Achieving Health related SDGs in China and Other Asian Countries: - PowerPoint PPT Presentation

Achieving Health related SDGs in China and Other Asian Countries: Issues and Challenges Shenglan Tang, PhD, MD Duke Global Health Institute, Duke University Global Health Research Center, Duke Kunshan University

Outline 1. Health related Millennium Development Goals (MDGs) and achievements of Asian countries 2. Transition from MDGs to Sustainable Development Goals (SDGs) 3. Current situation and gaps to achieve health SDGs in China and other Asian countries 4. Achieving Health SDGs – issues and challenges for China and other Asian countries 5. Achieving Health SDGs- opportunities for China and other Asian countries 6. Final remark

Health MDG Targets and achievements • Child mortality rate: cut by more than half since 1990 • Since 1990, the global maternal mortality ratio fell by 45% • Between 2000 and 2013, new HIV infections fell by 40% Inter-Agency and Expert Group on MDG Indicators. The Millennium Development Goals Report 2015.

MDG 4: achievements in China and other Asian countries Neonatal mortality rate per 1,000 live births in Under-five mortality rate per 1,000 live births in China China and other Asian countries (1990-2015) and other Asian countries (1990-2015) South Asia South Asia China China East Asia and Pacific East Asia and Pacific U5MR per 1,000 live births dropped substantially from 1990 to 2015 in NMR per 1,000 live births dropped substantially from 1990 to 2015 in Asian Asian countries: countries: South Asian countries: from 129.3 to 52.5 South Asian countries: from 58.4 to 29.9 East Asia and Pacific: from 56.6 to 18.0 already met SDG goal 25/1000 East Asia and Pacific: from 27.59 to 8.55 already met SDG goal 12/1000 China: from 53.8 to 11.2 already met SDG goal 25/1000 China: from 29.7 to 5.5 already met SDG goal 12/1000 Data and pictures cited from: Atlas of SDGs 2017, the World Bank Group http://datatopics.worldbank.org/sdgs/

MDG 5: achievements in China and other Asian countries Maternal mortality rate per 100,000 live births in China and other Asian countries (1990-2015) MMR per 100,000 live births dropped substantially from 1990 to 2015 in Asian countries: South Asian countries : from 558 to 182 East Asia and Pacific: from 159 to 59 South Asia already met SDG goal 70/100,000 China: from 97 to 27 already met SDG goal 70/100,000 East Asia and Pacific China Data and picture cited from: Atlas of SDGs 2017, the World Bank Group http://datatopics.worldbank.org/sdgs/

MDG 6: achievements in China and other Asian countries (HIV/AIDs is not prevalent in Asian countries) Malaria incidence per 100,000 people in China Tuberculosis incidence per 100,000 people in China and other Asian countries (2000-2015) and other Asian countries (2000-2015) South Asia East Asia and Pacific China South Asia East Asia and Pacific China TB incidence per 100,000 people decreased from 2000 to 2015 in Malaria incidence per 1,000 people decreased from 2000 to 2015 in Asian countries: Asian countries: South Asian countries: from 275 to 220 South Asian countries: from 43.5 to 16.9 East Asia and Pacific: from 167 to 136 East Asia and Pacific: from 22.7 to 5.7 China: from 109 to 67 China: from 0.1 to 0.0 already met SDG goal Data and pictures cited from: Atlas of SDGs 2017, the World Bank Group http://datatopics.worldbank.org/sdgs/

17 Sustainable Development Goals 2016-2030

From MDGs to SDGs • 17 goals and 169 targets • Applicable to all countries: no one left behind • Integrated approach: people, planet, prosperity, peace and partnership MDGs SDGs Total Health Total Health Goals 8 3 17 1 Targets 21 8 169 23

The place of health in the SDGs • Health is centrally placed in the 2030 agenda and linked to many other SDGs. • It emphasizes the need for a more integrated approach to sustainable development compared with the MDGs. • There is a strong focus on equity and UHC Picture cited from: Health in the SDGs: where are we now in the South-East Asia Region? What Next? The WHO 2016. http://apps.who.int/iris/bitstream/10665/249536/6/9789290225218-Eng.pdf

Goal 3: Good health and well-being Goal 3: 9 targets and 4 means Picture cited from: Health in the SDGs: where are we now in the South-East Asia Region? What Next? The WHO 2016. http://apps.who.int/iris/bitstream/10665/249536/6/9789290225218-Eng.pdf

New Health Targets Included in SDGs • Infectious diseases – hepatitis • NCDs – hypertension, stroke, CVD, diabetes, mental health, etc. Reduce by one-third • Road injuries Reduce by half • Substance abuse • Universal health coverage • Pollution

Current situation and gaps to achieve health SDGs in China and other Asian countries

Health-related SDG index • This is cited from GBD 2015 SDG Collaborators. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet 2016; 388: 1813 – 50 • The health-related index is a function of the 33 health-related SDG indicators • The majority of Asian countries are marked in yellow, pink or red: still huge gaps to fill to achieve the health-related SDGs, especially in NCDs, mental health, hepatitis, road injuries and pollution etc.

