(CNN) – Are nations around the globe on track to meet health-related sustainable development goals for the year 2030? A new analysis finds outstanding achievements — but a great deal of work still needed — before the goals can be reached
This is based on measurements of 37 of 50 health-related targets proposed by the United Nations that include infant mortality, vaccination, rates of various diseases (tuberculosis, HIV, and malaria, among them), smoking, child abuse, violence and universal health coverage.
The study, published Tuesday in the journal The Lancet, also ranks 188 nations. Singapore is at the top of the list, followed by Iceland, Sweden, Norway, the Netherlands, Finland, Israel, Malta, Switzerland and the UK. The United States trails these standout nations, landing in the 24th spot on the index.
Here are the top 30 countries among 188 nations ranked in 2016 based on progress made in meeting health-related United Nations Sustainable Development Goals
17. Antigua and Barbuda
28. South Korea
29. Czech Republic
At the opposite end were Afghanistan, which ranked last, preceded by Central African Republic, Somalia, South Sudan, Chad, Niger, Democratic Republic of the Congo, Lesotho, Burundi, Sierra Leone and Ethiopia.
The UN plan includes 17 separate goals — concerning everything from climate change to education — with 169 specific targets.
To monitor progress, 232 individual indicators of success were established by Fullman and her co-authors. Next, a small army of researchers around the globe — coordinated by the Institute of Health Metrics and Evaluation — measured 37 of the 50 health-related indicators for the period of 1990 though 2016.
Finally, based on these past trends, Fullman and her co-authors projected the world’s ability to meet each target goal by the third decade of this century.
More than 60% of the total 188 nations analyzed will meet the target for malaria and the goals for under-5 mortality, neonatal mortality and maternal mortality, the study found. However, fewer than 5% of countries will attain road injury mortality, tuberculosis and childhood overweight objectives, according to the research.
Measuring overall performance on a scale from 1 to 100, the authors of the study also ranked the ability of individual countries to meet the goals. “The intention is not to create ‘horse-race rankings,’ ” said Fulman. The aim is to provide a “scientifically strong, independent monitoring mechanism” against which countries can “benchmark their progress and identify priority areas for investment.”
“Neither a ‘one-size-fits-all’ solution nor a silver bullet exists,” said Fullman.
The countries with the lowest performance “have experienced ongoing conflict and/or recent resurgences in civil unrest, which can radically destabilize a country’s health system and overall development,” she said. However, many African countries with low scores are among those that have received relatively little development assistance to date, she noted.
From 2000 through 2016, universal health coverage measurements generally improved throughout the world, the authors noted, with significant improvements achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey and China. By contrast, other countries — including the low-income nations of Lesotho and the Central African Republic as well as the high-income countries of the United States and Andorra — showed minimal gains.
The US showed its poorest performance on indicators for suicide mortality, child sex abuse, alcohol use and homicide. As Fullman sees it, despite having good performance overall in 2016, the US has made “minimal progress” since 2000 on the measure for universal health coverage, “which represents coverage of essential health services.”
“The US spends more than any other nation on health care, but often has similar, or even worse, health outcomes than many high-income countries,” Fullman said.
Last year saw the first publication of this global assessment. This year’s analysis, funded by the Bill and Melinda Gates Foundation, was published ahead of the 72nd session of the United Nations General Assembly in the hopes that it might shape policy — and investments — addressing global health challenges.