《世界卫生组织（WHO）：2024世界卫生统计报告（英文版）（96页）.pdf》由会员分享，可在线阅读，更多相关《世界卫生组织（WHO）：2024世界卫生统计报告（英文版）（96页）.pdf（96页珍藏版）》请在三个皮匠报告上搜索。

1、World health statistics 2024Monitoring health for the SDGs,Sustainable Development GoalsWorld health statistics 2024Monitoring health for the SDGs,Sustainable Development GoalsWorld health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals ISBN 978-92-4-009470-3(electronic

2、version)ISBN 978-92-4-009471-0(print version)World Health Organization 2024Some rights reserved.This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence(CC BY-NC-SA 3.0 IGO;https:/creativecommons.org/licenses/by-nc-sa/3.0/igo).Under the terms of this lic

3、ence,you may copy,redistribute and adapt the work for non-commercial purposes,provided the work is appropriately cited,as indicated below.In any use of this work,there should be no suggestion that WHO endorses any specific organization,products or services.The use of the WHO logo is not permitted.If

4、 you adapt the work,then you must license your work under the same or equivalent Creative Commons licence.If you create a translation of this work,you should add the following disclaimer along with the suggested citation:“This translation was not created by the World Health Organization(WHO).WHO is

5、not responsible for the content or accuracy of this translation.The original English edition shall be the binding and authentic edition”.Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organizat

6、ion(http:/www.wipo.int/amc/en/mediation/rules/).Suggested citation.World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals.Geneva:World Health Organization;2024.Licence:CC BY-NC-SA 3.0 IGO.Cataloguing-in-Publication(CIP)data.CIP data are available at https:/iris.who

7、.int/.Sales,rights and licensing.To purchase WHO publications,see https:/www.who.int/publications/book-orders.To submit requests for commercial use and queries on rights and licensing,see https:/www.who.int/copyright.Third-party materials.If you wish to reuse material from this work that is attribut

8、ed to a third party,such as tables,figures or images,it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder.The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with t

9、he user.General disclaimers.The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country,territory,city or area or of its authorities,or concerning the delimitati

10、on of its frontiers or boundaries.Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by WHO in preference to other

11、s of a similar nature that are not mentioned.Errors and omissions excepted,the names of proprietary products are distinguished by initial capital letters.All reasonable precautions have been taken by WHO to verify the information contained in this publication.However,the published material is being

12、distributed without warranty of any kind,either expressed or implied.The responsibility for the interpretation and use of the material lies with the reader.In no event shall WHO be liable for damages arising from its use.iiiContentsForeword vAbbreviations viIntroduction 1Key messages 31.Life expecta

13、ncy,healthy life expectancy and burden of disease in the light of the COVID-19 pandemic 51.1 Life expectancy and healthy life expectancy 61.1.1 Global trend 61.1.2 Regional trends 71.2 Shifting disease burden 91.2.1 Broad categories of causes of deaths 91.2.2 Leading causes of death 121.3 Mortality-

14、related SDG indicators 141.3.1 Maternal and child mortality 141.3.2 Mortality due to injury 171.3.3 Mortality due to NCDs 191.3.4 Mortality attributable to environmental risk factors 212.Health-related SDGs 232.1 Infectious diseases 242.1.1 HIV 242.1.2 TB 252.1.3 Malaria 262.1.4 Hepatitis 282.1.5 NT

15、Ds 282.1.6 Polio 332.1.7 Antimicrobial resistance 332.2 Risk factors for health 342.2.1 Nutritional risk factors 342.2.2 Behavioural risk factors 342.2.3 Metabolic risk factors 382.2.4 Environmental risk factors 382.2.5 Risks to womens and girls health 422.3 Health systems strengthening as a key mea

16、ns to achieve UHC 432.3.1 Service delivery 442.3.2 Health financing 492.4 SDG progress to date 51iv3.Progress towards WHO Triple Billion targets 553.1 Healthier populations billion 563.2 UHC billion 583.3 Health emergencies protection billion 603.4 Health-related SDGs and health information system 6

17、13.5 Conclusion 644.Key issues and trends in global health 654.1 The double burden of malnutrition 664.1.1 The magnitude of the problem 674.1.2 Stunting,wasting and overweight among children under 5 years of age 674.1.3 Thinness and obesity among children and adolescents aged 519 years 694.1.4 Under

18、weight and obesity among adults aged 18 years and older 704.1.5 Double-duty actions to tackle the double burden of malnutrition 724.2 Disability-related health inequities 724.2.1 Premature mortality among persons with disabilities 734.2.2 Poorer health and higher disease risk among persons with disa

19、bilities 734.2.3 Contributing factors to health inequities among persons with disabilities 744.2.4 Towards disability-inclusive and data-informed health systems 764.3 Health of refugees and migrants 774.3.1 Key issues affecting the health of refugees and migrants 784.3.2 The need for quality data on

20、 refugee and migrant health 81ForewordThe latest edition of the World health statistics provides an essential examination of trends in global health over the past two decades that have shaped the world in which we live.It highlights the sobering reality that,due largely to the impact of the COVID-19

21、 pandemic,global life expectancy and healthy life expectancy have both regressed to the level a decade ago,although the impact was unequal across regions and income groups.This regression and its associated inequality signal significant challenges to health systems,demanding urgent attention and act

22、ion.Even though their share of all deaths reduced during the pandemic,noncommunicable diseases remain the worlds leading causes of death.This holds true for every WHO region except the African Region,where communicable,maternal,perinatal and nutritional conditions are still responsible for over half

23、 of all deaths.Globally,the rate of improvement in healthy life expectancy has slowed in recent years,reflecting the increasing burden of NCDs,and the need to strengthen health systems to improve quality of care and meet increasing demands.At the heart of this years report is a critical call to acti

24、on to accelerate progress towards the“triple billion”targets set out in WHOs 13th General Programme of Work,and the Sustainable Development Goals on which they are based.Globally,585 million more people are expected to be covered by essential health services without catastrophic health spending by 2

25、025 than in 2018 just over halfway to the target of 1 billion and 777 million more people are expected to be better protected from health emergencies.Healthier populations provide the sole bright spot,where an estimated 1.5 billion more people will enjoy healthier lives by 2025.Overall,however,progr

26、ess is insufficient to achieve the health-related SDG targets by 2030.These gaps reflect huge,missed opportunities in improving global health,and underscore the urgency for the global community to intensify efforts and investments in health.The 14th General Programme of Work aims to bring together M

27、ember States,the WHO Secretariat and a broad coalition of partners around a shared strategy to promote,provide and protect health,and to realize WHOs founding vision for the highest attainable standard of health,as a fundamental right for all people.Dr Tedros Adhanom GhebreyesusDirector-GeneralWorld

28、 Health OrganizationvAbbreviationsAAAA Addis Ababa Action AgendaABR adolescent birth ratesAMR antimicrobial resistanceAPC alcohol per capita consumptionARR average annual rate of reductionART antiretroviral therapyASDR age-standardized death ratesBMI body mass indexCC Creative CommonsCDR crude death

29、 rateCOVID-19 coronavirus disease 2019DMCF Data management competency frameworkDTP diphtheria,tetanus and pertussis(vaccine)EU European UnionGPW13 Thirteenth General Programme of WorkGTS Global technical strategy for malaria 20162030HALE healthy life expectancyHEP health emergencies protectionHIW he

30、alth information workersHPOP healthier populationsHPV Human papillomavirus(vaccine)IHR International Health RegulationsIPV intimate partner violenceIQR interquartile rangeITN insecticide-treated mosquito netMCV measles-containing vaccineMDG Millennium Development GoalMDS Model Disability SurveyMMR m

31、aternal mortality ratioMVIP Malaria Vaccine Implementation ProgrammeNCD noncommunicable diseaseNMR neonatal mortality rateNPA National Prevention AgreementNTDs neglected tropical diseasesODA official development assistanceOOP out-of-pocketOPRM other pandemic-related mortalityPCV pneumococcal conjuga

32、te vaccinePHC primary health carePM particulate matterpolio poliomyelitisR21 R21-Matrix-M malaria vaccineRMNCH reproductive,maternal,newborn and child healthRTS,S RTS,S/AS01 malaria vaccineSDG Sustainable Development GoalSENADIS National Disability Service(Chile)SPAR States Parties Self-Assessment A

33、nnual ReportTB tuberculosisTDR Special Programme for Research and Training in Tropical DiseasesTFA trans-fatty acidsU5MR under-five mortality rateUHC universal health coverageUI uncertainty intervalWASH water,sanitation and hygieneWHA World Health AssemblyWHO World Health OrganizationviIntroductionT

34、he World health statistics report is the annual compilation of health and health-related indicators,which has been published by the World Health Organization(WHO)since 2005.WHOs Division of Data,Analytics and Delivery for Impact produces this report,in collaboration with WHO technical departments an

35、d regional and country offices.The 2024 edition reviews more than 50 health-related indicators from the Sustainable Development Goals(SDGs)and WHOs Thirteenth General Programme of Work(GPW13).The report consists of four chapters,complemented by tables presenting the latest available data(https:/www.

36、who.int/data/gho/publications/world-health-statistics).Chapter 1 presents updated global and regional estimates of life expectancy,healthy life expectancy,and mortality from specific causes,particularly the impact of the COVID-19 pandemic on demographic and epidemiological profiles.Chapter 2 summari

37、zes global and regional trends in the health-related SDGs.Chapter 3 presents the latest update on WHOs Triple Billion target within the GPW13.And Chapter 4 looks at important global health issues,including the double burden of malnutrition,disability-related health inequities,and the health of refug

38、ees and migrants.Country-focused stories are presented throughout the report to highlight efforts undertaken to address various health issues.The information presented in World health statistics 2024 is based on data available from global monitoring as of May 2024.The data reference years vary,howev

39、er,as data series are updated on different timelines and with different lag between the data reference year and the publication year.Data have been compiled primarily from publications and databases produced and managed by WHO or United Nations partner entities and supplemented with data and analyse

40、s from peer-reviewed publications.1Key messagesIn just two years,the COVID-19 pandemic reversed over a decade of gains in both life expectancy at birth and healthy life expectancy(HALE).By 2020,both global life expectancy and HALE had rolled back to 2016 levels(72.5 years and 62.8 years,respectively

41、).The following year saw further declines,with both retreating to 2012 levels(71.4 years and 61.9 years,respectively).The WHO regions most affected were the Region of the Americas and South-East Asia Region,with declines of about 3 years in life expectancy and 2.5 years in HALE between 2019 and 2021

42、.The Western Pacific Region saw the smallest impacts over the first two pandemic years,with losses of less than 0.1 and 0.2 years in life expectancy and HALE,respectively.Globally,the share of deaths from noncommunicable diseases(NCDs)among all deaths rose steadily to 73.9%by 2019,while the share of

43、 communicable diseases dropped to 18.2%.With the emergence of COVID-19,communicable diseases surged back to 23.0%of all deaths in 2020 and 28.1%in 2021 a return to 2005 levels.Consequently,the share of NCD deaths declined to 70.0%in 2020 and 65.3%in 2021.COVID-19 ranked among the top three leading c

44、auses of death globally in 2020 and 2021,responsible for 4.1 million and 8.8 million lives lost,respectively.In the Region of the Americas it was the number one cause of death in both years,and ranked in the top five causes for all regions except for the African and Western Pacific regions.At the mi

45、dway point for the SDGs,progress on health-related Goals has been mixed.Among the 53 health-related indicators included in this report,32 have numeric SDG or global targets.None of these have yet been achieved,and none are on track under current trends.However,most indicators(42)are showing movement