Many Asian countries facing big challenges on NCD targets Probability of dying from any of CVD, cancer, diabetes, CRD between age 30 and exact age 70 (%)

Air pollution in Asian countries In 2013: • Among 2.6 million deaths from ambient air pollution globally, 64% are in Asian countries. • In China and India, less than 1% of the population lives in areas meeting WHO guidelines. • Deaths from ambient air pollution and household air pollution in China and India: Picture cited from: Global Burden of Air Pollution. Institute for Health Metrics and Evaluation http://www.healthdata.org/infographic/global-burden-air-pollution

Mental health issues in Asian countries Suicide mortality rate, per 100,000 people in China and other Asian countries (2000-2015) Suicide mortality per 100,000 people in 2015 in some Asian countries: • Korea, Rep.: 32.0 ( ranked first among Asian countries ) • Japan: 19.6 • Korea, Dem. People’s Rep.: South Asia 15.8 • India: 15.7 China East Asia and Pacific • China: 10 • Cambodia: 11.9 • Bangladesh:5.5 • Singapore: 9.9 • Vietnam: 7.4

Road injuries in Asian countries Mortality caused by road traffic injury, per 100,000 people in China and other Asian countries (2000-2015) Mortality caused by road traffic injuries per 100,000 people in 2015 in some Asian countries: • Vietnam: 24 (ranked first among Asian countries) China • Malaysia: 22.3 • Korea , Dem. People’s Rep.: East Asia and Pacific 20.7 • South Asia China: 19.4 • Cambodia: 18.9 • Bangladesh:12.8 • Singapore: 3.7

Alarming Numbers Show the State of Health in China - Over 90 million HBV infected people - 15 million HCV infected people - Over 300 million hypertensive patients - Over 2.4 million new stroke patients/year, and over 1 million death due to stroke - Over 100 million diabetes patients - Road injuries – approximately 300,000 deaths per year - Air pollution leads to an 1.2 million premature annual deaths

Hypertension in China • Prevalence rate among Chinese adults in 2010 o Men vs. women: 31.2% vs. 28% o North vs. south: 31.0% vs. 28.5% o Urban vs. rural: 32.0% vs. 29% • Awareness, treatment and control rate among Chinese adults in 2010: by gender and district 60 60 50.9 51 46.7 50 50 42.3 39.9 39.6 35.1 40 40 28.2 30.1 26.8 26.7 30 30 men 21.2 20 urban 18.5 11.3 20 7.6 women 10 rural 6.4 10 0 awearness rate treatment rate control rate (%) control rate (%) 0 (%) (%) among treated awearness rate treatment rate control rate (%) control rate (%) hypertensive (%) (%) among treated patients hypertensive Data cited from: Wang J, Zhang L et al. Prevalence, awareness, treatment and control of hypertension in China: results from a patients national survey. Am J Hypertension. 2014. Nov;27(11):1355-61. doi: 10.1093/ajh/hpu053. Epub 2014 Apr 3.

Diabetes in China • Diabetes prevalence among Chinese adults in 2010 • Awareness, treatment and control rate among Chinese adults in 2010 45 45 40.7 40.8 38.6 38.7 38.6 40 40 32.7 35 30.5 35 29.7 26.2 30 25.5 30 24.6 25 25 21.5 men urban 20 20 15 women rural 15 10 10 5 5 0 0 awearness rate treatment rate control rate (%) (%) (%) awearness rate (%) treatment rate (%) control rate (%) Data cited from: Xu Y, Wang L et al. Prevalence and Control of Diabetes in Chinese Adults, JAMA. 2013 Sep 4;310(9):948-59. doi: 10.1001/jama.2013.168118.

Pollution in China: Economy VS. Environment • China now produces the largest number of major pollutants in the world, which cause serious air pollution and substantially reduced visibility. In addition to 1.2 million annual premature deaths in China, airborne pollutants from China are estimated to have caused around 30 000 additional deaths outside the country. • Recent reports that more than half of China's groundwater is polluted. Data and picture cited from: Zhu C, Wang J et al. China tackles the health effects of air pollution. The Lancet; London382.9909 (Dec 14, 2013): 1959-60. Kan H. Globalisation and environmental health in China. The Lancet; Comment| volume 384, issue 9945, p721 – 723, 30 august 2014