Ranking Por Paises Desempeño en Salud 2015 PDF

Articles
Measuring the health-related Sustainable Development

Goals in 188 countries: a baseline analysis from the Global
Burden of Disease Study 2015
GBD 2015 SDG Collaborators*
Summary
Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs).
The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of
33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015
(GBD 2015).
Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 healthrelated SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst
observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG
indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals
(MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the
geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations
between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational
attainment, and total fertility rate) and each of the health-related SDG indicators and indices.
Findings In 2015, the median health-related SDG index was 593 (95% uncertainty interval 568618) and varied
widely by country, ranging from 855 (842865) in Iceland to 204 (154249) in Central African Republic. SDI was
a good predictor of the health-related SDG index (r=088) and the MDG index (r=092), whereas the non-MDG index
had a weaker relation with SDI (r=079). Between 2000 and 2015, the health-related SDG index improved by a median
of 79 (IQR 50104), and gains on the MDG index (a median change of 100 [67131]) exceeded that of the nonMDG index (a median change of 55 [2189]). Since 2000, pronounced progress occurred for indicators such as met
need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health
coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis
incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened.
Published Online
September 21, 2016
http://dx.doi.org/10.1016/
S0140-6736(16)31467-2
See Online/Comment
http://dx.doi.org/10.1016/
S0140-6736(16)31635-X
*Collaborators listed at the end
of the Article
Correspondence to:
Prof Christopher J L Murray,
University of Washington,
Institute for Health Metrics and
Evaluation, 2301 5th Avenue,
Suite 600, Seattle, WA 98121,
USA
cjlm@uw.edu
See Online for infographic

http://www.thelancet.com/
infographics/SDG
Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related
SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health
improvement but also emphasises that investments in these areas alone will not be sucient. Although considerable
progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many
cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related
indicators beyond the MDGs highlight the need for additional resources to eectively address the expanded scope of
the health-related SDGs.
Funding Bill & Melinda Gates Foundation.
Copyright The Authors(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license.
Background
In September, 2015, the UN General Assembly adopted
Transforming our World: The 2030 Agenda for
Sustainable Development, a resolution outlining a new
framework to form the cornerstone of the sustainable
development agenda for the period leading up to 2030.1
This new framework replaced the Millennium
Development Goal (MDG) framework that expired in 2015,
establishing 17 universal goals and 169 targets referred to
as the Sustainable Development Goals (SDGs). The SDGs
substantially broaden the development agenda beyond the
MDGs and are expected to frame UN member state
policies over the next 15 years. To measure progress

towards achieving the goals, the UN Statistical Commission
created the Inter-Agency and Expert Group on Sustainable
Development Goal Indicators (IAEG-SDGs) with a
mandate to draft an indicator framework that aligns with
the targets. The IAEG-SDGs announced a total of
230 indicators to measure achievement of the 169 targets.2
Health is a core dimension of the SDGs; goal 3 aims to
ensure healthy lives and promote wellbeing for all at all
ages. Health-related indicatorsie, indicators directly
pertaining to health services, health outcomes, and
environmental, occupational, behavioural, or metabolic
www.thelancet.com Published online September 21, 2016 http://dx.doi.org/10.1016/S0140-6736(16)31467-2
Articles
Research in context
Evidence before this study
Since the adoption of the Sustainable Development Goals
(SDGs) in September, 2015, demand to establish independent,
robust avenues for monitoring progress for the SDGs has
escalated. However, substantial challenges exist in undertaking
comprehensive and comparable assessments of health-related
SDG indicators to monitor and guide development agendas and
health policy implementation.
Added value of this study
The Global Burden of Diseases, Injuries, and Risk Factors Study
(GBD) features more than 1870 collaborators from
124 countries and three territories and provides an independent
analytical platform through which levels of health-related SDG
indicators can be assessed across geographies and over time in a
risks with well established causal connections to health

are also present in ten of the other 16 goals.3,4 Across these
11 goals, there are 28 health-related targets with a total of
47 health-related indicators.
The SDGs were developed through a highly
consultative and iterative process that included multiple
meetings with expert groups, civil society, and
governments. However, the process of developing the
SDGs and the accompanying goals, targets, and
indicators has not been without its critics. In both
scientic settings and the news media, the common
refrain has been that the SDGs are a long list of vague
goals that lack clear, realistic, and measurable targets
and indicators,511 and that they are not accompanied by a
clear theory of change12 articulating how the pieces t
together.3 In view of the potential importance of the
SDGs in directing national policies and donor
investments, there has also been intense debate about
the selection of targets and indicators;12 despite the
lengthy list, some think that the SDGs are missing key
areas of development, ranging from prohibition of
forced labour13 to improvement of mental health.1416
Concerns have also been expressed about the feasibility
of measuring the 230 proposed indicators.5,6,17 Indeed,
measurement of countries current status and progress
towards meeting the SDG targets will be an enormous
task and will require collective action across a range
of national and international organisations, both
governmental and non-governmental. The diculties of
measurement are also further compounded by persistent
problems of data availability, quality, and comparability
across a host of indicators.4,18 Furthermore, measurement
of development indicators is accompanied by a high
potential for political entanglement, which can lead to
distorted estimates.1922 Independent monitoring of the
SDG indicators will be crucial if they are to be used to
accurately evaluate progress to ensure accountability
and drive national and international development
agendas towards meeting the SDGs.4,2326
2
comparable manner. Drawing from GBD, we provide the

measurement of 33 of the 47 health-related SDG indicators and
introduce an overall health-related SDG index for 188 countries
from 1990 to 2015.
Implications of all the available evidence
GBD and its analytical framework allow detailed analyses of
country-level performance across health-related SDG indicators
and over time. This information can be used to identify
high-performing and low-performing countries, inform policy
decisions, guide resource allocation, and monitor progress
towards the health-related SDGs. The varied historical progress
in improving a subset of health-related SDG indicators and
rising prevalence of risks such as child overweight underscores
the complex health landscape the world faces in the SDG era.
Despite these concerns, increasing work has been done

in the past decade to generate independent, comparable,
valid, and consistent measurements of development
indicators.2732 To measure progress on the SDGs, these
existing eorts will need to be leveraged, particularly
those that provide comparable assessments of health
outcomes and risks across countries and over time. The
Global Burden of Diseases, Injuries, and Risk Factors
Study (GBD) is a primary example of such an initiative.
GBD is an open, collaborative, independent study to
comprehensively measure epidemiological levels and
trends of disease and risk factor burden worldwide,
with more than 1870 individual collaborators from
124 countries and three territories across the full range
of development. GBD uses a highly standardised
approach to overcome challenges of inconsistent coding
and indicator denitions across countries, missing and
conicting data, and time lags in measurement and
estimation. Of the 47 health-related indicators included
as part of the SDGs, estimates for 33 indicators are
presently included as part of GBD. The GBD study also
has several mechanisms to ensure independence,
including the GBD Scientic Council that meets
regularly to review all methods and major data changes,
and the Independent Advisory Committee that meets
twice yearly to review GBD progress and provide
recommendations for strengthening GBD estimates.33
In this analysis, while acknowledging the continued
debate about the structure, selection, and construction
of SDG indicators, we used the GBD study to assess the
current status of these 33 health-related SDG indicators.
With this baseline assessment, we developed and
estimated a summary indicator for the health-related
SDG indicators and documented historical trends for
this summary indicator. With the GBD results, we
identied countries with the largest improvements
between 1990 and 2015 to inform roadmaps and provide
a basis for monitoring the health-related SDG
indicators.
Articles
Methods
Overview of GBD
GBD is an annual eort to measure the health of
populations at regional, country, and selected subnational
levels.33 GBD produces estimates of mortality and
morbidity by cause, age, sex, and country for the period
1990 to the most recent year, reecting all available data
sources adjusted for bias. GBD also measures many
health system characteristics, risk factor exposure, and
mortality and morbidity attributable to these risks. In
addition to providing highly detailed standardised
information for many outcomes and risks, various
summary measures are also computed, including
disability-adjusted life-years (DALYs) and healthy life
expectancy. For the present analysis, we used estimates
from GBD 2015 to provide a baseline assessment for
188 countries. Further details on GBD 2015, which covers
19902015, are available elsewhere.3439
Indicators, denitions, and measurement approach

We dened health-related SDG indicators as indicators
for health services, health outcomes, and environmental,
occupational, behavioural, and metabolic risks with well
established causal connections to health. Many of the
47 health-related SDG indicators selected by the
IAEG-SDGs are produced as part of GBD. Table 1
outlines the ten goals, corresponding to 21 health-related
targets and 33 health-related indicators included in this
present iteration of GBD. This table also outlines the
denition of the indicator used in this analysis; detailed
descriptions of the estimation methods and data sources
are given in the methods appendix pp 10311. For the
14 health-related indicators that were not included in this
analysis, their prospects for measurement in future
iterations of GBD are described in table 2.
Direct outputs of GBD that are health-related SDG
indicators include mortality disaggregated by age
(under-5 and neonatal) and cause (maternal,
cardiovascular disease, cancer, diabetes, chronic
respiratory diseases, road injuries, self-harm, unintentional poisonings, exposure to forces of nature, interpersonal violence, and collective violence and legal
intervention [ie, deaths due to law enforcement actions,
irrespective of their legality]), as well as disease incidence
(HIV, malaria, tuberculosis, and hepatitis B) and
prevalence (neglected tropical diseases). The GBD
comparative risk assessment includes measurement of
exposure prevalence included as health-related SDG
indicators (under-5 stunting, wasting, and overweight;
tobacco smoking; harmful alcohol use; intimate partner
violence; unsafe water, sanitation, and hygiene;
household air pollution; and ambient particulate matter
pollution), as well as deaths or disease burden attributable
to risk factors selected as health-related SDG indicators
(unsafe water, sanitation, and hygiene; household air
pollution and ambient particulate matter pollution; and
occupational risks).
Underlying GBD outputs are a range of additional

health determinants that contribute to the estimation of
morbidity and mortality, for which data are
systematically compiled and estimates are produced.
For example, GBD comprehensively analyses data from
household surveys on vaccine coverage and combines
survey estimates with reported administrative data to
produce time series of vaccine coverage for all countries
from 1990 to 2015. Estimates of vaccine coverage are
then included as predictors of vaccine-preventable
morbidity and mortality in GBD. Additional health
indicators produced as part of GBD and included as
health-related SDG indicators in this analysis are: met
need with modern contraception among women of
reproductive age, adolescent birth rate, skilled birth
attendance coverage, and universal health coverage
(UHC) tracer interventions. For UHC tracer
interventions, we developed an index based on the
geometric mean of the coverage of a set of UHC tracer
interventions: met need with modern contraception;
antenatal care (one or more visits and four or more
visits); skilled birth attendance coverage; in-facility
delivery rates; vaccination coverage (three doses of
diphtheriapertussistetanus, measles vaccine, and
three doses of oral polio vaccine or inactivated polio
vaccine); tuberculosis case detection rate; coverage of
antiretroviral therapy for populations living with HIV,
and coverage of insecticide-treated nets for malariaendemic countries.
For selected indicators proposed by the IAEG-SDGs,
we made modications to the denition for clarity or on
the basis of the denition used in GBD (table 1). For
example, Indicator 2.2.2 proposes a measure of
malnutrition that combined prevalence of wasting and
overweight among children under age 5 years. As
childhood wasting and overweight have very dierent
determinants, we opted to report them separately. For
childhood overweight, we report prevalence in children
aged 24 years, the denition used in GBD based on
thresholds set by the International Obesity Task Force.40
Further details on the estimation and data sources
used for all indicators, compliant with Guidelines for
Accurate and Transparent Health Estimates Reporting
(GATHER),41,42 are included in the methods appendix
pp 10311.
See Online for appendices
Health-related SDG, health-related MDG, and healthrelated non-MDG indices

To identify broad patterns and more easily track general
progress, we developed an overall health-related SDG index
that is a function of the 33 health-related SDG indicators
(referred to as the health-related SDG index). We also
constructed two related indices: one reecting the SDG
health-related indicators previously included in the MDG
monitoring framework (referred to as the MDG index) and
one reecting SDG health-related indicators not included
in the MDGs (referred to as the non-MDG index).
Articles
Health-related SDG
indicator
Denition used in this

analysis
Further details
Inclusion in
MDG or
non-MDG index
Disaster (1.5.1; same

as Indicators 11.5.1
and 13.1.2)
Existing datasets do not comprehensively measure

Age-standardised death rate
missing people and people aected by natural
due to exposure to forces of
nature, per 100 000 population disasters. We revised this indicator to exposure to
forces of nature and reported in age-standardised
rates
Goal 1: End poverty in all its forms everywhere

Target 1.5: By 2030, build the resilience of the poor and those
in vulnerable situations and reduce their exposure and
vulnerability to climate-related extreme events and other
economic, social and environmental shocks, and disasters
Non-MDG
Goal 2: End hunger, achieve food security and improved nutrition, and promote sustainable agriculture
Stunting (2.2.1)
Target 2.2: By 2030, end all forms of malnutrition, including
achieving, by 2025, the internationally agreed targets on
stunting and wasting in children under 5 years of age, and
address the nutritional needs of adolescent girls, pregnant and
lactating women, and older persons
Prevalence of stunting in
children under age 5 years, %
Stunting is dened as below 2 SDs from the median MDG

height-for-age of the reference population.
No indicator modications required
Target 2.2 (as above)
Wasting (2.2.2a)
Prevalence of wasting in
children under age 5 years, %
Wasting is dened as below 2 SDs from the median

weight-for-height of the reference population.
We separated reporting for indicator 2.2.2 into
wasting (2.2.2a) and overweight (2.2.2b)
Overweight (2.2.2b)
Prevalence of overweight in
children aged 24 years, %
We used the IOTF thresholds because the WHO cuto Non-MDG

at age 5 years can lead to an articial shift in prevalence
estimates when the analysis covers more age groups.
Furthermore, considerably more studies use IOTF
cutos than WHO cutos, which allowed us to build a
larger database for estimating child overweight. We
separated reporting for indicator 2.2.2 into wasting
(2.2.2a) and overweight (2.2.2b)
Target 3.1: By 2030, reduce the global maternal mortality ratio Maternal mortality
to less than 70 per 100 000 livebirths
ratio (3.1.1)
Maternal deaths per

100 000 livebirths
MDG
Skilled birth
attendance (3.1.2)
Proportion of births attended No indicator modications required

by skilled health personnel
(doctors, nurses, midwives, or
country-specic medical sta
[eg, clinical ocers]), %
MDG
Target 3.2: By 2030, end preventable deaths of newborns and

children under 5 years of age, with all countries aiming to
reduce neonatal mortality to at least as low as 12 per
1000 livebirths and under-5 mortality to at least as low as
25 per 1000 livebirths
Under-5 mortality
(3.2.1)
Probability of dying before

age 5 years per 1000 livebirths
MDG
Neonatal mortality
(3.2.2)
Probability of dying during

the rst 28 days of life per
1000 livebirths
MDG
Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis,

malaria, and neglected tropical diseases and combat hepatitis,
water-borne diseases, and other communicable diseases
HIV (3.3.1)
Age-standardised rate of new

HIV infections, per
1000 population
We revised this indicator to HIV incidence of all

populations and reported in age-standardised rates
MDG
Tuberculosis (3.3.2)
Age-standardised rate of new

and relapsed tuberculosis
cases, per 1000 population
MDG
Malaria (3.3.3)
Age-standardised rate of
malaria cases, per
1000 population
MDG
Hepatitis B (3.3.4)
Age-standardised rate of
hepatitis B incidence, per
100 000 population
Non-MDG
Neglected tropical
diseases (3.3.5)
Age-standardised prevalence
of neglected tropical diseases,
per 100 000 population
Non-MDG
People requiring interventions against neglected
tropical diseases are not well dened; thus, we
revised this indicator to the sum of the prevalence of
14 neglected tropical diseases currently measured in
GBD: African trypanosomiasis, Chagas disease, cystic
echinococcosis, cysticerosis, dengue, food-borne
trematodiases, intestinal nematode infections,
leishmaniasis, leprosy, lymphatic lariasis,
onchocerciasis, rabies, schistosomiasis, and
trachoma
MDG
Goal 3: Ensure healthy lives and promote wellbeing for all at all ages
(Table 1 continues on next page)
Articles
Health-related SDG
indicator

analysis
Further details
Inclusion in
MDG or
non-MDG index
Target 3.4: By 2030, reduce by one-third premature mortality

from NCDs through prevention and treatment, and promote
mental health and wellbeing
NCDs (3.4.1)

due to cardiovascular disease,
cancer, diabetes, and chronic
respiratory disease in
populations aged 3070 years,
Non-MDG
Suicide (3.4.2)

due to self-harm, per
100 000 population
Non-MDG
Target 3.5: Strengthen the prevention and treatment of

substance abuse, including narcotic drug abuse and harmful
use of alcohol
Alcohol (3.5.2)
Risk-weighted prevalence of
alcohol consumption, as
measured by the SEV for
alcohol use, %
We revised this indicator to include six categories of

alcohol consumption because national alcohol
consumption per person does not capture the
distribution of use. The SEV for alcohol use is based
on two primary dimensions and subcategories of
each: individual-level drinking (current drinkers,
lifetime drinkers, lifetime abstainers, and alcohol
consumption by current drinkers) and drinking
patterns (binge drinkers and frequency of binge
drinks). The SEV then weights these categories with
their corresponding relative risks, which translates
to a risk-weighted prevalence on a scale of 0%
(no risk in the population) to 100% (the entire
population experiences maximum risk associated
with alcohol consumption)
Non-MDG
Target 3.6: By 2020, halve the number of global deaths and

injuries from road trac accidents
Road injuries (3.6.1)
Age-standardised death rate No indicator modications required

due to road trac injuries, per
100 000 population
Target 3.7: By 2030, ensure universal access to sexual and

reproductive health-care services, including for family
planning, information and education, and the integration of
reproductive health into national strategies and programmes

Family planning need Proportion of women of
reproductive age (1549 years)
met, modern
contraception (3.7.1) who have their need for family
planning satised with
modern methods, % women
aged 1549 years
MDG
Adolescent birth rate

(3.7.2)
Birth rates for women aged

1014 years and women aged
1519 years, number of
livebirths per 1000 women
aged 1014 years and women
aged 1519 years
MDG
Coverage of universal health

coverage tracer interventions
for prevention and treatment
services, %
Tracer interventions included immunisation coverage

(ie, coverage of three doses of diphtheriapertussis
tetanus, measles vaccine, and three doses of oral polio
vaccine or inactivated polio vaccine), met need with
modern contraception, antenatal care coverage (one
or more visits and four or more visits), skilled birth
attendance, in-facility delivery rates, coverage of
antiretroviral therapy for people living with HIV,
tuberculosis case detection rate, and coverage of
insecticide-treated nets in malaria-endemic countries
MDG
(Continued from previous page)
Universal health
Target 3.8: Achieve universal health coverage, including
nancial risk protection, access to quality essential health-care coverage tracer
(3.8.1)
services and access to safe, eective, quality, and aordable
essential medicines and vaccines for all
Non-MDG
Target 3.9: By 2030, substantially reduce the number of

deaths and illnesses from hazardous chemicals and air, water,
and soil pollution and contamination
Air pollution
mortality (3.9.1)

attributable to household air
pollution and ambient air
pollution, per
100 000 population
Non-MDG
WaSH mortality
(3.9.2)

attributable to unsafe WaSH,
Non-MDG
Poisons (3.9.3)

due to unintentional
poisonings, per
100 000 population
Non-MDG
Articles
Health-related SDG
indicator

analysis
Further details
Inclusion in
MDG or
non-MDG index
Smoking (3.a.1)
of daily smoking in
populations aged 10 years
and older, % population aged
10 years and older
We revised this indicator to daily smoking because

of data limitations regarding the systematic
measurement of current smoking and to reect
populations aged 10 years and older
Non-MDG
of women aged 15 years and
older who experienced
intimate partner violence, %
women aged 15 years and
older

the status of ever-partnered women relative to
never-partnered women; therefore, the
denominator was revised to all women aged
15 years and older. Data on exposure to subtypes of
violence are not systematically available across
geographies and over time
Non-MDG
populations using unsafe or
unimproved water sources, as
unsafe water, %
Dierent types of unsafe water sources have

dierent relative risks associated with poor health
outcomes; thus, we revised this indicator to SEV for
water, which captures the relative risk of dierent
types of unsafe water sources and then combines
them into a risk-weighted prevalence on a scale of
0% (no risk in the population) to 100% (the entire
population experiences maximum risk associated
with unsafe water)
MDG
Target 6.2: By 2030, achieve access to adequate and equitable Sanitation (6.2.1a)
sanitation and hygiene for all and end open defecation, paying
special attention to the needs of women and girls and those in
vulnerable situations
populations using unsafe or
unimproved sanitation, as
unsafe sanitation, %
We separated reporting for indicator 6.2.1 into

sanitation (6.2.1a) and hygiene (6.2.1b). We had
three mutually exclusive, collectively exhaustive
categories for sanitation at the household level:
households with piped sanitation (with a sewer
connection); households with improved sanitation
without a sewer connection (pit latrine, ventilated
improved latrine, pit latrine with slab, or
composting toilet), as dened by the JMP; and
households without improved sanitation (ush
toilet that is not piped to sewer or septic tank, pit
latrine without a slab or open pit, bucket, hanging
toilet or hanging latrine, shared facilities, or no
facilities), as dened by the JMP
MDG
populations with unsafe
hygiene (no handwashing
with soap), as measured by
the SEV for unsafe hygiene, %
Safe hygiene practices were dened as handwashing Non-MDG

with soap and water following toilet use or contact
with excreta. We separated reporting for indicator
6.2.1 into sanitation (6.2.1a) and hygiene (6.2.1b)
household air pollution, as
household air pollution, %

population use of clean fuels and technology for
heating and lighting across geographies; thus, we
revised this indicator to focus on exposure to clean
(or unclean) fuels used for cooking

Target 3.a: Strengthen the implementation of the World
Health Organization Framework Convention on Tobacco
Control in all countries, as appropriate
Goal 5: Achieve gender equality and empower all women and girls
Intimate partner
Target 5.2: Eliminate all forms of violence against all women
and girls in the public and private spheres, including tracking violence (5.2.1)
and sexual and other types of exploitation
Goal 6: Ensure availability and sustainable management of water and sanitation for all
Target 6.1: By 2030, achieve universal and equitable access to
safe and aordable drinking water for all
Water (6.1.1)
Hygiene (6.2.1b)
Goal 7: Ensure access to aordable, reliable, sustainable, and modern energy for all
Target 7.1: By 2030, ensure universal access to aordable,
reliable, and modern energy services
Household air
pollution (7.1.2)
Non-MDG
Goal 8: Promote sustained, inclusive, and sustainable economic growth, full and productive employment, and decent work for all
Target 8.8: Protect labour rights and promote safe and secure
working environments for all workers, including migrant
workers, in particular women migrants, and those in
precarious employment
Occupational risk
burden (8.8.1)
Age-standardised all-cause
DALY rate attributable to
occupational risks, per
100 000 population
We revised this indicator to the DALY rate

attributable to occupational risks because DALYs
combine measures of mortality and non-fatal
outcomes into a singular summary measure, and
occupational risks represent the full range of safety
hazards that could be encountered in working
environment
Non-MDG
Articles
Health-related SDG
indicator

analysis
Further details
Inclusion in
MDG or
non-MDG index

Goal 11: Make cities and human settlements inclusive, safe, resilient, and sustainable
Target 11.5: By 2030, signicantly reduce the number of
deaths and the number of people aected and substantially
decrease the direct economic losses relative to global gross
domestic product caused by disasters, including water-related
disasters, with a focus on protecting the poor and people in
vulnerable situations
Disaster (11.5.1; same Age-standardised death rate

due to exposure to forces
as Indicators 1.5.1
of nature, per
and 13.1.2)
100 000 population

disasters; we revised this indicator to exposure to
rates
Non-MDG
Target 11.6: By 2030, reduce the adverse per-capita

environmental impact of cities, including by paying special
attention to air quality and municipal and other waste
management
Mean PM25 (11.6.2)
Non-MDG

disasters; we revised this indicator to exposure to
rates
Non-MDG
Population-weighted mean
levels of PM25, g/m
Goal 13: Take urgent action to combat climate change and its impacts
Target 13.1: Strengthen resilience and adaptive capacity to
climate-related hazards and natural disasters in all countries
Disaster (13.1.2; same Age-standardised death rate

due to exposure to forces
as Indicators 1.5.1
of nature, per
and 11.5.1)
100 000 population
Goal 16: Promote peaceful and inclusive societies for sustainable development, provide access to justice for all, and build eective, accountable and inclusive institutions at all levels
Non-MDG
Target 16.1: Signicantly reduce all forms of violence and

related death rates everywhere
Violence (16.1.1)

due to interpersonal violence,

displacement and migratory status of victims of
intentional homicide; we revised this indicator to
deaths due to interpersonal violence (ie, homicide)
War (16.1.2)

due to collective violence and
legal intervention, per
100 000 population
Non-MDG
the displacement status of deaths due to conict; we
revised this indicator to deaths due to collective
violence and legal intervention (ie, war)
Detailed descriptions of the data sources and methods used to estimate each health-related SDG indicator are in the methods appendix pp 10311. SDG=Sustainable Development Goal. MDG=Millennium
Development Goal. IOTF=International Obesity Task Force. GBD=Global Burden of Disease Study. NCDs=non-communicable diseases. SEV=summary exposure value. WaSH=water, sanitation, and hygiene.
JMP=Joint Monitoring Program. DALY=disability-adjusted life-year. PM25=ne particulate matter smaller than 25 m.
Table 1: Health-related SDG goals and targets proposed by the Inter-Agency and Expert Group on SDG Indicators, and health-related SDG indicators used in this analysis
Three broad approaches can be used to create