46、 in the right direction globally.The world is also off-track to achieve the universal health coverage(UHC),health emergencies preparedness and healthier populations“Triple Billion”targets by 2025.From the 2018 baselines,585 million more people are expected to have access to essential health services

47、 without incurring catastrophic health spending by 2025,well short of the one billion UHC target.For health emergency preparedness,777 million more people are expected to be protected by 2025,again short of the target.Healthier populations is the sole area positioned to meet its one billion target,w

48、ith 1.5 billion additional people anticipated to be living healthier lives by 2025.But acceleration across all three areas is needed to achieve broader health-related SDGs by 2030.The world continues to grapple with the double burden of malnutrition,characterized by the coexistence of undernutrition

49、 and overweight/obesity.In 2022,worldwide over one billion people aged 5 years and over were living with obesity,while over half a billion were underweight.In the same year,148 million children under five were affected by stunting,45 million suffered from wasting and 37 million were living with over

50、weight.Double-duty actions that efficiently and effectively address both facets of malnutrition are critical to make the most of limited resources.This report also highlights health challenges faced by persons with disabilities,and refugees and migrants.Globally,in 2021,an estimated 1.3 billion peop

51、le(16%of the population)had disability and faced health inequities due to avoidable,unfair and unjust factors.Progress requires strengthening health systems that integrate targeted actions to increase equity.Refugees and migrants are not inherently less healthy than host populations,yet various subo

52、ptimal health determinants further exacerbated by linguistic,cultural,legal and other barriers mean that they often experience significant health disparities.Access to health care is often limited for refugees and migrants,with only half of the 84 countries surveyed between 2018 and 2021 providing t

53、hem access to government-funded health services on par with nationals.Lack of quality data further obstructs understanding of their needs and tracking progress on health goals.The report serves as a crucial reminder that todays health systems must swiftly adapt to respond to changing demographics an

54、d persisting inequities.31 Life expectancy,healthy life expectancy and burden of disease in the light of the COVID-19 pandemicThe COVID-19 pandemic has wreaked havoc in population health across the globe.The devastating impacts of the pandemic on health,economy,families and society have been observe

55、d worldwide since 2020 and are expected to continue to unfold in the years to come.This chapter documents its detrimental impact on global population health and the inequality of that impact,as reflected in life expectancy and HALE,against the backdrop of the overall progress made in many aspects of

56、 population health before the pandemic.1.1 Life expectancy and healthy life expectancy1 Unless otherwise noted,the statistics quoted in this report are presented with 95%uncertainty intervals.1.1.1 Global trendSteady gain in global life expectancy at birth was observed from the turn of the millenniu

57、m until the onset of the COVID-19 pandemic,up from 66.8 years(95%uncertainty interval1 UI:66.267.3 years)in 2000 to 73.1(UI:72.673.7)years in 2019,with men gaining 6.2 years from 64.4(UI:63.964.9)years to 70.6(UI70.171.2)years and women gaining 6.5 years from 69.2(UI:68.769.8)years to 75.7(UI:75.376

58、.2)years during this period.In parallel,global HALE at birth increased from 58.1(UI:57.458.9)years in 2000 to 63.5(UI:62.764.3)years in 2019,with that for men increasing from 57.0(UI:56.357.6)years to 62.3(UI:61.763.1)years and that for women increasing from 59.3(UI:58.660.2)years to 64.6(UI:63.865.

59、5)years(Fig.1.1)(1).Figure 1.1 Global trends in life expectancy and HALE at birth,by sex,20002021Life expectancy at birth(years)Healthy life expectancy at birth(years)Male Female020406020002010201920202021Life expectancy at birth(years)Source:WHO(1).World health statistics 2024:monitoring health for

60、 the SDGs,Sustainable Development Goals6However,the COVID-19 pandemic reversed this trend and wiped out the progress that was made in nearly a decade within just two years.Global life expectancy at birth dropped by 0.7 years to 72.5(UI:71.973.1)years in 2020(back to the level of 2016),and by a furth

61、er 1.1 years to 71.4(UI:70.872.0)years in 2021(back to the level of 2012).Similarly,global HALE dropped to 62.8(UI:62.063.7)years in 2020(back to the level of 2016)and 61.9(UI:61.162.8)years in 2021(back to the level of 2012)(1).The life expectancy at birth for both men and women dropped by about 1.

62、7 years between 2019 and 2021.However,the decline for men was relatively more evenly split in 2020(by 0.8 years)and 2021(by 0.9 years),while the decline for women was concentrated more in 2021(by 1.3 years)than in 2020(by 0.5 years).Similar disparity between sexes was observed for HALE:HALE among me

63、n dropped by 0.7 years to 61.6(UI:60.962.4)years in 2020 and another 0.8 years to 60.9(UI:60.161.6)years in 2021,and HALE among women dropped by 0.5 years to 64.1(UI:63.265.0)years in 2020 and 1.1 years to 63.0(UI:62.263.9)years in 2021(1).1.1.2 Regional trendsPrior to the pandemic,life expectancy a

64、nd HALE had risen across all WHO regions and World Bank country income groups between 2000 and 2019(Figs 1.2 and 1.3).The greatest gains were seen in low-resources settings including the African Region(11.2-year gain in life expectancy and 9.8-year gain in HALE)and the South-East Asia Region(7.3-yea

65、r gain in life expectancy and 6.5-year gain in HALE);and in low-income countries(10.6-year gain in life expectancy and 9.3-year gain in HALE).Populations in high-income and upper-middle-income countries continue to live longer and healthier lives than those in low-and lower-middle-income countries.H

66、owever,the pace of improvement in high-income countries has stagnated since 2010,with only a 1.1-year increase in life expectancy and a 0.6-year increase in HALE in 20102019,less than one third of the increases in low-income countries over the same period(1).Figure 1.2 Trends in life expectancy and

67、HALE at birth,by sex and by WHO region,20002021European RegionEastern Mediterranean RegionWestern Pacific RegionAfrican RegionRegion of the AmericasSouth-East Asia Region2000201020192020202120002010201920202021200020102019202020212000201020192020202120002010201920202021200020102019202020210204060800

68、20406080Life expectancy at birth(years)Life expectancy at birth(years)Healthy life expectancy at birth(years)Male FemaleSource:WHO(1).Life expectancy,healthy life expectancy and burden of disease in the light of the COVID-19 pandemic7Figure 1.3 Trends in life expectancy and HALE at birth,by sex and

69、World Bank income group,20002021Upper-middle-incomeHigh-incomeLow-incomeLower-middle-income20002010201920202021200020102019202020212000201020192020202120002010201920202021020406080020406080Life expectancy at birth(years)Life expectancy at birth(years)Healthy life expectancy at birth(years)Male Femal

70、eSource:WHO(1).In addition,the impact of the pandemic was unequal across regions and income groups.The Region of the Americas and the South-East Asia Region have been the hardest hit:life expectancy in both regions dropped by 3.0 years and HALE by 2.5 years between 2019 and 2021.The Western Pacific

71、Region was the least affected during the first two years of the pandemic,with less than 0.1 years and 0.2 years of loss seen for life expectancy and HALE,respectively.It was the only WHO region in which increases in life expectancy(0.2-year gain)and HALE (0.1-year gain)were observed in 2020.However,

72、the region experienced some losses(0.3 years in life expectancy and 0.3 years in HALE)in 2021 compared with 2020,that cancelled out the earlier gains(1).The scale of pandemic-related tolls also varied over time across regions.The Region of the Americas,the European Region and the Eastern Mediterrane

73、an Region all experienced more severe impact in the first pandemic year,with 2020 seeing at least two thirds of the life expectancy decline and three fifths of the HALE decline.In contrast,coinciding with the wider spread of the Delta variant,the decline in life expectancy and HALE in the African an

74、d South-East Asia regions occurred more predominantly in 2021,accounting for at least 65%of the total losses in 20192021(Fig.1.2)(1).By World Bank income groups,life expectancy was cut by 0.6 years in low-income countries and by 2.4 years in lower-middle-income countries,and HALE cut by 0.6 years an

75、d 2.0 years,respectively,between 2019 and 2021.Over half of the years lost in life expectancy and HALE in upper-middle-income countries and over 70%of those in high-income countries in 20192021 occurred during the first year of the pandemic.In lower-middle-income countries,the hardest hit occurred i

76、n 2021,seeing over 70%of the loss in life expectancy and HALE.In low-income countries,the worsening of longevity was rather minimal in 2020,associated with only 2%(0.01 of 0.55 years)of the decline in life expectancy(Fig.1.3)(1).World health statistics 2024:monitoring health for the SDGs,Sustainable

77、 Development Goals81.2 Shifting disease burden1.2.1 Broad categories of causes of deathsNot only has the pandemic set back healthy longevity worldwide by years,it also reversed the previous trends of shifting disease burden to NCDs.Grouping deaths into three broad categories of causes of death commu

78、nicable,maternal,perinatal and nutritional conditions(“communicable diseases”hereafter),NCDs,and injuries clear transition can be noticed well before the pandemic(1).Globally,NCDs accounted for 59.5%of all deaths in 2000,rising to 73.9%in 2019,while the share of communicable diseases dropped from 32

79、.2%in 2000 to 18.2%in 2019,and injuries remained relatively stable around 8%.As COVID-19 emerged as a new infectious disease and started to take a toll on human lives,the share of deaths due to communicable diseases jumped back to the 2012 level(23.0%)in 2020 and further back to the 2005 level(28.1%

80、)in 2021.Simultaneously,the share of NCD deaths dropped to 69.9%in 2020 and to 65.3%in 2021,and the share of injury deaths dropped to just about 7%in both years(Fig.1.4)(1).Figure 1.4 Composition of causes of death,global,20002021025507510020002005201020152020Percentage(%)InjuriesCommunicable,matern

81、al,perinatal and nutritional conditionsNoncommunicable diseasesNote:In countries that have low-quality vital registration,WHOs current estimates include a cause of death category,“other pandemic-related mortality(OPRM)”,which could include underlying causes of deaths from any of the three groups.The

82、 graph only shows the relative composition of the three groups;OPRM is not included.Source:WHO(1).9Life expectancy,healthy life expectancy and burden of diseaseAmong WHO regions,the African Region still had the largest share(54.9%)of deaths attributable to communicable diseases before the pandemic,w

83、ith NCDs accounting for only about 36%of all deaths in 2019.These levels remained largely stable in 2020 and 2021,indicating little impact of the COVID-19 pandemic on the broad distribution of causes of death.Similarly,the Western Pacific Region has seen limited change since 2019 in the distribution

84、 across the three categories,with NCDs accounting for about 88%and communicable diseases for about 6%of all deaths(Fig.1.5)(1).However,the pandemic has been more disruptive to the expected trajectories in other WHO regions.The European Region,which had the highest share of NCD deaths among all death

85、s in 2019(89.6%),experienced an abrupt shift of disease burden back to communicable diseases in 2020 and 2021,as the share of NCD deaths dropped to 75.9%in 2021 and the share of communicable diseases nearly quadrupled from 5.3%in 2019 to 20.0%in 2021.Other WHO regions also experienced sizable,revers

86、ed shift of disease burden from NCDs and injuries back to communicable diseases,leading to increases in its share ranging from about 10%(Eastern Mediterranean Region)to 18%(South-East Asia Region)(1).Similar disparity was also observed across World Bank income groups(Fig.1.6).Bearing the largest sha

87、re(nearly 50%)of deaths due to communicable diseases,low-income countries saw minimal change in the distribution of deaths from the three broad groups between 2019 and 2021.In contrast,NCDs in upper-middle-income and high-income countries were responsible for the largest share of deaths at 84.8%and

88、88.1%,respectively,in 2019,but these figures dropped by 9.9%and 8.1%between 2019 and 2021(1).Figure 1.5 Composition of causes of death,by WHO region,20002021European RegionEastern Mediterranean RegionWestern Pacific RegionAfrican RegionRegion of the AmericasSouth-East Asia Region20002005201020152020

89、 20002005201020152020 2000200520102015202002550751000255075100Percentage(%)InjuriesCommunicable,maternal,perinatal and nutritional conditionsNoncommunicable diseasesNote:In countries that have low-quality vital registration,WHOs current estimates include a cause of death category,“other pandemic-rel

90、ated mortality(OPRM)”,which could include underlying causes of deaths from any of the three groups.The graph only shows the relative composition of the three groups;OPRM is not included.Source:WHO(1).World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals10Figure 1.

