Goal 3: Ensure healthy lives and promote well-being for all at all ages

Ensuring healthy lives and promoting the well-being at all ages is essential to sustainable development.

Significant strides have been made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality, but working towards achieving the target of less than 70 maternal deaths per 100,000 live births by 2030 would require improvements in skilled delivery care.

Achieving the target of reducing premature deaths due to incommunicable diseases by 1/3 by the year 2030 would also require more efficient technologies for clean fuel use during cooking and education on the risks of tobacco.

Many more efforts are needed to fully eradicate a wide range of diseases and address many different persistent and emerging health issues. By focusing on providing more efficient funding of health systems, improved sanitation and hygiene, increased access to physicians and more tips on ways to reduce ambient pollution, significant progress can be made in helping to save the lives of millions.

Facts and figures

Child health

●17,000 fewer children die each day than in 1990, but more than five million children still die before their fifth birthday each year.

●Since 2000, measles vaccines have averted nearly 15.6 million deaths.

●Despite determined global progress, an increasing proportion of child deaths are in Sub-Saharan Africa and Southern Asia. Four out of every five deaths of children under age five occur in these regions.

●Children born into poverty are almost twice as likely to die before the age of five as those from wealthier families.

●Children of educated mothers—even mothers with only primary schooling—are more likely to survive than children of mothers with no education.

Maternal health

●Maternal mortality has fallen by 37% since 2000.

●In Eastern Asia, Northern Africa and Southern Asia, maternal mortality has declined by around two-thirds.

●But maternal mortality ratio – the proportion of mothers that do not survive childbirth compared to those who do –   in developing regions is still 14 times higher than in the developed regions.

●More women are receiving antenatal care. In developing regions, antenatal care increased from 65 per cent in 1990 to 83 per cent in 2012.

●Only half of women in developing regions receive the recommended amount of health care they need.

●Fewer teens are having children in most developing regions, but progress has slowed. The large increase in contraceptive use in the 1990s was not matched in the 2000s.

●The need for family planning is slowly being met for more women, but demand is increasing at a rapid pace.

HIV/AIDS, malaria and other diseases

●36.9 million people globally were living with HIV in 2017.

●21.7 million million people were accessing antiretroviral therapy in 2017.

●1.8 million people became newly infected with HIV in 2017.

●940 000 people died from AIDS-related illnesses in 2017.

●77.3 million people have become infected with HIV since the start of the epidemic.

●35.4 million people have died from AIDS-related illnesses since the start of the epidemic.

●Tuberculosis remains the leading cause of death among people living with HIV, accounting for around one in three AIDS-related deaths.

●Globally, adolescent girls and young women face gender-based inequalities, exclusion, discrimination and violence, which put them at increased risk of acquiring HIV.

●HIV is the leading cause of death for women of reproductive age worldwide.

●AIDS is now the leading cause of death among adolescents (aged 10–19) in Africa and the second most common cause of death among adolescents globally.

●Over 6.2 million malaria deaths have been averted between 2000 and 2015, primarily of children under five years of age in sub-Saharan Africa. The global malaria incidence rate has fallen by an estimated 37 per cent and the mortality rates by 58 per cent.

Goal 3 targets

●3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.

●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 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.

●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.

●3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

●3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

●3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents.

●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.

●3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

●3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.

●3.A Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.

●3.B Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.

●3.C Substantially increase health financing 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.D Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

GOOD HEALTH AND WELL-BEING: WHY IT MATTERS

(UN Photo / Hien Macline)

Spending $1 billion in immunization coverage can save 1 million children’s lives each year

What’s the goal here?

To ensure healthy lives and promote well-being for all at all ages.

Why?

Ensuring healthy lives and promoting well-being for all at all ages is important to building prosperous societies.

Major progress has been made in improving the health of millions of people. Maternal and child mortality rates have been reduced, life expectancy continues to increase globally, and the fight against some infectious diseases has made steady progress.

However, in the case of other diseases such as malaria and tuberculosis, progress has slowed or stalled.

At least half the world’s population are still without access to essential health services.

In rich and poor countries alike, a health emergency can push people into bankruptcy or poverty.

Concerted efforts are required to achieve universal health coverage and sustainable financing for health; address the growing burden of

non-communicable diseases, tackle antimicrobial resistance and environmental factors contributing to ill health.

What progress have we made so far?

Major progress has been made in several areas, including in child and maternal health as well as in addressing HIV/AIDS.

Despite this progress, maternal mortality continues to affect women in low- and middle-income countries disproportionately.

The total number of deaths of children under 5 years of age dropped from 9.8 million in 2000 to 5.4 million in 2017. Half of those deaths occurred in sub-Saharan Africa, and another 30 per cent in Southern Asia. Yet stark disparities persist across regions and countries.

How much will it cost to achieve these targets?

Ensuring healthy lives for all requires a strong commitment, but the benefits outweigh the cost. Healthy people are the foundation for healthy economies.

For example, if we spent $1 billion in expanding immunization coverage against influenza, pneumonia and other preventable diseases, we could save 1 million children’s lives each year. In the past decade, improvements in health and heath care led to a 24 per cent increase in income growth in some of the poorest countries.

The cost of inaction is greater—millions of children will continue to die from preventable diseases, women will die in pregnancy and childbirth, and health care costs will continue to plunge millions of people into poverty.

