Good health and well-being

Target 3.1 aims to  reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030.

Maternal mortality is defined as the death of a female due to pregnancy or childbirth. Besides the tragic loss of the mother’s life, there are long-term, adverse effects on the child, the family, and the community.

Maternal mortality occurs in all parts of the world, but it is much more prevalent in low and lower middle-income countries. In 2017 an average of 10 maternal deaths per 100,000 live births occurred in Europe, while an average of 415 maternal deaths per 100,000 live births occurred in lower income countries – a 40-fold difference. In several sub-Saharan African countries, there are over 1,000 maternal deaths for every 100,000 live births.

Most of these deaths are preventable: high blood pressure during pregnancy can be treated with medication; severe bleeding after childbirth can be prevented with an injection of oxytocic; infections after childbirth can be prevented with good hygiene practices and proper medication; unsafe abortion can be prevented with proper access to contraception and safe abortion practices. These are the leading causes of maternal death and their life-saving health interventions.

Women do not receive these health interventions because they do not have access to quality health care. Less than half of all births in the countries with the highest maternal mortality ratio are attended by a trained midwife, nurse or doctor. This SDG can be achieved by 2030 if women have quality health care before and during pregnancy and after childbirth.

Globally, 2.4 million children died in the first month of life in 2019 and there are approximately 7,000 newborn deaths every day world wide. Target 3.2 aims, by 2030 [AF3] to 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. It is categorized by two main indicators as mentioned above; Indicator 3.2.1 for Under-five mortality rate and indicator 3.2.2 Neonatal mortality rate

Indicator 3.2.1: - Under five child mortality is the probability that a child born in a specific year or period dying before reaching 5 years, if subjected to age specific mortality rates of that period expressed per 1000 live births.

Indicator 3.2.2: - Neonatal mortality rate is the probability that a child born in a specific year or period will die during the first 28 completed days of life is subjected to age specific mortality rates of that period per 1000 live births. It is further classified into early neonatal deaths, occurring during the first 7 days of life and late neonatal death deaths, occurring after the 7th day but before the 28th completed day of life.

These are key output indicators for child health and well-being, and, even for social and economic development in broad terms. In public health it reflects the access of children and the community at large to basic health interventions such as vaccination, medical treatment of infectious and communicable diseases and adequate nutrition.

SDG Target 3.3 aims to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases. In 2019 there were 1.7 million people infected with HIV and 229 million people with malaria. Furthermore, between 2015 and 2019 a reduction of 2% a year of tuberculosis was recorded.

Since the introduction of the SDGs, sign[AF4] ificant progress has already been made in diminishing new infections with AIDS, tuberculosis, malaria, neglected tropical diseases, and hepatitis B. This partial success is considerably due to efficient intervention programs, yet there is still a long way to go to end the epidemics of communicable diseases by 2030.

While existing interventions with a focus on both preventive actions and treatment have managed to bring down transmission rates, further advances in public health, infrastructure, and medicine are going to be vital for meeting this target. Public health institutions must ensure holistic case monitoring and disease surveillance to enable rapid identification of focal points and thus allow for quick response to infections with communicable diseases. Besides, they are also instrumental in the early detection of emerging threats like drug resistance, for raising these concerns to the international community and drug developers in particular. For reducing transmission, raising awareness for sources of infection and for the use of preventive measures are further crucial public health operations. This requires training and education of personnel, particularly when it comes to clinical tasks like acute care and drug administration.

With the support of the international community, the geographical coverage of existing public health intervention programs needs to be expanded in order to reach all those in need. To do so in an efficient manner, it is key that all parties who are involved in the process towards meeting this target, join forces in their fight against communicable diseases.

SDG Target 3.4 aims to reduce by one-third pre-mature mortality from non-communicable diseases (NCDs) through prevention and treatment, and promote mental health and wellbeing by 2030.

Noncommunicable diseases are a group [AF5] of conditions that includes diabetes, cardiovascular diseases, cancer, chronic respiratory diseases and mental disorders. They account for a significant number of deaths in the younger population. With these types of diseases, many people are unable to experience life in old age and thus, are losing years of life.

How noncommunicable diseases develop depends on various factors. In addition to genetic conditions, the overall lifestyle plays an important role. A healthy lifestyle reduces noncommunicable diseases and their consequences. Not only do these diseases cause great personal suffering, but they also represent a challenge for our health system and a burden for society. The positive side: They can be prevented. In order to ensure public health, public well-being, the prevention of noncommunicable disease and the prolongation of life, certain strategies must be applied. An equitable distribution of the benefits of effective strategies, such as the promotion of mental health, the capability to detect cancer at an early stage and further developments in science, could bring significant health gains for each individual as well as the world population.

SDG Target 3.5 aims to Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

Worldwide, an estimated 3 million lives are lost every year due to the abusive use of alcohol, and 500,000 lives from narcotic drug use.  The consequences of abuse from these drugs does not just affect the individual, both directly and indirectly, but also has impacts at the family and community level.  Further, the economic burden cannot be overlooked, with an estimated 700 billion dollars spent annually in the United States alone on the misuse of these drugs.  The unsafe use of alcohol is considered to be attributable to more than 200 diseases or injury, and this is illustrated in the 338,000 hospital admissions in the United Kingdom through 2017-2018 solely due to alcohol.  Generally speaking, substance abuse is an issue that has no strict bounds of socioeconomic status, education level, age, sex, or country of origin.  It is a matter of worldwide concern for all citizens of the world.  