91、6 Composition of causes of death,by World Bank income group,20002021Upper-middle-incomeHigh-incomeLow-incomeLower-middle-income200020052010201520202000200520102015202002550751000255075100InjuriesCommunicable,maternal,perinatal and nutritional conditionsNoncommunicable diseasesPercentage(%)Note:In co

92、untries that have low-quality vital registration,WHOs current estimates include a cause of death category,“other pandemic-related mortality(OPRM)”,which could include underlying causes of deaths from any of the three groups.The graph only shows the relative composition of the three groups;OPRM is no

93、t included.Source:WHO(1).These patterns are the result of a combination of transitioning cause-of-death profiles and changing population structure.Examining age-standardized death rates(ASDR)exhibits more clearly the progress achieved prior to the COVID-19 pandemic and the setback it caused.Globally

94、,the ASDR from communicable diseases was cut by about half from 244.5(UI:155.3373.9)to 119.3(UI:72.8189.1)per 100 000 population in 20002019.Yet,the pandemic brought back the rate to 160.4(UI:107.6237.8)per 100 000 in 2020 and 211.4(UI:150.1300.7)per 100 000 in 2021,representing 34.5%and 77.2%increa

95、ses from the 2019 baseline.While the global improvement up to 2019 was primarily driven by the progress in the African Region(56.1%decline),South-East Asia Region(63.3%decline)and Eastern Mediterranean Region(47.4%decline),the Region of the Americas and the European Region were hardest hit by the pa

96、ndemic in relative terms,with ASDR from communicable diseases more than tripled(3.4 and 3.8 times,respectively)between 2019 and 2021.The South-East Asia and Eastern Mediterranean regions also saw ASDR from communicable diseases more than doubled in the same period.In comparison,the African and Weste

97、rn Pacific regions only experienced moderate increases(14.3%and 11.9%increase,respectively)(1).Progress was also made in all WHO regions in 20002019 for mortality from NCDs(except for the South-East Asia Region)and mortality from injuries(except for the Eastern Mediterranean Region),leading to 18.8%

98、reduction in ASDR from NCDs and 23.1%reduction in ASDR from injuries globally in 20002019.Limited impact was seen in ASDR from these two groups of cause of death in 20192021 compared with that from communicable diseases(1).Similar trends were observed across all World Bank income groups,with sizable

99、 reductions observed in ASDR for all three broad cause categories in 20002019 and little excess change brought by the pandemic in 2020 and 2021 for NCDs and injuries.The COVID-19 pandemic reversed the declining trend in ASDR for communicable diseases in all income groups to the extent that the level

100、 in 2021 that was above the 2000 level in upper-income countries and nearly double the 2000 level in high-income countries;thus,undoing over two decades of work(1).11Life expectancy,healthy life expectancy and burden of disease1.2.2 Leading causes of deathLooking at the leading causes of death,there

101、 was also a clear transition from communicable causes to NCDs.Globally,five of the 10 leading causes in 2000 were communicable and four were NCDs,with road injury being the only injury cause(Fig.1.7).In 2019,seven of the 10 leading causes were NCDs and the remaining three communicable(1).The pace of

102、 transition was uneven across regions and income groups.In 2019,communicable diseases continued to take up seven of the top 10 causes of deaths along with two NCDs and one injury in the African Region and low-income countries(1).With communicable diseases being effectively prevented or treated,and p

103、opulations surviving to older ages where NCDs become the predominant risk,NCDs already accounted for nine of the top 10 causes in 2019 in the European Region and the Western Pacific Region(Fig.1.8),as well as in upper-middle-income and high-income countries(Fig.1.9).The only communicable disease tha

104、t ranked among the top 10 in these regions or income groups were lower respiratory infections(1).Figure 1.7 Top 10 causes of death globally in 2000,2019,2020 and 2021Diarrhoeal diseasesHIV/AIDSPreterm birth complicationsRoad injuryIschaemic heart diseaseCOVID-19StrokeChronic obstructive pulmonary di

105、seaseLower respiratory infectionsTrachea,bronchus,lung cancersAlzheimer disease and other dementiasDiabetes mellitusKidney diseasesTuberculosis10109876543212000201920202021RankCommunicable,maternal,perinatal and nutritional conditionsInjuriesNoncommunicable diseasesNote:Solid lines represent movemen

106、t within the top 10 causes of death.Dashed lines represent movement in or out of the top 10 causes of death.Source:WHO(1).World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals12Figure 1.8 Top 10 causes of death,by WHO region,in 2000,2019,2020 and 2021Self-harmCirr

107、hosis of the liverStomach cancerIschaemic heart diseaseCOVID-19StrokeTrachea,bronchus,lung cancersColon and rectum cancersHypertensive heart diseaseLower respiratory infectionsDiabetes mellitusRoad injuryDrug use disordersCOVID-19Ischaemic heart diseaseStrokeAlzheimer disease and other dementiasAlzh

108、eimer disease and other dementiasChronic obstructive pulmonary diseaseDiabetes mellitusKidney diseasesLower respiratory infectionsTrachea,bronchus,lung cancersInterpersonal violencePreterm birth complicationsBirth asphyxia and birth traumaKidney diseasesCOVID-19Ischaemic heart diseaseStrokeChronic o

109、bstructive pulmonary diseaseTuberculosisDiarrhoeal diseasesLower respiratory infectionsDiabetes mellitusCirrhosis of the liverRoad injuryEuropean RegionRegion of the AmericasSouth-East Asia Region20002019202020212000201920202021200020192020202110109876543211010987654321Diarrhoeal diseasesMeaslesTube

110、rculosisHypertensive heart diseaseIschaemic heart diseaseCOVID-19StrokePreterm birth complicationsLower respiratory infectionsDiabetes mellitusKidney diseasesCirrhosis of the liverRoad injuryEastern Mediterranean Region2000201920202021Road injuryOesophagus cancerSelf-harmStrokeIschaemic heart diseas

111、eTrachea,bronchus,lung cancersStomach cancerLower respiratory infectionsHypertensive heart diseaseColon and rectum cancersKidney diseasesWestern Pacific2000201920202021101098765432110109876543211010987654321RankCommunicable,maternal,perinatal and nutritional conditionsInjuriesNoncommunicable disease

112、sChronic obstructive pulmonary diseaseChronic obstructive pulmonary diseaseAlzheimer disease and other dementiasBirth asphyxia and birth traumaMeaslesRoad injuryLower respiratory infectionsMalariaStrokeTuberculosisDiarrhoeal diseasesCOVID-19HIV/AIDSIschaemic heart diseasePreterm birth complicationsB

113、irth asphyxia and birth traumaAfrican Region20002019202020211010987654321Note:Solid lines represent movement within the top 10 causes of death.Dashed lines represent movement in or out of the top 10 causes of death.Source:WHO(1).Life expectancy,healthy life expectancy and burden of disease in the li

114、ght of the COVID-19 pandemic13Figure 1.9 Top 10 causes of death,by World Bank income group,in 2000,2019,2020 and 2021MeaslesRoad injuryLower respiratory infectionsStrokeIschaemic heart diseaseMalariaPreterm birth complicationsCOVID-19Diarrhoeal diseasesTuberculosisBirth asphyxia and birth traumaHIV/

115、AIDSRoad injuryTuberculosisCirrhosis of the liverKidney diseasesStrokeIschaemic heart diseaseCOVID-19Chronic obstructive pulmonary diseaseTrachea,bronchus,lung cancersAlzheimer disease and other dementiasLower respiratory infectionsDiabetes mellitusHypertensive heart diseaseStomach cancerHIV/AIDSBir

116、th asphyxia and birth traumaMeaslesRoad injuryCOVID-19Ischaemic heart diseaseStrokeChronic obstructive pulmonary diseaseLower respiratory infectionsTuberculosisDiarrhoeal diseasesDiabetes mellitusCirrhosis of the liverPreterm birth complicationsDiabetes mellitusBreast cancerStomach cancerPancreas ca

117、ncerIschaemic heart diseaseCOVID-19StrokeAlzheimer disease and other dementiasTrachea,bronchus,lung cancersChronic obstructive pulmonary diseaseLower respiratory infectionsColon and rectum cancersKidney diseasesHypertensive heart diseaseUpper-middle-incomeHigh-incomeLow-incomeLower-middle-income2000

118、2019202020212000201920202021200020192020202120002019202020211010987654321101098765432110109876543211010987654321RankCommunicable,maternal,perinatal and nutritional conditionsInjuriesNoncommunicable diseasesNote:Solid lines represent movement within the top 10 causes of death.Dashed lines represent m

119、ovement in or out of the top 10 causes of death.Source:WHO(1).1.3 Mortality-related SDG indicatorsThe SDG framework includes several indicators on mortality pertaining to specific age groups,such as young children,and mortality due to specific causes(2).Overall progress has been observed for mortali

120、ty-related SDG indicators;however,the current trends are not strong enough to reach the targets by 2030.1.3.1 Maternal and child mortalitySince the turn of the millennium,enhancing the health of mothers and children has been a top priority for global development.Maternal and child mortality reductio

121、nsThis distribution of the leading 10 causes of death by broad cause group at global level remained unchanged from 2019 in 2020 and 2021;however,COVID-19 emerged as the third and second leading causes,respectively,claiming 4.1 million and 8.8 million lives globally.In all but two WHO regions(the Afr

122、ican and Western Pacific regions),COVID-19 ranked among the top five causes of deaths in 2020 and 2021,responsible for the largest number of deaths in both years in the Region of the Americas,in 2021 in the South-East Asia Region and the second largest number of deaths in both years in the European

123、and the Eastern Mediterranean regions.In the African Region,the disease only moved up from 12th to sixth in 2021.While in the Western Pacific Region it remained out of the top 10,it rose from being 50th in 2020 to 19th in 2021(1).World health statistics 2024:monitoring health for the SDGs,Sustainabl

124、e Development Goals14were among the Millennium Development Goals(MDGs),steering the global efforts through to the year 2015.They remain among the global targets in the SDG period,which runs from 2015 to 2030.Maternal mortality Marked reduction in maternal mortality was achieved during the MDG years

125、between 2000 and 2015.The global maternal mortality ratio(MMR)(SDG indicator 3.1.1)dropped by a third from 339(80%UI:319360)deaths per 100 000 live births in 2000 to 227(80%UI:211246)deaths per 100 000 live births in 2015,equivalent to a 2.7%(80%,UI:2.03.2%)average annual rate of reduction(ARR).Howe

126、ver,progress has stagnated since,and the global MMR only dropped to 223(80%UI:202255)deaths per 100 000 live births in 2020 as the ARR fell to 0.04%(80%UI:1.6 to 1.1%)between 2016 and 2020(Fig.1.10).An estimated 287 000(80%UI:273 000343 000)women globally died from a maternal cause in 2020,a number