composite measures: normative, preference weighted,
and statistical. Normative approaches combine each
indicator based on rst principles or an over-riding
construct such as the contribution of each indicator to
overall health. Preference-weighted approaches weight
each indicator by expressed or elicited social preferences
for the relative importance of dierent indicators.
Statistical approaches seek to reduce a long set of
variables or indicators into common components of
variance using methods such as principal component
analysis or factor analysis. In this case, because the SDGs
reect the collective vision of UN member states, we
used a preference-weighted approach, assuming that
each SDG target should be treated equally.
To combine indicators, we adopted methods used to
construct the Human Development Index,43 which
include rescaling each indicator on a scale from 0 to 100
and then combining indicators using the geometric
mean. The geometric mean allows indicators with very
high values to partly compensate for low values on other
indicators (referred to as partial substitutability). In the
methods appendix pp 31213, we describe results from
alternative index construction methods (ie, principal
component analysis; the arithmetic mean across targets

referred to as complete substitutability; and the minimum
value across targets referred to as zero substitutability).
Quantitative targets for each of the health-related SDG
indicators are not universally specied. As a result, we
rescaled each health-related SDG indicator on a scale
from 0 to 100, with 0 being the lowest (worst) value
observed and 100 being the highest (best) value observed
over the time period 19902015. We log-transformed
mortality and morbidity before rescaling. We then
estimated the health-related SDG index by rst computing
the geometric mean of each rescaled health-related SDG
indicator for a given target, followed by the geometric
mean of resulting values across all SDG targets. To avoid
problems with indicator values close to 0, when
computing indices we applied a oor of one to all
indicators. This analytic approach weights each of the
health-related SDG targets equally. In addition to the
health-related SDG index, we also used the same methods
to construct an index that represents 14 health-related
SDG indicators that were previously MDG indicators and
an index representing 19 non-MDG indicators (table 1).
Uncertainty in the indicator and indices values was
computed using a simulation analysis.
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Health-related SDG indicator
Measurement needs and strategy
Goal 3: Ensure healthy lives and promote wellbeing for all at all ages
Target 3.5: Strengthen the prevention and treatment of
substance abuse, including narcotic drug abuse and harmful
use of alcohol
3.5.1: Coverage of treatment interventions (pharmacological,

psychosocial and rehabilitation and aftercare services) for
substance use disorders
Prevalence of specic substance use disorders (opioid use

disorders, cocaine use disorders, amphetamine use disorders,
and cannabis use disorders), as well as alcohol use disorders,
are presently estimated as part of GBD. Systematic reviews on
coverage of specic interventions (eg, opioid substitution
therapy) are in progress by GBD collaborators
Target 3.8: Achieve universal health coverage, including

nancial risk protection, access to quality essential health-care
services and access to safe, eective, quality and aordable
essential medicines and vaccines for all
3.8.2: Number of people covered by health insurance or a

public health system per 1000 population
Omission of information on insurance depth and status of user

fees within the public health system might limit the
applications of this indicator. Construction of proxy measures
of health-care use, for both outpatient and hospital care, by
country and over time is feasible as part of future iterations of
GBD and is likely to be an improved measurement strategy
Target 3.b: Support the research and development of vaccines

and medicines for the communicable and non-communicable
diseases that primarily aect developing countries, provide
access to aordable essential medicines and vaccines, in
accordance with the Doha Declaration on the TRIPS Agreement
and Public Health, which arms the right of developing
countries to use to the full the provisions in TRIPS regarding
exibilities to protect public health, and, in particular, provide
access to medicines for all
3.b.1: Proportion of the population with access to aordable

medicines and vaccines on a sustainable basis. The
recommended measure is percentage of health facilities with
essential medicines and life-saving commodities in stock
Across all geographies and over time, comparable data on

the stocking and stock-out rates of essential medicines and
vaccines for all facility types (hospitals, primary care
facilities, pharmacies, and other health-care outlets) and
facility ownership (public, private, informal) are not
available at present. In the absence of robust measures of
stock-outs in both the public and private sectors across
countries and over time, the measurement strategy for
producing comparable results for this indicator is unclear.
Furthermore, the proposed indicator stipulates
measurement of not only access to medicines and vaccines,
but also access to affordable medicines and vaccines. No
comprehensive and comparable datasets on the status of
essential medicine and vaccine affordability, in addition to
their stocks, presently exist
Target 3.b (as above)
3.b.2: Total net ocial development assistance to the medical

research and basic health sectors
DAH is currently assessed within a comprehensive, comparable

analytical framework by source, channel, recipient country,
and health focus area from 1990 to 2015; however, funding
specically for medical research (eg, research and development
of vaccines and medicines, as described in Target 3.b) is not
systematically available across source and recipient countries.
Additionally, the appropriate assessment of country-level
performance remains unclear (eg, whether countries that
receive high levels of DAH for medical research are equivalent,
in terms of indicator performance, to countries that disperse
high levels of DAH for medical research)
Target 3.c: Substantially increase health nancing and the

recruitment, development, training and retention of the
health workforce in developing countries, especially in least
developed countries and small island developing States
3.c.1: Health worker density and distribution, as measured by

number of health workers per 1000 population by cadre.
Cadres include generalist medical practitioners, specialist
medical practitioners (surgeons, anaesthetists,
obstetricians, emergency medicine specialists, cardiologists,
paediatricians, psychiatrists, ophthalmologists,
gynaecologists, etc), nursing and midwifery professionals,
and traditional and complementary medicine professionals,
among others
A systematic analysis of population census data and Labour

Force Surveys is possible as part of future iterations of GBD.
The total quantity of individual health worker cadres that
could be comparably assessed by geography by year will be a
function of the availability of detailed International Labour
Organization occupational codes across geographies and
survey iteration
3.d.1: International Health Regulations (IHR) capacity and

Target 3.d: Strengthen the capacity of all countries, in
health emergency preparedness. The WHO-recommended
particular developing countries, for early warning, risk
reduction and management of national and global health risks measure is the percentage of 13 core capacities that have
been attained at a specic time (IHR core capacity index).
The 13 core capacities are (1) national legislation, policy, and
nancing; (2) coordination and national focal point
communications; (3) surveillance; (4) response;
(5) preparedness; (6) risk communication; (7) human
resources; (8) laboratory; (9) points of entry; (10) zoonotic
events; (11) food safety; (12) chemical events; and
(13) radionuclear emergencies
Comprehensive and comparable data for all components of

the IHR core capacity index, for all geographies and over time,
are not available at present. Specic core capacities, such as
zoonotic events, could be assessed as part of future iterations
of GBD; other core capacities, such as coordination and
national focal point communications, have no clear
measurement strategy beyond self-report from country
representatives or secondary research on policy status and
types of surveillance systems available, among others
Relations between health-related SDG indicators and the

Socio-demographic Index and healthy life expectancy
As part of GBD 2015, we assessed cause-specic disease
burden and risk exposure along the development
spectrum, providing context on expected changes as
8
countries progress to higher levels of income per person,

higher educational attainment, and lower fertility.34,3739
We conducted a similar analysis by examining the
relations of the overall health-related SDG index and
each of the individual health-related SDG indicators
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Goal 5: Achieve gender equality and empower all women and girls
5.2.2: Proportion of women and girls aged 15 years and older
Target 5.2: Eliminate all forms of violence against all women
and girls in the public and private spheres, including tracking subjected to sexual violence by persons other than an intimate
partner in the previous 12 months, by age and place of
and sexual and other types of exploitation
occurrence
Prevalence of intimate partner violence among women and

girls aged 15 years and older is currently estimated as part of
GBD. An updated systematic review of the literature, data
re-extraction, and analysis are needed to specically quantify
prevalence of sexual violence (separately or in addition to
physical violence, or both) and by persons other than an
intimate partner. Data availability by geography by year on the
latter, sexual violence by persons other than intimate partners,
might be limited
Target 5.6: Ensure universal access to sexual and reproductive

health and reproductive rights as agreed in accordance with
the Programme of Action of the International Conference on
Population and Development and the Beijing Platform for
Action and the outcome documents of their review
conferences
5.6.1: Proportion of women aged 1549 years who make their

own informed decisions regarding sexual relations,
contraceptive use, and reproductive health care
The proportion of women who make their own informed

decisions regarding all three dimensions of this indicator
sexual relations, contraceptive use, and reproductive health
careare included in the Demographic and Health Survey
(DHS) series. Data availablility for non-DHS countries is
unclear. The feasibility of measuring this indicator as part of
future iterations of GBD is under review at present
5.6.2: Number of countries with laws and regulations that

guarantee women aged 1549 access to sexual and
reproductive health care, information, and education
Across all geographies and over time, comprehensive and

comparable data documenting the status of laws and
regulations regarding access to sexual and reproductive health
care, information, and education do not exist at present.
Compiling the past and current status of such laws and
regulations might be possible; however, systematic
assessment of their depth or intensity, enforcement, and
eectiveness in guaranteeing access to reproductive health
care, information, and education might be challenging across
countries and over time
Goal 6: Ensure availability and sustainable management of water and sanitation for all
Target 6.3: By 2030, improve water quality by reducing
pollution, eliminating dumping and minimising release of
hazardous chemicals and materials, halving the proportion of
untreated waste water, and substantially increasing recycling
and safe reuse globally
6.3.1: Proportion of waste water safely treated.

UN Water denes this indicator as the proportion of waste
water generated by both households (sewage and faecal
sludge), as well as economic activities (based on ISIC
categories) safely treated compared to total waste water
generated both through households and economic activities.
While the denition conceptually includes waste water
generated from all economic activities, monitoring will focus
on waste water generated from hazardous industries (as
dened by relevant ISIC categories)
Across all geographies and over time, comprehensive and

comparable data containing information on total waste water,
as generated by both households and non-household entities
(however they are to be dened), and waste water treatment
status do not exist at present. UN Water suggests there will be
sucient data to generate estimates of global and regional
levels of safely treated waste water by 2018; however, in the
absence of more country-level data, it is dicult to determine
the representativeness of such global and regional estimates
Goal 16: Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build eective, accountable, and inclusive institutions at all levels
Target 16.1: Signicantly reduce all forms of violence and
related death rates everywhere
16.1.3: Proportion of population subjected to physical,

psychological, or sexual violence in the previous 12 months

girls aged 15 years and older is currently estimated as part of
GBD, as are the incidence and prevalence of interpersonal
violence among all populations. An expanded systematic
review of the literature and available data sources for all types
of violence (physical, psychological, and sexual) for both men
and women of all ages would be required for inclusion in
future iterations of GBD
16.1.4: Proportion of people that feel safe walking alone

around the area they live
Comprehensive data on reported safety, in general or walking

alone near ones residence (or both), do not currently exist
across geographies or over time. Substantive primary data
collection is likely to be required
Target 16.2: End abuse, exploitations, tracking and all forms

of violence against and torture of children
16.2.3: Proportion of young women and men aged

1829 years who experienced sexual violence by age 18

girls aged 15 years and older is estimated as part of GBD.
An expanded systematic review and analysis of the literature
and available data sources for both men and women, and for all
types of sexual violence (ie, not limited to intimate partners)
would be required. The feasibility of measuring this indicator as
part of future iterations of GBD is under review at present
with the Socio-demographic Index (SDI), a summary

measure of development that uses lag-distributed
income per person, average educational attainment in
the population over age 15 years, and the total fertility
rate. The SDI was constructed using the same method

for the Human Development Index and the health-related
SDG index. Each of the three components was rst
rescaled on a 01 scale, with 0 being the lowest (worst)
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Goal 17: Strengthen the means of implementation and revitalise the global partnership for sustainable development
Target 17.19: By 2030, build on existing initiatives to develop
measurements of progress on sustainable development that
complement gross domestic product, and support statistical
capacity building in developing countries
17.19.2: Proportion of countries that (a) have conducted at

least one population and housing census in the last 10 years;
and (b) have achieved 100% birth registration and 80% death
registration
For Indicator 17.19.2(a), a comprehensive assessment of the

availability and timing of population and housing censuses
across all geographies is possible as part of GBD.
For Indicator 17.19.2(b), the systematic collation of vital
registration data for all geographies is required; at present,
vital registration data reported to WHO do not fully cover all
geographies or years under analysis. Such data collation eorts
would be required for both birth and death registration
individually to determine completeness, with the latter viewed
as more immediately feasible for future iterations of GBD
SDG=Sustainable Development Goal. GBD=Global Burden of Disease. TRIPS=Agreement on Trade-Related Aspects of Intellectual Property Rights. DAH=development assistance for health. IHR=International
Health Regulations. DHS=Demographic and Health Survey. ISIC=International Standard Industrial Classication.
Table 2: Health-related SDG indicators (proposed by the Inter-Agency and Expert Group on SDG Indicators) excluded in the present analysis, and measurement needs and strategy for
future reporting, by SDG target
value observed in the time period 19802015 and 1 being

the highest (best) value observed. SDI was then
computed as the geometric mean of these three rescaled
components. To capture average relations, we used a
spline regression (ie, piecewise linear regression with
so-called knots specifying the intersection between
pieces) of the health-related SDG indicators and
health-related SDG index on SDI using the full set of
data by country from 1990 to 2015. We also compared the
health-related SDG indicators with the GBD 2015
estimates of healthy life expectancy38 to explore the
relation between the SDGs and overall health
achievement for each country.
Role of the funding source

The funder of the study had no role in study design, data
collection, data analysis, data interpretation, or writing of
the report. The corresponding author had full access to
all the data in the study and had nal responsibility for
the decision to submit for publication.
Results
Of the 33 health-related SDG indicators, 21 were
associated with a dened target, with 18 of them having
an absolute level and three having a target relative to
2015 levels (table 3). The proportion of countries already
meeting targets linked to health-related SDG indicators
in 2015, as specied by absolute levels to be achieved,
ranged from more than 60% for two indicators
(maternal mortality ratio and under-5 mortality) to 0%
for nine indicators. For these nine indicators, all targets
involved full elimination of diseases (eg, tuberculosis,
HIV, and neglected tropical diseases), reducing
prevalence of health outcomes or risk to 0% (eg,
childhood overweight and intimate partner violence),
or reaching 100% for intervention coverage or health
service provision (eg, skilled birth attendance, met need
with modern contraception, and UHC tracer
interventions).
10
In 2015, the median health-related SDG index was

593 (95% uncertainty interval [UI] 568618) across
all 188 countries. This index was highest in Iceland
(855, 842865), Singapore (853, 841863), and
Sweden (853, 842862) and lowest in the Central
African Republic (204, 159249), Somalia (216,
160259), and South Sudan (225, 155266;
gure 1). Dierences in the 95% UI range stem largely
from dierences in the availability and quality of
underlying data sources for estimating individual
indicators; for example, data were sparser for Somalia
than they were for Sweden. Some patterns emerged
contrary to what might have been expected. For
example, the USA (749, 736759) ranked 28th,
driven by poorer performance on MDG indicators (eg,
maternal mortality ratio) than other high-income
countries44 and worse performance on non-MDG
indicatorsmost notably, alcohol consumption,
childhood overweight, and mortality due to
interpersonal violence, self-harm, and unintentional
poisoning. India (417, 397437), despite rapid
economic growth, was ranked 143rd, just below
Comoros and Ghana.
Levels of the health-related SDG index were highly
clustered (gure 2), with countries in the highest
quintile (715) located mainly in western Europe,
high-income North America, parts of Asia (Japan,
South Korea, Singapore, and Brunei), and Australasia.
The second highest quintile (625715) included
countries in southern Latin America, parts of eastern
Europe, most of the Caribbean, and a subset of
countries across other regions (eg, Mexico, Jordan,
Azerbaijan, Malaysia, and Costa Rica), whereas
countries in the middle quintile (557625) were
primarily located in South America; parts of east,
central, and southeast Asia; and parts of North Africa
and the Middle East. The countries in the fourth
quintile (378557) were mainly found in south and
southeast Asia, southern sub-Saharan Africa, parts of
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Median (IQR)
Disaster (Indicator 1.5.1; same as Indicators 11.5.1 and 13.2.1)age-standardised death rate
due to exposure to forces of nature, per 100 000 population
00 (0001)
Minimum Maximum
00
75
SDG target by
2030*
Proportion of
188 countries
achieving the SDG
target in 2015
Undened
NA
Stunting (Indicator 2.2.1)prevalence of stunting in children under age 5 years, %
125% (46265)
00%
545% Eliminate
165%
Wasting (Indicator 2.2.2a)prevalence of wasting in children under age 5 years, %
36% (1871)
00%
217% Eliminate
165%
Overweight (Indicator 2.2.2b)prevalence of overweight in children aged 24 years, %
231% (141321)
26%
545% Eliminate
Maternal mortality ratio (Indicator 3.1.1)maternal deaths per 100 000 livebirths
491 (1522391)
07
Skilled birth attendance (Indicator 3.1.2)proportion of births attended by skilled health

personnel (doctors, nurses, midwives, or country-specic medical sta [eg, clinical ocers]), %
981% (809992)
206%
Under-5 mortality (Indicator 3.2.1)probability of dying before age 5 years per 1000 livebirths
175 (71449)
19
1305
At least as low as
25 deaths per
1000 livebirths
601%
Neonatal mortality (Indicator 3.2.2)probability of dying during the rst 28 days of life per
1000 livebirths
93 (35210)
10
406
At least as low as
12 deaths per
1000 livebirths
575%
HIV (Indicator 3.3.1)age-standardised rate of new HIV infections, per 1000 population
01 (0004)
00
274
Eliminate
00%
Tuberculosis (Indicator 3.3.2)age-standardised rate of new and relapsed tuberculosis cases,

per 1000 population
06 (0215)
00
261
Eliminate
00%
Malaria (Indicator 3.3.3)age-standardised rate of malaria cases, per 1000 population

Hepatitis B (Indicator 3.3.4)age-standardised rate of hepatitis B incidence, per
100 000 population
00 (00185)
18 386 (1070420984)
Neglected tropical diseases (Indicator 3.3.5)age-standardised prevalence of neglected tropical 14 4740 (236346 1390)
diseases, per 100 000 population
Non-communicable diseases (Indicator 3.4.1)age-standardised death rate due to
cardiovascular disease, cancer, diabetes, and chronic respiratory disease in populations aged
3070 years, per 100 000 population
Suicide (Indicator 3.4.2)age-standardised death rate due to self-harm, per
100 000 population
Alcohol (Indicator 3.5.2)risk-weighted prevalence of alcohol consumption, as measured by
the SEV for alcohol use, %
4220 (29145525)
103 (69143)
78% (42111)
10739
<70 deaths per

100 000 livebirths
996% 100%
00%
612%
00%
00
2868
Eliminate
521%
4445
25541
Undened
NA
98
119 6954
Eliminate
1540
14425
Reduce by
one-third
NA
22
340
Reduce by
one-third
NA
07%
287% Undened
NA
30
639
NA
Road injuries (Indicator 3.6.1)age-standardised death rate due to road injuries, per
100 000 population
153 (97232)
Family planning need met, modern contraception (Indicator 3.7.1)proportion of women of

reproductive age (1549 years) who have their need for family planning satised with modern
methods, % women aged 1549 years
724% (466870)
Adolescent birth rate (Indicator 3.7.2)birth rates for women aged 1014 years and women
aged 1519 years, number of livebirths per 1000 women aged 1014 years and women aged
1519 years
229 (94378)
Universal health coverage tracer (Indicator 3.8.1)coverage of universal health coverage tracer
interventions for prevention and treatment services, %
792% (649881)
233%
Air pollution mortality (Indicator 3.9.1)age-standardised death rate attributable to

household air pollution and ambient air pollution, per 100 000 population
749 (4061707)
90
4273
Undened
NA
WaSH mortality (Indicator 3.9.2)age-standardised death rate attributable to unsafe WaSH,

84 (24442)
07
3180
Undened
NA
Poisons (Indicator 3.9.3)age-standardised death rate due to unintentional poisonings, per

100 000 population
08 (0420)
01
71
Undened
NA
NA
158%
11
Reduce by half
00%
991% 100%
1026
00%
Undened
946% 100%
NA
00%
Smoking (Indicator 3.a.1)age-standardised prevalence of daily smoking in populations aged

10 years and older, % population aged 10 years and older
110% (65163)
07%
295% Undened
Intimate partner violence (Indicator 5.2.1)age-standardised prevalence of women aged

15 years and older who experienced intimate partner violence, % women aged 15 years and older
190% (137257)
47%
446% Eliminate
00%
Water (Indicator 6.1.1)risk-weighted prevalence of populations using unsafe or unimproved

water sources, as measured by the SEV for unsafe water, %
627% (212830)
00%
984% Eliminate
160%
Sanitation (Indicator 6.2.1a)risk-weighted prevalence of populations using unsafe or

unimproved sanitation, as measured by the SEV for unsafe sanitation, %
206% (36575)
00%
964% Eliminate
160%
Hygiene (Indicator 6.2.1b)risk-weighted prevalence of populations with unsafe hygiene

(no handwashing with soap), as measured by the SEV for unsafe hygiene, %
742% (605941)
360%
997% Eliminate
00%
11
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Median (IQR)
Minimum Maximum
SDG target
by 2030*
Proportion of
188 countries
achieving the SDG
target in 2015

Household air pollution (Indicator 7.1.2)risk-weighted prevalence of household air pollution,
as measured by the SEV for household air pollution, %
71% (03360)
Occupational risk burden (Indicator 8.8.1)age-standardised all-cause DALY rate attributable

to occupational risks, per 100 000 population
7577 (55279992)
Mean PM25 (Indicator 11.6.2)population-weighted mean levels of PM25, g/m
00%
736% Eliminate
2787
21483
Undened
165%
NA
217 (151376)
34
1073
Undened
NA
Violence (Indicator 16.1.1)age-standardised death rate due to interpersonal violence, per

100 000 population
37 (1682)
04
583
Undened
NA
War (Indicator 16.1.2)age-standardised death rate due to collective violence and legal
intervention, per 100 000 population
00 (0000)
00
3099
Undened
NA
SDG=Sustainable Development Goal. NA=not applicable. SEV=summary exposure value. WaSH=water, sanitation, and hygiene. DALY=disability-adjusted life-year. PM25=ne particulate matter smaller than
25 m in diameter. *SDG targets without explicit achievement thresholds, such as signicantly reduce by 2030, or with reduction-based thresholds, such as reduce by one-third, are reported as undened.
The target year for achieving indicator 3.6.1 is 2020.
Table 3: Performance of health-related SDG indicators across all countries, 2015
North Africa and the Middle East, and parts of eastern

Europe. Countries in western, eastern, and central
sub-Saharan Africa, as well as a subset of other
countries (eg, Afghanistan, Papua New Guinea, Yemen,
and Nepal), dominated the lowest quintile (<378) of
the health-related SDG index. Although the MDG index
was correlated with the non-MDG index, country-level
performance on these two indices varied considerably
(gure 3). Performing well on the health-related MDG
index did not guarantee good performance on the
health-related non-MDG index. For example, the
health-related MDG index in 2015 was similar for
Indonesia (523, 498546) and South Africa (489,
460513), but Indonesia had a much higher
non-MDG index (641, 620666) than that of
South Africa (429, 403455). This dierence for the
non-MDG index was primarily driven by South Africas
lower performance for indicators such as childhood
overweight, harmful alcohol use, and mortality due to
self-harm and interpersonal violence.
SDI was highly predictive of the overall health-related
SDG index (r=088) and MDG index (r=092; gure 4).
The non-MDG index was less well predicted by SDI
(r=079). This nding is reective of the variable
relations between individual health-related SDG
indicators and SDI (results appendix pp 34647). For
instance, SDI was a poor predictor of mortality due to
exposure to forces of nature, self-harm, interpersonal
violence, and war (collective violence and legal
intervention), as well as childhood overweight, intimate
partner violence, and ambient particulate matter
pollution. By contrast, SDI was highly predictive of
maternal mortality ratio, under-5 mortality, and neonatal
mortality, as well as mortality attributable to unsafe
water, sanitation, and hygiene. Notably, the overall
health-related SDG index also had a strong relation with
healthy life expectancy (r=086), a summary measure of
population health.
12
By subtracting expected levels for the health-related

SDG index, on the basis of SDI alone, from observed
levels (gure 5), we could identify potential geographical
deviations well above or below expected values on the
health-related SDG index. Countries that represent
substantial deviations from the average might warrant
further investigation to understand how and why they
are underperforming or overperforming relative to the
average. This deviation might be due, for example, to
more or less ecient use of resources to improve health.
Many countries in western Europe, Latin America, and
parts of east and southeast Asia, as well as other countries
such as Australia, recorded health-related SDG index
levels that were higher than expected on the basis of SDI
alone. Many of the countries with a health-related SDG
index below expected levels on the basis of SDI were
located in southern and central sub-Saharan Africa,
eastern Europe and central Asia (eg, Belarus and
Ukraine), North Africa and the Middle East, south Asia,
and selected countries such as the USA.
To provide a preliminary indication of potential
trajectories in the next 15 years, we assessed absolute
changes in the past 15 years for each of the
33 health-related SDG indicators and three summary
indices (overall health-related SDG index, health-related
MDG index, and non-MDG index). Overall,
health-related SDG indicators largely improved since
2000, as summarised by the health-related SDG index;
notably, gains in the health-related MDG index generally
exceeded improvements in the non-MDG index
(gure 6). Across countries, the most pronounced
progress occurred for UHC tracer interventions, met
need with modern contraception, hygiene, under-5
mortality, and neonatal mortality. Such striking gains
for the indicator on UHC tracer interventions reected
the scale-up of antiretroviral therapy and coverage of
insecticide-treated nets in malaria-endemic countries
since the early 2000s.31,44,45 Of note, the relatively small
Articles
Value
25
1
Iceland
Singapore
Sweden
85 100 100 100 51
79 100 94 94 65 82 100 85 100 87 51
Andorra
83 100 100 100 57
89 100 100 99 52 70 100 81 100 99 66 42 94 95 73
UK
Finland
Spain
Netherlands
Canada
10
Australia
11
Norway
12
Luxembourg
13
Ireland
14
Malta
15
Germany
80 100 100 100 47 71 100 89 91 57
16
Denmark
79 100 100 100 51
17
Cyprus
18
Belgium
19
Switzerland
20
Italy
21
Brunei
22
Portugal
23
Israel
24
France
25
Slovenia
26
Greece
27
Japan
28
USA
29
Estonia
30
New Zealand
31
Austria
32
Taiwan
(province of China)
33
Antigua and
Barbuda
34
Czech Republic
DG
85 100 100 100 43 100 100 99 99 57
85 100 100 100 62 78 99 97 98 54 56 100 62 100 85 59 87 93 87 92 97 77
82 100 100 100 64 70 99 84 85 51
50
69 100 81 100 91 60 62 96 95 84 89 94 86 71
57
74 100 85 100 78 64 57
82 100 100 100 57
74 100 87 87 60 86 100 83 100 80 57
81 100 100 100 34 73
100
62 100 72
67 100 100 88 100 98 55 97 100 92 81
75
80 100 100 95 100 81 81 74 100 94 80
94 91 84 99 96 87 71
96 93 89 84 48 83 100 100 95 100 76 70 87 100 92 77
94 95 73 100 83 77
75
55 80 100 100 93 100 74 65 86 100 90 78