Strengthening the prevention and treatment of substance abuse is a keystone to public health, and therefore an important target for the Sustainable Development Goals.  At the core of prevention must be education and awareness, especially during the formative years.  First, by addressing the risks during youth, it is possible to curtail the incidence of substance abuse before it begins.  Secondly, treatment for those battling addiction must be another central pillar of addressing this global health concern.  It is important to consider the obstacles individuals face when fighting addiction, such as cost of treatment, availability of support groups, and criminalisation of addictive behaviour.  By setting policy to favour education and support, while regulating the accessibility of these drugs, all members of society will benefit.

SDG Target 3.6 aims to halve the number of global deaths and injuries from road traffic accidents.

Road traffic accidents (RTAs) account for 1.35 million deaths per year. Between 20 and 50 million people suffer injuries from RTAs each year. Some of the most common risk factors for RTAs are speeding, driving under the influence (alcohol and/or other drugs), distracted driving, non-use of seatbelts, car seats, and motorcycle helmets, unsafe vehicles and road infrastructure, and inadequate enforcement of traffic laws. Public health is essential to reducing the number of deaths and injuries due to RTAs, by implementing laws and regulations to decrease the risk factors of RTAs. Recently, 22 countries have changed their laws to account for the key risk factors, mentioned above, to decrease the risk of RTAs. Some examples of public health interventions that have already made a difference is through laws and regulations regarding seatbelts, helmets and car seats, higher penalties for speeding and driving under the influence and stricter traffic enforcement. However, these public health interventions are not prevalent in all countries.  Road traffic deaths and injuries disproportionately affect low and middle-income countries. Deaths from traffic accidents in middle and low-income countries account for more than 90% of total road traffic deaths. Higher income countries are more likely to have public health regulations regarding road traffic safety. Therefore, there is an opportunity for more public health interventions in middle and low-income countries, to decrease the number of injuries and deaths from RTAs.

SDG 3.7 aims to 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 programs.

This target directly contributes to improving the health of whole populations, as people all over the world can be affected by adverse consequences of neglected reproductive health services. Improving and enabling access and usage of these services, in combination with education, is crucial to tackle the burden of poor sexual and reproductive health on a community level. This is important, as reproductive health and related diseases are still stigmatised and need a public health approach to be naturally integrated into a life course of individuals.

Reproductive health impacts men and women of all ages. Comprehensive information about sexually transmitted infections, contraception and family planning is essential for individuals, not only but especially in their reproductive years. Furthermore, understandable education about sexuality and sustainable integration into people's lives is important to avoid a vicious cycle of poor reproductive health. Nevertheless, adverse outcomes from poor reproductive health can also reduce and threaten quality of life into older age, and national programmes need to reach these age groups as well. In addition, children directly benefit from knowledge and preventive behaviour of their social environment. By enabling youth access to reproductive health related services and education before their reproductive period begins, they may be protected from adverse outcomes later in life.

This target is strongly related to the Essential Public Health Operation 5 of the World Health Organization: Disease prevention, including early detection of illness. In combination, the fight against poor reproductive health can be combated using all three levels of prevention. Benefits can therefore be reached due to this broad approach by including policies to integrate understanding and usage of reproductive health into all aspects of life.

Target 3.8 aims to 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.

In simpler terms, this means ensuring all individuals and communities receive essential health services without having to pay for it out of their own pockets. Universal health coverage does not include free coverage for all health interventions because this is not a sustainable approach for most countries. Instead, it aims to provide a minimum package of health services to individuals, families and communities throughout their life course in order to significantly reduce their financial hardships, especially in the event of severe, unexpected or long-term illness. It goes beyond health financing to include and improve essential health system components that immensely affect quality of care. These include health service delivery systems, the health workforce, health facilities and communications networks, health technologies, governance and legislation amongst others. It encompasses the whole spectrum of health care- from services that focus on the needs and expectations of people and communities to the funding, management and delivery of these services. WHO, in collaboration with many different partners around the world, is helping countries improve their health systems and commit to primary health care as the key to achieving Universal health coverage. To evaluate each country`s progress in the area, WHO has introduced 16 essential health services in 4 categories as indicators of the level and equity of coverage. Universal health coverage can have a direct positive impact on public health because affordable access to quality health care services and products ensures good health, reduces poverty and provides the basis for long-term economic development.

SDG 3.9 aims to substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination by 2030.

At present, the environmental problems faced by human beings mainly include air pollution, climate change, chemical and waste pollution, water and soil pollution, etc. These environmental problems have become an urgent issue for the sustainable development of human society. Air pollution has become the single biggest environmental health risk in the world. Nearly 3 billion people in developing countries rely on solid fuels, traditional biofuels, coal, open fires, and traditional stoves for cooking and heating, making them the most affected by indoor air pollution. Household air pollution from the inefficient use of solid fuels will cause disease. Climate change will affect the concentration of fine particulate matter and ozone in the air, which will potentially lead to cardiovascular and respiratory diseases. Ozone destruction leads to increased human exposure to ultraviolet radiation, which increases the risk of skin cancer, cataracts, and immune system suppression, among other diseases.The effects of unsafe use of chemicals and inadequate waste disposal occur mostly in poor areas. Nearly all deaths due to pesticide exposure occur in developing countries. E-waste which can disrupt the function of the human endocrine system and affect human growth and neurological development is one of the fastest growing forms of waste worldwide

More than the average hospital bed worldwide is occupied by patients with water-related diseases and 90% of diarrheal diseases are related to environmental pollution and lack of access to safe drinking water and sanitation. Additionally, in coastal areas salinization can cause diseases such as hypertension and eclampsia, which can cause maternal mortality, neonatal death, and neurological disorders.

Soil is an important source of nutrients for the human food supply and medicines such as antibiotics. However, as a result of human activities or natural conditions, nutrient imbalances in soil biomes have led to toxic levels of elements and chemicals in the soil.