127、that remained unacceptably high and is equivalent to almost 800 deaths every day or one every two minutes(3).The African Region remained the region with the highest MMR throughout the two decades,despite a sustained decline with an ARR of 2%.The South-East Asia Region had experienced the steepest de

128、cline,reducing MMR from 372(80%UI:336423)deaths per 100 000 live births in 2000 to 117(80%UI:106133)deaths per 100 000 live births in 2020 and still maintaining an ARR at nearly 5%in the SDG era.Increasing MMRs were seen in the Region of the Americas,the European Region and Western Pacific Region be

129、tween 2016 and 2020,despite the sizable decline during the MDG era.However,the levels of MMR have remained below 80 deaths per 100 000 live births in these three regions since 2000(3).To achieve the SDG global target of MMR below 70 deaths per 100 000 live births by 2030,an ARR of 11.6%is required b

130、etween 2021 and 2030,equivalent to over 1 million deaths averted,compared with a scenario where the 20162020 global stagnation continues(2,3).Mortality among children under 5 years of age and among newbornsSubstantial global progress has been made in reducing childhood mortality since 2000.The total

131、 number of deaths among children under 5 years of age worldwide declined from 9.9 million(90%UI:9.810.1 million)in 2000 to 4.9 million(90%UI:4.65.4 million)in 2022,reflecting a 51%decline in the global under-five mortality rate(U5MR,SDG indicator 3.2.1)from 76(90%UI:7578)deaths per 1000 live births

132、in 2000 to 37(90%UI:3541)deaths per 1000 live births in 2022(4).Figure 1.10 Global MMR stratified by five-year time period,20002020PeriodShaded area indicates 80%uncertainty intervals.20112015200120052016202020062010MMR30025020035045321YearSource:WHO et al.(3).Life expectancy,healthy life expectancy

133、 and burden of disease in the light of the COVID-19 pandemic15Despite the noteworthy progress at the global level,inequality across regions persists.Children in the African Region continued to have the highest risk of dying before reaching the age of five.In 2022,the U5MR in the region was 70(90%UI:

134、6382)deaths per 1000 live births,10 times the U5MR in the European Region(Fig.1.11).In fact,the African Region accounted for over half(2.7 million,90%UI:2.53.2 million)of the total under-five deaths in 2022,while only accounting for 30%of the global live births(4).At the country level,U5MRs in 2022

135、ranged from 1.5(90%UI:0.73.1)deaths per 1000 live births to 117.3(90%UI:93.3147.7)deaths per 1000 live births,which means that the risk of dying before turning five for a child born in the highest-mortality country was about 80 times that in the lowest-mortality country(4).Figure 1.11 U5MR and NMR,g

136、lobally and by WHO region,2022 African RegionEasternMediterranean RegionSouth-East AsiaRegionRegion of theAmericasWestern PacificRegionEuropean RegionGlobalUnder-fiveNeonatalUnder-fiveNeonatalUnder-fiveNeonatalUnder-fiveNeonatalUnder-fiveNeonatalUnder-fiveNeonatalUnder-fiveNeonatal051015202530354045

137、5055606570Mortality rate(per 1000 live births)Source:UNICEF et al.(4).World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals16Newborn deaths represent an increasing share of total under-five deaths,up from 41%in 2000 to 47%in 2022.Globally,2.3 million(90%UI:2.22.6

138、million)children died in the first month of life in 2022,down from 4.1 million(90%UI:4.04.2 million)in 2000.However,the decline in global neonatal deaths from 2000 to 2020,at 44%,has been slower compared with the 56%drop in the number of deaths among children aged 159 months during the same period(4

139、).The chances of survival from birth varies widely depending on where a child is born.The WHO African and Eastern Mediterranean regions had the highest neonatal mortality rates(NMR,SDG indicator 3.2.2)in 2022 at 26(90%UI:2432)deaths per 1000 live births and 25 (90%UI:2130)deaths per 1000 live births

140、,respectively (Fig.1.11).With country-level NMRs in 2022 ranging from 0.7(90%UI:0.31.5)deaths per 1000 live births to 39.4(90%UI:10.8108.7)deaths per 1000 live births across the world,the risk of a newborn dying before their 28th day of life in the highest-mortality country was almost 60 times that

141、in the lowest-mortality country(4).Progress in reducing U5MR and NMR slowed in the first half of the SDG era(20152022)compared with what was achieved in the MDG era(20002015).Globally,the average ARR in U5MR decreased from 3.8%(UI:3.64.0%)in 20002015 to 2.1%(90%UI:0.92.7%)in 20152022.Similarly,the A

142、RR for global NMR decreased from 3.0%(90%UI:2.73.3%)in 20002015 to 1.8%(90%UI:0.52.5%)in 20152022(4).If current trends continue,59 countries will not meet the SDG target for U5MR(25 or fewer deaths per 1000 live births by 2030).Even more countries are at risk of missing the SDG target for NMR(12 or

143、fewer deaths per 1000 live births by 2030):64 countries will need to accelerate the mortality decline to meet the target on time.The majority of the countries not on track to achieve the SDG targets are in the African Region,reinforcing the fact that children face different chances of survival depen

144、ding on where they are born.Reaching the targets in all countries and areas will avert 9 million deaths among children under 5 years of age between 2023 and 2030,some 42%of which would be among neonates(2,4).1.3.2 Mortality due to injuryRoad injuryDespite the growth in the global population and numb

145、er of vehicles,the global number of road traffic fatalities declined by 5.9%from 1.25 million(UI:1.111.39 million)deaths in 2010 to 1.18 million(UI:1.051.30 million)deaths in 2021(1,5).While 10 countries in four regions achieved the target to halve the number of road traffic deaths during this perio

146、d,at the global level the reduction fell far short of the target of the United Nations Decade of Action for Road Safety 20102020,and at this pace the global target of the United Nations Decade of Action for Road Safety 20212030 to halve deaths by 2030 would not be met either(6,7).In 2021,the South-E

147、ast Asia and the Western Pacific regions shouldered more than half of the global burden of road traffic deaths,with 319 000(UI:284 000354 000)deaths(27%of the global burden)and 298 000(UI:278 000317 000)deaths(25%of the global burden),respectively(1,5).The decline in the global number of deaths corr

148、esponds to a 17%decline from the crude death rate(CDR)due to road traffic injuries(SDG indicator 3.6.1)from 17.9(UI:16.019.8)deaths per 100 000 population in 2010 to 14.9(UI:13.316.4)deaths per 100 000 population in 2021.Declines in CDRs were observed in all regions in the period.However,the region

149、with the highest CDR in 2021(the African Region,at 19.4(UI:16.422.4)per 100 000 population)still had a CDR that was nearly three times as high as in the region with the lowest CDR(the European Region,at 6.7 UI:6.27.3 per 100 000 population).The slowest progress was seen in the Region of the Americas

150、,yet still even this was down by 9.4%from 15.6(UI:14.516.6)per 100 000 population in 2010 to 14.1(UI:13.015.2)per 100 000 population in 2021.In 2021,low-income countries faced the highest CDR from road injuries at 21.3(UI:17.924.8)per 100 000 population,while high-income countries had the lowest CDR

151、 at 7.6(UI:7.18.2)per 100 000 population(1,5).SuicideThe global total of suicide deaths decreased from an estimated 762 000(UI:590 000892 000)in 2000 to 717 000(UI:545 000913 000)in 2021.The CDR from suicide(SDG indicator 3.4.2)declined steadily between 2000 and 2020 from 12.4(UI:9.614.5)deaths per

152、100 000 population to 9.0(UI:7.011.3)deaths per 100 000 population,and then increased slightly to 9.1(UI:6.911.6)deaths per 100 000 population in 2021(1).The highest burden of suicide deaths shifted from the Western Pacific Region in 2000(243 000 deaths,UI:168 000282 000)to the South-East Asia Regio

153、n(206 000 deaths,UI:151 000257 000)in 2021,with the former seeing over a third reduction in suicide CDR from 14.5(UI:10.116.8)per 100 000 population to 9.4(UI:7.012.1)per 100 000 population,and the latter seeing a one fifth reduction in CDR from 12.7(UI:9.415.1)per 100 000 population to 10.0(UI:7.41

154、2.5)per 100 000 population Life expectancy,healthy life expectancy and burden of disease in the light of the COVID-19 pandemic17between 2000 and 2021.The European Region also observed striking decline in suicide deaths,with CDR falling from 21.3(UI:19.822.9)per 100 000 population,the highest among a

155、ll regions in 2000,to 12.3(UI:10.314.4)per 100 000 population in 2021.The African Region underwent a very modest decline in suicide CDR between 2000 and 2020(7.0 UI:4.510.2 per 100 000 population to 6.9 UI:4.410.3 per 100 000 population),followed by an increase to 7.2(UI:4.610.9)per 100 000 populati

156、on in 2021.The Eastern Mediterranean remained the region with the lowest CDR throughout the period.The Region of the Americas was the only region where overall increase was seen,rising from 7.2(UI:6.67.8)per 100 000 in 2000 to 9.8(UI:8.710.8)per 100 000 in 2021(1).Globally,the rate of suicide deaths

157、 for men was more than double that for women in 2021(CDR 12.3 UI:9.615.4 per 100 000 population versus 5.9 UI:4.27.7 per 100 000 population).However,the sex disparity was uneven across regions,with a male-to-female ratio ranging from as low as 1.4 in the South-East Asia Region to nearly 4.0 in the R

158、egion of the Americas(Fig.1.12)(1).HomicideNearly 481 000(UI:360 000649 000)people were homicide victims in 2021,although there was a slight increase(478 000 UI:400 000578 000)from 2000,corresponding to a decline in CDR by about 22%,from 7.8(UI:6.59.4)per 100 000 population in 2000 to 6.1(UI:4.68.2)

159、per 100 000 population in 2021.About 80%of the victims were men(1).The WHO Region of the Americas had the highest mortality burden from homicide in 2021 with a total of 199 000(UI:169 000233 000)deaths,accounting for 41.3%of the total global homicide deaths but only 13.0%of the global population.In

160、contrast,about a quarter of the global population resides in the Western Pacific Region,but this region accounted for only 6.2%of global homicide deaths,with a CDR(1.6 UI:1.12.1 per 100 000 population)that was 8%of that in the highest region(Region of the Americas,19.4(UI:16.522.7)per 100 000 popula

161、tion)and just about 16%of that in the second highest(African Region,9.6 UI:5.915.1 per Figure 1.12 Global and regional trends in the mortality rates due to suicide and homicide,20002021African RegionRegion of the AmericasSouth-East Asia RegionEuropean RegionEastern Mediterranean RegionWestern Pacifi

162、c RegionGlobal20002021 20002021 20002021 20002021 20002021 20002021 20002021HomicideSuicide05101520253035Crude death rate(per 100 000 population)05101520253035Crude death rate(per 100 000 population)FemaleMaleSource:WHO(1).World health statistics 2024:monitoring health for the SDGs,Sustainable Devel

163、opment Goals18100 000 population)in 2021.Compared with the Region of the Americas and the African Region,the CDR of homicide was also relatively low in the European,South-East Asia and Eastern Mediterranean regions,at 2.6(UI:2.13.3)per 100 000 population,3.7(UI:2.75.0)per 100 000 population and 5.4(

164、UI:3.28.6)per 100 000 population,respectively(1).Men and women face disproportionate risk of homicide deaths,and the sex disparity was unevenly distributed across WHO regions.Globally,the male-to-female ratio for CDR for homicide mortality in 2021 was 4.0,ranging from about 2.8 in the South-East Asi

165、a,Eastern Mediterranean and European regions to 7.1 in the Region of the Americas.A strong age pattern was also observed,with young adults at age 2024 years having the highest age-specific mortality rate,peaking at 12.7(UI:9.517.1)deaths per 100 000 population globally and up to 40.6(UI:36.145.3)dea

166、ths per 100 000 population in the Region of the Americas(Fig.1.12)(1).Unintentional poisoning Globally,about 59 000(UI:32 00090 000)people died from unintentional poisoning in 2021,approximately down by over 4000 from the figure in 2000.This represents a drop in the CDR from unintentional poisoning(

167、SDG indicator 3.9.3)of a quarter,from 1.0(UI:0.81.5)per 100 000 population in 2000 to 0.7(UI:0.41.1)per 100 000 population in 2021.The highest CDR in 2021 was observed in the African Region at 1.2(UI:0.72.2)per 100 000 population,closely followed by the Western Pacific Region at just under 1.2(UI:0.

