December 18, 2014
The Lancet Global Health recently published an article that estimates annual rates of mortality decline to predict the feasibility of achieving the Lancet Commission on Investing in Health (CIH) targets for 2030. The study, Annual rates of decline in child, maternal, HIV, and tuberculosis mortality across 109 countries of low and middle income from 1990 to 2013: an assessment of the feasibility of post-2015 goals, was co-authored by CIH Commissioners Dean Jamison and Gavin Yamey with Stephane Verguet, Ole Norheim, and Zachary Olsen.
The authors measured countries’ health performance by examining the annual rate of decline in child, maternal, AIDS, and TB deaths over the past two decades for 109 low- and middle-income countries. These rates were then projected forwards to determine whether countries are currently on course to meet the CIH’s proposed targets for 2030 (i.e., 20 deaths per 1000 for under-5 mortality, 94 deaths per 100,000 for maternal mortality, four deaths per 100,000 for tuberculosis mortality, and eight deaths per 100,000 for HIV mortality). Very few countries will meet these targets at their current rates of decline.
However, the authors then estimated what would happen if all countries were able to emulate rates of decline in best performing countries. Using aspirational best-performer rates, many more countries would be on track to meet the CIH’s goals. Most would meet the CIH’s 2030 targets for tuberculosis and HIV mortality, about half would reach the child mortality target, and fewer than half would meet the maternal mortality target.
These findings call attention to the gap between countries’ projected performance and the health targets under consideration for the post-2015 Sustainable Development Goals. For countries to significantly reduce deaths, it’s necessary to aggressively scale-up existing tools and invest in the development of new technologies.