59 71 100 100 94 100 77
77
66 100 94 76
86 91 86 97 91 87 83 47 91 100 100 77 100 73
71
82 100 92 74
82 100 100 100 58 81 100 96 95 69 84 100 81 100 82 43 48 89 97 83 98 92 100 73

82 100 100 100 33 76 99 92 93 49 78 100 86 100 86 69 57
75
66 100 100 100 90 100 69 76 83 100 93 79
55 90 92 90 97 83 80 89 58 83 100 100 88 100 70 61 74 100 92 76
99 83 83 54 93 100 71 100 82 54 56 79 96 81 96 94 88 71
69 74 100 100 100 100 74 78 69 100 91 75
81 59 100 100 63 76 100 87 88 60 87 100 69 100 88 55 54 79 97 76 96 99 95 74 66 78 100 100 97 100 76 82 72 100 92 76

81 45 100 100 49 81 100 94 95 64 81 100 81 100 86 57
64 95 95 84 97 90 81 63 65 83 100 100 98 100 73
72
81 100 94 74
81 100 100 100 48 68 100 94 97 56 77 100 81 100 84 59 53 85 94 85 91 86 87 85 49 77 100 100 85 100 91 58 77 100 91 75
81 100 100 100 51
78 99 89 90 57
80 100 81 100 82 56 49 92 95 81 96 86 80 77
80 100 100 100 36 76 99 79 76 54 73 100 81 100 84 82 62 100 82 75
73
55 54 88 92 86 96 83 84 94 46 70 100 100 89 100 71
62 81 100 92 73
60 66 100 100 93 100 71
68 77 100 92 73
99 83 83 62 85 100 82 100 83 87 57
99 88 89 57
81 100 83 100 77
78 61 100 100 39 79 99 91 90 54 87 100 82 100 85 71
78 100 100 100 40 71
70 93 92 96 84 92 84 39 92 100 100 92 100 63 55 68 100 92 73
41 47 73
78 40 100 100 62 76 100 86 87 56 84 100 82 100 92 50 51
78 48 100 100 74 54 99 72
95 81 97 82 78 76 55 78 100 100 89 100 82 59 69 100 92 73
93 95 92 97 90 92 89 54 96 100 100 87 100 64 64 82 100 92 72
68 75
86 87 97 83 96 81 52 66 100 100 86 100 72
78 54 49 100 56 100 61 79 70 61 89 67 96 96 76 79 72
99 92 94 37
65 100 81 100 79 57
54 72
77 100 100 100 45 76 99 87 90 55 82 100 81 100 86 65 87 77

77 100 100 100 59 72 100 90 93 57
88 83 96 88 73
95 73
70 99 90 89 64 84 100 77 100 75
67 100 100 92 100 92 86 69 100 85 75
20 91 70
44 87 100 100 82 100 81 65 77
22 92 70
89 95 78 80 80 50 92 87 97 55 95 68 53 81 100 89 68
87 53 67 74 86 94 80 94 83 23 83 100 100 85 100 72

77
43 100 100 69 58 99 79 80 46 99 100 85 100 69 49 54 64 100 68 98 86 84 57
74 100 92 91 50 78 100 90 94 41 56 100 49 100 63 46 40 83 79 79 93 77
57
69 70 100 100 95 100 80 74 42 100 88 70
95 66 47 84 90 92 66 94 71
74 44 100 100 49 80 100 89 90 53 82 100 81 100 80 49 38 83 92 84 93 83 99 80 37
74 100 95 92 77
47 71
58 89 91 82 76 71
72
99 95 96 69 81 100 66 100 65 50 46 79 79 82 96 71
77
74 96 72
IP
48 100 85 68
84 71 100 90 68
83 100 92 66
95 66 100 61 42 67 100 83 67
46 86 55 98 63 63 41 100 72
76 42 60 86 99 58 99 68 51
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74 21 100 100 53 67 100 82 86 61 85 100 63 100 81 53 56 76 95 66 95 99 95 81 63 67 100 100 96 100 71
74 100 100 100 52 68 99 78 83 54 60 100 18 86 72
67 100 89 70
62 100 100 97 100 79 52 57
97 84 82 84 57
76 19 100 100 83 74 99 93 97 70 74 100 61 100 90 36 64 91 79 90 96 89 75

75
53 77 100 92 70
82 55 82 100 100 68 100 58 71
80 100 83 100 79 41 53 78 94 80 96 91 83 71
76 100 94 90 39 76 99 94 94 74 75 100 66 100 79 44 50 80 71

76 100 100 100 37
82 100 92 75
87 83 81 88 54 90 100 100 70 100 70 59 74 100 87 74
80 100 89 89 56 85 100 83 100 78 55 39 88 90 89 95 84 80 73
79 100 100 100 53 77

79 100 100 100 57
86 100 85 100 77
49 83 100 100 90 100 65 71
75
74 100 90 66
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(Figure 1 continues on next page)
13
Articles
Value
25
50
75
100
35
South Korea
36
Hungary
73 100 97 88 47 69 99 83 82 66 75 100 66 100 52 40 52 80 78 75
37
Slovakia
73
38
Uruguay
72 100 87 94 39 60 99 71
39
Poland
40
Seychelles
41
Barbados
42
Croatia
43
The Bahamas
44
Jordan
69 100 88 90 82 58 100 63 63 74 83 100 43 86 71
45
Latvia
69 100 92 92 55 66 100 82 85 42 54 100 49 100 50 36 50 70 76 79 90 65 90 56 36 76 89 88 66 96 68 52 41 100 82 63
46
Malaysia
69 100 82 68 53 47 100 78 82 40 46 57
47
Lithuania
68 100 92 91 59 69 100 86 91 51
48
Mauritius
68 36 90 68 57
49
Dominica
68 100 92 92 69 53 99 52 46 37
50
Saint Lucia
51
Montenegro
52
Argentina
53
Albania
54
Chile
73
56 100 100 54 67 99 90 95 60 50 80 46 99 85 25 62 62 94 100 95 80 83 68 49 67 100 100 92 100 90 44 64 100 90 65
60 93 89 62 75
99 79 82 78 77 100 66 100 60 55 51
73
77
40 68 100 74 100 60 39 62 57
79 73
97 66 90 82 40 90 85 93 51
96 69 74 75
95 74 49 69 100 86 66
52 83 84 98 53 98 74 52 60 100 87 66
80 48 94 81 67 67 55 84 95 97 67 100 58 67 44 100 80 66
72 100 94 90 50 80 99 85 84 61 68 100 78 100 58 39 54 68 41 78 91 67 79 80 45 89 83 97 56 94 64 48 65 100 82 66

71 100 95 92 80 55 98 69 72
71 100 90 82 57
41 57 100 32 70 56 61 77
53 99 62 56 36 67 100 76 100 60 77
70 100 91 88 46 71
68 67 91 56 93 81 61 75
99 85 84 69 69 100 66 100 62 47 54 72
69 100 94 91 60 49 99 62 54 34 63 100 76 100 55 86 64 57
57
88 95 59 64 62 86 72
67 33 97 98 27
71
99 82 83 71
70 99 67 81 72
60 99 75
77
71
72 100 80 64
49 92 53 99 58 63 20 100 72
94 62 97 79 63 69 87 73
68
64 55 65 44 100 40 100 79 36 51 100 74 68
72
60 60 73
97 60 100 57
59 48 100 73
66
47 100 49 100 53 20 42 64 70 83 90 66 88 59 45 82 86 87 66 96 61 54 41 100 82 62
59 100 76 100 54 75
68 58 90 61 93 76 56 51
58 67 61 63 88 49 93 75
74 100 66 100 55 53 64 71
31
75
74 94 51
75 100 66 100 64 74 71
41 62 100 74 86 79 51
98 72
40 76 43 95 57
92 73
43 71
59 74 82 73
60 57 100 73
64
63 29 100 67 68
39 95 58 62 25 100 67 68
82 56 94 64 28 83 79 95 46 74 67 49 48 100 79 61
67 56 90 96 29 49 99 66 66 33 59 100 74 91 61 52 58 59 86 45 97 75
31
48 86 48 100 67 61 30 100 71
91 73
49 100 64 63 41 59 100 32 99 53 59 80 66 66 63 83 74 64 93 64 73
67 100 88 90 44 77
90 59 99 65 65 39 100 76 68
34 80 84 68 88 84 32 91 81 97 43 94 63 51
60 59 59 94 44 62 76 89 67 51
67 100 97 88 92 47 99 60 58 39 57 100 76 77
67 100 69 77
71
59 85 47 92 76 54 68 67 73
78 10 63 77
62 62 58 84 89 92 78 99 47 63 42 100 77
64 81 77
59 63 87 52 94 79 72
61
64 87 68 97 38 86 47 56 62 100 68 65
94 95 82 98 70 52 48 100 82 59
80 39 71
55
Uzbekistan
67 100 78 84 55 57 100 53 51
58 50 100 43 100 44 55 78 61 84 59 93 48 69 52 81 80 81 54 59 89 48 35 53 100 70 64
56
Trinidad and
Tobago
67 100 95 87 81 49 100 58 51
35 62 100 76 98 47 46 65 55 76 60 93 74 64 71
57
Costa Rica
67 45 93 96 42 58 100 71
45 73
72
95 72
80 87 64 73
59 91 48 94 81 71
58 Saint Vincent and

the Grenadines
66 100 92 92 51
59
Jamaica
66 100 92 89 59 49 99 59 56 35 81 100 76 64 58 86 76 71
60
Turkmenistan
61
Macedonia
62
Bahrain
63
Maldives
64
Peru
65
Serbia
66
Cuba
67
Bulgaria
68
Kuwait
G
SD
52 99 55 50 30 56 100 76 85 46 61 72
66 100 80 83 47 61 99 44 41 37
66 100 94 93 57
72
99 71
70 73
46 100 41 98 41 60 80 71
88 45 93 72
65 31
76 57
68 100 66 100 55 64 59 76 17
71
58 100 32 100 91 49 88 76 46 73
70 100 66 100 54 44 59 69 37
89 92 49 52 100 79 81 43 79 100 76 84 64 47 73
64 54 91 85 39 61 99 73
64 100 95 93 23 75
73
76 59 63 100 63 100 47 53 55 72
99 74 75
75
43 96 61 62 20 100 66 66
66 66 78 59 42 78 38 92 54 57
80 56 89 73
18 100 68 64
79 72
79 77
50 32 97 41 100 63 26 60 100 71
21
62 58 56 73
50 80 64 51
62 82 84 71
70 84 58 88 73
93 52 94 72
28 83 79 93 41 82 69 35 59 100 74 62
80 32 95 71
74 43 79 54 44 53 100 67 63
55 100 76 60
39 82 42 98 52 56 42 100 72
61 78 64 73
59
44 52 100 61 67
43 82 74 85 43 78 60 51
60
59 60 81 58 81 67 23 84 80 95 48 95 66 44 60 100 78 57
64 100 31 100 80 91 98 58 77
73
83 67 67 86 63 50 37
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98 55 100 74 21
14
Articles
Value
25
69
Mexico
70
Grenada
71
Ecuador
72
Panama
73
Bosnia and
Herzegovina
74
Romania
75
Azerbaijan
76
Palestine
62 100 87 95 79 63 99 60 58 58 68 100 31
77
Lebanon
62 100 84 84 55 64 100 74 75
78
Venezuela
79
Sri Lanka
62 23 81 63 81 55 100 74 75
61 53 100 40 90 71
25 87 59 69 75
80
Moldova
62 46 92 91 67 65 99 69 71
40 48 100 49 100 51
46 29 70 72
81
Federated States
of Micronesia
Dominican
Republic
62 100 88 88 67 43 99 68 73
41 53 100 17
82
64 41 81 94 66 50 98 62 62 41 66 77
63 27
92 91 71
63 34 72
93 71
54 100 62 60 37
97 88 72
71
63 33 92 96 76 45 94 59 62 29 52 51
70 71
72
72
93 82 70 72
79 52 46 100 66 100 51
74 89 24 83 81 58 93 55 31
71
75
65 57
74 45 88 38 77
71
86
Armenia
87
Suriname
61 100 90 85 82 49 98 48 42 31
88
Colombia
61 29 83 96 89 48 97 62 65 40 63 32 70 74 81 69 71
89
Qatar
61 100 93 89 32 58 100 73
90
Brazil
60 33 90 92 50 46 99 60 59 36 58 37
91
Indonesia
92
China
60 39 87 91 62 62 97 66 69 46 45 94 40 89 58 59 74 49 86 69 81 48 75
93
Oman
60 41 86 78 55 64 99 71
94
Vietnam
95
Fiji
96
Belize
97
Marshall Islands
98
Paraguay
59 32 82 96 70 40 92 59 57
99
Tajikistan
59 42 62 71
100
Nicaragua
59 31
101
Algeria
102
El Salvador
DG
58 31
75
49 74 51
75
58 89 50 77
72
67 83 77
95 79 53 100 68 72
53 41 92 57
43 93 43 81 72
45 80 54 68 56 57
49 69 42 91 61 51
92 75
49 72
44 82 51
91 84 50 22 95 31
59 75 100 52 64
99 73
27
54 41 89 45 90 57
76 41 100 66 55
29 89 51
45 18 100 55 62
59 83 89 16 77
57
77
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43 100 62 55
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63 38 46 76 42 29 54 100 58 59
71
65 62 69 80 74 31
90 70 57
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53 41 68 54 45 32 100 57
61
50 22 84 23 100 78 38 79 23 62 56
56 81 42 82 44 92 66 56 78 86 76 37
in
54
50 52 96 50 66 38 79 43 25 69 100 70 55
86 78 48 49 78 42 50 47 77
54 96 32 90 68 91 95 41 68 73
77 100 72
56 83 76 93 40 89 36 94 47 67 15 100 64 58
88 63 57
74 93 79 63 81 61 90 36 71
39 69 94 72
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63 28 44 90 55 79 42 74 60 47 52 68 54 33 79 34 90 44 71
80 58 94 47 47 50 52 100 41 95 52 75
46 94 54 52 57
33 86 32 94 67 56 32 100 59 63
86 68 80 82 78 50 34 98 51 100 53
35 56 69 62 88 58 68 67 41 85 46 87 61 56 76 77
45 97 62 63 39 66 37
92 38 53 28 100 69 58
80 26 80 63 98 43 47 45 100 62 61
69 54 63 59 73
41 99 49 53 44 59 100 26 63 24 47 85 61 86 49 82 66 42 63 75
59 100 84 87 43 40 95 59 63 45 54 100 17
59 52 78 90 57
63 85 62 80 61 51
74 53 69 100 30 100 67 84 95 25 48 77
64 71
65
44 42 61 35 82 42 80 42 91 57 100 68 53
18 36 84 47 88 95 50 89 49 52 58 32 69 39 73
90 74 55 98 61 59 28 52 60 76 96 51
74 35 94 49 53 26 100 57
76 58 92 54 78 38 53 87 61 70 73
91 36 67 71
46 28 33 84 60 60 77
42 100 67 58
59 59 85 56 60 69 79 50 34 99 54 100 43 22 76 100 69 58
61 50 80 87 45 58 100 63 63 52 60 100 41 100 50 65 79 69 37
76 96 73
31
44 85 32 84 68 58 74 85 72
62 100 85 87 52 57 100 60 60 42 37 100 41 88 38 22 58 51
62 87 61 68 71
8 100 64 62
56 49 95 69 52 45 100 69 58
Kazakhstan
62 100 29 100 82 75
69 59
66 82 60 79 53 56 68 57
93 43 65 91 60 84 69 87 69 51
62 33 76 94 55 29 73
69 53 61 64 44 45 100 70 59
85
59 100 75
40 68
78 81 51
87 59 60 77
62 100 77
59 30 90 89 51
99 69 52 42 100 61 63
69 70 44 92 63 100 53 49
Tonga
59 44 69 80 86 64 95 64 66 37
91 27
32 43 90 59 83 60 81 59 50 55 68 54 35 83 41 84 38 77
65 68 62 100 82 83 53 68 100 29 100 53 81 85 27
58
67 93 39 42 50 100 62 63
58 73
United Arab
Emirates
87 33 90 54 52 30 27
78 64 73
45 50 22 97 40 100 71
84
60 100 62 72
91 35 61 70 30 57 100 76 57
82 73
83
74 73
67 92 58 63 23 100 62 66
70 80 46 89 49 53 61 100 73
95 52 91 95 61 56 42 74 64 64 82 61 39 21
56 73 100 32 100 67 90 88 76 68 76 88 71
99 60 63 44 61 100 17
83 77
53 49 68 41 60 88 60 76 66 46 57
48 100 53 47 32 50 36 76 98 66 67 71
62 100 98 95 16 37
43 78 44 98 56 61 36 100 70 61
55 92 39 69 78 58 65 93 70 45 77
63 100 79 84 44 61 95 49 46 50 45 100 41 98 48 80 69 76 25 42 79 54 67 62 51
62 100 85 89 59 46 98 60 60 39 62 40 72
100
53 23 100 68 64
62 82 40 80 39 88 79 56 63 89 60 67 86 42 97 58 64 25 100 69 61
63 39 89 89 48 67 99 81 83 74 64 100 66 100 64 75
62 100 90 93 77
75
61 68 78 64 44 90 59 92 57
68 100 76 84 44 67 64 59 87 61 92 70 54 59 86 73
49 98 59 66 36 51
63 50 88 89 52 61 99 73
50
69 74 53 87 44 88 72
IP
70 44 89 62 37
3 100 66 56
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No
V
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15
Articles
Value
25
50
103
Turkey
104
Iran
105
Saudi Arabia
106
Georgia
107
Samoa
57
108
Tunisia
57 100 89 90 65 52 99 64 64 54 64 100 32 95 69 75
109
Morocco
110
Guyana
111
Mongolia
112
Thailand
56 29 85 84 71
61 99 81 80 34 45 26 33 87 61 42 74 36 66 54 69 61 49 69 60 57
113
Kyrgyzstan
56 33 78 89 71
50 99 50 44 46 49 100 41 87 40 46 75
114
Bhutan
115
Honduras
55 36 69 95 80 39 97 55 54 36 55 38 72
75
116
North Korea
55 32 53 83 97 45 95 59 58 46 50 38 15
94 42 45 83 39 62 93 77
117
Syria
118
Ukraine
119
Russia
120
Belarus
53 100 96 93 65 72
121
Bolivia
53 22 68 95 59 36 83 49 47 49 50 52 69 82 67 49 77
122
Timor-Leste
53 100 34 51
88 30 49 44 45 44 36 16 32 83 61 55 87 60 41 46 55 48 42 63 37
123
Cape Verde
53 100 84 77
73
124
Egypt
53 100 68 73
48 51
125
Guatemala
126
Libya
127
Philippines
128
Iraq
129
Kiribati
130
Cambodia
131
So Tom
and Prncipe
132
Vanuatu
133
Botswana
134
South Africa
135
Myanmar
136
Laos
58 33 86 96 65 64 94 61 59 64 69 100 43 97 73
58 39 90 86 77
58 48 88 75
61 99 63 62 46 63 83 60 99 56 70 94 27
99 60 59 49 54 100 41 100 43 63 72
16 94 95 22 48 91 74 81 42 62 100 17
53 73
75
57 100 76 77
54 56 54 86 52 82 57
97 47 54 85 69 69 60 71
94 51
72
82 39 96 50 44 20 43 19 76 87 37
41 100 41 100 30 19 72
47 76 65 87 41 75
65 75
47 21
48 67 96 37
47 100 73
46 15
71
70 83 77
55 41 54 13
70 63 88 55 60 36 56 56 37
66 50 43 57
54 65 40 28 51
56
55 55 55 100 43 57
64 55 36 26 100 50 52
97 26 100 66
30 67 31
69 53 39
53
61 49
9 100 50 53
50 26 92 20 99 54 16 64
64 44
44 43 85 50 88 32 88 48 70 45 49 25 35 51
50 57
65 69 78 23 91 22 99 65 28 22
66 22 36 88 62 64 69 81 62 29 49 13
35 24 60 27
39 39 60 58 84 32 49 21
41
51
56 46
80 46 95 17 100 55 40
53 31
43 56 100 45 49
35 44 63 39 100 39 48
65 24 38 93 50 65 49 58 40 41 47 63 54 19 48 26 61 31
75
70 100 46 46
45 34 69 42 88 56 82 46 29 49 74 59 24 44 16 64 42 56 32 100 41 47
23 35 73
70 84 51
34 95 42 42
59 35 61 43 43 66 29 91 57
46 36 62 76 80 23 86 47 45 31
38
79 51
32 55 66 78 31
32 86 44 76 97 59 50 70 60 40 37
53 63 64 31
IP
71
20 85 64 43 10 22 49 43
42 27
53 30 27
59 14 43 47
38 66 22 49 33 40 87 100 43 47
47 76 93 29 47 35 30 34 42 24 35 80 44 42 88 40 50 42 48 36 36 55 34 73
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77
33 63 48 85 76 55 34 35 78 35 33 55 93 53 11
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26 73 100 56 51
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50 81 70 94 57
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63
39 100 58 56
67 85 62 79 47 41 64 86 79 69 98 67 58 25 31
99 80 83 40 54 100 49 100 36 21
80 69 48 89 51
34 98 46 88 54 46 34 100 63 54
48
53 75
48 53 73
43 58 68 42 49 33 100 59 55
73
61 80 93 45 79 54 55 34 33 22 32 66 46 70 77
60
32 41 100 49 99 41 21
84 40 59 92 60 63 49 65 100 32 96 59 75
21 100 51
78 65 97 60 54 38
75
89 56 53 63 73 100 46 93 46 84 96 57
63 55
59 52
85 90 46 61 99 72
50 13
33 69 29 94 61 57
80 31
62 76 66 82 57
50 47 71
92 48 100 69 49
97 52 49 57 100 56 56
78 60 68 60 65 50 19 88 22 100 73
71
57
34 61
51
41 100 49 100 42 34
44 64 52 60 39 60 34 72
40 51
39 69 45 57
31
24 38 93 75
58 82 50 18 78 13
59 68 81 55 80 43 68 49 44 54 79 73
49 70 50 48 29 54 95 33 99 60 39 76 67 75
86 54 68 52
95 23 70 70 80 41 52 52 100 60 57
47 38 68 86 53 75
73
51
50 61 49 88 46 66 54 59 54 41 38 60 81 42 57
48 97 55 65 74 73 100 43 86 58 92 95 59 57
58 19 67 54
81 88 69 64 67 54 50 16 92 26 100 49 32 65
54 100 84 94 68 58 99 71
54 57
50 30 96 37 100 83
24 68 46 65 35 76 60 46 59 80 73
80 81 30 58 41 32 47 35 59 50 90 65 65 93 67 57
54 100 67 68 57
51
100
37
30 86 32 100 68 33 57 100 67 55
31
65 54 60 43 49 40 94 48 72
63 46 83 55 52 50 49 100 32 92 60 62 97 49 78 59 80 70 57
56 100 80 93 56 47 100 50 48 73
55 100 57
74 64 90 60 67 41 77
36 64 98 68 69 52 63 93 46 96 83 86 97 40 59 81 85 62 61 63 72
58 29 84 92 46 51
57
81 90 66 70 61 82 71
75
76 80 47 53 29 87 28 98 51
e
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V
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16
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Value
25
137
Namibia
45 19 66 74 87 41 86 43 39
10 11
37
88 60 45 66 36 86 38 82 42 28 51
138 Solomon Islands
44 14 63 86 43 32 95 57
139
Gabon
44 100 74 87 71
140
Djibouti
141
Ghana
142
Comoros
42 100 53 57
61 31
143
India
42 36 46 51
86 28 75
39 28 36 34 10 57
144
Senegal
75
92 22 75
38 38 29 33 11
145
Haiti
41 27
69 80 89 19 42 36 35 25 51
23 76 95 37
146
Kenya
40 37
63 86 84 25 52 38 38 16 37
147
Zimbabwe
40 31
59 89 87 27
148
Swaziland
38 32 59 96 73
149
Pakistan
150
Mauritania
38 100 66 65 84 22 64 37
151
Bangladesh
38 52 48 56 97 29 36 44 34 53 43 24 52 72
152
Yemen
153
Zambia
37 100 41 80 45 30 74 33 38 11
24
35 57
35 33 79 33 59 31
154
Tanzania
36 58 45 81 82 26 56 35 36 17
29
35 71
55 54 72
155
Papua New
Guinea
36 32 51
22 65 42 47 35 48
21
156
The Gambia
36 100 68 66 82 24 59 41 38 27
157
Equatorial
Guinea
158
Nepal
36
159
Congo
36 43 66 79 84 21
96 36 38 19 33
160
Sudan
35 50 50 44 81 27
91 36 34 40 54 14 42 77
161
Cte dIvoire
162
Eritrea
35 100 38 59 99 16 28 33 36 31
163
Nigeria
34 42 53 58 73
164
Togo
34 100 64 77
165
Benin
34 100 36 60 51
166
Liberia
167
Rwanda
168
Malawi
169
Lesotho
170
Angola
G
SD
62 41 50 12
33 94 40 37
18 28
22 74 21
41 54 71
82 88 28 65 36 32 25 39
53 32 46 77
86 71
33 100 54 77
39
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26 49 37
83 21
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47 57
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30 29 100 36 43
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36 23 13
55 100 36 39
50 11
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32 46 31 100 36 35
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39 49 40 100 29 37
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44 36 69 14 20 16 55
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48 100 31
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59 35 34 48 89 41
87
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44 17
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18 34
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36 40
38
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24 100 36 39
75
33 83 55 63 84 53 20 26 65 35 30 49 78 66
45 35 23 57
41
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34 57
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27
47
48 24 57
47 64 40 21
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70 100 35 42
47 10 28 40 50 41 100 37
41 15
2
33 100 31
75
19 52 92 36 85 99 52 44 50 39 31
39 43 13
94 69
79 38 25 48 75
38 52 52 28 40 84 36 67 97 29 42 42 49 37
62 26 21
18 60 100 38 35
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23
31
40 28 45 100 29 37
39 47 36 41 47 100 21
20 11
57
51
23 43 82 57
33
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39 49 81 100 25 41
33 89 53
22
27
43 33 28 100 25 39
33 73
18 31
43 67 90 30
47 42 81 43 26 20 59 31
64 40 45 92 43 15
45 46 31
11
29 65
27
41
23 42
28 43 23 22 20 38
33 56 73
32 26 40 42 19 52 93 75
35
28 47 36 81
25 41
33 92 48 47 87 46 30 32 65 30 24 46 90 66
24
33 40 50 100 25 39
40
33 78 46 47 88 50 15
34 64 29 24 44 90 61
13
37
32 26 32
33 39 56 58 80 57
48 88 43
29
45 76 58 100 25 36
88 27
67 29 27
23 88 29 31
79 17
63 31
33 55 45 91 62 24 77
27
33 33 24 40 13
67 64 73
34 28 58 38 21
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31
61 56 55 70 36 53 59 77
36 26 39 83 32 26 19
33 29 48 100 38 29
37
87 55 52 91 50 59 20 73
32 47 65 100 25 33
31
76 28 31
13
28
40 18 40 82 67 12
88 78 21
67 28 20
5 100 35 66 23 23 74 18 81 32 76 26 16 38 68 62 13
15
10 41 19 48 11 100 28 34
44
32 26 39 82 77
32 29 51
23 79 31
34 83 37
45 64 96 25 47 45 37
35 49 56 72
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14 37
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62 52 81 52 72
15
56 33 80 39 100 46 42
53 15
67 61 46 22 39 72
42 41 53 56 34 33 46 88 71
33 100 41 46
84 53 35 47 100 37
33 89 50 47 94 54 32 36 68 36 23 46 90 61 12
60 72
42 58 51
85 46 40 83 40 82 55 51
35
36 100 74 88 30 26 92 27
9
67 54 56 98 51
41 75
15
50
58 78 50 31
67 37
31
68 20 57
100
81 24 15
66 46 53 82 44 27
35 79 51
84 41 36 44 44 10 31
38 28 38 61 85 24 61 34 19 49 37
37
72
75
39 93 50 54 47 55 38 40 46 54 48 26 40 21
33 35 49 48 70 42 41 32 61 50 33 51
43 100 60 44 53 22 90 33 35 25 34 30 31
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50
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29 35 21
28
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171
Cameroon
31
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172
Burkina Faso
31
58 53 50 78 25 68 22 27
173
Uganda
31
53 55 82 82 28 68 32 34 15
174
Ethiopia
30 100 41 64 88 23 15
175
Guinea
176
Guinea-Bissau
177
Mozambique
178
58 80 68 21
29 100 53 66 82 17
67 27
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5
24 40 21
66 34 19 42 81 84
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30 35 80 100 21
87 18 26 20
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42 92 61
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33
49 22 22 23 36
33 56 45 55 94 53 18 20 48 27
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39 20 20 18 30 10 33 74 46 53 82 48 20 33 52 26 19 39 87 61
24
35 40 38 100 21
28 32 44 79 71
27
61 29 32 11
20 39 78 42
11
31
Madagascar
28 28 33 39 87 26 44 34 35 46 41
31
57
179
Sierra Leone
27
26 36
34 78 45 54 73
180
Afghanistan
26 18 33 66 88 13
181
Mali
42 46 67 68 15
61 20 21
40 28 29 57
45 14 31
54 37
28 22 30
23 29
26 39 29 21
41 77
53 19
20 53 60 12
47 35 25 64 28 21
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38 44 66 50
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78 92 24 63 30 32 24 34
35 79 47 49 71
29 53 65 31
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29 32 74
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30 26 30
32 47 47 53 87 50 14 23 56 27
23 42 84 12
15
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33 70 50 55 81 47 16 19 34 27
14 39 85 79
33 31
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15
30
36 42 90 24 32 22 34 34 35
33 97 57
46 30 16 42 91 61
40 23 53
13
28
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31
26 47 49 54 75
26 30 21
24 48 43 71
25 57
84 21
Chad
24 52 48 47 82 20 21
185
Niger
23 31
186
South Sudan
187
Somalia
188
Central African
Republic
22 28 54 30 72
22 25 44 55 86 17
20 100 45 71
84 12
19 17
87 27
184
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23 32
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29 100 54 77
35
59 44 43 89 40 38 20 59 37
Burundi
53
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37
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Republic of
the Congo
26 34
24
34 75
183
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Figure 1: Performance of the health-related SDG index, MDG index, and non-MDG index, and 33 individual health-related indicators, by country, 2015
Countries are ranked by their health-related SDG index from highest to lowest. Indicators have been scaled from 0 to 100. Denitions of health-related SDG indicators are shown in table 1.
SDG=Sustainable Development Goal. MDG=Millennium Development Goal. MMR=maternal mortality ratio. SBA=skilled birth attendance. Mort=mortality. NN mort=neonatal mortality. NTDs=neglected
tropical diseases. NCDs=non-communicable diseases. FP need met, mod=family planning need met, modern contraception. Adol=adolescent. UHC=universal health coverage.
Air poll mort=mortality attributable to air pollution. WaSH=water, sanitation, and hygiene. IPV=intimate partner violence. HH air poll=household air pollution.
Occ risk burden=burden attributable to occupational risks. PM25=ne particulate matter smaller than 25 m.
improvement for the indicator on malaria incidence

