfied with modern contraceptive methods has continued to increase slowly, from 74 per cent in 2000 to 76 per cent in 2019.
- Adolescent fertility declined from 56 births per 1,000 adolescent women in 2000 to 45 births in 2015 and 44 births in 2019. The level of adolescent fertility has remained high in sub-Saharan Africa, at 101 births per 1,000 adolescent women.