Noncommunicable diseases alone will cost low- and middle-income countries more than $7 trillion in the next 15 years.

What can I do to help?

You can start by promoting and protecting your own health and the health of those around you, by making well-informed choices, practicing safe sex and vaccinating your children.

You can raise awareness in your community about the importance of good health, healthy lifestyles as well as people’s right to quality health care services, especially for the most vulnerable such as women and children.

You can also hold your government, local leaders and other decision-makers accountable to their commitments to improve people’s access to health and health care.

Source: un.org

●Cases

Shenzhen’s 10-Year Medical Reform Has Achieved Great Success, with Average Life Expectancy over 81 Years

Since 2009, the medical reforms taking place in Shenzhen have led to new developments in improving health. In Shenzhen, many reforms and innovations have emerged in the field of medicine, and due to this, Shenzhen has provided its own wisdom for national medical reforms. 

In the past 10 years, Shenzhen has always closely integrated the rapid growth of medical demand and the integration of the development of medical and health care throughout the special economic zone, which was expanded to the whole city in 2010. It has continuously increased investment, continued to increase the number of new construction, reconstruction and expansion projects, and promoted the balanced and coordinated development of health care. 

Shenzhen has invested more than 110 billion yuan and has promoted the construction of 115 major health projects, 80 of which are outside the original special zone. Six new municipal hospitals and seven district hospitals have been added, while 17 regional medical centers and 12 grassroots medical organizations have been established. 

The total amount of health resources and medical services in Shenzhen has doubled since 2009. With the rapidly growing population, the total amount of medical resources per capita has also increased substantially, and the integrated development of medical and healthcare service throughout the special economic zone has achieved remarkable results.

In the past 10 years, Shenzhen has greatly improved its medical and healthcare fields.  The number of medical and health institutions has increased from 2,597 to 4,406. The number of hospitals has increased from 115 to 156, the number of Grade 3 hospitals has increased from 17 to 42, and the number of 3A hospitals has increased from 5 to 18. The number of hospital beds and number of practicing doctors have increased from 21,399 and 21,388 to 47,551 and 36,402 respectively, and the number of hospital beds per thousand and the number of medical practitioners per thousand have  increased from 2.2 and 2.2 to 3.7 and 2.8 respectively. In 2018, the average life expectancy of citizens is around 81.25 years old, nearly three years older than that in 2009. 

In the new era of medical reform, Shenzhen has overcome many difficulties and functioned as the prime example for other cities to follow.

The “five in one” basic medical and health system framework and the modern hospital management system have been basically established in Shenzhen, which became the first national pilot city for public hospital reform and a national model city for comprehensive reform of public hospitals.

The reform has achieved substantial results, and the welfare of public hospitals been well reflected. The proportion of personal health expenditure to total health expenditure fell to 19.13 percent, and the proportion of medicine sales to the total income of public hospitals dropped from 39.5 percent in 2008 to 24.34 percent in 2018. 

Shenzhen has promoted the separation of ownership and management rights of public hospitals over the past 10 years, and the city has seen hospitals and medical schools run by famous universities, such as Peking University, the University of Hong Kong, Sun Yat-Sen University, Southern Medical University, Beijing University of Chinese Medicine, Guangzhou University of Chinese Medicine, and Shanghai University of Traditional Chinese Medicine. The Shenzhen Center of the Cancer Hospital of the Chinese Academy of Medical Sciences and the Shenzhen Hospital of Fuwai Hospital of the Chinese Academy of Medical Sciences have alleviated the lack of prominent cancer and cardiovascular hospitals. 

Shenzhen has also implemented its medical care project of “famous doctors (departments), famous hospitals and famous clinics”, featuring the introduction of 228 professional teams, which are among top 10 domestic high-level teams or first-class international teams, to assist in the construction of more disciplines and talents, and the increased resources devoted to solving difficult cases. This has reduced the troubles that many people face when attempting to receive medical treatment.

A number of national-level major platforms, such as the National Tuberculosis Clinical Medical Research Center, the National Center in South China for Cardiovascular Diseases, the National Center in the Region for Infectious Diseases, and the National Center in the Region for Traditional Chinese Medicine for Liver Diseases, have settled in Shenzhen, and 12 medical disciplines of the city rank among the top 50 in the country.

In the past 10 years, Shenzhen has continuously promoted the development concept of great health, and the city has made preparations to build a new era of health in China, aptly named the “Shenzhen Model”. 

Shenzhen has launched 11 action plans to improve health, and it has undertaken the construction of national pilot zones and demonstration zones in seven areas, including mental health, AIDS prevention, health emergency, integration of medical care and prevention, and integration of medical care and old-age care. The city has obtained a first prize in the national mental health comprehensive supervision and evaluation. Nanshan District is the first place winner of the national evaluation for the prevention and control of chronic illnesses. Longhua District is now a national health promotion area. 

In its next step in medical reform, Shenzhen will reform key areas, strengthening the linkage of medical care, medical insurance, and medical reform. In doing so, Shenzhen will enhance the overall, systematic, and synergistic reforms. Thus, the city will take the lead in establishing and improving basic medical and health systems with Chinese characteristics. 

Source: Shenzhen Municipal Health Commission, Shenzhen Special Zone Daily