168、51.7)per 100 000 population.The greatest decline in CDR was achieved in the European Region,with a nearly two thirds drop between 2000 and 2021.Slight increases were seen in the Region of the Americas and the Western Pacific Region(1).Sex and age disparity were observed.Men were dying at a rate that

169、 was 68%higher than women.The greatest male-to-female ratios were observed in the Region of the Americas and the European Region at 2.3 and 2.6,respectively,whereas the lowest ratio was in the African Region at 1.4.The youngest and the oldest population were at the highest risk of dying from uninten

170、tional poisoning,with population under 5 years old and 65 years old and over accounting for less than 20%of the global population but nearly 40%of the global deaths from unintentional poisoning in 2021(1).1.3.3 Mortality due to NCDs Improved prevention,diagnosis and treatments has led to steady decl

171、ine in premature mortality from NCDs.Globally,a person aged 30 years in 2000 had a 22.7%(UI:18.727.2%)chance of dying from one of the four major NCDs(cardiovascular disease,cancer,chronic respiratory disease and diabetes)before the age of 70 years(SDG indicator 3.4.1).This risk fell to 18.2%(UI:14.2

172、23.0%)in 2019 before the onset of the pandemic,corresponding to an approximately 20%reduction(1).Regional disparity exists in both the levels and pace of progress.The Eastern Mediterranean Region started with the highest risk of premature mortality(27.2%UI:19.436.4%)in 2000 and,notwithstanding a 15.

173、4%reduction,the risk in 2019(23.0%UI:15.931.5%)remained high compared with other regions except for the South-East Asia Region,where the progress stagnated in 20002019.In contrast,the Region of the Americas had the lowest risk of NCD premature mortality(18.2%UI:16.619.9%)in 2000 among all regions an

174、d stayed at the lowest level(13.9%UI:12.315.7%)in 2019,with a 23.8%reduction between 2000 and 2019.The other three regions started at similar levels(22.223.9%)in 2000;however,the African Region saw more moderate decline(10.9%)and reached a premature mortality risk of 21.3%(UI:13.531.3%)in 2019,where

175、as the fastest declines among all regions were observed in the European and Western Pacific regions(32.0%and 28.0%decline,respectively)(Fig.1.13)(1).Despite the progress made,the pace of change in most countries has slowed since the beginning of the SDG era in 2015.With the global ARR slowing signif

176、icantly(more than halved compared with the first 15 years of the century)between 2015 and 2019 to under 1%,the world is not on track to reach the 2030 SDG target.The only region where some acceleration was seen was the Eastern Mediterranean Region,yet the accelerated ARR was still less than half of

177、that required to meet the SDG target.The region of most concern in meeting the target is South-East Asia Region,where the previous overall slow but still declining trend in 20002015 has reversed,with an increase in premature NCD mortality in 20152019.The other regions all underwent major declines in

178、 ARR,ranging from a 8%reduction in the African Region to over a third reduction in the Western Pacific Region(1).Life expectancy,healthy life expectancy and burden of disease in the light of the COVID-19 pandemic19Figure 1.13 Trends in the probability of dying between ages 30 and 69 years from one o

179、f the four major NCDs,globally,by WHO region and by World Bank income group,20002019African RegionRegion of the AmericasSouth-East Asia RegionEuropean RegionEastern Mediterranean RegionWestern PacificGlobalGlobalLow-incomeLower-middle-incomeUpper-middle-incomeHigh-incomeWorld Bank income groupsWHO r

180、egion2000200520102015201910152025301015202530Risk of premature death from target NCDs(%)Source:WHO(1).About 60 countries with good vital registration data that are available for 2020 and/or 2021 present a mixed picture of NCD premature mortality during the pandemic.2 Some countries saw further slowd

181、own of reduction or even increasing NCD mortality during the pandemic as a result of disruptions to NCD services,while other countries observed accelerated decline in NCD premature mortality.The latter may well be an artefact,as patients with 2 Trajectories of NCD mortality after the onset of the CO

182、VID-19 pandemic are still being understood.In countries that have low-quality vital registration,WHOs current estimates include a cause of death category,“other pandemic-related mortality”,that likely includes NCD mortality.Future work will explore how NCD mortality changed in these countries in 202

183、02021(1).NCDs are also at greater danger of dying prematurely from COVID-19 as a competing risk(and so recorded as COVID-19 deaths).There are still many unknowns around the progress in NCD premature mortality during the COVID-19 pandemic that can only be answered with more and better cause of death

184、data to document the trends during and after the pandemic.World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals201.3.4 Mortality attributable to environmental risk factorsMillions of deaths annually can be attributed to environmental factors,such as air pollution

185、and unsafe drinking-water,sanitation and hygiene(WASH).Mortality attributed to air pollutionExposure to air pollution increases the risk for many negative health outcomes.Five health conditions stroke,ischaemic heart disease,lung cancer and chronic obstructive pulmonary disease in adults,and acute l

186、ower respiratory infections at all ages are included in the estimation of SDG indicator 3.9.1 on mortality attributed to air pollution.Household and ambient air pollution are estimated to have jointly caused 6.7 million deaths worldwide in 2019,corresponding to 4.2 million attributable to ambient ai

187、r pollution and 3.2 million to household air pollution.The global age-standardized mortality rate attributable to air pollution in 2019 was 104(UI:81130)deaths per 100 000 population,a slight decline from 133(UI:106162)deaths per 100 000 population in 2010.The African,Eastern Mediterranean and South

188、-East Asia regions had the highest age-standardized mortality rates attributable to air pollution among WHO regions in 2019(8).The causes of the observed differences in air pollution-attributable mortality rates between regions and countries are diverse.First,they are due to the different(population

189、-weighted)ambient and household particulate matter concentrations,but the different population distribution by age and underlying mortality patterns by cause also play a role.Mortality attributed to unsafe WASHUnsafe WASH can lead to undesired health outcomes,including deaths.SDG indicator 3.9.2 is

190、defined as mortality rate attributed to unsafe WASH,and considers four health conditions in the estimation,namely diarrhoea,acute respiratory infections,undernutrition and soil-transmitted helminthiases.The latest estimate suggests that globally in 2019,safe WASH could have prevented 1.4 million(UI:

191、1.31.5 million)deaths.An estimated 395 000 of these deaths were among children under 5 years of age(9).The global WASH-attributable mortality rate in 2019 was 18.3 deaths per 100 000 population,ranging from 3.7 deaths per 100 000 population in high-income countries up to 41.7 deaths per 100 000 popu

192、lation in low-income countries.Among WHO regions,the highest mortality rates in 2019 were in the African Region(46.7 deaths per 100 000 population)and the South-East Asia Region(29.6 deaths per 100 000 population)(9).Life expectancy,healthy life expectancy and burden of disease in the light of the C

193、OVID-19 pandemic21References1.Global health estimates 2021.Geneva:World Health Organization;in press(https:/www.who.int/data/global-health-estimates).2.Work of the Statistical Commission pertaining to the 2030 Agenda for Sustainable Development:resolution/adopted by the General Assembly.New York:Uni

194、ted Nations;2017(A/RES/71/313;https:/digitallibrary.un.org/record/1291226?v=pdf).3.Trends in maternal mortality 2000 to 2020:estimates by WHO,UNICEF,UNFPA,World Bank Group and UNDESA/Population Division.Geneva:World Health Organization;2023(https:/iris.who.int/handle/10665/366225).Licence:CC BY-NC-S

195、A 3.0 IGO.4.Levels&trends in child mortality:report 2023.Estimates developed by the United Nations Inter-agency Group for Child Mortality Estimation.New York,Geneva,Washington,DC:United Nations Childrens Fund,World Health Organization,World Bank Group,United Nations Department of Economic and Social

196、 Affairs,Population Division;2024(https:/childmortality.org/wp-content/uploads/2024/03/UNIGME-2023-Child-Mortality-Report.pdf).5.Global status report on road safety 2023.Geneva:World Health Organization;2023(https:/iris.who.int/handle/10665/375016).Licence:CC BY-NC-SA 3.0 IGO.6 Improving global road

197、 safety:resolution/adopted by the General Assembly.New York:United Nations;2020(A/RES/74/299;https:/digitallibrary.un.org/record/3879711?ln=zh_CN&v=pdf).7.Improving global road safety:resolution/adopted by the General Assembly.New York:United Nations;2010(A/RES/64/255;https:/digitallibrary.un.org/re

198、cord/684031?ln=en&v=pdf).8.Air pollution data portal.The global health observatory online database.Geneva:World Health Organization;(https:/www.who.int/data/gho/data/themes/air-pollution).9.Burden of disease attributable to unsafe drinking-water,sanitation and hygiene,2019 update.Geneva:World Health

199、 Organization;2023(https:/iris.who.int/handle/10665/370026).Licence:CC BY-NC-SA 3.0 IGO.World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals222 Health-related SDGsThe World health statistics 2023 revealed that not only have many advances attained in the MDG era(2

200、0002015)stalled since 2015,but the COVID-19 pandemic has further hampered improvements since 2020(1).This chapter presents the latest available evidence of trends in health-related SDG and WHO GPW13 indicators,assessing progress towards achieving the global targets.The topics covered in this chapter

201、 include infectious diseases,risk factors for health,and health systems as a key to UHC.SDG indicators related to mortality are discussed in Chapter 1.2.1 Infectious diseases1 Percentage change in HIV incidence rate was calculated from unrounded incidence rates.SDG target 3.3 advocates to end the ep

202、idemics of HIV/AIDS,tuberculosis(TB),malaria and neglected tropical diseases(NTDs),and to combat hepatitis,waterborne diseases and other communicable diseases.This section describes the status of progress in the related SDG indicators along with that in combating polio and antimicrobial resistance(A

203、MR).2.1.1 HIVAt the end of 2022,there were an estimated 39.0 million(UI:33.145.7 million)people living with HIV globally,of which 37.5 million(UI:31.843.6 million)were aged 15 years or older and 1.5 million(UI:1.22.1 million)were children aged under 15 years(2).In 2022,there were 1.3 million(UI:1.01

204、.7 million)new HIV infections globally.This represents a 54%reduction from 2.8 million(UI:2.23.8 million)in 2000,and 27%from 1.8 million(UI:1.42.4 million)in 2015.The global HIV incidence rate(number of new HIV infections per 1000 uninfected population,SDG indicator 3.3.1)was 0.17(UI:0.130.23)in 202

205、2,a 32%reduction from 0.25(UI:0.190.33)in 2015.However,progress varied across regions.The Eastern Mediterranean Region has seen a 45%increase in HIV incidence rate since 2015,although it still had the lowest number of new infections across WHO regions in 2022.HIV incidence rate declined by 31%during

