Progress toward goals in global health is slowing

(HealthDay)—Global progress in health has slowed, and improvements in health have been unevenly distributed, according to a series of articles published in a special issue of The Lancet, highlighting the fact that global progress in health is not inevitable.

Researchers from the Global Burden of Disease Study (GBD) 2017 provided estimates of the mortality experience of populations globally using data from 1950 to 2017 for 195 countries and territories and subnational locations.

The researchers found there have been global successes in mortality, such as the large decline for under-5s, but other mortality patterns show cause for concern, especially among adult men and, to a lesser extent, adult women. Total fertility rates decreased during the study period, but as mortality declined, the global population continued to grow. Improvements in global health have been unevenly distributed among populations, with a continuing disparity in mortality rates by sex across age groups; for some common diseases, reductions in the mortality rates are slowing or have ceased, while there have been increases for selected causes. Rates of global all-cause age-standardized years lived with disability improved only slightly from 1996 to 2017; however, there has been a global expansion in the magnitude of nonfatal disease burden. Life expectancy is increasing in most countries, but the additional years of life gained are spent in poor health in some countries. The effects of population growth and aging have largely been offset by decreases in behavioral, environmental, and occupational risks in relation to trends in absolute disease burden. Finally, current projections show that many health-related U.N. Sustainable Development Goals, noncommunicable diseases (NCDs), NCD-related risks, and violence-related indicators require prevention-oriented policy action and investments to achieve 2030 aims.

“Not only do the amalgamated global figures show a worrying slowdown in progress but the more granular data unearths exactly how patchy progress has been,” write the authors of an editorial published in the issue. “GBD 2017 is a reminder that, without vigilance and constant effort, progress can easily be reversed.”

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