represents the large number of malaria-free countries
in both 2000 and 2015.46 Health-related indicators
covered by Target 3.3which aims to end the epidemics
of HIV, tuberculosis, malaria, and neglected tropical
diseases, and to combat hepatitis by 2030generally
saw moderate progress (median absolute change of 27
[IQR 02 to 46] for HIV incidence and 39
[IQR 17 to 57] for tuberculosis incidence), although
minimal changes occurred for hepatitis B incidence
(02 [04 to 005]). In combination, these trends
highlight the need for accelerated progress in order to
meet Target 3.3. Substantial improvements occurred for
childhood stunting (82 [35 to 142]) and, to a more
modest extent, wasting (27 [00 to 60]), yet childhood
overweight considerably worsened in the past 15 years
(45 [92 to 07]). This trend occurred across SDI
18
quintiles, emphasising the need for concerted policy

attention to reverse this trend. Alcohol consumption
worsened slightly in the past 15 years as well
(04 [23 to 07]).
Between 2000 and 2015, distinct patterns for absolute
changes in health-related SDG indicators surfaced
across SDI quintiles (gure 6). While the indicator for
UHC tracer interventions improved across all SDI
quintiles, the most pronounced gains occurred in
low-SDI and low-middle-SDI countries. Childhood
stunting and wasting also improved at a faster pace for
the low-SDI quintile than for other quintiles. Notably,
mortality measures from the MDG agendamaternal
mortality ratio, under-5 mortality, and neonatal
mortalityprogressed at a similar pace across SDI
quintiles. By contrast, mortality due to road injuries,
non-communicable diseases (NCDs), and interpersonal
Articles
Health-related SDG index

<378
378557
557625
625715
715
ATG
VCT
Barbados
Comoros
West Africa
Dominica
Caribbean
LCA
Grenada
TTO
Maldives
TLS
Mauritius
Seychelles
Marshall Isl
Kiribati
Solomon Isl
FSM
Vanuatu
Samoa
Fiji
Tonga
Eastern
Mediterranean
Malta
Persian Gulf
Singapore
Balkan Peninsula
Figure 2: Map of health-related SDG index, by quintile, 2015

SDG=Sustainable Development Goal. ATG=Antigua and Barbuda. VCT=Saint Vincent and the Grenadines. LCA=Saint Lucia. TTO=Trinidad and Tobago. TLS=Timor-Leste. FSM=Federated States of
Micronesia.
violence declined faster in the higher-SDI quintiles

than in the lower-SDI quintiles. Prevalence of smoking
also had the largest reductions in countries in the
high-SDI quintile.
Between 2000 and 2015, progress on the health-related
SDG index (gure 7), as well as on individual
health-related SDG indicators and on the MDG and
non-MDG indices (results appendix p 6), was highly
heterogeneous across geographies. Since 2000, the
largest absolute improvements in the health-related SDG
index occurred in Timor-Leste (185, 95% UI 162208),
Bhutan (162, 136187), and Colombia (156,
141168), whereas three countriesLibya, Syria, and
Chileexperienced signicant declines. Declines for the
next two countries (Brunei and South Sudan) were
between 0 and 05 and rounded to 0 in gure 7.
Countries with the most pronounced gains for the
health-related SDG index were found mainly in east,
southeast, and central Asia, as well as parts of
Latin America (eg, Venezuela and Honduras). Several
countries in sub-Saharan Africa also recorded
considerable gains in the health-related SDG index,
including Rwanda, Ethiopia, Ghana, Namibia, and
Angola.
To demonstrate the usefulness of these estimates for
informing progress towards the SDGs, we also identied
the geographies with the largest improvement in overall

health-related SDG index between 2000 and 2015,
stratied by SDI quintile classication in 2000. The
ve geographies were: Timor-Leste in the low-SDI
quintile, Tajikistan in the low-middle-SDI quintile,
Colombia in the middle-SDI quintile, Taiwan (province
of China) in the middle-high-SDI quintile, and Iceland in
the high-SDI quintile. Based on their gains for
the health-related SDG index, these geographies could
serve as case studies for understanding potential drivers
of progress on the SDGs.
In Timor-Leste, changes in the health-related SDG
index were largely driven by improvements in UHC
tracer interventions, skilled birth attendance, met need
with modern contraception, under-5 and neonatal
mortality, childhood stunting, risk exposure to unsafe
water and sanitation, and mortality from war or conict.
This overall improvement was despite worsening
measures for childhood overweight, smoking
prevalence, and alcohol use since 2000. Tajikistan
recorded sizeable improvements across various
health-related SDG indicators. Among indicators
related to the MDGs, these included both measures of
child mortality, childhood stunting, coverage of UHC
tracer interventions, malaria incidence, and exposure to
household air pollution. Improvements were also noted
19
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GHA
KHM
STP
LAO
MMB
HTI
BWA
NAM
MRT
COM
VUT
GAB
DJI
SLB
SDN
CIV
YEM
ERI
TZA
COG
LBR
GMB
ZWE
PAK
SWZ
TGO
MWI
ZAF
IND
SEN
KEN
BGD
PNG
GNQ
NPL
ZMB
CMR
AGO
LSO
100
SGP
SWE
ISL
GBR
AND
FIN
NLD
AUS
LUX
IRL
CAN
NOR
ESP
CYP
DEU
DNK
BEL
CHE
80
MLT
ATG
BRN
Non-MDG index
TWN
URY
IDN
60
GUY
TLS
GTM
CPV
LBY
NGA
40
20
BEN
BFA
GNB GIN
TCD
SLE
ETH
MLI MOZ MDG
NER
COD
AFG
BDI
SSD
CAF
SOM
20
WSM
UKR
RUS
ISR
FRA
ITA
JPN
GRC
SVN
EST
HUN
PRK
PHL BTN BOL
EGY
IRQ
PRT
USA
POL
LTU
LVA
CHL
NZL
SVK
AUT
CZE
KOR
BLR
KIR
UGA
RWA
40
60
MDG index
80
100
BRB
High SDI
DMA
VCT
PAN
DOM
PSE
SUR
AZE
BLZ
Middle SDI
BHS
JOR
TTO
TKM
MDV
High-middle SDI
LCA
ALB
UZB
JAM
MEX
PER
MYS
CRI
ARM
MKD
GEO
MAR
Low SDI
KGZ
MNG
HND
SYR
PRY
BRA
VNM
OMN
DZA
MHL
TUN
THA
ECU GRD
COL
TJK
Low-middle SDI
HRV
MUS
VEN
NIC
SYC
FJI
LBN ARE LKA

BHR
FSM MDA KAZ
CUB
ROU
BIH
SLV
IRN
TUR
MNE
ARG
SRB
BGR
KWT
CHN
QAT
TON
SAU
Figure 3: Non-MDG index versus MDG index, by country, 2015

The dark blue line shows the equivalence line, such that values that fall on this line are equivalent for both the MDG index and non-MDG index. Countries are
abbreviated according to the ISO3 code. MDG=Millennium Development Goal. SDI=Socio-demographic Index.
in mortality due to NCDs, interpersonal violence, and

war or conict, as well as mortality attributable to unsafe
water, sanitation, and hygiene and to air pollution.
However, several indicators either had minimal progress
or worsened in Tajikistan, particularly childhood
overweight and intimate partner violence. Colombias
most pronounced improvements since 2000 occurred
20
for many of the non-MDG indicators, which included

smoking prevalence and mortality rates due to NCDs,
road injuries, interpersonal violence, and war. Sizeable
improvements were also recorded for a subset of
health-related MDG indicatorsnamely, coverage of
UHC tracer interventions, adolescent birth rates, met
need with modern contraception, and unsafe sanitation.
Articles
100
r2=092
75
MDG index
75
100
High income
Central Europe, eastern Europe, and central Asia
Sub-Saharan Africa
North Africa and Middle East
South Asia
Southeast Asia, east Asia, and Oceania
Latin America and Caribbean
50
25
50
25
r2=088
0
0
025
050
SDI
075
100
100
100
025
r2=079
075
100
70
80
r2=086
75
75
Non-MDG index
050
SDI
50
25
50
25
0
0
025
050
SDI
075
100
40
50
60
Healthy life expectancy (years)
Figure 4: Relations (A) between the SDI and the health-related SDG index, (B) between the SDI and the MDG index, (C) between the SDI and the non-MDG index, and (D) between healthy life
expectancy and the health-related SDG index, by country representing each of the seven GBD super regions, 2015
Each point represents a country and is colour coded according to the seven GBD super regions. The black lines were generated by spline regression. SDG=Sustainable Development Goal.
SDI=Socio-demographic Index. MDG=Millennium Development Goal. GBD=Global Burden of Disease.
Nonetheless, similar to other countries, Colombia had

minimal progress in or worsened levels of alcohol
consumption and hepatitis B incidence. In Taiwan,
marked gains occurred for a subset of health-related
SDG indicators previously associated with the MDG
agenda (eg, adolescent birth rates and coverage of UHC
tracer interventions); in parallel, Taiwan had
considerable improvements for many non-MDG
indicators, such as smoking prevalence and mortality
due to NCDs, interpersonal violence, and road injuries.
However, HIV and hepatitis B incidence worsened in
Taiwan since 2000, and minimal progress occurred for
ambient particulate matter pollution and several

maternal and child health indicators. For Iceland, its
progress on the health-related SDG health index was
primarily driven by improvements in mortality due to
NCDs and road injuries, smoking prevalence, adolescent
birth rates, and both measures of child mortality.
Similar to other countries, particularly those in the
high-middle-SDI and high-SDI quintiles, Iceland had
little progress in childhood overweight and worsening
levels of alcohol consumption.
Further results are provided in the results appendix,
and dynamic visualisations are available online.
For dynamic visualisations of

results see https://vizhub.
healthdata.org/sdg
21
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Observed minus expected

health-related SDG index
1 to 1
<15
1 to 5
15 to 10
5 to 10
10 to 5
>10
5 to 1
ATG
VCT
Barbados
Comoros
West Africa
Dominica
Caribbean
LCA
Grenada
TTO
Maldives
TLS
Mauritius
Seychelles
Marshall Isl
Kiribati
Solomon Isl
FSM
Vanuatu
Samoa
Fiji
Tonga
Eastern
Mediterranean
Malta
Persian Gulf
Singapore
Balkan Peninsula
Figure 5: Map of observed health-related SDG index minus expected health-related SDG index, on the basis of SDI alone, 2015
The dierence between the observed health-related SDG index and expected index (on the basis of SDI) reects whether a country has a health-related SDG index above or below the expected level.
Values for this dierence are colour coded such that dark red reects an observed health-related SDG index that is much lower than expected on the basis of SDI, and dark blue indicates that observed
levels are much higher than expected on the basis of SDI. SDG=Sustainable Development Goal. SDI=Socio-demographic Index. ATG=Antigua and Barbuda. VCT=Saint Vincent and the Grenadines.
LCA=Saint Lucia. TTO=Trinidad and Tobago. TLS=Timor-Leste. FSM=Federated States of Micronesia.
Discussion
Summary of ndings and implications
The ambitious SDG agenda is accompanied by
numerous goals, targets, and indicators for tracking
progress. Leading up to and following the UN SDG
resolution1 in September, 2015, considerable debate
surrounded the selection of indicators, including
scepticism about the feasibility of their measurement.5,6
In this study, we produced independent, highly
standardised, and comparable estimates of 33 of the
47 health-related SDG indicators across 188 countries. To
facilitate overall tracking, we also distilled these
33 health-related indicators into a health-related SDG
index. Our ndings show the wide range in this
health-related SDG index in 2015, from 204 in Central
African Republic to 855 in Iceland. Our historical
analysis of these indicators also shows that progress can
be achieved. Notable improvements were recorded for
several health-related SDG indicators, particularly those
that were also MDG indicators, such as under-5
mortality, met need with modern contraception, and
childhood stunting. An index of the 14 MDG indicators
that were included in the health-related SDG indicators
22
had a median absolute change of 100 from 2000 to

2015, and larger reductions were generally found for
countries at the lower end of the development spectrum.
Our analysis also highlights the challenges associated
with the expanded scope of the SDGs, with several of the
non-MDG indicators having minimal improvements
(eg, hepatitis B incidence) or worsening (eg, childhood
overweight) between 2000 and 2015. This nding is
further supported by the highly variable relation between
the health-related MDG index and the health-related
non-MDG indexgood performance on the MDG index
did not guarantee good performance on the non-MDG
index. The overall health-related SDG index was well
predicted by SDI; however, SDI was a variable predictor
of the performance of individual health-related SDG
indicators, particularly indicators that were not in the
MDG agenda. Drawing from GBD, these ndings
provide a strong, comparable basis for monitoring the
SDGs; furthermore, the independent nature of these
results can enable accountability mechanisms for the
multiple national and international, governmental, and
non-governmental actors that must achieve progress on
the SDGs.
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Median absolute change for the rescaled indicator
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Indices
Goal 1
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x x x r g g t R A rt rt V is ia B s s e l s d e r t rt s g V r n e ll n 5 e r
de de de te in in gh M B o o HI los alar itis TD CD icid ohojurie mo rat race or mo ison kin IP ate atio ien po rde M2 lenc Wa
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Figure 6: Median absolute change for health-related SDG index, MDG index, and 33 individual health-related SDG indicators (rescaled), (A) across all countries and in the (B) low-SDI quintile,
(C) low-middle-SDI quintile, (D) middle-SDI quintile, (E) high-middle-SDI quintile, and (F) high-SDI quintile, 200015
Positive values indicate improvements between 200015, and negative values point to worsening performance for a given indicator during this time. Black stripes represent median absolute change
and boxes represent IQR. Health-related indicators are colour coded according to the health-related goals they represent. Denitions of health-related SDG indicators are shown in table 1.
SDG=Sustainable Development Goal. MDG=Millennium Development Goal. SDI=Socio-demographic Index. MMR=maternal mortality ratio. SBA=skilled birth attendance. Mort=mortality.
NN mort=neonatal mortality. NTDs=neglected tropical diseases. NCDs=non-communicable diseases. FP need met, mod=family planning need met, modern contraception. Adol=adolescent.
UHC=universal health coverage. Air poll mort=mortality attributable to air pollution. WaSH=water, sanitation, and hygiene. IPV=intimate partner violence. HH air poll=household air pollution.
Occ risk burden=burden attributable to occupational risks. PM25=ne particulate matter smaller than 25 m.
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High SDI
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Figure 7: Health-related SDG index in 2015 versus 2000, by country

The blue line shows the equivalence line, such that values that fall on this line are equivalent for both the health-related SDG index in 2000 and health-related SDG
index in 2015. Only the top ve and bottom ve improvers in each SDI quintile, as determined by the absolute change from 2000 to 2015, are labelled; full results are
shown in the results appendix. Countries are abbreviated according to the ISO3 code. SDI=Socio-demographic Index. SDG=Sustainable Development Goal.
These estimates also allow the identication of places

that have made substantial progress on the health-related
SDG indicators. These ndings stand to strengthen the
global evidence base of lessons learned for accelerating
improvements in the health-related SDGs. The
ve geographies with the greatest improvement in the
health-related SDG index between 2000 and 2015,
stratied by SDI quintiles (Timor-Leste, Tajikistan,
Colombia, Taiwan, and Iceland), have implemented a
range of policies and interventions that might have
contributed to their progress.
For instance, following acute conict and violence
during the late 1990s, Timor-Leste, in concert with
the World Bank and other development partners,
implemented a series of health sector rehabilitation and
development projects in 2000 and 2001 to re-establish
the countrys health system and improve health service
delivery to the poor.47,48 In more recent years, health-care
reform and nancing have topped policy agendas in
Timor-Leste,49 including the Ministry of Healths roll-out
of a Basic Health Services Package and Hospital Services
24
Package in 2007 under the pursuit of achieving UHC.50

Following almost a decade of civil conict that severely
disrupted health service provision, Tajikistan launched a
series of health reforms beginning in the late 1990s51 and
introduced a new benets package for guaranteed health
services in 2007.52 Moreover, after the civil war, the Tajik
Government refocused policy attention for initiatives
on particular diseases such as malaria;53 indeed, the
countrys multipronged malaria programme, which
emphasises strong surveillance and cross-border
activities with Afghanistan,54 has now brought Tajikistan
close to eliminating the disease. Colombia, which
experienced ongoing conict and violence from the late
1980s to 2003,55 is globally recognised for its expansion
of health insurance and services, especially to the poor.
While Colombias health system reforms began well
before 2000 (the country approved its universal health
insurance scheme in 1993),56 coverage increased
substantially over time, as have the types of services
covered by its insurance scheme (eg, cancer care).57
During the mid-1990s, Taiwan adopted a universal
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health insurance system,58 which is viewed as one of its

most successful public entities. Taiwan also enacted
many road safety laws between the mid-1990s and
early 2000s, including mandatory helmet laws for
motorcyclists in 1996 and an extension of seat belt laws
to general roads in 2001.59 Icelands tobacco control
policies have been viewed as some of the worlds most
comprehensive,60 and the countrys long-standing
publicly funded health system provides UHC,61 a factor
that might have contributed to its declines in
NCD mortality.
Such progress also highlights important interactions
between development goals and wider contextual factors,
such as post-conict experiences in Timor-Leste,
Tajikistan, and Colombia, as well as a rebound in health
following the dissolution of Soviet rule for Tajikistan.
Furthermore, Taiwans gains underscore the interplay
between advancing economic development and
deliberate investments in improving UHC. These
vignettes highlight only a fraction of the possible learning
for informing action towards improving the health-related
SDGs. An important future area of work will be to
understand in detail how these and other high-performing
geographies have achieved substantial improvements in
key SDG indicators.
Besides showing the feasibility and value of measuring
many of the health-related SDGs, our ndings also
arm concerns voiced during the SDG development
process and following the UN resolution. One criticism
of the SDGs was the incredibly ambitious nature of
some of the targets,5 such as Target 3.3, which calls for
the end of the epidemics of HIV, tuberculosis, and
malaria by 2030. Our analysis of these indicators in the
past 15 years suggests that a substantial change in the
present trajectory of HIV and tuberculosis incidence
will be needed to meet this target, and major
technological leaps coupled with universal delivery are
likely to be necessary. The vague nature of many of the
SDG targets has also been a common criticism;4,8,10,62 Of
the 33 health-related SDG indicators in our study, we
identied specic targets for only 21 of them. The
absence of specic and attainable targets for SDG
indicators, health related or otherwise, undermines the
usefulness of the SDGs in driving development
agendas, a limitation that can and should be addressed
at this early stage of the SDG period.
Our analysis also represents a step towards producing
a more cohesive understanding of the interactions
between dierent SDG goals, targets, and indicatorsa
widely noted criticism.3,4 We show the potential for
quantifying these interactions by comparing the
relations between education, income, and fertility
components of the SDIand the 33 health-related SDG
indicators and accompanying health-related SDG,
MDG, and non-MDG indices. Although we acknowledge
the ecological nature of this analysis and its usual
caveats, SDI was a strong predictor of the overall
health-related SDG and MDG indices, highlighting the

general importance of income, education, and fertility,
as well as intersectoral action for health-related
development. However, SDI was a weaker predictor of
the non-MDG index, particularly for indicators such as
violence (intimate partner, interpersonal, and collective
violence) and ambient particulate matter pollution. This
nding shows that a sole focus on increasing income
and education and decreasing fertility is probably
insucient to meet the SDG targets. It also raises
questions about whether other common drivers,
analogous to income, education, and fertility, can be
determined and their relations with SDG indicators
assessed. Combining this initial assessment of the
33 health-related SDG indicators with an expanded
quantication and analysis of other potential drivers is
an important future area of work that could help to
create a more concise, cohesive, and actionable
monitoring framework for the SDGs.
Future directions for GBD monitoring eorts