206、 the same period in the South-East Asia Region,where both incidence rate and number are among the lowest.Despite impressive progress in reducing incidence,the African Region continued to bear the heaviest HIV burden(Fig.2.1)(2,3).1Figure 2.1 Percentage change in the number of new HIV infections per

207、1000 uninfected population,a 20152022,and number of new HIV infections,2022,globally and by WHO region 56 180 140 160 110 6601 300Number of new HIV infections(thousands),2022African RegionGlobalSouth-East Asia RegionRegion of the AmericasWestern Pacific RegionEuropean RegionEastern MediterraneanRegi

208、on-60-40-2002040Percentage change in HIV incidence rate(20152022)-32%-53%-31%10%45%-7%7%a Percentage change in HIV incidence rate was calculated from unrounded incidence rates.Source:Joint United Nations Programme on HIV/AIDS(2,3).World health statistics 2024:monitoring health for the SDGs,Sustainab

209、le Development Goals24Global initiatives call for curbing the number of new HIV infections to 370 000 in 2025 and 335 000 in 2030,equivalent to HIV incidence rates of 0.05 in 2025 and 0.025 in 2030(4,5).The latest estimates suggest that while the world is moving in the right direction,it is still fa

210、r from reaching these targets.2.1.2 TBAn estimated 10.6 million(UI:9.911.4 million)people developed TB globally in 2022,of which 55%were men,33%were women and 12%were children under 15 years of age.The global TB incidence rate(SDG indicator 3.3.2)was 133(UI:124143)per 100 000 population in 2022,down

211、 from 180(UI:134233)per 100 000 population in 2000 and 146(UI:133160)per 100 000 population in 2015.Figure 2.2 shows that TB incidence rates varied enormously across countries and areas in 2022(6).The WHO End TB strategy calls for a 50%reduction of TB incidence rate by 2025 relative to the 2015 base

212、line,as a milestone towards the SDG 2030 and End TB 2035 targets(7).While TB incidence rate had continuously declined for many years up to 2020,two consecutive years of global increases in TB incidence(in 2021 and 2022)led to the TB incidence rate in 2022 reverting to the level of 2019.Globally,the

213、net relative reduction in the TB incidence rate from 2015 to 2022 was 8.7%,falling far behind the WHO End TB strategy milestone(6).Nevertheless,there were encouraging signs of progress.The global trends in the number of people diagnosed with TB and treated showed a major recovery in 2022,after a sha

214、rp drop in 2020 due to the disruptions related to the COVID-19 pandemic(see section 2.3.1).Figure 2.2 TB incidence rate by country and area,2022Source:WHO(6).Health-related SDGs252.1.3 MalariaIn 2022,there were an estimated 249 million(UI:225278 million)malaria cases in 85 endemic countries and area

215、s,leading to an estimated 631 000(UI:587 000747 000)deaths(8).The Global technical strategy for malaria 20162030(GTS)calls for a reduction in malaria case incidence by at least 40%by 2020,75%by 2025 and 90%by 2030 from a 2015 baseline,among other milestones and targets(9).The global malaria incidenc

216、e rate(malaria cases per 1000 population at risk,SDG indicator 3.3.3)was 59.8(UI:54.865.7)in 2015,having declined by 26%from 81.0(UI:75.787.7)in 2000.The incidence rate continued to fall until 2019,before rising by 3%in 2020 and remaining stable since.In 2022,the incidence rate was 58.4(UI:52.965.3)

217、;the expected rate was 26.2 if it was on trajectory to reach GTS targets.If the current trends continue,it is unlikely that the GTS incidence targets will be achieved)(8).The WHO African Region continues to bear the heaviest burden of malaria.In 2022,the region accounted for 94%of global malaria cas

218、es and 95%of global malaria deaths.Children under the age of five are particularly vulnerable;in 2022,almost four in every five malaria deaths in the region were among these young children(8).WHO recently added the programmatic use of malaria vaccines for children living in endemic areas to the mala

219、ria prevention toolbox.The first malaria vaccine,RTS,S/AS01(RTS,S),was recommended by WHO in 2021 after successful pilot programmes in Ghana,Kenya and Malawi through the Malaria Vaccine Implementation Programme(Box 2.1).In 2023,WHO recommended a second safe and effective malaria vaccine,R21-Matrix-M

220、(R21)(10).Wide implementation of malaria vaccines is expected to save tens of thousands of lives each year.Box 2.1 Malaria vaccine implementation in Ghana,Kenya and MalawiThe Malaria Vaccine Implementation Programme(MVIP)was established by WHO to evaluate the public health use of the first malaria v

221、accine,RTS,S/AS01(10).Findings from the pilot programme informed the historic WHO recommendation in October 2021 for a vaccine to prevent malaria in children.Through the collaborative effort with the ministries of health in Ghana,Kenya and Malawi from 2019 to 2023,the RTS,S malaria vaccine was integ

222、rated into routine child immunization services as part of each countrys national malaria control programme.Over 2 million children received the RTS,S malaria vaccine through the pilot.Findings from MVIP show that the RTS,S vaccine substantially reduces early childhood deaths and hospitalizations for

223、 severe malaria.In October 2023,WHO recommended a second safe and effective malaria vaccine,R21,for routine use.This recommendation,resulting in sufficient vaccine supply to scale up malaria vaccines broadly,coupled with the high impact seen with the introduction of the RTS,S vaccine,underscores the

224、 potential of malaria vaccines as important interventions to act against Plasmodium falciparum,the deadliest malaria parasite globally and the most prevalent in Africa,and further supports the case for implementing the malaria vaccine as a routine child immunization.The wide-scale implementation of

225、the malaria vaccines,which began in early 2024,holds the potential to save tens of thousands of lives each year.This is not just a scientific breakthrough but a life-saving intervention that can significantly reduce the burden of malaria on our communities.Key findings:substantial public health impa

226、ct(11)Disease surveillance during 46 months of RTS,S vaccine use and scale-up,as part of the MVIP,showed that malaria vaccine introduction resulted in a 13%vaccine-attributable reduction in all-cause mortality(excluding injury)among children age-eligible for vaccination compared with children living

227、 in areas where the vaccine was not in use.Substantial reductions in severe malaria and malaria hospitalizations of children were also documented.Measured impact was additional to the benefits from insecticide-treated mosquito net(ITN)use and access to other child health interventions and care.World

228、 health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals26These findings were measured in the context of vaccine scale-up,with an average third-dose coverage of about 68%and average fourth-dose coverage of about 40%across the three countries.The substantial public health

229、impact of malaria vaccine is expected to increase as vaccine coverage increases.Figure 2.3 shows the coverage of immunization with malaria and other vaccines in the MVIP areas in the three countries from 2020 to 2023.Figure 2.3 Coverage of immunization with RTS,S vaccine(first,third and fourth dose)

230、,pentavalent vaccine(third dose)and measlesrubella vaccine(first and second dose)in the MVIP areas in Ghana,Kenya and Malawi,20202023VaccineYearGhanaKenyaMalawi020406080100Coverage(%)020406080100Coverage(%)020406080100Coverage(%)Penta-32020202120222023RTS,S-12020202120222023RTS,S-32020202120222023MR

231、-12020202120222023MR-22020202120222023RTS,S-42020202120222023Source:Administrative data,Essential Programme on Immunization,ministries of health of Ghana,Kenya and Malawi.Other findings Malaria vaccine uptake is high,with no unintended consequences,such as reduction in ITN use,uptake of other childh

232、ood vaccines or change in health-seeking behaviour.Quantitative analysis shows that parents understand that malaria vaccine reduces malaria but does not prevent all cases of malaria,and continue to use other preventive and care-seeking measures.Community demand for and health worker acceptance of ma

233、laria vaccine is high.The malaria vaccine has a good safety profile with more than 6 million doses provided.In the three pilot countries,malaria vaccine even reached children who were not using other forms of malaria prevention,thereby extending the programmatic reach of malaria prevention intervent

234、ions.The MVIP further established that a moderately efficacious malaria vaccine can have high effectiveness and impact and will be accepted by communities and health workers.Health-related SDGs27The MVIP also provided critical information to inform the recently updated WHO recommendation for malaria

235、 vaccines that applies to both RTS,S and R21 vaccines,and forged a pathway for future malaria vaccine development.Next stepsThe high demand for malaria vaccines is unprecedented.More than 20 countries have been approved for malaria vaccine introduction support by Gavi,the Vaccine Alliance,and wider

236、implementation began in 2024.As of 25 April 2024,eight countries in Africa offer the malaria vaccine as part of their childhood immunization programmes(Benin,Burkina Faso,Cameroon,Ghana,Kenya,Liberia,Malawi and Sierra Leone)and up to 10 additional countries are likely to introduce it this year.Imple

237、menting malaria vaccines in Africa represents an important step in the fight against the disease.At least 30 countries in Africa are interested in deploying malaria vaccines as part of their national malaria control plans.Moreover,the ministers of health of 11 African countries representing the High

238、 Burden High Impact(HBHI)countries in Africa,met in Yaound,Cameroon,on 6 March 2024,and declared their unwavering commitment to the accelerated reduction of malaria mortality and pledged to hold each other and countries accountable for the commitments outlined in the Declaration for accelerated mala

239、ria mortality reduction in Africa:commitment that“No one shall die from malaria”.2.1.4 HepatitisGlobally,an estimated 304 million people were living with chronic hepatitis B and C in 2022,of whom 254 million were living with hepatitis B and 50 million with hepatitis C.The estimated number of people

240、newly infected by viral hepatitis B and C declined from 2.5 million in 2019 to 2.2 million in 2022(12).While this decline is encouraging,it is still far from the 2030 targets of 170 000 new hepatitis B infections and 350 000 new hepatitis C infections(5).Of the 2.2 million new infections in 2022,mor

241、e than 1.2 million(UI:0.81.5 million)were hepatitis B and nearly 1.0 million(UI:0.81.3 million)hepatitis C(12).The African Region saw an estimated 771 000 new hepatitis B infections in 2022,representing 63%of the global incidence(Fig.2.4)(12).It also had the highest hepatitis B surface antigen(HBsAg

242、)prevalence among children under five years(SDG indicator 3.3.4)2 in 2020,at 2.53%(UI:2.103.07%),more than double the global prevalence of 0.94%(UI:0.821.06%)(13).In 2022,the South-East Asia and the Eastern Mediterranean regions had the highest number of new hepatitis C infections,with 225 000 and 1

243、83 000 cases,respectively(Fig.2.4).The Eastern Mediterranean Region also had the highest total chronic hepatitis C infections at 11.7 million,23%of the global total in 2022(12).There is,however,promising momentum in the region,as Egypt became the first country to achieve the“gold tier”status on the

244、path to eliminating hepatitis C infection(Box 2.2).2 The SDG framework currently uses“Hepatitis B surface antigen(HBsAg)prevalence among children under 5 years”as a proxy for the official indicator 3.3.4 (Hepatitis B incidence per 100 000 population),reflecting the high burden of Hepatitis B in this

245、 age group.2.1.5 NTDsThirteen of the 21 diseases or groups of disease recognized by WHO as NTDs are targeted for eradication,elimination of transmission or elimination as a public health problem,and 50 countries have eliminated at least one NTD.Bangladesh,for example,has recently eliminated lymphati

246、c filariasis and visceral leishmaniasis as a public health problem(Box 2.3).This is an encouraging sign that NTDs can be defeated by combining diverse interventions including mass and individual treatment,vector control,veterinary public health,and provision of safe water and sanitation.The NTD road

