COVID-19 FURTHER IMPEDES PROGRESS TOWARDS MEETING THE SUSTAINABLE DEVELOPMENT GOAL 3

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Download PDF The 17 Sustainable Development Goals (SDGs) that were adopted by all United Nations Member States in 2015 set ambitious targets to transform and improve the lives of people by 2030. According to the 2020 Sustainable Development Goals Report, global progress to meet these ambitious goals was already off track at the end of 2019. Concerted efforts are required to…

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Concerted efforts are required to put the Sustainable Development Goal 3 on track

ABSTRACT Globally there has been some progress in meeting the Sustainable Development Goal 3, which focuses on good health and well-being for all by 2030, though the progress is still not rapid enough to meet the targets. For instance, the progress in reducing maternal deaths has been declining by 2.9% annually between 2000 and 2017, which is less than the annual decline of 6.4% required to achieve the 2030 target. The number of new HIV cases was 1.7 million in 2019, and unless interventions are accelerated, the target to end AIDS by 2030 remains a mirage. The COVID-19 pandemic, which has overwhelmed most health systems, throws the progress made towards meeting targets for SDG 3 even further off-track.

The 17 Sustainable Development Goals (SDGs) that were adopted by all United Nations Member States in 2015 set ambitious targets to transform and improve the lives of people by 2030. According to the 2020 Sustainable Development Goals Report, global progress to meet these ambitious goals was already off track at the end of 2019. Concerted efforts are required to set the world back on track. The onset of the COVID-19 pandemic exacerbates the unequitable progress made in meeting the SDGs. The disease has highly negative socio-economic implications, affecting almost all sectors of production all over the world. Besides introducing a health crisis, the disease is feared to have sparked an economic recession, according to the World Bank.

COVID-19 is overwhelming most health systems and disrupting essential health service provisions in many countries across the world. The pandemic has caused a significant loss of lives. According to the World Health Organization’s (WHO) Coronavirus disease (COVID-19) Situation Report, by 29 July 2020, 16.6 million people were infected with the COVID-19, and 656 093 had succumbed to the disease globally. America is the most affected, with over half of the COVID-19 infections and subsequent deaths reported in the region.

SDG 3: Good health and well-being

SDG 3 aims to ensure good health and well-being for all by 2030. It is based on the premise that good health is necessary for sustainable development. It takes the existing burden of infectious diseases and non-communicable diseases, prevailing socio-economic inequalities, rapid urbanization, and climate change into account. It aspires to achieve universal health coverage and provide access to therapeutics and vaccines.

COVID-19 has had an impact on the realization of SDG 3, particularly with regard to maternal and child health, and communicable and non-communicable diseases.

COVID-19 negatively impacts on maternal and child health

SDG 3 aims to reduce maternal deaths to less than 70 per 100 000 live births, neonatal deaths to less than 17 per 1 000 live births, and the deaths of children under five years to less than 25 per 1 000 live births, by 2030, according to the United Nations. WHO defines maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.” Live birth is the delivery of a child who is alive irrespective of the duration of the pregnancy.

Between 2000 and 2017, there was some improvement in maternal health globally, but not enough to meet the 2030 target. In this period, the maternal deaths declined from 342 to 211 per 100 000 live births. This translates to a 2.9% annual decline in global maternal deaths, when an annual decline of 6.4% is required to achieve the 2030 target.

Tremendous progress has been made in reducing global deaths of neonates and children under five years in the last two decades. The world is on track to achieve its target by 2030, according to the 2020 Sustainable Development Goals Report. Between 2000 and 2018, global neonatal deaths declined from 31 to 18 per 1 000 live births, while deaths of children under five years declined from 76 to 39 per live births globally. A total of 121 countries met the target for reducing deaths of children under five years by 2018, and 21 are expected to meet the target by 2030. However, 53 countries, of which two-thirds are in sub-Saharan Africa, require fast-tracking interventions to meet this target by then.