In this report, we focused on measuring indicators
proposed by the IAEG-SDGs. In future years, we plan to
address three related sets of issues: rst, improved
assessment of the health-related SDG indicators
measured at present; second, inclusion of the 14 currently
excluded health-related indicators in the annualised
GBD study; and third, potential expansion of indicators
consistent with the framing of the targets. We address
each of these issues in turn.
Improving the measurement of currently included

health-related indicators
With the present analysis, we made several modications
that we believe improve several health-related indicators
for the purposes of measuring progress towards each
health-related SDG target. Future iterations are likely to
incorporate further modications to these and other
indicators. First, as noted in the Methods section, rather
than reporting on the combined prevalence of childhood
wasting and overweight, we assessed and measured
them separately. Our results support this decision, since
they had divergent relations over time (ie, childhood
wasting improved for most countries, whereas the
prevalence of childhood overweight generally increased)
and with SDI (ie, childhood wasting and overweight
were negatively and positively correlated with SDI,
respectively).
Second, the IAEG-SDGs proposed indicator for
harmful use of alcohol is the average national-level
consumption per person in litres of pure alcohol. The
health and non-health risks associated with harmful
alcohol use are a function of not only average
consumption at the population level but also use patterns
(ie, amount consumed at a given time and frequency of
consumption). For this analysis, we reported on the
summary exposure value of harmful alcohol use, which
25
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takes into account the distribution of consumption and

the prevalence of binge drinking.39
Third, we made two modications to the measurement
of disaster (Indicators 1.5.1, 11.5.1, and 13.1.2). For
mortality attributable to disasters, we chose to report on
the lagged 5 year average of disaster mortality. One of the
corresponding health-related SDG targets (Target 1.5) is
to build the resilience of the poor and those in vulnerable
situations and reduce their exposure and vulnerability to
climate-related extreme events and other economic,
social and environmental shocks and disasters. Focusing
solely on the observed mortality caused by natural
disaster ignores the role of chance in the occurrence of
natural disasters; for example, nations with weak
resilience to natural disasters might not experience a
natural disaster during a given period of time, whereas
those with strong resilience might encounter them more
frequently. Taking the moving average of disaster
mortality lessens the contribution of chance in assessing
progress for this indicator. Nonetheless, this adjustment
cannot account for background risk of natural disasters,
which varies by geography, and future research eorts
could include developing a risk-standardised version of
the indicator. For natural disasters, data on missing
people and people aected by disaster are not readily
available across countries and over time.
Fourth, for occupational health (Indicator 8.8.1), we
reported on age-standardised all-cause DALY rate
attributable to occupational risks rather than the
suggested indicator, which is limited to fatal and non-fatal
occupational injuries. This revision captures a wider set
of occupational risks instead of only those that result in
injuries, which supports the stated target of promotion of
safe and secure working environments for all workers
(Target 8.8). Fifth, for tobacco use prevalence
(Indicator 3.a.1), GBD does not presently assess
smokeless tobacco use. Furthermore, smokeless tobacco
use has a notably dierent risk prole to smoked tobacco
use,63 and thus it might warrant a subindicator akin to
childhood malnutrition. Sixth, for clean fuels and
technology (Indicator 7.1.2), we presently use a more
limited denition that covers fuels used primarily
for household cooking. Seventh, for homicide
(Indicator 16.1.1), GBD does not measure this indicator
by displacement or migratory status, and similarly for
conict-related deaths (Indicator 16.1.2), we do not
measure deaths by displacement status or by more
specied causes.
Eighth, data gaps also account for limitations in the
estimation of the UHC tracer indicator (Indicator 3.8.1).
We used a set of tracer interventions that were restricted
to reproductive, maternal, and child health, as well as a
subset of infectious diseases. There is a paucity of data
for the coverage of NCD interventions in particular6467
and for higher-level care. Furthermore, the UHC tracer
indicator only captures the use of interventions and not
the quality of the intervention provided.68,69 As more data
26
become available on the delivery of interventions for

NCDs and the modication of key risk factors, this
information will be incorporated into revisions of the
UHC tracer indicator. Finally, data gaps mean that, in
this initial assessment, we have also not been able to
include a measure of nancial risk protection. Substantial
investments are needed in this area to address data gaps
to be able to track the central role of health system
delivery in improving health.
Indicators not presently measured

Of the 14 health-related SDG indicators that were not
included in this analysis, there are several that the GBD
does not currently measure but that could be assessed
in the future through GBD (table 2). These indicators
include the coverage of treatment interventions for
substance use disorders (Indicator 3.5.1), which would
leverage the work on quantifying incidence, prevalence,
and mortality for these conditions. Estimating the
proportion of women and girls aged 15 years and older
who are subjected to sexual violence by people other
than an intimate partner (Indicator 5.2.2) would
leverage work already undertaken by GBD on
measuring prevalence of intimate partner violence. As
part of GBD, we have also assembled a host of
population-level data that would facilitate measurement
of the coverage of health insurance or public health
systems (Indicator 3.8.2), health worker density and
distribution (Indicator 3.c.1), and completeness of
death registration (Indicator 17.19.2). Other indicators
are more dicult to measure because of data gaps or
unclear denitions. For example, data sources to
measure the proportion of people that feel safe walking
alone around the area they live (Indicator 16.1.4) are not
readily available for most countries.
Strengthening the indicators for selected targets

Various commentaries have pointed out the absence of
indicators for key health outcomes and determinants.
Proponents have argued for indicators for mental health
that go beyond substance abuse disorders and suicide;1416
other NCDs beyond cardiovascular diseases, cancer,
diabetes, and chronic respiratory diseases;70 diseases
related to ageing, including osteoarthritis and
Alzheimers disease;71,72 non-fatal disorders that lead to
substantial morbidity (eg, sensory disorders); and a host
of major risk factors. Another example is Target 3.3,
which aims to combat hepatitisthe indicator only
tracks hepatitis B, although the data for hepatitis C
monitoring are as robust as those for hepatitis B and a
highly eective cure for hepatitis C is available. As
shown in this report, our GBD collaboration provides
the basis for measuring many of these indicators. The
danger is that an exhaustive laundry list of indicators, a
criticism already levelled at the present SDG list, would
dilute the value of the SDGs in focusing attention on
where it is most needed.
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Comparison with other assessments

There are several important similarities and dierences
between our assessment of the health-related SDGs
and those produced by WHO18 and the Sustainable
Development Solutions Network (SDSN).17 Like WHO,
we focused on the health-related SDG indicators and did
not cover indicators across all goals as SDSN does. With
our focus on health, we covered 33 health-related
indicators, compared with 21 by SDSN and 32 by WHO.
Similar to SDSN, we produced a summary measure for
the health-related SDG indicators included in the
analysis. Most importantly, GBD uses standardised and
internally consistent approaches to generate estimates
across causes, risk factors, and underlying indicators. For
example, we constrain the aggregation of cause-specic
deaths to equal all-cause deaths. Furthermore, GBD also
produces a complete set of estimates for 188 countries
and for individual years from 1990 to 2015. By contrast,
WHO and SDSN draw on disparate sources and methods
for estimation and, as a result, report on an incomplete
set of estimates by country. SDSN provides estimates for
149 countries, whereas estimates for health-related SDG
indicators produced by WHO range from 194 countries
for under-5 mortality and neonatal mortality to
109 countries for HIV incidence. WHO and SDSN also
do not generate estimates for a consistent set of years.
WHO reports 2015 estimates for only seven indicators
and combines data from a range of years for
ten indicators; for example, WHO combined skilled birth
attendance estimates by country ranging from 2006 to
2014. SDSN reports 2015 estimates for only four
indicators and combines data from a range of years for
eight indicators; for example, country estimates for
smoking prevalence from the SDSN report range from
2006 to 2013. Complete, consistent, comparable, and
contemporary estimates of health-related SDG indicators
are necessary to properly track progress on the SDGs.
An alternative could be to weight each indicator by their

contribution to healthy life expectancy. Third, we opted to
construct the summary measure using the Human
Development Index method of rescaling each component
on a scale of 0 to 100, and then taking the geometric
mean of the components. We chose to use the minimum
and maximum observed values to rescale, as targets for
all indicators are not clearly specied; however, the
limitation of this approach is that minimum and
maximum values might change in the future. In the next
iteration of this analysis, we will use targets for all
indicators and rescale them accordingly; to establish
targets for indicators currently lacking explicit ones, we
will determine plausible targets based on forecasts of
trends through 2030. Fourth, a clear limitation, as
highlighted by the UHC tracer indicator, is the need for
broad investment in data systems in countries to properly
assess progress on key health and development indicators
such as the SDGs. As an example, there remains
considerable uncertainty about levels and age patterns of
mortality and the cause of death structure.34 Investments
in high-quality vital registration systems and other
related data collection systems, from censuses and
household surveys to health management information
systems, are crucial to the proper monitoring of progress
towards the SDGs.
Our GBD collaboration aims to address several of the
limitations noted above in future reporting of the
health-related SDGs on an annual cycle. As noted, we
will also leverage work that is underway to forecast
country-specic disease burden, which will additionally
provide information on the future trajectory of
health-related SDG indicators based on historical trends
and provide an explicit way to understand how those
trajectories could be changed with dierent policy
adoption. We will also address, in a staged manner, the
absence of measures of geographical and socioeconomic
inequality in the health-related SDG indicators.
Limitations
This study has several limitations in addition to the ones
we already described. First, all the limitations of GBD
relevant to the 33 indicators used here apply.34,3739 Second,
we tried to summarise the complexity of the 33 indicators
using a summary measure for the health-related SDGs.
Many approaches are available for developing summary
measures. Since the SDGs are the outcome of a political
consensus building process, we opted to use the stated
targets as preferences of UN member states that have
agreed to the SDG declaration. Our sensitivity analysis
shows that using alternative weighting schemes produces
broadly similar results (methods appendix pp 31213).
Our sensitivity analysis also highlights the limitation of
the statistical approach (ie, principal component analysis)
for constructing an index for this purpose, with the rst
principal component including both positive correlations
with indicators such as maternal mortality ratio and
negative correlations with indicators such as alcohol use.
Conclusions
The measurement of 33 health-related SDG indicators
presented here is the product of an extensive, open
collaboration that represents many countries across a
broad range of development. We invite others to join in
this eort to produce an independent, robust basis for
monitoring and assessing progress towards the SDGs.
Independent measurement is a crucial component of
accountability, but it is not the only component. These
results should ideally be used as the basis for review
and action at the country level. We hope that this
collaboration is a major contribution to creating a
culture of accountability for the SDGs. Other actors,
especially governments, civil society organisations,
donors, and global development institutions, need to
participate in the process of using this information to
enhance accountability through open and transparent
review and action.
27
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GBD 2015 SDG Collaborators

Stephen S Lim, Kate Allen, Zulqar A Bhutta, Lalit Dandona,
Mohammad H Forouzanfar, Nancy Fullman, Peter W Gething,
Ellen M Goldberg, Simon I Hay, Mollie Holmberg, Yohannes Kinfu,
Michael J Kutz, Heidi J Larson, Xiaofeng Liang, Alan D Lopez,
Rafael Lozano, Claire R McNellan, Ali H Mokdad, Meghan D Mooney,
Mohsen Naghavi, Helen E Olsen, David M Pigott, Joshua A Salomon,
Theo Vos, Haidong Wang, Amanuel Alemu Abajobir*,
Kalkidan Hassen Abate*, Cristiana Abbafati*, Kaja M Abbas*,
Foad Abd-Allah*, Abdishakur M Abdulle*, Biju Abraham*,
Ibrahim Abubakar*, Laith J Abu-Raddad*, Niveen M E Abu-Rmeileh*,
Gebre Yitayih Abyu*, Tom Achoki*, Akindele Olupelumi Adebiyi*,
Isaac Akinkunmi Adedeji*, Kossivi Agbelenko Afanvi*, Ashkan Afshin*,
Arnav Agarwal*, Anurag Agrawal*, Aliasghar Ahmad Kiadaliri*,
Hamid Ahmadieh*, Kedir Yimam Ahmed*, Ali Shafqat Akanda*,
Rufus Olusola Akinyemi*, Tomi F Akinyemiju*, Nadia Akseer*,
Ziyad Al-Aly*, Khurshid Alam*, Uzma Alam*, Deena Alasfoor*,
Fadia S AlBuhairan*, Saleh Fahed Aldhahri*, Robert William Aldridge*,
Zewdie Aderaw Alemu*, Raghib Ali*, Alaa Alkerwi*,
Mohammad AB Alkhateeb*, Franois Alla*, Peter Allebeck*,
Christine Allen*, Rajaa Al-Raddadi*, Khalid A Altirkawi*,
Elena Alvarez Martin*, Nelson Alvis-Guzman*, Azmeraw T Amare*,
Alemayehu Amberbir*, Adeladza Ko Amegah*, Heresh Amini*,
Walid Ammar*, Stephen Marc Amrock*, Hjalte H Andersen*,
Benjamin O Anderson*, Gregory M Anderson*,
Carl Abelardo T Antonio*, Palwasha Anwari*, Johan rnlv*,
Al Artaman*, Hamid Asayesh*, Rana Jawad Asghar*, Suleman Atique*,
Euripide Frinel G Arthur Avokpaho*, Ashish Awasthi*,
Beatriz Paulina Ayala Quintanilla*, Peter Azzopardi*, Umar Bacha*,
Alaa Badawi*, Kalpana Balakrishnan*, Amitava Banerjee*,
Aleksandra Barac*, Ryan Barber*, Suzanne L Barker-Collo*,
Till Brnighausen*, Lope H Barrero*, Tonatiuh Barrientos-Gutierrez*,
Sanjay Basu*, Tigist Assefa Bayou*, Shahrzad Bazargan-Hejazi*,
Justin Beardsley*, Neeraj Bedi*, Ettore Beghi*, Yannick Bjot*,
Michelle L Bell*, Aminu K Bello*, Derrick A Bennett*,
Isabela M Bensenor*, Habib Benzian*, Adugnaw Berhane*,
Eduardo Bernab*, Oscar Alberto Bernal*, Balem Demtsu Betsu*,
Addisu Shunu Beyene*, Neeraj Bhala*, Samir Bhatt*,
Sibhatu Biadgilign*, Kelly A Bienho*, Boris Bikbov*,
Agnes Binagwaho*, Donal Bisanzio*, Espen Bjertness*, Jed Blore*,
Rupert R A Bourne*, Michael Brainin*, Michael Brauer*,
Alexandra Brazinova*, Nicholas J K Breitborde*, David M Broday*,
Traolach S Brugha*, Rachelle Buchbinder*, Zahid A Butt*,
Leah E Cahill*, Ismael Ricardo Campos-Nonato*,
Julio Cesar Campuzano*, Hlne Carabin*, Rosario Crdenas*,
Juan Jesus Carrero*, Austin Carter*, Daniel Casey*, Valeria Caso*,
Carlos A Castaeda-Orjuela*, Jacqueline Castillo Rivas*,
Ferrn Catal-Lpez*, Fiorella Cavalleri*, Pedro Ceclio*,
Hsing-Yi Chang*, Jung-Chen Chang*, Fiona J Charlson*, Xuan Che*,
Alan Zian Chen*, Peggy Pei-Chia Chiang*, Mirriam Chibalabala*,
Vesper Hichilombwe Chisumpa*, Jee-Young Jasmine Choi*,
Rajiv Chowdhury*, Hanne Christensen*, Liliana G Ciobanu*,
Massimo Cirillo*, Matthew M Coates*, Megan Coggeshall*,
Aaron J Cohen*, Graham S Cooke*, Cyrus Cooper*,
Leslie Trumbull Cooper*, Benjamin C Cowie*, John A Crump*,
Solomon Abrha Damtew*, Rakhi Dandona*, Paul I Dargan*,
Jos das Neves*, Adrian C Davis*, Kairat Davletov*, E Filipa de Castro*,
Diego De Leo*, Louisa Degenhardt*, Liana C Del Gobbo*,
Kebede Deribe*, Sarah Derrett*, Don C Des Jarlais*,
Aniruddha Deshpande*, Gabrielle A deVeber*, Subhojit Dey*,
Samath D Dharmaratne*, Preet K Dhillon*, Eric L Ding*,
E Ray Dorsey*, Kerrie E Doyle*, Tim R Driscoll*, Leilei Duan*,
Manisha Dubey*, Bruce Bartholow Duncan*, Hedyeh Ebrahimi*,
Aman Yesuf Endries*, Sergey Petrovich Ermakov*, Holly E Erskine*,
Babak Eshrati*, Alireza Esteghamati*, Saman Fahimi*, Talha A Farid*,
Carla Soa e Sa Farinha*, Andr Faro*, Maryam S Farvid*,
Farshad Farzadfar*, Valery L Feigin*, Manuela Mendonca Felicio*,
Seyed-Mohammad Fereshtehnejad*, Jeerson G Fernandes*,
Joao C Fernandes*, Alize J Ferrari*, Florian Fischer*,
Joseph R A Fitchett*, Christina Fitzmaurice*, Nataliya Foigt*,
Kyle Foreman*, F Gerry R Fowkes*, Elisabeth Barboza Franca*,
28
Richard C Franklin*, Maya Fraser*, Joseph Friedman*, Joseph Frostad*,

Thomas Frst*, Belinda Gabbe*, Alberto L Garcia-Basteiro*,
Teshome Gebre*, Tsegaye Tewelde Gebrehiwot*,
Amanuel Tesfay Gebremedhin*, Alemseged Aregay Gebru*,
Bradford D Gessner*, Richard F Gillum*,
Ibrahim Abdelmageem Mohamed Ginawi*, Ababi Zergaw Giref*,
Maurice Giroud*, Melkamu Dedefo Gishu*, William Godwin*,
Philimon Gona*, Amador Goodridge*, Sameer Vali Gopalani*,
Carolyn C Gotay*, Atsushi Goto*, Hebe N Gouda*, Nicholas Graetz*,
Karen Fern Greenwell*, Max Griswold*, Yuming Guo*, Rahul Gupta*,
Rajeev Gupta*, Vipin Gupta*, Reyna A Gutirrez*, Bishal Gyawali*,
Juanita A Haagsma*, Annie Haakenstad*, Nima Hafezi-Nejad*,
Demewoz Haile*, Gessessew Bugssa Hailu*, Yara A Halasa*,
Randah Ribhi Hamadeh*, Samer Hamidi*, Mouhanad Hammami*,
Graeme J Hankey*, Hilda L Harb*, Josep Maria Haro*,
Mohammad Sadegh Hassanvand*, Rasmus Havmoeller*,
Ileana Beatriz Heredia-Pi*, Hans W Hoek*, Masako Horino*,
Nobuyuki Horita*, H Dean Hosgood*, Damian G Hoy*,
Aung Soe Htet*, Guoqing Hu*, Hsiang Huang*,
Kim Moesgaard Iburg*, Bulat T Idrisov*, Manami Inoue*,
Farhad Islami*, Troy A Jacobs*, Kathryn H Jacobsen*,
Nader Jahanmehr*, Mihajlo B Jakovljevic*, Peter James*,
Henrica A F M Jansen*, Mehdi Javanbakht*,
Achala Upendra Jayatilleke*, Sun Ha Jee*, Panniyammakal Jeemon*,
Vivekanand Jha*, Ying Jiang*, Tariku Jibat*, Ye Jin*, Jost B Jonas*,
Zubair Kabir*, Yogeshwar Kalkonde*, Ritul Kamal*, Haidong Kan*,
Amit Kandel*, Andr Karch*, Corine Kakizi Karema*,
Chante Karimkhani*, Palitha Karunapema*, Amir Kasaeian*,
Nicholas J Kassebaum*, Anil Kaul*, Norito Kawakami*,
Jeanne Franoise Kayibanda*, Peter Njenga Keiyoro*, Laura Kemmer*,
Andrew Haddon Kemp*, Andre Pascal Kengne*, Andre Keren*,
Chandrasekharan Nair Kesavachandran*, Yousef Saleh Khader*,
Abdur Rahman Khan*, Ejaz Ahmad Khan*, Gulfaraz Khan*,
Young-Ho Khang*, Tawk Ahmed Muthafer Khoja*,
Ardeshir Khosravi*, Jagdish Khubchandani*, Christian Kieling*,
Cho-il Kim*, Daniel Kim*, Sungroul Kim*, Yun Jin Kim*,
Ruth W Kimokoti*, Niranjan Kissoon*, Miia Kivipelto*,
Luke D Knibbs*, Yoshihiro Kokubo*, Dhaval Kolte*, Soewarta Kosen*,
Georgios A Kotsakis*, Parvaiz A Koul*, Ai Koyanagi*,
Michael Kravchenko*, Hans Krueger*, Barthelemy Kuate Defo*,
Ricardo S Kuchenbecker*, Ernst J Kuipers*, Xie Rachel Kuliko*,
Veena S Kulkarni*, G Anil Kumar*, Gene F Kwan*, Hmwe H Kyu*,
Aparna Lal*, Dharmesh Kumar Lal*, Ratilal Lalloo*, Hilton Lam*,
Qing Lan*, Sinead M Langan*, Anders Larsson*, Dennis Odai Laryea*,
Asma Abdul Latif*, Janet L Leasher*, James Leigh*, Mall Leinsalu*,
Janni Leung*, Ricky Leung*, Miriam Levi*, Yichong Li*, Yongmei Li*,
Margaret Lind*, Shai Linn*, Steven E Lipshultz*, Patrick Y Liu*,
Shiwei Liu*, Yang Liu*, Belinda K Lloyd*, Loon-Tzian Lo*,
Giancarlo Logroscino*, Paulo A Lotufo*, Robyn M Lucas*,
Raimundas Lunevicius*, Mohammed Magdy Abd El Razek*,
Carlos Magis-Rodriguez*, Mahdi Mahdavi*, Marek Majdan*,
Azeem Majeed*, Reza Malekzadeh*, Deborah Carvalho Malta*,
Chabila C Mapoma*, David Joel Margolis*, Randall V Martin*,
Jose Martinez-Raga*, Felix Masiye*, Amanda J Mason-Jones*,
Joo Massano*, Richard Matzopoulos*, Bongani M Mayosi*,
John J McGrath*, Martin McKee*, Peter A Meaney*, Alem Mehari*,
Alemayehu B Mekonnen*, Yohannes Adama Melaku*, Peter Memiah*,
Ziad A Memish*, Walter Mendoza*, Gert B M Mensink*,
Atte Meretoja*, Tuomo J Meretoja*, Yonatan Moges Mesn*,
Francis Apolinary Mhimbira*, Renata Micha*, Ted R Miller*,
Edward J Mills*, Mojde Miraren*, Awoke Misganaw*,
Philip B Mitchell*, Charles N Mock*, Alireza Mohammadi*,
Shau Mohammed*, Lorenzo Monasta*, Jonathan de la Cruz Monis*,
Julio Cesar Montaez Hernandez*, Marcella Montico*,
Maziar Moradi-Lakeh*, Lidia Morawska*, Rintaro Mori*,
Ulrich O Mueller*, Michele E Murdoch*, Brighton Murimira*,
Joseph Murray*, Gudlavalleti Venkata Satyanarayana Murthy*,
Srinivas Murthy*, Kamarul Imran Musa*, Jean B Nachega*,
Gabriele Nagel*, Kovin S Naidoo*, Luigi Naldi*, Vinay Nangia*,
Bruce Neal*, Chakib Nejjari*, Charles R Newton*, John N Newton*,
Frida Namnyak Ngalesoni*, Peter Nguhiu*, Grant Nguyen*,
Articles
Quyen Le Nguyen*, Muhammad Imran Nisar*,