247、map 20212030 calls for a 90%reduction of the global population requiring NTD interventions between 2010 and 2030(16).Between 2010 and 2022,the reported number of people requiring mass or individual treatment and care for NTDs declined by 26%from 2.19 billion to 1.62 billion progress in the right dir

248、ection but not sufficient to reach the 2030 target without substantial acceleration(Fig.2.5).In recent years,the world has faced multiple challenges in the fight against NTDs,including a slow recovery of NTD programmes after the massive service disruption at the start of the COVID-19 pandemic,an unc

249、ertain financial situation and the ever-increasing threat of climate change,which is likely to result in increased distribution of many NTDs(17).World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals28Figure 2.4 Number of new hepatitis B and hepatitis C infections,

250、by WHO region,2022Hepatitis BHepatitis CWestern PacificRegion98 000WesternPacificRegion83 000South-East Asia Region225 000South-East Asia Region266 000Region of the Americas176 000European Region126 000European Region18 000EasternMediterraneanRegion183 000EasternAfrican Region172 000African Region77

251、1 000MediterraneanRegion86 000Region of the Americas8 000Source:WHO(12).Health-related SDGs29Box 2.2 Egypt becomes the first country to achieve the“gold tier”status on the path to elimination of hepatitis C In 2023,Egypt became the first country to achieve gold tier status on the path to eliminating

252、 hepatitis C in accordance with WHO criteria.This means that Egypt has fulfilled WHOs targets that will set the country up to achieve the reduced incidence and mortality targets of full elimination before 2030.Egypt has implemented one of the worlds largest nationwide public health screening and tre

253、atment programmes for hepatitis C.Egypt had one of the highest rates of viral hepatitis in the world.Between the 1950s and 1980s,inadvertent infection transmission associated with unsafe injection practices occurred in the attempt to control schistosomiasis,a parasitic disease carried by water snail

254、s.Since the early 1990s,the government has put a huge effort into strengthening hepatitis prevention,with programmes covering blood safety,infection control and injection safety.It also worked on raising public awareness and running harm reduction programmes.Egypt launched a network of specialized t

255、reatment centres in 2006 and,with the new antiviral medicines discovered in 2014,hepatitis testing and treatment were made accessible and free of charge for everyone.In 2018,the government launched the presidential initiative“100 million seha”(100 million healthy lives),a massive and unprecedented n

256、ationwide campaign to detect and treat everyone with hepatitis C,escalating its elimination efforts.Through the campaign,everyone over 18 was tested,later expanding to children 12 years and older.In addition to routine testing at all health facilities,the campaign used outreach in the community,with

257、 teams visiting big squares,markets,workplaces,sports clubs,mosques and churches,and popular meeting places such as barbershops.Vulnerable communities such as refugees and migrants,and persons with disabilities were also included,to leave no one behind.Between 2018 and 2022,over 60 million people we

258、re tested with WHO-approved rapid diagnostic tests.Patients were also assessed and treated for other chronic diseases,such as hypertension and diabetes.A total of 4.1 million received treatment for hepatitis C with locally manufactured medicines between 2014 and 2022,of which 98%were virally suppres

259、sed.Expanding direct public health approaches to community prevention,testing and treatment,as shown by Egypts successful public health programme to eliminate hepatitis C,can have a population-wide impact.A case study concluded that five key elements contributed to Egypts successful programme:the av

260、ailability of sufficient and reliable epidemiological data;a robust public health care infrastructure;inclusive care that reached all sectors of society;political commitment with increased health-care spending and a comprehensive long-term strategy for viral hepatitis;and use of innovation and infor

261、mation technology(14).Source:WHO(15).World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals30Figure 2.5 Global trend in the reported number of people requiring mass or individual treatment and care for NTDs,and its relative reduction,2010202220102011201220132014201

262、520162017201820192020202120221 0001 1001 2001 3001 4001 5001 6001 7001 8001 9002 0002 1002 2002 300Number of people requiring interventions against neglected tropical diseases(million)02468101214161820222426Percentage reduction from baseline12%18%0%1%19%20%20%20%21%3%26%7%25%Number of people(million

263、s)Percentage reductionSource:WHO(17).Health-related SDGs31Box 2.3 Bangladesh eliminates visceral leishmaniasis and lymphatic filariasis as a public health problem In 2023,Bangladesh became the first country globally to be validated for elimination of visceral leishmaniasis,also called kala azar,as a

264、 public health problem.The country achieved the elimination target of less than one case per 10 000 population at the sub-district(upazila)level in 2017 and has sustained it to date despite disruptions related to the COVID-19 pandemic.In 2005,Bangladesh,together with India and Nepal,launched a Regio

265、nal Kala-azar Elimination Initiative with the aim of wiping out the disease.The Government of Bangladesh,WHO,the Special Programme for Research and Training in Tropical Diseases(TDR)and several other partners supported research and development of new diagnostic tools,effective treatments and vector

266、control(especially indoor residual spraying),and facilitated their roll-out and access by all those in need through donation programmes,which helped the country meet the criteria set by WHO for elimination as a public health problem(18).Kala azar is the most severe form of leishmaniasis and is trans

267、mitted by sandflies;it is commonly prevalent among the most disadvantaged rural communities.The disease leads to symptoms such as fever,weight loss,and spleen and liver enlargement and,if left untreated,can prove fatal in over 95%of cases.In 2023,Bangladesh was also validated as the fourth country i

268、n the WHO South-East Asia Region to eliminate lymphatic filariasis as a public health problem,after Maldives,Sri Lanka and Thailand.Lymphatic filariasis,also known as elephantiasis,occurs when filarial parasites are transmitted to humans through mosquito bites.The infection is usually acquired in ch

269、ildhood with painful and disfiguring visible manifestations appearing much later in life,often in the form of enlargement of body parts,causing pain,severe disability and associated stigma.Lymphatic filariasis was a major public health problem in Bangladesh and was endemic in 19 of its 64 districts.

270、In 2001,the country established a national elimination programme.Between 2001 and 2015,high-coverage mass drug administration campaigns were carried out in all endemic districts.A series of transmission assessment surveys was carried out by programme personnel between 2011 and 2021,which demonstrate

271、d that transmission levels were below the threshold established by WHO for elimination as a public health problem.To meet WHOs validation criteria on morbidity management and disability prevention(19),Bangladesh also strengthened access to the recommended essential package of care in all endemic dis

272、tricts.Notably,over 31 000 people affected by lymphatic filariasis have been trained in self-care and provided with kits to manage their disease condition and improve their quality of life.For both kala azar and lymphatic filariasis,Bangladesh will now focus on post-validation surveillance to sustai

273、n its hard-won status and prevent recurrence of infection.Source:WHO(20,21).World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals322.1.6 PolioPoliomyelitis(polio)is a highly infectious viral disease.It primarily affects children under 5 years of age,but an unvacci

274、nated person at any age can contract the disease.Of the three strains of wild poliovirus(type 1,type 2 and type 3),wild poliovirus type 2 was eradicated in 1999 and wild poliovirus type 3 was eradicated in 2020.As at 2022,endemic wild poliovirus type 1 remains in two countries,Afghanistan and Pakist

275、an.In 2023,a total of 12 cases of wild poliovirus were reported in Afghanistan and Pakistan and,unlike in previous years,no cases were reported from non-endemic countries(22).Although immunization coverage,including polio,began to recover from the impact of the COVID-19 pandemic during 2022,progress

276、 is uneven.There were 14.3 million children missing out on any vaccination the so-called“zero-dose children”worldwide in 2022.Afghanistan and Pakistan were among the top 15 countries with the highest number of zero-dose children in 2022,highlighting the need for continued,intensified efforts to reac

277、h all remaining un-or under-immunized children in those endemic areas(23).2.1.7 Antimicrobial resistanceAMR affects countries in all regions and at all income levels.It is a complex problem that requires both sector-specific actions in the human health,food production,animal and environmental sector

278、s,and a coordinated approach across these sectors.In 2015,the World Health Assembly adopted the Global Action Plan on AMR,committing,among other things,to the development and implementation of multisectoral national action plans(24).As of November 2023,some 178 countries had such plans developed.How

279、ever,in 2023 only 27%of countries reported implementing their national action plans effectively and only 11%had allocated national budgets to do so(25).SDG indicator 3.d.2 is defined as the percentage of bloodstream infections due to selected antimicrobial-resistant organisms.Median resistance to th

280、ird-generation cephalosporins in Escherichia coli(E.coli)and methicillin resistance in Staphylococcus aureus(S.aureus)were 41%and 32%in 2021,respectively,compared with 26.9%and 13.4%in 2016.However,no conclusions can be made on whether changes in resistance have occurred over time.The reasons for th

281、is are twofold:first,the pool of reporting countries has changed significantly over the years.In 2016,only 16 countries contributed data on resistance to third-generation cephalosporins in E.coli,compared with 77 in 2021.Similarly,only 15 countries provided data in 2016 on methicillin resistance in

282、S.aureus in 2016,compared with 78 in 2021.Second,the number of resource-limited settings providing data has increased in recent years.Testing coverage in these settings is often low,with data often limited to tertiary referral,private hospitals and/or research facilities,and biased towards complex i

283、nfections and treatment failures.Higher median resistance in recent years is at least in part consistent with potential biases resulting from the convenience sampling of health facilities for reporting AMR data in many settings(26).Priorities to address AMR include surveillance of antimicrobial cons

284、umption.The Global Antimicrobial Resistance and Use Surveillance System(GLASS)provides a common and standardized set of methods for measuring and reporting.Of the 57 countries with data(20182021),36(63%)achieved the target of at least 60%of total antibiotic consumption being“Access”group antibiotics

285、(26).The overall goal is to reduce the use of“Watch and reserve”group antibiotics and to increase the relative benefit and the availability of Access group antibiotics,where needed.Health-related SDGs332.2 Risk factors for healthMany factors affect the health of individuals and communities.A risk fa

286、ctor for health is any attribute,characteristic or exposure of an individual that increases their likelihood of developing a disease or injury.This section presents progress towards achieving SDG and GPW13 targets related to several risk factors for health.2.2.1 Nutritional risk factorsBetter nutrit

287、ion is related to improved infant,child and maternal health,stronger immune systems,lower risk of NCDs,and longevity.Today,the world faces the multiple burden of malnutrition that comprises undernutrition,overweight(including obesity)and micronutrient deficiencies.Section 4.1 discusses the global tr

288、ends in undernutrition and overweight or obesity.This section summarizes the global progress towards the reduction of anaemia among women and the consumption of trans-fatty acids(TFA).Anaemia among womenWomen with anaemia are more likely to experience fatigue and impaired physical capacity in their

289、daily lives.Moderate and severe anaemia are also risk factors for adverse maternal and perinatal outcomes.Global trends in the prevalence of anaemia among all women 1549 years of age(SDG indicator 2.2.3)show no significant change from 31.2%(UI:28.734.1)in 2000 to 29.9%(UI:27.032.8)in 2019.With popul

290、ation growth,the total number of women aged 1549 years affected increased from 493 million in 2000 to 571 million in 2019.While there was a slight decrease in anaemia prevalence among pregnant women from 40.9%(UI:38.743.1)in 2000 to 36.5%(UI:34.039.1)in 2019,prevalence among non-pregnant women remai

291、ned stagnant,at 30.7%(UI:28.133.7)in 2000 and 29.6%(UI:26.632.5)in 2019(27).Across WHO regions,the decline in anaemia prevalence among women observed during the MDG era either halted or slowed after 2015.This latest evidence suggests that the global target of 50%reduction of anaemia in women of repr

