World Not On Track to Achieve Most Sustainable Development Goals by 2030: Report
India has already achieved the SDG for malaria but will fall short of achieving the goals for malnutrition and sanitation
Bengaluru: Seven years after 193 nations agreed to the ambitious target of achieving 17 Sustainable Development Goals (SDGs), "the world is on track to achieve almost none of the goals", as per the Bill & Melinda Gates Foundation's (BMGF) Goalkeepers Report 2022.
Projections of the Goalkeeper's report show that India too will not meet several SDG targets by 2030. India is projected to miss the target for stunting, maternal deaths, child mortality, neonatal mortality, and tuberculosis (TB). In 2021, India's new malaria cases were already below the 2030 target.
Globally, the percentage of people living below $1.9 a day or in extreme poverty was projected to be 8.4% in 2019, and it reduced by just 0.1 percentage point to 8.3% in 2022. The number of people who were employed but living in poverty rose for the first time in two decades due to the impact of Covid-19, according to the United Nations' (UN) 2022 Sustainable Development Goals Report.
The NITI Aayog's National Multidimensional Poverty Index estimates that a quarter of the Indian population (322.5 million of the projected population in 2016) was "multidimensionally" poor--that is considering income, education and health--in 2015-16, IndiaSpend reported in April 2022.
IndiaSpend has asked senior officials at the NITI Aayog for comments on India's progress towards the SDGs, and we will update the story when we receive a response.
"Despite significant setbacks caused by overlapping global crises, the report is optimistic, underscoring opportunities to accelerate progress toward ending poverty, fighting inequality, and reducing the impacts of climate change," a BMGF press statement said.
How the report calculates progress
The report projects data for three periods: The first is the pre-Covid-19 period from 1990 to 2021, the second is for the duration when the Covid-19 pandemic impacted the world the most, between 2020 and 2022, and the third is a future projection from 2023 to 2030.
The data sources include public data, surveys, population mobility data, administrative data from governments and the World Health Organization, and Covid-19 case data, which have been analysed by the Institute for Health Metrics Evaluation (IHME).
Here is a selection of SDG goals from the report which compares India data to the global scenario and shows how India is placed to achieve the SDGs by 2030.
Maternal and child deaths
Globally, the maternal mortality ratio (MMR) in 2021 increased to nearly 159 deaths per 100,000 live births, compared to 157 deaths per 100,000 live births in 2020. The trajectory projects 140.9 deaths per 100,000 live births in 2030, double the SDG target of 70 maternal deaths per 100,000 births, according to the BMGF Goalkeepers report.
In 2021, India reported 125 maternal deaths per 100,000 live births. India accounted for 12% of the world's maternal deaths in 2017, second only to Nigeria (23%), IndiaSpend reported in April 2022.
At a projected 82 deaths per 100,000 live births, India's maternal mortality trajectory by 2030 shows that the country is close to reaching the target of 70 deaths per 100,000, but will still fall short.
The India average also hides state-level disparities. Kerala has the lowest maternal mortality at 30 deaths per 100,000 live births while Assam has the worst, at 205, according to a July 2022, NITI Aayog report, The Indian Model of SDG Localisation.
"Planning only at the national level for achieving SDGs will be inefficacious in responding to such a diverse development status wherein the advanced states' performance is at least 4-5 times higher than the states that are at the bottom of the performance ranking," said the report.
Similarly, India's under-five mortality rate is projected to fall to 27 deaths per 1,000 live births in 2030 from 33 in 2021. The SDG target is to end preventable deaths of children under five years of age, with all countries aiming to reduce under‑five mortality to at least 25 per 1,000 live births by 2030.
Among all states, Uttar Pradesh (60 child deaths for every 1,000 live births), Bihar (56.4/1,000) and Chhattisgarh (50.4/1,000) have the highest under-five mortality rate in India.
Sri Lanka (5 child deaths per 1,000 live births), Bangladesh (21), Nepal (19) and Bhutan (22) in the subcontinent are also projected to meet the SDG target by 2030.