Patrick Martial Nkamedjie Pete*, Sandra Nolte*, Marika Nomura*,
Ole F Norheim*, Bo Norrving*, Carla Makhlouf Obermeyer*,
Felix Akpojene Ogbo*, In-Hwan Oh*, Olanrewaju Oladimeji*,
Pedro R Olivares*, Bolajoko Olubukunola Olusanya*,
Jacob Olusegun Olusanya*, John Nelson Opio*, Eyal Oren*,
Alberto Ortiz*, Richard H Osborne*, Erika Ota*, Mayowa O Owolabi*,
Mahesh PA*, Eun-Kee Park*, Hye-Youn Park*, Charles D Parry*,
Mahboubeh Parsaeian*, Tejas Patel*, Vikram Patel*,
Angel J Paternina Caicedo*, Snehal T Patil*, Scott B Patten*,
George C Patton*, Deepak Paudel*, Joo Mrio Pedro*,
David M Pereira*, Norberto Perico*, Konrad Pesudovs*, Max Petzold*,
Michael Robert Phillips*, Frdric B Piel*, Julian David Pillay*,
Christine Pinho*, Farhad Pishgar*, Suzanne Polinder*,
Richie G Poulton*, Farshad Pourmalek*, Mostafa Qorbani*,
Rynaz H S Rabiee*, Amir Radfar*, Vafa Rahimi-Movaghar*,
Mahfuzar Rahman*, Mohammad Hifz Ur Rahman*,
Sajjad Ur Rahman*, Rajesh Kumar Rai*, Sasa Rajsic*,
Murugesan Raju*, Usha Ram*, Saleem M Rana*, Chhabi Lal Ranabhat*,
Kavitha Ranganathan*, Puja C Rao*, Amany H Refaat*,
Marissa B Reitsma*, Giuseppe Remuzzi*, Serge Resniko*,
Antonio L Ribeiro*, Maria Jesus Rios Blancas*, Hirbo Shore Roba*,
Bayard Roberts*, Alina Rodriguez*, David Rojas-Rueda*, Luca Ronfani*,
Gholamreza Roshandel*, Gregory A Roth*, Dietrich Rothenbacher*,
Ambuj Roy*, Nobhojit Roy*, Ben Benasco Sackey*, Rajesh Sagar*,
Muhammad Muhammad Saleh*, Juan R Sanabria*,
Damian F Santomauro*, Itamar S Santos*, Rodrigo Sarmiento-Suarez*,
Benn Sartorius*, Maheswar Satpathy*, Miloje Savic*, Monika Sawhney*,
Susan M Sawyer*, Josef Schmidhuber*, Maria Ins Schmidt*,
Ione J C Schneider*, Aletta E Schutte*, David C Schwebel*,
Soraya Seedat*, Sadaf G Sepanlou*, Edson E Servan-Mori*,
Katya Shackelford*, Amira Shaheen*, Masood Ali Shaikh*,
Teresa Shamah Levy*, Rajesh Sharma*, Jun She*, Sara Sheikhbahaei*,
Jiabin Shen*, Kevin N Sheth*, Muki Shey*, Peilin Shi*, Kenji Shibuya*,
Mika Shigematsu*, Min-Jeong Shin*, Rahman Shiri*,
Kawkab Shishani*, Ivy Shiue*, Inga Dora Sigfusdottir*, Naris Silpakit*,
Diego Augusto Santos Silva*, Jonathan I Silverberg*, Edgar P Simard*,
Shireen Sindi*, Abhishek Singh*, Gitanjali M Singh*,
Jasvinder A Singh*, Om Prakash Singh*, Prashant Kumar Singh*,
Vegard Skirbekk*, Amber Sligar*, Samir Soneji*, Kjetil Sreide*,
Reed J D Sorensen*, Joan B Soriano*, Sergey Soshnikov*,
Luciano A Sposato*, Chandrashekhar T Sreeramareddy*,
Hans-Christian Stahl*, Jerey D Stanaway*, Vasiliki Stathopoulou*,
Nadine Steckling*, Nicholas Steel*, Dan J Stein*, Caitlyn Steiner*,
Heidi Stckl*, Saverio Stranges*, Mark Strong*, Jiandong Sun*,
Bruno F Sunguya*, Patrick Sur*, Soumya Swaminathan*,
Bryan L Sykes*, Cassandra E I Szoeke*, Rafael Tabars-Seisdedos*,
Karen M Tabb*, Roberto Tchio Talongwa*,
Mohammed Rasoul Tarawneh*, Mohammad Tavakkoli*, Bineyam Taye*,
Hugh R Taylor*, Bemnet Amare Tedla*, Worku Tefera*,
Teketo Kassaw Tegegne*, Dejen Yemane Tekle*, Girma Temam Shifa*,
Abdullah Sulieman Terkawi*, Gizachew Assefa Tessema*, J S Thakur*,
Alan J Thomson*, Andrew L Thorne-Lyman*, Amanda G Thrift*,
George D Thurston*, Taavi Tillmann*, Ruoyan Tobe-Gai*,
Marcello Tonelli*, Roman Topor-Madry*, Fotis Topouzis*,
Bach Xuan Tran*, Zacharie Tsala Dimbuene*, Abera Kenay Tura*,
Emin Murat Tuzcu*, Stefanos Tyrovolas*, Kingsley Nnanna Ukwaja*,
Eduardo A Undurraga*, Chigozie Jesse Uneke*, Olalekan A Uthman*,
Aaron van Donkelaar*, Yuri Y Varakin*, Tommi Vasankari*,
Ana Maria Nogales Vasconcelos*, J Lennert Veerman*,
Narayanaswamy Venketasubramanian*, Raj Kumar Verma*,
Francesco S Violante*, Vasiliy Victorovich Vlassov*, Patricia Volkow*,
Stein Emil Vollset*, Gregory R Wagner*, Mitchell T Wallin*,
Linhong Wang*, Valentine Wanga*, David A Watkins*,
Scott Weichenthal*, Elisabete Weiderpass*, Robert G Weintraub*,
Daniel J Weiss*, Andrea Werdecker*, Ronny Westerman*,
Harvey A Whiteford*, James D Wilkinson*, Charles Shey Wiysonge*,
Charles D A Wolfe*, Ingrid Wolfe*, Sungho Won*, Anthony D Woolf*,
Shimelash Bitew Workie*, Mamo Wubshet*, Gelin Xu*,
Ajit Kumar Yadav*, Bereket Yakob*, Ayalnesh Zemene Yalew*,
Lijing L Yan*, Yuichiro Yano*, Mehdi Yaseri*, Pengpeng Ye*, Paul Yip*,
Naohiro Yonemoto*, Seok-Jun Yoon*, Mustafa Z Younis*,

Chuanhua Yu*, Zoubida Zaidi*, Maysaa El Sayed Zaki*,
Carlos Zambrana-Torrelio*, Tomas Zapata*, Elias Asfaw Zegeye*,
Yi Zhao*, Maigeng Zhou*, Sanjay Zodpey*, David Zonies*,
Christopher J L Murray.
*Authors listed alphabetically. Corresponding author.
Aliations
Institute for Health Metrics and Evaluation (Prof S S Lim PhD,
K Allen BA, Prof L Dandona MD, M H Forouzanfar MD,
N Fullman MPH, E M Goldberg BSc, Prof S I Hay DSc,
M Holmberg BS, M J Kutz BS, H J Larson PhD, Prof A D Lopez PhD,
C R McNellan BA, Prof A H Mokdad PhD, M D Mooney BS,
Prof M Naghavi PhD, H E Olsen MA, D M Pigott DPhil,
Prof T Vos PhD, H Wang PhD, T Achoki MD, A Afshin MD, C Allen BA,
G M Anderson MSEE, R Barber BS, K A Bienho MA, J Blore PhD,
Prof M Brauer ScD, A Carter BS, D Casey BA, F J Charlson PhD,
A Z Chen BS, M M Coates MPH, M Coggeshall BA, A J Cohen DSc,
A Deshpande MPH, H E Erskine PhD, A J Ferrari PhD,
C Fitzmaurice MD, K Foreman PhD, M Fraser BA, J Friedman BA,
J Frostad MPH, W Godwin BS, N Graetz MPH, M Griswold MS,
J A Haagsma PhD, A Haakenstad MA, N J Kassebaum MD,
L Kemmer PhD, X R Kuliko BA, H H Kyu PhD, J Leung PhD,
M Lind BS, P Y Liu BA, F Masiye PhD, M Miraren MPH,
A Misganaw PhD, M Moradi-Lakeh MD, G Nguyen MPH, C Pinho BA,
P C Rao MPH, M B Reitsma BS, G A Roth MD, D F Santomauro PhD,
K Shackelford BA, N Silpakit BS, A Sligar MPH, R J D Sorensen MPH,
J D Stanaway PhD, C Steiner MPH, P Sur BA, Prof S E Vollset DrPH,
V Wanga MS, Prof H A Whiteford PhD, Y Zhao MS, Prof M Zhou PhD,
Prof C J L Murray DPhil), School of Dentistry (G A Kotsakis DDS),
Harborview Injury Prevention and Research Center (C N Mock PhD),
University of Washington, Seattle, WA, USA (Prof B O Anderson MD,
D A Watkins MD); Centre of Excellence in Women and Child Health
(Z A Bhutta PhD), Aga Khan University, Karachi, Pakistan
(M I Nisar MSc); Centre for Global Child Health, The Hospital for Sick
Children, Toronto, ON, Canada (Z A Bhutta PhD, N Akseer MSc,
G A deVeber MD); Centre for Control of Chronic Conditions
(P Jeemon PhD), Public Health Foundation of India, New Delhi, India
(Prof L Dandona MD, R Dandona PhD, G A Kumar PhD); Department
of Zoology (P W Gething PhD), Nueld Department of Medicine
(D Bisanzio PhD), NIHR Musculoskeletal Biomedical Research Centre
(Prof C Cooper FMedSci), University of Oxford, Oxford, UK
(R Ali FRCP, D A Bennett PhD, Prof V Jha DM, D J Weiss PhD); Centre
for Research & Action in Public Health, Faculty of Health, University of
Canberra, Canberra, ACT, Australia (Y Kinfu PhD); Department of
Infectious Disease Epidemiology (H J Larson PhD), Centre for Global
Mental Health (Prof V Patel PhD), London School of Hygiene and
Tropical Medicine, London, UK (S M Langan PhD, Prof M McKee DSc,
Prof G V S Murthy MD, B Roberts PhD, H Stckl DPhil); National
Center for Chronic and Noncommunicable Disease Control and
Prevention (L Duan MD, Y Jin MS, Y Li MPH, S Liu PhD,
Prof L Wang MD, P Ye MPH, Prof M Zhou PhD), Chinese Center for
Disease Control and Prevention, Beijing, China (Prof X Liang MD);
Melbourne School of Population and Global Health
(Prof A D Lopez PhD), Department of Paediatrics (P Azzopardi MEpi),
The Peter Doherty Institute for Infection and Immunity
(Prof B C Cowie PhD), Department of Medicine (A Meretoja PhD),
Murdoch Childrens Research Institute (Prof G C Patton MD,
K Alam PhD, P Azzopardi MEpi, R G Weintraub MBBS), Department of
Pediatrics (Prof S M Sawyer MD), Institute of Health and Ageing
(Prof C E I Szoeke PhD), The University of Melbourne, Melbourne, VIC,
Australia (K Alam PhD, Prof H R Taylor AC, R G Weintraub MBBS);
National Institute of Public Health, Cuernavaca, Mexico (R Lozano MD,
T Barrientos-Gutierrez PhD, I R Campos-Nonato PhD,
J C Campuzano PhD, I B Heredia-Pi PhD,
J C Montaez Hernandez MSc, M J Rios Blancas MPH,
Prof E E Servan-Mori MSc, T Shamah Levy PhD); Department of Global
Health and Population, Harvard T H Chan School of Public Health
(Prof J A Salomon PhD), Department of Global Health and Social
Medicine, Harvard Medical School (Prof A Binagwaho PhD),
Department of Epidemiology (P James ScD) Harvard T H Chan School
of Public Health (Prof T Brnighausen MD, L E Cahill PhD,
29
Articles
I R Campos-Nonato PhD, E L Ding ScD, M S Farvid PhD,

A Haakenstad MA, G R Wagner MD), Department of Nutrition, Harvard
T H Chan School of Public Health (A L Thorne-Lyman ScD), Channing
Division of Network Medicine, Brigham & Womens Hospital, Harvard
Medical School (P James ScD), Harvard University, Boston, MA, USA
(J R A Fitchett MD); School of Public Health (A A Abajobir MPH,
F J Charlson PhD, H E Erskine PhD, A J Ferrari PhD, L D Knibbs PhD,
J Leung PhD, D F Santomauro PhD, J L Veerman PhD,
Prof H A Whiteford PhD), School of Dentistry (Prof R Lalloo PhD),
University of Queensland, Brisbane, QLD, Australia (H N Gouda PhD,
Y Guo PhD, Prof J J McGrath MD); Jimma University, Jimma, Ethiopia
(K H Abate MS, T T Gebrehiwot MPH, A T Gebremedhin MPH);
La Sapienza, University of Rome, Rome, Italy (C Abbafati PhD); Virginia
Tech, Blacksburg, VA, USA (Prof K M Abbas PhD); Department of
Neurology, Cairo University, Cairo, Egypt (Prof F Abd-Allah MD);
New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
(A M Abdulle PhD); NMSM Government College Kalpetta, Kerala, India
(Prof B Abraham MPhil); Institute for Global Health
(Prof I Abubakar PhD, R W Aldridge PhD), Centre for Public Health
Data Science, Institute of Health Informatics (R W Aldridge PhD), Farr
Institute of Health Informatics Research (R W Aldridge PhD,
A Banerjee DPhil), Department of Epidemiology and Public Health
(H Benzian PhD, T Tillmann MSc), University College London, London,
UK; Infectious Disease Epidemiology Group, Weill Cornell Medical
College in Qatar, Doha, Qatar (L J Abu-Raddad PhD); Institute of
Community and Public Health, Birzeit University, Ramallah, Palestine
(N M Abu-Rmeileh PhD); School of Public Health (Y A Melaku MPH),
Mekelle University, Mekelle, Ethiopia (Prof G Y Abyu MS, T A Bayou BS,
B D Betsu MS, A A Gebru MPH, G B Hailu MSc, D Y Tekle MS,
A Z Yalew MS); College of Medicine (A O Adebiyi MD), Department of
Medicine (M O Owolabi Dr Med), University of Ibadan, Ibadan, Nigeria
(R O Akinyemi PhD); University College Hospital, Ibadan, Nigeria
(A O Adebiyi MD); Olabisi Onabanjo University, Ago-Iwoye, Nigeria
(I A Adedeji MS); Direction du District Sanitaire de Haho, Notse, Togo
(K A Afanvi MD); Faculte des Sciences de Sante, Universite de Lome,
Lome, Togo (K A Afanvi MD); Friedman School of Nutrition Science and
Policy (A Afshin MD, R Micha PhD), Tufts University, Boston, MA, USA
(P Shi PhD, G M Singh PhD); Dalla Lana School of Public Health
(N Akseer MSc), Department of Nutritional Sciences, Faculty of
Medicine (A Badawi PhD), University of Toronto, Toronto, ON, Canada
(A Agarwal BHSc); McMaster University, Hamilton, ON, Canada
(A Agarwal BHSc); CSIR Institute of Genomics and Integrative Biology,
Delhi, India (A Agrawal PhD); Department of Internal Medicine, Baylor
College of Medicine, Houston, TX, USA (A Agrawal PhD); Department
of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit
(A Ahmad Kiadaliri PhD), Skane University Hospital, Department of
Clinical Sciences Lund (Prof B Norrving PhD), Lund University, Lund,
Sweden; Health Services Management Research Center, Institute for
Futures Studies in Health, Kerman University of Medical Sciences,
Kerman, Iran (A Ahmad Kiadaliri PhD); Ophthalmic Research Center
(H Ahmadieh MD, M Yaseri PhD), School of Public Health
(N Jahanmehr PhD), Shahid Beheshti University of Medical Sciences,
Tehran, Iran; Department of Ophthalmology, Labbanejad Medical
Center, Tehran, Iran (H Ahmadieh MD); Debre Markos University,
Debre Markos, Ethiopia (K Y Ahmed MPH, Z A Alemu MPH,
T K Tegegne MPH); University of Rhode Island, Kingston, RI, USA
(A S Akanda PhD); Newcastle University, Newcastle upon Tyne, UK
(R O Akinyemi PhD); Department of Epidemiology
(T F Akinyemiju PhD), University of Alabama at Birmingham,
Birmingham, AL, USA (D C Schwebel PhD, J A Singh MD); Washington
University in Saint Louis, St Louis, MO, USA (Z Al-Aly MD); Sydney
School of Public Health (Prof T R Driscoll PhD), The University of
Sydney, Sydney, NSW, Australia (K Alam PhD,
J Leigh PhD, A B Mekonnen MS, Prof B Neal PhD); International Center
for Humanitarian Aairs, Nairobi, Kenya (U Alam PhD); Ministry of
Health, Al Khuwair, Oman (D Alasfoor MSc); King Abdullah Specialized
Childrens Hospital, King Saud bin Abdulaziz University for Health
Sciences, Riyadh, Saudi Arabia (F S AlBuhairan MD); King Abdullah
International Medical Research Center, Riyadh, Saudi Arabia
(F S AlBuhairan MD); King Khalid University Hospital
(M A Alkhateeb BA), King Saud University, Riyadh, Saudi Arabia
30
(S F Aldhahri MD, K A Altirkawi MD); Department of Anesthesiology

(A S Terkawi MD), King Fahad Medical City, Riyadh, Saudi Arabia
(S F Aldhahri MD); Luxembourg Institute of Health (LIH), Strassen,
Luxembourg (A Alkerwi PhD); School of Public Health, University of
Lorraine, Nancy, France (Prof F Alla PhD); Department of Public Health
Sciences (P Allebeck PhD, R H S Rabiee MPH, N Roy MD), Aging
Research Center (Prof M Kivipelto PhD), Department of Clinical
Science, Intervention and Technology (Prof J J Carrero PhD),
Department of Neurobiology, Care Sciences and Society (NVS)
(S M Fereshtehnejad PhD), Department of Medical Epidemiology and
Biostatistics (E Weiderpass PhD), Karolinska Institutet, Stockholm,
Sweden (R Havmoeller PhD, S Sindi PhD); Ministry of Health, Jeddah,
Saudi Arabia (R Al-Raddadi PhD); Government, Madrid, Spain
(E Alvarez Martin PhD); Universidad de Cartagena, Cartagena, Colombia
(Prof N Alvis-Guzman PhD, A J Paternina Caicedo MD); School of
Medicine (A T Amare MPH, Y A Melaku MPH), University of Adelaide,
Adelaide, SA, Australia (L G Ciobanu MS, G A Tessema MPH); College
of Medicine and Health Sciences, Bahir Dar University, Bahir Dar,
Ethiopia (A T Amare MPH); Dignitas International, Zomba, Malawi
(A Amberbir PhD); University of Cape Coast, Cape Coast, Ghana
(A K Amegah PhD); Environmental Health Research Center, Kurdistan
University of Medical Sciences, Sanandaj, Iran (H Amini MSPH);
Department of Epidemiology and Public Health (H Amini MSPH,
T Frst PhD), Swiss Tropical and Public Health Institute, Basel,
Switzerland (C K Karema MSc); Ministry of Public Health, Beirut,
Lebanon (W Ammar PhD, H L Harb MPH); Oregon Health & Science
University, Portland, OR, USA (S M Amrock MD); Center for SensoryMotor Interaction, Department of Health Science and Technology,
Faculty of Medicine, Aalborg University, Aalborg, Denmark
(H H Andersen MSc); Department of Health Policy and Administration,
College of Public Health, University of the Philippines Manila, Manila,
Philippines (C A T Antonio MD); Self-employed, Kabul, Afghanistan
(P Anwari MD); Department of Medical Sciences, Uppsala University,
Uppsala, Sweden (Prof J rnlv PhD, Prof A Larsson PhD); Dalarna
University, Falun, Sweden (Prof J rnlv PhD); University of Manitoba,
Winnipeg, MB, Canada (A Artaman PhD); Department of Medical
Emergency, School of Paramedic, Qom University of Medical Sciences,
Qom, Iran (H Asayesh PhD); South Asian Public Health Forum,
Islamabad, Pakistan (R J Asghar MD); Graduate Institute of Biomedical
Informatics, Taipei Medical University, Taipei, Taiwan (S Atique MS);
Institut de Recherche Clinique du Bnin, Cotonou, Benin Republic
(E F G A Avokpaho MPH); Laboratoire dEtudes et de Recherche-Action
en Sant (LERAS Afrique), Parakou, Benin Republic
(E F G A Avokpaho MPH); Sanjay Gandhi Postgraduate Institute of
Medical Sciences, Lucknow, India (A Awasthi MSc); The Judith Lumley
Centre for Mother, Infant and Family Health Research, La Trobe
University, Melbourne, VIC, Australia (B P Ayala Quintanilla PhD);
Peruvian National Institute of Health, Lima, Peru
(B P Ayala Quintanilla PhD); Wardliparingga Aboriginal Research Unit,
South Australian Health and Medical Research Institute, Adelaide, SA,
Australia (P Azzopardi MEpi); Centre for International Health, Burnet
Institute, Melbourne, VIC, Australia (P Azzopardi MEpi); School of
Health Sciences, University of Management and Technology, Lahore,
Pakistan (U Bacha PhD); Public Health Agency of Canada, Toronto, ON,
Canada (A Badawi PhD); Department of Environmental Health
Engineering, Sri Ramachandra University, Chennai, India
(K Balakrishnan PhD); Faculty of Medicine, University of Belgrade,
Belgrade, Serbia (A Barac PhD); School of Psychology, University of
Auckland, Auckland, New Zealand (S L Barker-Collo PhD); Africa Health
Research Institute, Mtubatuba, South Africa (Prof T Brnighausen MD);
Institute of Public Health, Heidelberg University, Heidelberg, Germany
(Prof T Brnighausen MD, S Mohammed PhD); Department of
Industrial Engineering, School of Engineering, Ponticia Universidad
Javeriana, Bogot, Colombia (L H Barrero ScD); Stanford University,
Stanford, CA, USA (S Basu PhD, L C Del Gobbo PhD); College of
Medicine, Charles R Drew University of Medicine and Science,
Los Angeles, CA, USA (Prof S Bazargan-Hejazi PhD); David Geen
School of Medicine, University of California, Los Angeles, Los Angeles,
CA, USA (Prof S Bazargan-Hejazi PhD); Kermanshah University of
Medical Science, Kermanshah, Iran (Prof S Bazargan-Hejazi PhD);
Oxford University, Ho Chi Minh City, Vietnam (J Beardsley MBChB);
Articles
College of Public Health and Tropical Medicine, Jazan, Saudi Arabia

(N Bedi MD); IRCCS - Istituto di Ricerche Farmacologiche Mario Negri,
Milan, Italy (E Beghi MD); University Hospital and Medical School of
Dijon, University of Burgundy, Dijon, France (Prof Y Bjot PhD); School
of Medicine (K N Sheth MD), Yale University, New Haven, CT, USA
(Prof M L Bell PhD); University of Alberta, Edmonton, AB, Canada
(A K Bello PhD); Internal Medicine Department (Prof I S Santos PhD),
University of So Paulo, So Paulo, Brazil (I M Bensenor PhD,
Prof P A Lotufo DrPH); Department of Epidemiology and Health
Promotion, College of Dentistry (H Benzian PhD), New York University,
New York, NY, USA; Debre Berhane University, Debre Berhan, Ethiopia
(A Berhane PhD); Division of Health and Social Care Research
(Prof C D Wolfe MD), Kings College London, London, UK
(E Bernab PhD, I Wolfe PhD); University Andes, Bogot, Colombia
(O A Bernal PhD); College of Health and Medical Sciences
(H S Roba MPH), Haramaya University, Harar, Ethiopia
(A S Beyene MPH, Y M Mesn MPH); Queen Elizabeth Hospital
Birmingham, Birmingham, UK (N Bhala DPhil); University of Otago
Medical School, Wellington, New Zealand (N Bhala DPhil); Imperial
College, London, UK (S Bhatt DPhil); Independent Public Health
Consultants, Addis Ababa, Ethiopia (S Biadgilign MPH); Department of
Nephrology Issues of Transplanted Kidney, Academician V I Shumakov
Federal Research Center of Transplantology and Articial Organs,
Moscow, Russia (B Bikbov MD); Department of Pediatrics & The
Dartmouth Institute for Health Policy and Clinical Practice, Geisel
School of Medicine (Prof A Binagwaho PhD), Dartmouth College,
Hanover, NH, USA (S Soneji PhD); The University of Global Health
Equity, Kigali, Rwanda (Prof A Binagwaho PhD); Department of
Community Medicine (Prof E Bjertness PhD), University of Oslo, Oslo,
Norway (A S Htet MPhil); Vision & Eye Research Unit, Anglia Ruskin
University, Cambridge, UK (Prof R R A Bourne FRCOphth);
Danube-University Krems, Krems, Austria (Prof M Brainin PhD);
School of Population and Public Health (H Krueger PhD), University of
British Columbia, Vancouver, BC, Canada (Prof M Brauer ScD,
C C Gotay PhD, Prof N Kissoon MD, S Murthy MD, F Pourmalek PhD);
Faculty of Health Sciences and Social Work, Department of Public
Health, Trnava University, Trnava, Slovakia (A Brazinova PhD,
M Majdan PhD); International Neurotrauma Research Organization,
Vienna, Austria (A Brazinova PhD); College of Medicine (J Shen PhD),
The Ohio State University, Columbus, OH, USA
(Prof N J K Breitborde PhD); Technion, Haifa, Israel (Prof D M Broday DSc);
University of Leicester, Leicester, UK (Prof T S Brugha MD); Monash
Department of Clinical Epidemiology, Cabrini Institute, Melbourne, VIC,
Australia (Prof R Buchbinder PhD); Department of Epidemiology and
Preventive Medicine (Prof R Buchbinder PhD), School of Public Health
and Preventive Medicine (Prof B Gabbe PhD), Department of Medicine,
School of Clinical Sciences at Monash Health (Prof A G Thrift PhD),
Monash University, Melbourne, VIC, Australia; Al Shifa Trust Eye
Hospital, Rawalpindi, Pakistan (Z A Butt PhD); Department of Physics
and Atmospheric Science (A van Donkelaar PhD), Dalhousie University,
Halifax, NS, Canada (L E Cahill PhD, Prof R V Martin PhD); Department
of Biostatistics and Epidemiology, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, USA (H Carabin PhD);
Metropolitan Autonomous University, Mexico City, Mexico
(R Crdenas ScD); Stroke Unit, University of Perugia, Perugia, Italy
(V Caso MD); Colombian National Health Observatory, Instituto
Nacional de Salud, Bogot, Colombia (C A Castaeda-Orjuela MSc);
Epidemiology and Public Health Evaluation Group, Public Health
Department, Universidad Nacional de Colombia, Bogot, Colombia
(C A Castaeda-Orjuela MSc); Caja Costarricense de Seguro Social,
San Jose, Costa Rica (Prof J Castillo Rivas MPH); Universidad de Costa
Rica, San Pedro, Montes de Oca, Costa Rica (Prof J Castillo Rivas MPH);
Department of Medicine, University of Valencia/INCLIVA Health
Research Institute and CIBERSAM, Valencia, Spain
(F Catal-Lpez PhD); Clinical Epidemiology Program, Ottawa Hospital
Research Institute, Ottawa, ON, Canada (F Catal-Lpez PhD); Faculty of
Medicine, University of the Republic, Montevideo, Uruguay
(F Cavalleri BS); i3S - Instituto de Investigao e Inovao em Sade
(P Ceclio MS, J das Neves PhD); Pharmacy Faculty (P Ceclio MS),
INEB - Instituto de Engenharia Biomdica (J das Neves PhD), Faculty of
Medicine (J Massano MD), EPIUnit - Institute of Public Health
(J M Pedro MS), University of Porto, Porto, Portugal; National Health