292、oductive age by 2025(from a 2012 baseline)is unlikely to be met(27,28).Trans-fatty acidsIntake of TFA is associated with increased risk of heart attacks and death from coronary heart disease.WHO designated TFA elimination as one of its priority targets in 2018,calling for the global elimination of i

293、ndustrially produced TFA by 2023.Mandatory TFA policies are currently in effect in 69 countries in all WHO regions,covering 55%of the global population(4.4 billion people).Of these countries,53 have“best-practice”policies,which include mandatory national limit of 2 g of industrially produced TFA per

294、 100 g of total fat in all foods and mandatory national ban on the production or use of partially hydrogenated oils as an ingredient in all foods.Population coverage by best-practice TFA policies has grown considerably.In 2018,best-practice policies were in effect for just 6%of the global population

295、(480 million people).By the end of 2023,this has increased to 46%coverage(3.7 billion people)(29).However,accelerated actions are needed to meet the target of 100%global population coverage(30).2.2.2 Behavioural risk factorsModifiable behaviours such as tobacco use,alcohol consumption,physical inact

296、ivity and an unhealthy diet are among the known risk factors associated with NCDs.This section summarizes the global progress towards the reduction of tobacco use and alcohol consumption.Tobacco useThe Global action plan for the prevention and control of NCDs 20132020,which has been extended until 2

297、030,includes a target for reducing the global prevalence of tobacco use by 30%by the year 2025,relative to 2010(31,32).In 2022,the global age-standardized prevalence of current tobacco use among persons aged 15 years and older(SDG indicator 3.a.1)was estimated at 20.9%(UI:18.822.9),a 21%relative dec

298、line from 26.4%in 2010.If current trends continue,the world will see a 25%relative reduction in prevalence by 2025.While this is short of the 30%reduction target,progress is encouraging as tobacco use has been declining in all WHO regions.The South-East Asia Region,having consistently the highest pr

299、evalence since 2000,is projected to achieve a 34%reduction by 2025 relative to 2010.The African Region is expected to reach a 32%relative reduction by 2025 and remain the region with the lowest prevalence.The European Region,in contrast,is projected to have the highest prevalence across all WHO regi

300、ons in 2030 at 23.1%(33).Owing to its long history of tobacco control,the World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals34Netherlands(Kingdom of the)is among the countries to have experienced a decline in tobacco use faster than the European regional averag

301、e,and one of only four countries worldwide to have attained best-practice level adoption of all MPOWER measures3(Box 2.4)(33,34).3 MPOWER is WHOs technical package that assists countries to implement the evidence-based demand-reduction measures of the WHO Framework Convention on Tobacco Control.Toba

302、cco use prevalence differs markedly by sex.While the prevalence among both men and women has decreased since 2000,it has remained much higher among men than women in 2022,both globally and in all six WHO regions(33).Box 2.4 Tobacco control in the Netherlands(Kingdom of the)The estimated age-standard

303、ized prevalence of tobacco use among persons aged 15 years and older in the Netherlands(Kingdom of the)declined from 34.5%(UI:27.741.2)in 2000 to 27.7%(UI:23.332.2)in 2010 and 21.3%(UI:17.125.5)in 2022.If current trends continue,the prevalence is projected to reduce further to around 19.9%(UI:15.824

304、.1)in 2025(33).This would represent a 28%relative reduction over the period 20102025,close to the 30%voluntary reduction target under the Global action plan for the prevention and control of NCDs(31).On average,prevalence in the WHO European Region is projected to reduce more slowly,by 17%over the s

305、ame period.The prevalence among both men and women in the Netherlands(Kingdom of the)has been declining at a faster pace than the European Region averages;the prevalence among women in the Netherlands(Kingdom of the)has been declining remarkably faster than the European Region average(Fig.2.6)(33).F

306、igure 2.6 Age-standardized prevalence of tobacco use among persons aged 15 years and older,by sex,Netherlands(Kingdom of the)and the European Region,20002025200020052010201520202025051015202530354045Age-standardized prevalence of tobacco use among persons aged 15 years and olderEuropean Region,MaleE

307、uropean Region,FemaleNetherlands(Kingdom of the),MaleNetherlands(Kingdom of the),FemaleSource:WHO(33).Dotted lines=projection;solid vertical line at 2010 indicates baseline date for comparison.Health-related SDGs35The Netherlands(Kingdom of the)has a long history of tobacco control dating back to th

308、e 1950s.In more recent times,some examples of measures adopted in line with the WHO Framework Convention on Tobacco Control include(34):2005:Netherlands(Kingdom of the)became a Party to the WHO Framework Convention on Tobacco Control.2008:Extension of a smoking ban to the hospitality sector(with som

309、e exceptions).2014:Rise in the legal age for purchase of tobacco from 16 to 18 years of age.2016:Implementation of EU Tobacco Products Directive II,restricting the use of flavourings and dangerous additives,and adding pictorial health warnings on tobacco packs.Establishment of a new,toll-free nation

310、al quit-smoking line.2018:Signing of National Prevention Agreement(NPA)by the government and 70 organizations to address tobacco use(among other risk factors),with the aim that,by 2040,the country would have less than 5%of its population as smokers,and no children or pregnant women smoking.2019:Adop

311、tion of the NPA by the House of Representatives.Amendment to the Tobacco Act to include a ban on the display of tobacco products at point of sale,except inside specialized tobacconists,with different steps and transitional periods until mid-2022.2020:Netherlands(Kingdom of the)became a Party to the

312、Protocol to Eliminate Illicit Trade in Tobacco Products.Implementation of plain packaging and a ban on tobacco vending machines.2021:Closing of long-standing tobacco control gaps,such as banning advertising of tobacco products at points of sale and allowing no designated smoking rooms in public plac

313、es,workplaces and public transport.Over recent years,the Netherlands(Kingdom of the)has increased excise tax on tobacco products,which has led to real price increases over time(14%above inflation over the past 10 years).In 2022,total taxes represented close to 77%of the retail price of the most sold

314、 brand.In the 2023 WHO report on the global tobacco epidemic,the Netherlands(Kingdom of the)is featured as one of only four countries in the world that have attained best-practice level adoption of all MPOWER measures WHOs technical package that assists countries to implement the evidence-based dema

315、nd-reduction measures of the WHO Framework Convention on Tobacco Control(34).Alcohol consumptionSDG indicator 3.5.2 is defined as total(recorded and unrecorded)alcohol per capita consumption(APC)per year,adjusted for tourist consumption,in persons aged 15 years and older,measured in litres of pure a

316、lcohol.Globally in 2019,the total APC stood at 5.5 litres(UI:4.86.2),a 4.5%decline from 5.7 litres(UI:5.16.4)in 2010(35).Comparing this pace of decline with the global targets of at least 10%reduction by 2025 and at least 20%by 2030,it is evident that acceleration is needed(31,36,37).Moreover,the 20

317、19 global APC was still higher than the 2000 level(5.1 litres,UI:4.65.6)(35).Despite consistent reduction since 2000,including 9.8%reduction since 2010,the European Region continued to have the highest total APC.The South-East Asia Region is the only region where total APC has continuously increased

318、,although the rise has considerably slowed since 2010.Total APC remained very low in the Eastern Mediterranean Region,with total APC of 0.3 litres(UI:0.20.5)in 2019.As with tobacco use,globally alcohol consumption among men has been consistently higher than among women.Box 2.5 presents an analysis o

319、f sex-related inequalities in alcohol consumption globally and by WHO region(35).The COVID-19 pandemic had an apparent impact on alcohol consumption globally,although its magnitude and duration remain to be reliably defined.The preliminary global estimate for total APC in 2020 is 4.9 litres(UI:4.35.

320、6)(38).World health statistics 2024:monitoring health for the SDGs,Sustainable Development Goals36Box 2.5 Sex-related inequalities in the global and regional levels of alcohol consumptionGlobally,there are sex-related inequalities in total APC among persons aged 15+years,with higher alcohol consumpt

321、ion among men than women.In 2019,alcohol consumption among men was four times that among women.Between 2000 and 2019,alcohol consumption did not change substantially among men(from 8.0 litres of pure alcohol UI:7.29.0 in 2000 to 8.7 litres of pure alcohol UI:7.79.9 in 2019)and women(2.1 litres of pu

322、re alcohol UI:1.92.4 in 2000 and 2.2 litres of pure alcohol UI:2.02.5 in 2019).The situation varied across WHO regions(Fig.2.7).The largest absolute sex-related inequalities in 2019 were evident in the European Region(difference of 10.9 percentage points between men and women),followed by the Region

323、 of the Americas(difference 8.7 percentage points),the Western Pacific Region(difference 7.2 percentage points),the African Region(difference 5.9 percentage points)and the South-East Asia Region(difference 5.1 percentage points).Between 2000 and 2019,absolute sex-related inequality increased in the

324、South-East Asia and Western Pacific regions due to a faster increase in alcohol consumption among men than women.Absolute sex-related inequality decreased in the African and European regions due to a faster decrease in alcohol consumption among men than women.Sex-related inequality did not change in

325、 the Region of the Americas(where inequality remained high)and the Eastern Mediterranean Region(where there was no inequality).Figure 2.7 Total alcohol per capita consumption among persons aged 15+years,by sex,globally and by WHO region,200020192000200120022003200420052006200720082009201020112012201

326、320142015201620172018201905101520Annual consumption(litres)GlobalAfrican RegionRegion of the AmericasSouth-East Asia RegionEuropean RegionEastern MediterraneanRegionWestern Pacific Region20002004200820122016201920192000200420082012201620002004200820122016200020042008201220162019201920192019200020042

327、008201220162000200420082012201605101520Annual consumption(litres)FemaleMaleShaded areas represent 95%uncertainty intervals.Source:WHO(35).Health-related SDGs372.2.3 Metabolic risk factorsMetabolic risk factors for NCDs include hypertension,overweight and obesity,high blood glucose levels and high le

328、vels of fat in the blood.This section summarizes the global progress towards the reduction of hypertension;overweight and obesity are discussed in section 4.1.HypertensionFor the purpose of monitoring population health,hypertension is defined as having raised blood pressure4 or taking medication for

329、 hypertension.The age-standardized prevalence of hypertension among adults aged 3079 has changed little in the past three decades globally and in all WHO regions,with a notable exception in the European Region,where there has been a continuous decline.In 2019,the global prevalence stood at 33.1%(UI:

330、31.534.8%),and slightly higher among men(34.5%;UI:32.036.9%)than women(31.7%;UI:29.633.9%).However,available data suggests a higher treatment coverage among women globally,leading to a higher prevalence of controlled hypertension than for men(Box 2.6)(39).The voluntary global target on blood pressur

331、e envisages a 25%reduction in raised blood pressure(uncontrolled hypertension)by 2025 against a 2010 baseline(31,32).Globally,the age-standardized prevalence of uncontrolled hypertension declined slightly from 28.6%(UI:28.029.3%)in 2010 to 26.2%(UI:24.727.8%)in 2019,but this pace of decline is insuf

332、ficient to achieve the global target by 2025(39).4 Defined as systolic blood pressure(SBP)140 mmHg or diastolic blood pressure(DBP)90 mmHg,regardless of diagnosis or medication status.2.2.4 Environmental risk factorsHuman health is dependent on a variety of environmental factors,such as safe WASH,cl

333、ean air,safe chemical use,healthy built environments,sound agricultural practices,and protected natural areas and water sources.This section outlines the global progress towards universal access to WASH and the reduction of air pollution.Trends in mortality attributable to environmental risk factors are discussed in Chapter 1.WASHBetween 2000 and 2022,worldwide some 2.1 billion people gained acces