The target is to end all forms of malnutrition, including achieving, by 2025, the internationally agreed-upon targets on stunting (short for age) and wasting (low weight for the height) in children under five years. Until 2021, 35% of children under five years were reported to be stunted, which means they were short for their age, in India, and by 2030 it would fall only 2 percentage points compared to the target of 15%, as per projections in the BMGF Goalkeepers report.
Caste discrimination and other kinds of social exclusion reduce communities' access to maternal and child health, leading to more cases of stunting, IndiaSpend reported in September 2021. A 1% loss in adult height due to childhood stunting is associated with a 1.4% loss in economic productivity, and it is estimated that stunted children earn 20% less as adults.
The report also comes up with best and worst case projections. For stunting, a worse case projection for India is that as many will continue to be stunted by 2030 as are today, and at best, stunting will fall to 29%.
In 2030, 33% of Afghanistan's child population will be stunted, as will 29% of Pakistan's and 24% of Bangladesh's. Sri Lanka has already achieved the SDG target of 15%, the BMGF Goalkeeper's report projects.
Tuberculosis and malaria
India has 27% of the world's TB cases, the most of any country, followed by China, with 866,000 cases.
Between January 1 and September 1, 2022, India recorded 1.63 million TB cases across the country, more than the 1.4 million recorded for the period in 2021, and about 32% more than cases recorded during the same period in 2020. The number of people reported with TB dropped during the pandemic years not because fewer people contracted the disease but because of a drop in case notifications, IndiaSpend reported in March 2022.
According to the BMGF Goalkeepers report, globally, cases are expected to drop from 107 TB cases per 100,000 in 2021 to 95 per 100,000 people in 2030. India is projected to report 155 cases per 100,000 people in 2030, nearly eight times the target of 20 per 100,000 people.
Despite India accounting for about 82% of all malaria deaths and as many cases in South-East Asia in 2020, it has already met the SDG target. In 2021, 5 new cases per 1,000 people were reported in India, lower than the target of 9 per 1,000 people. At 2 cases per 1,000 people, India's malaria cases will continue to be below the target.
If India is able to eradicate malaria, it will join countries including Iran and Malaysia that had not reported a single malaria case for the past three years as of 2020, and China and El Salvador that were declared malaria-free in 2021, IndiaSpend reported in September 2022.
Universal health coverage
The ambitious goal of providing universal health coverage for all was still behind target by 40 percentage points in 2021, globally. India's effective universal coverage was 52% in 2021 and is projected to increase to 60% in 2030, which is the current global coverage.
Three years after the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana was launched in September 2018, the scheme has been unable to meet one of its most important objectives--of providing 'cashless and paperless' access to healthcare for patients at the point of care, IndiaSpend reported in August 2021.
Government expenditure on health reduced from 1.35% of India's gross domestic product (GDP) in 2017-18 to 1.28% in 2018-19.
"...no country has effectively managed to provide equitable and inclusive healthcare to all following the goal of universal health coverage--which India has recognised as its own goal--without investing in the public health system," said Yamini Aiyar, president and CEO of the Centre for Policy Research, a think-tank.
Women, globally, spend 3.2 times as many hours as men performing domestic and care work, according to the BMGF Goalkeeper's report.
In India, women spend 7.8 times as many hours as men on domestic and care work. The South Asia regional average is 7.1. Indian women do the most unpaid care and domestic work of any country globally, except Kazakhstan--a country with 94% lower GDP than India ($163 billion vs. India's $2.6 trillion).
This high burden of domestic and care work dissuades women from taking up jobs. Read IndiaSpend's Women@Work series on the challenges that women face in joining and continuing in the workforce.
In 2014, the Union government embarked on a programme, the Swachh Bharat Mission, to ensure that all rural households have access to toilets, and to end open defecation. In five years the government declared 100% coverage, although the data are contested.
The SDG's aim is to ensure "safely managed" sanitation, which includes both improved toilet facilities as well as ensuring that the excreta are safely disposed of. This can include sewer connections to a functioning wastewater treatment plan and other lower-cost technologies to safely manage waste.
According to the projection by the BMGF report, except for the high income countries, no other region reports a population with more than 90% access to safely managed sanitation by 2030. India's coverage is expected to increase from 39% in 2021 to 51% in 2030, compared to a global change from 58% to 65% during the same period.
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