Research Institutes, Zhunan Town, Taiwan (Prof H Chang DrPH);
National Yang-Ming University, Taipei, Taiwan (Prof H Chang DrPH);
School of Nursing, College of Medicine, National Taiwan University,
Taipei, Taiwan (Prof J Chang PhD); Queensland Centre for Mental
Health Research, Brisbane, QLD, Australia (F J Charlson PhD,
H E Erskine PhD, A J Ferrari PhD, J Leung PhD, D F Santomauro PhD,
Prof H A Whiteford PhD); African Centre for Statistics, United Nations
Economic Commission for Africa, Addis Ababa, Ethiopia (X Che PhD);
Clinical Governance Unit, Gold Coast Health, Southport, QLD, Australia
(P P Chiang PhD); Crowd Watch Africa, Lusaka, Zambia
(M Chibalabala BS); University of Zambia, Lusaka, Zambia
(V H Chisumpa MPhil, C C Mapoma PhD, F Masiye PhD); University of
Witwatersrand, Johannesburg, South Africa (V H Chisumpa MPhil);
Seoul National University Medical Library, Seoul, South Korea
(J J Choi PhD); Department of Public Health and Primary Care,
University of Cambridge, Cambridge, UK (R Chowdhury PhD);
Bispebjerg University Hospital, Copenhagen, Denmark
(Prof H Christensen DMSCi); University of Salerno, Baronissi, Italy
(Prof M Cirillo MD); Health Eects Institute, Boston, MA, USA
(A J Cohen DSc); Department of Infectious Disease Epidemiology
(T Frst PhD), Department of Epidemiology and Biostatistics
(F B Piel PhD), Department of Epidemiology and Biostatistics, School of
Public Health (Prof A Rodriguez PhD), Imperial College London,
London, UK (G S Cooke DPhil, Prof A Majeed MD, Prof B Neal PhD);
MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, UK (Prof C Cooper FMedSci); NIHR Biomedical
Research Centre, University of Southampton and University Hospital
Southampton NHS Foundation Trust, Southampton, UK
(Prof C Cooper FMedSci); Mayo Clinic, Jacksonville, FL, USA
(L T Cooper MD); WHO Collaborating Centre for Viral Hepatitis,
Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC,
Australia (Prof B C Cowie PhD); Centre for International Health,
Dunedin School of Medicine (Prof J A Crump MD), Injury Prevention
Research Unit, Department of Preventive and Social Medicine, Dunedin
School of Medicine (Prof S Derrett PhD), University of Otago, Dunedin,
New Zealand (Prof R G Poulton PhD); Wolaita Sodo University, Wolaita
Sodo, Ethiopia (S A Damtew MPH, S B Workie MPH); School of Public
Health (K Deribe MPH), College of Health Sciences, School of Public
Health (W Tefera MPH), Addis Ababa University, Addis Ababa, Ethiopia
(S A Damtew MPH, A Z Giref PhD, D Haile MPH,
G Temam Shifa MPH); Guys and St Thomas NHS Foundation Trust,
London, UK (Prof P I Dargan FRCP); Public Health England, London,
UK (Prof A C Davis PhD, Prof J N Newton FRCP, Prof N Steel PhD);
School of Public Health, Kazakh National Medical University, Almaty,
Kazakhstan (K Davletov PhD); National Institute of Public Health,
Mexico City, Mexico (E F de Castro PhD); Grith University, Brisbane,
QLD, Australia (Prof D De Leo DSc); National Drug and Alcohol
Research Centre (Prof L Degenhardt PhD), Brien Holden Vision
Institute (Prof S Resniko MD), School of Optometry and Vision
Science (Prof S Resniko MD), University of New South Wales, Sydney,
NSW, Australia (Prof P B Mitchell MD); Brighton and Sussex Medical
School, Brighton, UK (K Deribe MPH); Mount Sinai Beth Israel, New
York, NY, USA (Prof D C Des Jarlais PhD); Icahn School of Medicine at
Mount Sinai, New York, NY, USA (Prof D C Des Jarlais PhD); Indian
Institute of Public Health-Delhi (S Dey PhD, Prof G V S Murthy MD),
Centre for Control of Chronic Conditions (P Jeemon PhD), Centre for
Chronic Conditions and Injuries (Prof V Patel PhD), Public Health
Foundation of India, Gurgaon, India (P K Dhillon PhD, D K Lal MD,
Prof S Zodpey PhD); Department of Community Medicine, Faculty of
Medicine, University of Peradeniya, Peradeniya, Sri Lanka
(S D Dharmaratne MD); University of Rochester Medical Center,
Rochester, NY, USA (E R Dorsey MD); RMIT University, Bundoora, VIC,
Australia (Prof K E Doyle PhD); The University of Sydney, Camperdown,
NSW, Australia (Prof A H Kemp PhD); International Institute for
Population Sciences, Mumbai, India (M Dubey MPhil,
M H U Rahman MPhil, Prof U Ram PhD, A Singh PhD,
R K Verma MPhil, A K Yadav MPhil); Federal University of Rio Grande
do Sul, Porto Alegre, Brazil (B B Duncan PhD, C Kieling MD,
Prof M I Schmidt MD); University of North Carolina, Chapel Hill, NC,
USA (B B Duncan PhD); Non-Communicable Diseases Research Center,
31
Articles
Endocrinology and Metabolism Population Sciences Institute

(H Ebrahimi MD, Prof A Esteghamati MD, F Farzadfar MD,
N Hafezi-Nejad MD, A Kasaeian PhD, M Parsaeian PhD, F Pishgar MD,
S Sheikhbahaei MD), Liver and Pancreaticobiliary Diseases Research
Center, Digestive Disease Research Institute, Shariati Hospital
(H Ebrahimi MD), Digestive Diseases Research Institute (S Fahimi PhD,
Prof R Malekzadeh MD, G Roshandel PhD, S G Sepanlou PhD), Center
for Air Pollution Research, Institute for Environmental Research
(M S Hassanvand PhD), Hematology-Oncology and Stem Cell
Transplantation Research Center (A Kasaeian PhD), Non-Communicable
Diseases Research Center (A Khosravi PhD), Department of
Epidemiology and Biostatistics, School of Public Health
(M Parsaeian PhD), Uro-Oncology Research Center (F Pishgar MD),
Sina Trauma and Surgery Research Center
(Prof V Rahimi-Movaghar MD), Tehran University of Medical Sciences,
Tehran, Iran (M Yaseri PhD); Arba Minch University, Arba Minch,
Ethiopia (A Y Endries MPH, G Temam Shifa MPH); The Institute of
Social and Economic Studies of Population, Russian Academy of
Sciences, Moscow, Russia (Prof S P Ermakov DSc); Federal Research
Institute for Health Organization and Informatics, Ministry of Health of
the Russian Federation, Moscow, Russia (Prof S P Ermakov DSc,
S Soshnikov PhD); Ministry of Health and Medical Education, Tehran,
Iran (B Eshrati PhD); Arak University of Medical Sciences, Arak, Iran
(B Eshrati PhD); University of Louisville, Louisville, KY, USA
(T A Farid MD, A R Khan MD); DGS Directorate General of Health,
Lisboa, Portugal (C S E S Farinha MSc); Universidade Aberta, Lisboa,
Portugal (C S E S Farinha MSc); Federal University of Sergipe, Aracaju,
Brazil (Prof A Faro PhD); Harvard/MGH Center on Genomics,
Vulnerable Populations, and Health Disparities, Mongan Institute for
Health Policy, Massachusetts General Hospital, Boston, MA, USA
(M S Farvid PhD); National Institute for Stroke and Applied
Neurosciences, Auckland University of Technology, Auckland, New
Zealand (V L Feigin PhD); ARS Norte, I P, Departamento Sade Pblica,
Porto, Portugal (M M Felicio MD); Institute of Education and Sciences,
German Hospital Oswaldo Cruz, So Paulo, Brazil
(Prof J G Fernandes PhD); Centre for Experimental Medicine &
Rheumatology, William Harvey Research Institute, Barts and The
London School of Medicine & Dentistry, Queen Mary University of
London, London, UK (J C Fernandes PhD); Bielefeld University,
Bielefeld, Germany (F Fischer MPH); Institute of Gerontology, Academy
of Medical Science, Kyiv, Ukraine (N Foigt PhD); Alzheimer Scotland
Dementia Research Centre (I Shiue PhD), University of Edinburgh,
Edinburgh, UK (Prof F G R Fowkes PhD); Federal University of Minas
Gerais, Belo Horizonte, Brazil (Prof E B Franca PhD); James Cook
University, Townsville, QLD, Australia (R C Franklin PhD); University of
Basel, Basel, Switzerland (T Frst PhD); Manhia Health Research
Center, Manhia, Mozambique (A L Garcia-Basteiro MSc); Barcelona
Institute for Global Health, Barcelona, Spain (A L Garcia-Basteiro MSc);
The Task Force for Global Health, Decatur, GA, USA (T Gebre PhD);
Ludwig Maximilians University, Munich, Germany
(A T Gebremedhin MPH); Kilte Awlaelo Health and Demographic
Surveillance System, Mekelle, Ethiopia (A A Gebru MPH, G B Hailu MSc);
Agence de Medecine Preventive, Paris, France (B D Gessner MD);
College of Medicine, Howard University, Washington, DC, USA
(R F Gillum MD, A Mehari MD); College of Medicine, University of
Hail, Hail, Saudi Arabia (I A Ginawi MD); University Hospital of Dijon,
Dijon, France (Prof M Giroud MD); College of Health and Medical
Sciences (H S Roba MPH), Haramaya University, Dire Dawa, Ethiopia
(M D Gishu MS, A K Tura MPH); Kersa Health and Demographic
Surveillance System, Harar, Ethiopia (M D Gishu MS); University of
Massachusetts Boston, Boston, MA, USA (Prof P Gona PhD); Instituto
de Investigaciones Cienticas y Servicios de Alta Tecnologia INDICASAT-AIP, Ciudad del Saber, Panam (A Goodridge PhD);
Department of Health and Social Aairs, Government of the Federated
States of Micronesia, Palikir, Federated States of Micronesia
(S V Gopalani MPH); Division of Epidemiology, Center for Public Health
Sciences (A Goto PhD), National Cancer Center, Tokyo, Japan
(M Inoue MD); Stattis LLC, Chisinau, Moldova (K F Greenwell PhD);
West Virginia Bureau for Public Health, Charleston, WV, USA
(R Gupta MD); Eternal Heart Care Centre and Research Institute, Jaipur,
32
india (R Gupta PhD); Department of Anthropology, University of Delhi,

Delhi, India (V Gupta PhD); National Institute of Psychiatry Ramon de
la Fuente, Mexico City, Mexico (R A Gutirrez PhD); Aarhus University,
Aarhus, Denmark (B Gyawali MPH, K M Iburg PhD); Department of
Public Health, Erasmus MC, University Medical Center, Rotterdam,
Netherlands (J A Haagsma PhD); Brandeis University, Waltham, MA,
USA (Y A Halasa MS, E A Undurraga PhD); Arabian Gulf University,
Manama, Bahrain (Prof R R Hamadeh DPhil); Hamdan Bin Mohammed
Smart University, Dubai, United Arab Emirates (S Hamidi PhD); Wayne
County Department of Health and Human Services, Detroit, MI, USA
(M Hammami MD); School of Medicine and Pharmacology, University
of Western Australia, Perth, WA, Australia (Prof G J Hankey MD);
Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
(Prof G J Hankey MD); Western Australian Neuroscience Research
Institute, Nedlands, WA, Australia (Prof G J Hankey MD); Parc Sanitari
Sant Joan de Du - CIBERSAM, Sant Boi de Llobregat (Barcelona), Spain
(J M Haro MD); Universitat de Barcelona, Barcelona, Spain
(J M Haro MD); Department of Psychiatry, University Medical Center
Groningen (Prof H W Hoek MD), University of Groningen, Groningen,
Netherlands (A K Tura MPH); Department of Epidemiology, Mailman
School of Public Health (Prof H W Hoek MD), Columbia University,
New York, NY, USA (Prof V Skirbekk PhD); Nevada Division of Public
and Behavioral Health, Department of Health and Human Services,
Carson City, NV, USA (M Horino MPH); Department of Pulmonology,
Yokohama City University Graduate School of Medicine, Yokohama,
Japan (N Horita MD); Albert Einstein College of Medicine, Bronx, NY,
USA (Prof H D Hosgood PhD); Public Health Division, The Pacic
Community, Noumea, New Caledonia (D G Hoy PhD); International
Relations Division, Ministry of Health, Nay Pyi Taw, Myanmar
(A S Htet MPhil); Department of Epidemiology and Health Statistics,
School of Public Health, Central South University, Changsha, China
(G Hu PhD); Cambridge Health Alliance, Cambridge, MA, USA
(H Huang MD); Boston Medical Center (B T Idrisov MD), School of
Medicine (G F Kwan MD), Boston University, Boston, MA, USA;
Graduate School of Medicine (M Inoue MD), School of Public Health
(Prof N Kawakami MD), University of Tokyo, Tokyo, Japan
(K Shibuya MD); American Cancer Society, Atlanta, GA, USA
(F Islami PhD); MCH Division, USAID - Global Health Bureau, HIDN,
Washington, DC, USA (T A Jacobs MD); Department of Global and
Community Health, George Mason University, Fairfax, VA, USA
(K H Jacobsen PhD); Faculty of Medical Sciences, University of
Kragujevac, Kragujevac, Serbia (Prof M B Jakovljevic PhD); UNFPA Asia
and the Pacic Regional Oce, Bangkok, Thailand (H A F Jansen Drs);
University of Aberdeen, Aberdeen, UK (M Javanbakht PhD);
Postgraduate Institute of Medicine, Colombo, Sri Lanka
(A U Jayatilleke PhD); Institute of Violence and Injury Prevention,
Colombo, Sri Lanka (A U Jayatilleke PhD); Graduate School of Public
Health (Prof S H Jee PhD), Yonsei University, Seoul, South Korea;
Centre for Chronic Disease Control, New Delhi, India (P Jeemon PhD);
George Institute for Global Health India, New Delhi, India
(Prof V Jha DM); Department of Health Development, Institute of
Industrial Ecological Sciences, University of Occupational and
Environmental Health, Kitakyushu, Japan (Y Jiang PhD); School of
Public Health (K Deribe MPH), College of Health Sciences, School of
Public Health (W Tefera MPH), Addis Ababa University, Debre Zeit,
Ethiopia (T Jibat MS,); Wageningen University, Wageningen,
Netherlands (T Jibat MS); Department of Ophthalmology, Medical
Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim,
Germany (Prof J B Jonas MD); University College Cork, Cork, Ireland
(Z Kabir PhD); Society for Education, Action and Research in
Community Health, Gadchiroli, India (Y Kalkonde MD); CSIR - Indian
Institute of Toxicology Research, Lucknow, India (R Kamal MSc,
C N Kesavachandran PhD); Department of Pulmonary Medicine,
Zhongshan Hospital (J She MD), Fudan University, Shanghai, China
(H Kan MD); University at Bualo, Bualo, NY, USA (A Kandel MBBS);
Epidemiological and Statistical Methods Research Group, Helmholtz
Centre for Infection Research, Braunschweig, Germany (A Karch MD);
Hannover-Braunschweig Site, German Center for Infection Research,
Braunschweig, Germany (A Karch MD); Quality and Equity Health Care,
Kigali, Rwanda (C K Karema MSc); Case Western University Hospitals,
Articles
Cleveland, OH, USA (C Karimkhani MD); Ministry of Health, Colombo,

Sri Lanka (P Karunapema MD); Oklahoma State University, Tulsa, OK,
USA (A Kaul MD); Institut de recherche de lhpital de Monttfort,
Ottawa, ON, Canada (J F Kayibanda PhD); Institute of Tropical and
Infectious Diseases, Nairobi, Kenya (P N Keiyoro PhD); School of
Continuing and Distance Education, Nairobi, Kenya (P N Keiyoro PhD);
Swansea University, Swansea, UK (Prof A H Kemp PhD); Burden of
Disease Research Unit (R Matzopoulos PhD), Alcohol, Tobacco & Other
Drug Research Unit (Prof C D Parry PhD), South African Medical
Research Council, Cape Town, South Africa (A P Kengne
PhD, Prof C S Wiysonge PhD); School of Public Health and Family
Medicine (R Matzopoulos PhD), Department of Psychiatry
(Prof D J Stein PhD), University of Cape Town, Cape Town, South Africa
(A P Kengne PhD, Prof B M Mayosi DPhil, M Shey PhD,
D A Watkins MD); Assuta Hospitals, Assuta Hashalom, Tel Aviv, Israel
(Prof A Keren MD); Jordan University of Science and Technology, Irbid,
Jordan (Prof Y S Khader ScD); Health Services Academy, Islamabad,
Pakistan (E A Khan MPH); Department of Microbiology and
Immunology, College of Medicine & Health Sciences, United Arab
Emirates University, Al Ain, United Arab Emirates (G Khan PhD);
College of Medicine (Prof Y H Khang MD), Graduate School of Public
Health (Prof S Won PhD), Seoul National University, Seoul, South
Korea; Executive Board of the Health Ministers Council for Cooperation
Council States, Riyadh, Saudi Arabia (Prof T A M Khoja FRCP); Iranian
Ministry of Health and Medical Education, Tehran, Iran (A Khosravi PhD);
Ball State University, Muncie, IN, USA (J Khubchandani PhD); Hospital
de Clnicas de Porto Alegre, Porto Alegre, Brazil (C Kieling MD); Korea
Health Industry Development Institute, Cheongju-si, South Korea
(C Kim PhD); Department of Health Sciences, Northeastern University,
Boston, MA, USA (Prof D Kim DrPH); Soonchunhyang University,
Seoul, South Korea (S Kim PhD); Southern University College, Skudai,
Malaysia (Y J Kim PhD); Simmons College, Boston, MA, USA
(R W Kimokoti MD); Department of Preventive Cardiology, National
Cerebral and Cardiovascular Center, Suita, Japan (Y Kokubo PhD);
Division of Cardiology, Brown University, Providence, RI, USA
(D Kolte MD); Center for Community Empowerment, Health Policy and
Humanities, NIHRD, Jakarta, Indonesia (S Kosen MD); Sher-i-Kashmir
Institute of Medical Sciences, Srinagar, India (Prof P A Koul MD);
Research and Development Unit, Parc Sanitari Sant Joan de Deu
(CIBERSAM), Barcelona, Spain (A Koyanagi MD); Research Center of
Neurology, Moscow, Russia (M Kravchenko PhD, Prof Y Y Varakin MD);
Department of Demography and Public Health Research Institute
(Prof B Kuate Defo PhD), Department of Social and Preventive
Medicine, School of Public Health (Prof B Kuate Defo PhD), University
of Montreal, Montreal, QC, Canada; Universidade Federal do Rio Grande
do Sul, Porto Alegre, Brazil (Prof R S Kuchenbecker PhD); Erasmus MC,
University Medical Center Rotterdam, Rotterdam, Netherlands
(Prof E J Kuipers PhD); Arkansas State University, State University, AR,
USA (V S Kulkarni PhD); National Centre for Epidemiology and
Population Health, The Australian National University, Canberra, ACT,
Australia (A Lal PhD, Prof R M Lucas PhD); Institute of Health Policy
and Development Studies, National Institutes of Health, Manila,
Philippines (Prof H Lam PhD); National Cancer Institute, Rockville,
MD, USA (Q Lan PhD); Komfo Anokye Teaching Hospital, Kumasi,
Ghana (D O Laryea MD); Department of Zoology, Lahore College for
Women University, Lahore, Pakistan (A A Latif PhD); College of
Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
(J L Leasher OD); National Institute for Health Development, Tallinn,
Estonia (M Leinsalu PhD); Stockholm Centre for Health and Social
Change, Sdertrn University, Stockholm, Sweden (M Leinsalu PhD);
State University of New York, Albany, Rensselaer, NY, USA
(R Leung PhD); Tuscany Regional Centre for Occupational Injuries and
Diseases, Florence, Italy (M Levi PhD); San Francisco VA Medical
Center, San Francisco, CA, USA (Y Li PhD); University of Haifa, Haifa,
Israel (Prof S Linn MD); School of Medicine, Wayne State University,
Detroit, MI, USA (Prof S E Lipshultz MD, Prof J D Wilkinson MD);
Childrens Hospital of Michigan, Detroit, MI, USA
(Prof S E Lipshultz MD); Rollins School of Public Health
(E P Simard PhD), Emory University, Atlanta, GA, USA (Prof Y Liu PhD,
Prof M R Phillips MD); Eastern Health Clinical School (B K Lloyd PhD),
Monash University, Fitzroy, VIC, Australia; Turning Point, Eastern
Health, Melbourne, VIC, Australia (B K Lloyd PhD); UnionHealth

Associates, LLC, St Louis, MO, USA (L Lo MD); Alton Mental Health
Center, Alton, IL, USA (L Lo MD); University of Bari, Bari, Italy
(Prof G Logroscino PhD); Aintree University Hospital National Health
Service Foundation Trust, Liverpool, UK (Prof R Lunevicius PhD);
School of Medicine, University of Liverpool, Liverpool, UK
(Prof R Lunevicius PhD); Aswan University Hospital, Aswan Faculty of
Medicine, Aswan, Egypt (M Magdy Abd El Razek MBBCh); National
Center for the Prevention and Control of HIV/AIDS, Secretariat of
Health, Mexico City, Mexico (C Magis-Rodriguez PhD); Social Security
Organization Research Institute, Tehran, Iran (M Mahdavi PhD);
Institute of Health Policy and Management, Erasmus University
Rotterdam, Rotterdam, Netherlands (M Mahdavi PhD); Universidade
Federal de Minas Gerais, Belo Horizonte, Brazil (Prof D C Malta PhD);
Perelman School of Medicine (P A Meaney MD), University of
Pennsylvania, Philadelphia, PA, USA (D J Margolis PhD); University
Hospital Doctor Peset, University of Valencia, Valencia, Spain
(J Martinez-Raga PhD); CEU Cardenal Herrera University, Moncada
(Valencia), Spain (J Martinez-Raga PhD); Department of Health
Sciences, University of York, York, UK (A J Mason-Jones PhD); Hospital
Pedro Hispano/ULS Matosinhos, Matosinhos, Portugal (J Massano MD);
Childrens Hospital of Philadelphia, Philadelphia, PA, USA
(P A Meaney MD); University of Gondar, Gondar, Ethiopia
(A B Mekonnen MS, B A Tedla BS); University of West Florida,
Pensacola, FL, USA (P Memiah PhD); Saudi Ministry of Health, Riyadh,
Saudi Arabia (Prof Z A Memish MD); College of Medicine, Alfaisal
University, Riyadh, Saudi Arabia (Prof Z A Memish MD); United
Nations Population Fund, Lima, Peru (W Mendoza MD); Robert Koch
Institute, Berlin, Germany (G B M Mensink PhD); Department of
Neurology, Helsinki University Hospital, Helsinki, Finland
(A Meretoja PhD); Helsinki University Hospital, Comprehensive Cancer
Center, Breast Surgery Unit, Helsinki, Finland (T J Meretoja PhD);
University of Helsinki, Helsinki, Finland (T J Meretoja PhD); Ifakara
Health Institute, Bagamoyo, Tanzania (F A Mhimbira MS); Pacic
Institute for Research & Evaluation, Calverton, MD, USA
(T R Miller PhD); Centre for Population Health, Curtin University,
Perth, WA, Australia (T R Miller PhD); University of Ottawa, Ottawa,
ON, Canada (E J Mills PhD); Neuroscience Research Center, Baqiyatallah
University of Medical Sciences, Tehran, Iran (A Mohammadi PhD);
Health Systems and Policy Research Unit, Ahmadu Bello University,
Zaria, Nigeria (S Mohammed PhD); Institute for Maternal and Child
Health, IRCCS Burlo Garofolo, Trieste, Italy (L Monasta DSc,
M Montico MSc, L Ronfani PhD); Bureau of International Health
Cooperation, Manila City, Philippines (J D Monis MSc); Department of
Community Medicine, Gastrointestinal and Liver Disease Research
Center, Preventive Medicine and Public Health Research Center, Iran
University of Medical Sciences, Tehran, Iran (M Moradi-Lakeh MD);
International Laboratory for Air Quality and Health (L Morawska PhD),
School of Public Health and Social Work (J Sun PhD), Queensland
University of Technology, Brisbane, QLD, Australia; National Center for
Child Health and Development, Setagaya, Japan (R Mori PhD);
Competence Center Mortality-Follow-Up of the German National Cohort
(A Werdecker PhD), Federal Institute for Population Research,
Wiesbaden, Germany (Prof U O Mueller PhD, R Westerman PhD); West
Herts Hospitals NHS Trust, Watford, UK (M E Murdoch FRCP); AIDS &
TB Unit, Ministry of Health and Child Care, Bindura, Zimbabwe
(B Murimira MS); Zimbabwe National Family Planning Council, Harare,
Zimbabwe (B Murimira MS); Federal University of Pelotas, Pelotas,
Brazil (Prof J Murray PhD); School of Medical Sciences, University of
Science Malaysia, Kubang Kerian, Malaysia (K I Musa MD); Graduate
School of Public Health (Prof J B Nachega PhD), Public Health
Dynamics Laboratory (A J Paternina Caicedo MD), University of
Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry
(Prof C D Parry PhD), Stellenbosch University, Cape Town, South Africa
(Prof J B Nachega PhD, Prof S Seedat PhD, Prof C S Wiysonge PhD);
Bloomberg School of Public Health (Prof J B Nachega PhD), Johns
Hopkins University, Baltimore, MD, USA (B X Tran PhD); Institute of
Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
(Prof G Nagel PhD, Prof D Rothenbacher MD); University of
KwaZulu-Natal, Durban, South Africa (Prof K S Naidoo PhD,
O Oladimeji MD, Prof B Sartorius PhD, E A Zegeye MS); Azienda
33
Articles
Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (Prof L Naldi MD,