The COVID-19 crisis has disrupted the provision of essential health services, including births assisted by skilled attendants, vaccination programs and nutritional services, and led to a spike of domestic violence against women and children. This potentially slows down the progress made in maternal, neonatal, and child health as more mothers and children are likely to die due to the disruption of routine health care. A study published on 1 July 2020 predicts a monthly increase in maternal and under-five child deaths by 8.3–38.6% and 9.8–44.7%, respectively, as a result of health service disruption caused by the pandemic.

COVID-19 could potentially increase illnesses and deaths from communicable diseases

Communicable diseases are infectious diseases spread from one person to another through contact with body fluids, ingesting or breathing in a disease-causing agent, or through an insect bite.

SDG 3 aspires to end the epidemics of acquired immunodeficiency syndrome (AIDS), tuberculosis (TB), malaria, and neglected tropical diseases by 2030. AIDS, a disease caused by the attack of the body’s immune system by human immunodeficiency virus (HIV), was the cause of 600 000 deaths in 2019, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS) Global AIDS Update of 2020. The number of new HIV infections was estimated at 1.7 million at the time, which was a decrease of 23% compared to the 2010 figure.

Between 2000 and 2018, the rate of new TB cases decreased from 172 to 132 per 100 000 population. New cases of malaria dropped from 81 to 57 per 1000 population between 2000 and 2014. However, between 2014 and 2018, the numbers have remained the same. Notable progress has been made to reduce cases of neglected tropical diseases over the last decade as the number of people who sought treatment for the diseases dropped from 2.19 billion in 2010 to 1.76 billion in 2018. The remarkable progress is partly attributed to the elimination of at least one neglected tropical disease in 40 countries.

These figures show just how far the world is from ending these epidemics in the next decade. The COVID-19 pandemic erodes what has been gained so far and worsens an already bad situation. Disruption of HIV services for six months, as has been witnessed during the COVID-19 crisis, will result in half a million additional deaths in 2021-2022 in sub-Saharan Africa. Similarly, a three-month disruption in TB detection would result in a death surge of 13%. Disruption of malaria interventions due to the pandemic will result in an increase in malaria cases by 23% and 100% deaths by the end of 2020 in sub-Saharan Africa. Gains made in combating neglected tropical diseases are likely to be eroded by health service provision due to COVID-19.

COVID-19 could potentially increase illnesses and deaths from non-communicable diseases

Non-communicable diseases cannot be transmitted from one person to another. SDG 3 aspires to decrease the premature deaths from non-communicable diseases by a third by 2030. There has been slow progress in the reduction of the number of deaths from diseases affecting the heart or blood vessels (such as hypertension), cancer, diabetes, and chronic respiratory disease. Between 2000 and 2010, the number of people aged 30 to 70 dying from the four non-communicable diseases decreased from 22% to 19%. A slower reduction was reported in 2010-2016 as the number of deaths reduced to 18%. The shortage of health services to prevent and treat non-communicable diseases is attributed to slow progress in decreasing deaths from non-communicable diseases.

The COVID-19 pandemic aggravates the situation since people with pre-existing conditions are at higher risk of death from the disease, as reported in a study published on 8 July 2020. A survey conducted in May in 155 countries revealed COVID-19 caused disruption of hypertension services in more than half of the countries. Furthermore, the pandemic disrupted diabetes and cancer treatments in 49% and 42% of the countries, respectively. In most countries, disruptions were a result of the reassignment of staff and the postponement of screening.

Way forward

Achieving the SDGs on health remains a very distant possibility with the onset of the COVID-19 pandemic. Concerted efforts are what the world needs to combat the disease to reduce its negative impact in the health sector and beyond.

Further resources

• The 2020 United Nations report, ‘The Sustainable Development Goals Report 2020“, 07 July 2020
• The 2020 UNAIDS report, “Seizing the moment – Tackling entrenched inequalities to end epidemics“, 6 July 2020