Prof G Remuzzi MD); Suraj Eye Institute, Nagpur, India (V Nangia MD);
The George Institute for Global Health, Sydney, NSW, Australia
(Prof B Neal PhD); Royal Prince Alfred Hospital, Sydney, NSW, Australia
(Prof B Neal PhD); Faculty of Medicine, Fez, Morocco
(Prof C Nejjari PhD); KEMRI Wellcome Trust, Kili, Kenya
(Prof C R Newton MD); Ministry of Health and Social Welfare, Dar es
Salaam, Tanzania (F N Ngalesoni MSc); KEMRI - Wellcome Trust
Research Program, Nairobi, Kenya (P Nguhiu BPharm); Institute for
Global Health Innovations, Duy Tan University, Da Nang, Vietnam
(Q L Nguyen MD); Institute For Research, Socio-Economic Development
and Communication, Yaound, Cameroon (P M Nkamedjie Pete MS);
Department of Psychosomatic Medicine, Center for Internal Medicine
and Dermatology, Charit Universittsmedizin, Berlin, Germany
(S Nolte PhD); Population Health Strategic Research Centre, School of
Health and Social Development (S Nolte PhD), Deakin University,
Geelong, VIC, Australia (Prof R H Osborne PhD); National Institute of
Public Health, Saitama, Japan (M Nomura PhD); Department of Global
Public Health and Primary Care (Prof S E Vollset DrPH), University of
Bergen, Bergen, Norway (Prof O F Norheim PhD); Center for Research
on Population and Health, Faculty of Health Sciences, American
University of Beirut, Beirut, Lebanon (Prof C M Obermeyer DSc);
Centre for Health Research, Western Sydney University, Sydney, NSW,
Australia (F A Ogbo MPH); Department of Preventive Medicine, School
of Medicine, Kyung Hee University, Seoul, South Korea (Prof I Oh PhD);
Human Sciences Research Council, Durban, South Africa
(O Oladimeji MD); Universidad Autonoma de Chile, Talca, Chile
(Prof P R Olivares PhD); Center for Healthy Start Initiative, Lagos,
Nigeria (B O Olusanya PhD, J O Olusanya MBA); Lira District Local
Government, Lira Municipal Council, Uganda (J N Opio MPH);
University of Arizona, Tucson, AZ, USA (Prof E Oren PhD); IISFundacion Jimenez Diaz-UAM, Madrid, Spain (Prof A Ortiz PhD);
St Lukes International University, Tokyo, Japan (E Ota PhD); JSS
Medical College, JSS University, Mysore, India (Prof Mahesh PA DNB);
Department of Medical Humanities and Social Medicine, College of
Medicine, Kosin University, Busan, South Korea (E Park PhD); California
Air Resources Board, Sacramento, CA, USA (H Park PhD); Mount Sinai
Health System, New York, NY, USA (T Patel MD); Sangath, Goa, India
(Prof V Patel PhD); Krishan Institute of Medical Sciences, Deemed
University, School of Dental Sciences, Karad, India (S T Patil MDS);
Department of Community Health Sciences (Prof S B Patten PhD),
University of Calgary, Calgary, AB, Canada (Prof M Tonelli MD); UK
Department for International Development, Lalitpur, Nepal
(D Paudel PhD); Health Research Centre of Angola, Caxito, Angola
(J M Pedro MS); REQUIMTE/LAQV, Laboratrio de Farmacognosia,
Departamento de Qumica, Faculdade de Farmcia, Universidade do
Porto, Porto, Portugal (Prof D M Pereira PhD); IRCCS - Istituto di
Ricerche Farmacologiche Mario Negri, Bergamo, Italy (N Perico MD,
Prof G Remuzzi MD); Flinders University, Adelaide, SA, Australia
(Prof K Pesudovs PhD); Health Metrics Unit, University of Gothenburg,
Gothenburg, Sweden (Prof M Petzold PhD); University of the
Witwatersrand, Johannesburg, South Africa (Prof M Petzold PhD);
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Prof M R Phillips MD); Durban University of Technology, Durban,
South Africa (J D Pillay PhD); Department of Public Health, Erasmus
University Medical Center, Rotterdam, Netherlands (S Polinder PhD);
Department of Community Medicine, School of Medicine, Alborz
University of Medical Sciences, Karaj, Iran (M Qorbani PhD); A T Still
University, Kirksville, MO, USA (A Radfar MD); Research and
Evaluation Division, BRAC, Dhaka, Bangladesh (M Rahman PhD);
Hamad Medical Corporation, Doha, Qatar (S U Rahman FCPS); Society
for Health and Demographic Surveillance, Suri, India (R K Rai MPH);
ERAWEB Program, University for Health Sciences, Medical Informatics
and Technology, Hall in Tirol, Austria (S Rajsic MD); University of
Missouri, Columbia, MO, USA (M Raju PhD); Contech School of Public
Health, Lahore, Pakistan (Prof S M Rana PhD); Contech International
Health Consultants, Lahore, Pakistan (Prof S M Rana PhD); Department
of Preventive Medicine, Wonju College of Medicine (C L Ranabhat PhD),
Yonsei University, Wonju, South Korea; University of Michigan Health
Systems, Ann Arbor, MI, USA (K Ranganathan MD); Walden University,
Minneapolis, MN, USA (Prof A H Refaat PhD); Suez Canal University,
34
Ismailia, Egypt (Prof A H Refaat PhD); Department of Biomedical and

Clinical Sciences L Sacco, University of Milan, Milan, Italy
(Prof G Remuzzi MD); Hospital das Clinicas da Universidade Federal de
Minas Gerais, Belo Horizonte, Brazil (Prof A L Ribeiro MD); School of
Psychology, University of Lincoln, Lincoln, UK (Prof A Rodriguez PhD);
(ISGlobal) Instituto de Salud Global de Barcelona, Barcelona, Spain
(D Rojas-Rueda PhD); Golestan Research Center of Gastroenterology
and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
(G Roshandel PhD); All India Institute of Medical Sciences, New Delhi,
India (A Roy DM, R Sagar MD, M Satpathy PhD); BARC Hospital, HBNI
University, Mumbai, India (N Roy MD); World Health Organization,
Accra, Ghana (B B Sackey MS); All India Institute of Medical Sciences,
New Delhi, India (R Sagar MD, M Satpathy PhD); Development
Research and Projects Center, Abuja, Nigeria (M M Saleh MPH);
Marshall University J Edwards School of Medicine, Huntington, WV,
USA (J R Sanabria MD); Case Western Reserve University, Cleveland,
OH, USA (J R Sanabria MD); Universidad Ciencias Aplicadas y
Ambientales, Bogot, Colombia (R Sarmiento-Suarez MPH); Centre for
Disease Burden (Prof S E Vollset DrPH), Norwegian Institute of Public
Health, Oslo, Norway (M Savic PhD, Prof V Skirbekk PhD); Marshall
University, Huntington, WV, USA (M Sawhney PhD); Global Perspective
Studies Unit, Food and Agriculture Organization, Rome, Italy
(J Schmidhuber PhD); Federal University of Santa Catarina,
Florianpolis, Brazil (I J C Schneider PhD, D A S Silva PhD);
Hypertension in Africa Research Team (HART), North-West University,
Potchefstroom, South Africa (Prof A E Schutte PhD); Burden of Disease
Research Unit (R Matzopoulos PhD), Alcohol, Tobacco & Other Drug
Research Unit (Prof C D Parry PhD), South African Medical Research
Council, Potchefstroom, South Africa (Prof A E Schutte PhD);
Department of Public Health, An-Najah University, Nablus, Palestine
(A Shaheen PhD); Independent Consultant, Karachi, Pakistan
(M A Shaikh MD); Indian Institute of Technology Ropar, Rupnagar,
India (R Sharma MA); Research Institute at Nationwide Childrens
Hospital, Columbus, OH, USA (J Shen PhD); National Institute of
Infectious Diseases, Tokyo, Japan (M Shigematsu PhD); Sandia National
Laboratories, Albuquerque, NM, USA (M Shigematsu PhD);
Department of Public Health Science, Graduate School
(Prof M Shin PhD), Department of Preventive Medicine, College of
Medicine (S Yoon PhD), Korea University, Seoul, South Korea; Work
Organizations, Work Disability Prevention, The Finnish Institute of
Occupational Health, Helsinki, Finland (R Shiri PhD); Washington State
University, Spokane, WA, USA (K Shishani PhD); Faculty of Health and
Life Sciences, Northumbria University, Newcastle upon Tyne, UK
(I Shiue PhD); Reykjavik University, Reykjavik, Iceland
(I D Sigfusdottir PhD); Feinberg School of Medicine (J I Silverberg MD),
Department of Preventive Medicine (Y Yano MD), Northwestern
University, Chicago, IL, USA; Department of Medicine, Institute of
Medical Sciences, Banaras Hindu University, Varanasi, India
(O P Singh PhD); Institute for Human Development, New Delhi, India
(P K Singh PhD); Stavanger University Hospital, Stavanger, Norway
(K Sreide PhD); Instituto de Investigacin Hospital Universitario de la
Princesa, Universidad Autnoma de Madrid, Madrid, Spain
(Prof J B Soriano PhD); Department of Clinical Neurological Sciences,
Western University, London, ON, Canada (L A Sposato MD);
Department of Community Medicine, International Medical University,
Kuala Lumpur, Malaysia (C T Sreeramareddy MD); Institute of Public
Health, University Hospital Heidelberg, Heidelberg, Germany
(H Stahl PhD); University Medical Centre Freiburg, Freiburg, Germany
(H Stahl PhD); Attikon University Hospital, Athens, Greece
(V Stathopoulou PhD); Institute and Outpatient Clinic for Occupational,
Social and Environmental Medicine, University Hospital Munich,
Munich, Germany (N Steckling MSc); University of East Anglia,
Norwich, UK (Prof N Steel PhD); South African Medical Research
Council Unit on Anxiety & Stress Disorders, Cape Town, South Africa
(Prof D J Stein PhD); Luxembourg Institute of Health, Strassen,
Luxembourg (S Stranges PhD); School of Health and Related Research,
University of Sheeld, Sheeld, UK (M Strong PhD); Institute for
Resilient Regions, University of Southern Queensland, Springeld,
QLD, Australia (J Sun PhD); Muhimbili University of Health and Allied
Sciences, Dar es Salaam, Tanzania (B F Sunguya PhD); Indian Council
of Medical Research, New Delhi, India (S Swaminathan MD);
Articles
Departments of Criminology, Law & Society, Sociology, and Public

Health, University of California, Irvine, Irvine, CA, USA
(Prof B L Sykes PhD); Department of Medicine, University of Valencia,
INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
(Prof R Tabars-Seisdedos PhD); School of Social Work, University of
Illinois at Urbana-Champaign, Champaign, IL, USA (K M Tabb PhD);
Ministry of Health, MINSANTE, Yaound, Cameroon
(R T Talongwa MD); Ministry of Health, Amman, Jordan
(M R Tarawneh MPH); New York Medical College, Valhalla, NY, USA
(M Tavakkoli MD); Department of Biology, Colgate University, Hamilton,
NY, USA (B Taye PhD); James Cook University, Cairns, QLD, Australia
(B A Tedla BS); Department of Anesthesiology, University of Virginia,
Charlottesville, VA, USA (A S Terkawi MD); Outcomes Research
Consortium (A S Terkawi MD), Cleveland Clinic, Cleveland, OH, USA
(Prof E M Tuzcu MD); University Of Gondar, Gondar, Ethiopia
(G A Tessema MPH); School of Public Health, Post Graduate Institute of
Medical Education and Research, Chandigarh, India (Prof J Thakur MD);
Adaptive Knowledge Management, Victoria, BC, Canada
(A J Thomson PhD); WorldFish, Penang, Malaysia
(A L Thorne-Lyman ScD); Nelson Institute of Environmental Medicine,
School of Medicine, New York University, Tuxedo, NY, USA
(Prof G D Thurston ScD); National Center for Child Health and
Development, Tokyo, Japan (R Tobe-Gai PhD); Institute of Public Health,
Faculty of Health Sciences, Jagiellonian University Medical College,
Krakw, Poland (R Topor-Madry PhD); Faculty of Health Sciences,
Wroclaw Medical University, Wroclaw, Poland (R Topor-Madry PhD);
Aristotle University of Thessaloniki, Thessaloniki, Greece
(Prof F Topouzis PhD); Hanoi Medical University, Hanoi, Vietnam
(B X Tran PhD); Department of Population Sciences and Development,
Faculty of Economics and Management, University of Kinshasa,
Kinshasa, Democratic Republic of the Congo (Z Tsala Dimbuene PhD);
African Population and Health Research Center, Nairobi, Kenya
(Z Tsala Dimbuene PhD); Parc Sanitari Sant Joan de Du, Fundaci Sant
Joan de Du, Universitat de Barcelona, CIBERSAM, Barcelona, Spain
(S Tyrovolas PhD); Department of Internal Medicine, Federal Teaching
Hospital, Abakaliki, Nigeria (K N Ukwaja MD); Ebonyi State University,
Abakaliki, Nigeria (C J Uneke PhD); Warwick Medical School, University
of Warwick, Coventry, UK (O A Uthman PhD); UKK Institute for Health
Promotion Research, Tampere, Finland (Prof T Vasankari PhD);
University of Brasilia, Braslia, Brazil (Prof A M N Vasconcelos PhD);
Raes Neuroscience Centre, Raes Hospital, Singapore, Singapore
(N Venketasubramanian FRCP); University of Bologna, Bologna, Italy
(Prof F S Violante MD); National Research University Higher School of
Economics, Moscow, Russia (Prof V V Vlassov MD); National Cancer
Institute, Mexico City, Mexico (P Volkow MD); National Autonomous
University of Mexico, Mexico City, Mexico (P Volkow MD); National
Institute for Occupational Safety and Health, Washington, DC, USA
(G R Wagner MD); VA Medical Center, Washington, DC, USA
(M T Wallin MD); Neurology Department, Georgetown University,
Washington, DC, USA (M T Wallin MD); McGill University, Montreal,
QC, Canada (S Weichenthal PhD); Department of Research, Cancer
Registry of Norway, Institute of Population-Based Cancer Research, Oslo,
Norway (E Weiderpass PhD); Department of Community Medicine,
Faculty of Health Sciences, University of Troms, The Arctic University
of Norway, Troms, Norway (E Weiderpass PhD); Genetic Epidemiology
Group, Folkhlsan Research Center, Helsinki, Finland (E Weiderpass PhD);
Royal Childrens Hospital, Melbourne, VIC, Australia
(R G Weintraub MBBS); German National Cohort Consortium,
Heidelberg, Germany (R Westerman PhD); Childrens Hospital of
Michigan, Detroit, MI, USA (Prof J D Wilkinson MD); National Institute
for Health Research Comprehensive Biomedical Research Centre, Guys
& St Thomas NHS Foundation Trust and Kings College London,
London, UK (Prof C D Wolfe MD); Evelina London Childrens
Healthcare, St Thomas Hospital, London, UK (I Wolfe PhD); Royal
Cornwall Hospital, Truro, UK (Prof A D Woolf FRCP); St Pauls
Hospital, Millennium Medical College, Addis Ababa, Ethiopia
(M Wubshet PhD); Department of Neurology, Jinling Hospital, Nanjing
University School of Medicine, Nanjing, China (Prof G Xu PhD);
Discipline of Public Health Medicine, School of Nursing and Public
Health, University of KwaZulu Natal, Durban, South Africa
(B Yakob PhD); Global Health Research Center, Duke Kunshan
University, Kunshan, China (Prof L L Yan PhD); Social Work and Social
Administration Department and The Hong Kong Jockey Club Centre for
Suicide Research and Prevention, University of Hong Kong, Hong Kong,
China (Prof P Yip PhD); Department of Biostatistics, School of Public
Health, Kyoto University, Kyoto, Japan (N Yonemoto MPH); Jackson
State University, Jackson, MS, USA (Prof M Z Younis DrPH);
Department of Epidemiology and Biostatistics, School of Public Health
(Prof C Yu PhD), Global Health Institute (Prof C Yu PhD), Wuhan
University, Wuhan, China; University Hospital, Setif, Algeria
(Prof Z Zaidi PhD); Faculty of Medicine, Mansoura University,
Mansoura, Egypt (Prof M E Zaki PhD); EcoHealth Alliance, New York,
NY, USA (C Zambrana-Torrelio MS); Instituto de Ecologia-Bolivia,
La Paz, Bolivia (C Zambrana-Torrelio MS); World Health Organization,
Windhoek, Namibia (T Zapata MD); Ethiopian Public Health Institute,
Addis Ababa, Ethiopia (E A Zegeye MS); Oregon Health and Science
University, Portland, OR, USA (D Zonies MD)
Contributors
Stephen S Lim, Nancy Fullman, and Christopher J L Murray prepared
the rst draft. Michael J Kutz, Ellen M Goldberg, and David M Pigott
constructed the indices. Claire R McNellan, Nancy Fullman, and
Kate Allen constructed the UHC tracer intervention indicator.
Stephen S Lim and Christopher J L Murray provided overall guidance.
Meghan D Mooney managed the project. Stephen S Lim,
Nancy Fullman, Christopher J L Murray, and Meghan D Mooney
nalised the manuscript based on comments from other authors and
reviewer feedback. Helen E Olsen managed the appendices. All other
authors provided data or developed models for SDG indicators, reviewed
results, initiated modelling infrastructure, or reviewed and contributed
to the report.
Declaration of interests
Bruce Bartholow Duncan and Maria Ins Schmidt have received
additional funding from the Brazilian Ministry of Health (Process
number 25000192049/2014-14). Itamar S Santos reports grants from
FAPESP (Brazilian public agency) outside the submitted work.
Rafael Tabars-Seisdedos was supported in part by grant
PROMETEOII/2015/021 from Generalitat Valenciana and the national
grand PI14/00894 from ISCIII-FEDER. Ai Koyanagis work is
supported by the Miguel Servet contract nanced by the CP13/00150
and PI15/00862 projects, integrated into the National R + D + I and
funded by the ISCIIIGeneral Branch Evaluation and Promotion of
Health Researchand the European Regional Development Fund
(ERDF-FEDER). Benjamin C Cowie acknowledges funding support
from the Australian Government Department of Health and the Royal
Melbourne Hospital Research Funding Program.
Elisabeth Barboza Franca acknowledges funding from the Brazilian
Ministry of Health (Project number 25000192049/2014-14).
Aletta E Schutte is funded by the Medical Research Council of South
Africa, and the South African Research Chair Initiative by the
National Research Foundation. Amador Goodridge acknowledges
funding from Sistema Nacional de Investigadores de Panam-SNI.
Jos das Neves was supported in his contribution to this work by a
Fellowship from Fundao para a Cincia e a Tecnologia, Portugal
(SFRH/BPD/92934/2013). Thomas Frst has received nancial
support from the Swiss National Science Foundation (SNSF; project
number P300P3-154634). Jost B Jonas reports personal fees from
being a consultant for Mundipharma and a patent holder with
Biocompatibles UK (title: Treatment of eye diseases using
encapsulated cells encoding and secreting neuroprotective factor
and/or anti-angiogenic factor; patent number: 20120263794), and has
applied for patent with University of Heidelberg (title: Agents for use
in the therapeutic or prophylactic treatment of myopia or hyperopia;
Europische Patentanmeldung 15 000 771.4) outside the submitted
work. Stefanos Tyrovolass work is supported by the Foundation for
Education and European Culture (IPEP), the Sara Borrell postdoctoral
programme (reference number CD15/00019) from the Instituto de
Salud Carlos III (ISCIII), Spain, and the Fondos Europeo de
Desarrollo Regional (FEDER). Beatriz Paulina Ayala Quintanilla
acknowledges the institutional support of PRONABEC (National
Program of Scholarship and Educational Loan), provided by the
Peruvian Government, while studying for her doctoral course at the
35
Articles
Judith Lumley Centre of La Trobe University funded by PRONABEC.

Manami Inoue is the beneciary of a nancial contribution from the
AXA Research fund as chair holder of the AXA Department of Health
and Human Security, Graduate School of Medicine, The University of
Tokyo from Nov 1, 2012; the AXA Research Fund has no role in this
work. Olanrewaju Oladimeji is an African Research Fellow at Human
Sciences Research Council (HSRC) and a Doctoral Candidate at the
University of KwaZulu-Natal (UKZN), South Africa, and
acknowledges the institutional support by leveraging on the existing
organisational research infrastructure at HSRC and UKZN.
Sun Ha Jee has been funded by a grant of the Korean Health
Technology R&D project (HI14C2686), South Korea. Dan J Stein
reports personal fees from Lundbeck, Novartis, AMBRF, Biocodex,
Sevier, SUN, and CIPLA; and grants from NRGF and MRC outside
the submitted work. Mayowa O Owolabis work is supported by U54
HG007479 from the US National Institutes of Health. All other
authors declare no competing interests.
For HBSC principal investigators

see http://www.hbsc.org
36
Acknowledgments
We thank the countless individuals who have contributed to the Global
Burden of Disease Study 2015 in various capacities. The data used in this
paper came from the 200910 Ghana Socioeconomic Panel Study Survey,
which is a nationally representative survey of more than 5000 households
in Ghana. The survey is a joint eort undertaken by the Institute of
Statistical, Social and Economic Research (ISSER) at the University of
Ghana, and the Economic Growth Centre (EGC) at Yale University. It was
funded by the Economic Growth Center. At the same time, ISSER and the
EGC are not responsible for the estimations reported by the analyst(s).
HBSC is an international study carried out in collaboration with
WHO/EURO. A list of principal investigators in each country can be found
online. The Panel Study of Income Dynamics is primarily sponsored by
the National Science Foundation, the National Institute on Aging, and the
National Institute of Child Health and Human Development and is
conducted by the University of Michigan. This analysis uses data or
information from the LASI Pilot micro data and documentation. The
development and release of the LASI Pilot Study was funded by the
National Institute on Ageing/National Institute of Health (R21AG032572,
R03AG043052, and R01 AG030153). Collection of these data was made
possible by the US Agency for International Development (USAID) under
the terms of cooperative agreement GPO-A-00-08-000_D3-00. The
opinions expressed are those of the authors and do not necessarily reect
the views of USAID or the US Government. Data for this research were
provided by MEASURE Evaluation, funded by the USAID. Views
expressed do not necessarily reect those of USAID, the US Government,
or MEASURE Evaluation. The Palestinian Central Bureau of Statistics
granted the researchers access to relevant data in accordance with licence
number SLN2014-3-170, after subjecting data to processing aiming to
preserve the condentiality of individual data in accordance with the
General Statistics Law2000. The researchers are solely responsible for
the conclusions and inferences drawn upon available data. We thank the
Russia Longitudinal Monitoring Survey, RLMS-HSE, conducted by the
National Research University Higher School of Economics and ZAO
Demoscope together with Carolina Population Center, University of
North Carolina at Chapel Hill and the Institute of Sociology RAS for
making these data available. This research used data from the National
Health Survey 200910, and we gratefully acknowledge the Ministry of
Health, Survey copyright owner, for use of the database. All results of the
study are those of the authors and in no way committed to the ministry.
The following individuals acknowledge various forms of institutional
support: Amanda G Thrift is supported by a fellowship from the Australian
National Health and Medical Research Council (GNT1042600).
Panniyammakal Jeemon is supported by the Wellcome TrustDBT India
Alliance, Clinical and Public Health, Intermediate Fellowship (201520).
Boris Bikbov, Giuseppe Remuzzi, and Norberto Perico acknowledge that
their contribution to this paper has been on behalf of the International
Society of Nephrology (ISN) as a follow-up of the activities of the GBD
2010 Genitourinary Diseases Expert Group. Tonatiuh Barrientos-Gutierrez
and E Filipa de Castro acknowledge that the data shared on Water and
Sanitation for Mexico, was derived from the Encuesta Nacional de Nios,
Nias y Mujeres en Mxico 2015, which is the implementation in Mexico
of the Multiple Indicators Cluster Survey (MICS) carried out with the
nancial support of UNICEF. Miriam Levi would like to acknowledge the
institutional support received from CeRIMP, Regional Centre for

Occupational Diseases and Injuries, Tuscany Region, Florence, Italy.
Charles Wolfes research was funded/supported by the National Institute
for Health Research (NIHR) Biomedical Research Centre based at Guys
and St Thomas NHS Foundation Trust and Kings College London. The
views expressed are those of the author(s) and not necessarily those of the
NHS, the NIHR or the Department of Health. No individuals
acknowledged receiving additional compensation for their eorts.
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Measuring the health-related Sustainable Development

See Online for infographic

policies over the next 15 years. To measure progress

www.thelancet.com Published online September 21, 2016 http://dx.doi.org/10.1016/S0140-6736(16)31467-2

risks with well established causal connections to health

comparable manner. Drawing from GBD, we provide the

Despite these concerns, increasing work has been done

www.thelancet.com Published online September 21, 2016 http://dx.doi.org/10.1016/S0140-6736(16)31467-2

Indicators, denitions, and measurement approach

Underlying GBD outputs are a range of additional

See Online for appendices

Health-related SDG, health-related MDG, and healthrelated non-MDG indices

www.thelancet.com Published online September 21, 2016 http://dx.doi.org/10.1016/S0140-6736(16)31467-2

Denition used in this

Disaster (1.5.1; same

Existing datasets do not comprehensively measure

Goal 1: End poverty in all its forms everywhere

Stunting is dened as below 2 SDs from the median MDG

Target 2.2 (as above)

Wasting is dened as below 2 SDs from the median

Target 2.2 (as above)

We used the IOTF thresholds because the WHO cuto Non-MDG

Maternal deaths per

No indicator modications required

Target 3.1 (as above)

Proportion of births attended No indicator modications required

Target 3.2: By 2030, end preventable deaths of newborns and

Probability of dying before

Target 3.2 (as above)

Probability of dying during

No indicator modications required

Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis,

Age-standardised rate of new

We revised this indicator to HIV incidence of all

Target 3.3 (as above)

Age-standardised rate of new

No indicator modications required

Target 3.3 (as above)

No indicator modications required

Target 3.3 (as above)

No indicator modications required

Target 3.3 (as above)

(Table 1 continues on next page)

www.thelancet.com Published online September 21, 2016 http://dx.doi.org/10.1016/S0140-6736(16)31467-2

Denition used in this

Target 3.4: By 2030, reduce by one-third premature mortality

Age-standardised death rate

No indicator modications required

Target 3.4 (as above)

Age-standardised death rate

No indicator modications required

Target 3.5: Strengthen the prevention and treatment of

We revised this indicator to include six categories of

Target 3.6: By 2020, halve the number of global deaths and

Road injuries (3.6.1)

Age-standardised death rate No indicator modications required

Target 3.7: By 2030, ensure universal access to sexual and

No indicator modications required

Target 3.7 (as above)

Adolescent birth rate

Birth rates for women aged

No indicator modications required