SDG Target #4.b

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.b:

By 2020, substantially expand globally the number of scholarships available to developing countries, in particular least developed countries, small island developing States and African countries, for enrolment in higher education, including vocational training and information and communications technology, technical, engineering and scientific programmes, in developed countries and other developing countries

Target 4.b has one indicator:

  • Indicator 4.b.1: Volume of official development assistance flows for scholarships by sector and type of study

This indicator reintroduces us to the concept of official development assistance (ODA). Otherwise known as foreign aid, the high-income OECD countries bear the responsibility to donate ODA. These donor countries form the OECD's Development Assistance Committee (DAC) to offer aid flows to the list of ODA recipients. This target focuses on ODA for scholarships to finance the development of education systems.

To track the progress for this target and indicator, let’s look at the development flows to the respective regions mentioned in the body of target 4.b. For African countries, as of 2021, ODA intended for scholarships was $US297 million, an increase from $US225 million from 2015. For developing countries, aid for scholarships in 2021 was $1.35 billion, down from $1.49 billion in 2015. For the least developed countries, 2021 scholarship aid was $221 million, down from $225 million in 2015. For the Small Islands Developing States, scholarship aid was $43 million in 2021, down from $104 million in 2015.

SDG Target #4.a

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.a:

Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all

Target 4.a has one indicator:

  • Indicator 4.a.1: Proportion of schools offering basic services, by type of service

Key to achieving this in the modern-day is access to information and communication technologies. ICTs allow even the remotest schools and children to access education systems. It even allows the possibility to access some of the best education institutions in the world. Schools need electricity to power the information and communication technologies. They also need an internet connection and computers for teaching and learning. Still, solutions to achieve this are available at low-cost.

The infrastructure of the learning environment also needs to adapt to be suitable for those with a disability. The learning materials need to factor in disabled students also.

School facilities also need basic facilities for drinking water, sanitation, and handwashing. 

Let's look at the worldwide progress toward this target and indicator. The proportion of schools offering the basic service of access to electricity as of 2020 was 90% in upper secondary, and 75% in primary. 80% of secondary schools offered access to handwashing facilities, and 76% of primary schools. 84% of secondary schools offered access to drinking water, and 75% of primary schools. 76% of upper secondary schools offered access to computers, and 46% of primary schools. The proportion of primary schools offering internet access for the purposes of teaching worldwide in 2022 was 39%. 89% of secondary schools offered single-sex toilets worldwide in 2020, and 76% of primary schools. 56% of secondary schools offered learning materials and infrastructure adapted to disabled students. This proportion was 47% for primary schools. 

SDG Target #4.7

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.7:

By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural diversity and of culture’s contribution to sustainable development

Target 4.7 has one indicator:

  • Indicator 4.7.1: Extent to which (i) global citizenship education and (ii) education for sustainable development are mainstreamed in (a) national education policies; (b) curricula; (c) teacher education; and (d) student assessment 

For us to have peace and sustainable development, we first need to educate ourselves on what sustainable development is. How we achieve it is the foundation for peace. The issues the SDGs place before are urgent. But we can take actions to foster sustainable development to keep at bay the most sudden and striking outcomes on our planet. Our world is interdependent, and whether we choose to be or not, we’re global citizens. 

But what does it mean to be a good global citizen? Like anything in life, to light the way, we need an education in global citizenship. In this way, we can go on to contribute, whatever our age, and this opportunity ought to inspire us all. Education to foster understanding across countries, as well as being a human right, opens a world of freedom for the learner.

The responsibility to put in place this right of citizens in each country lies with the relevant ministries of education. But we have an opportunity at the international level for member states to cooperate via UNESCO’s efforts. 

UNESCO has issued a recommendation document outlining how governments should foster such education. Recommendations are part of the legal jargon of UNESCO to set standards for member states to put into practice or law.

The results for this indicator are encouraging among the countries with data. We're measuring the extent of mainstreaming global citizenship and sustainable development education. The unit of measure is an index, where 0 is the worst and 1 the best. Most reporting countries record indexes greater than 0.8 for mainstreaming in national education. The results are similar for mainstreaming in curricula, teacher education and student assessment.

SDG Target #4.6

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.6:

By 2030, ensure that all youth and a substantial proportion of adults, both men and women, achieve literacy and numeracy 

Target 4.6 has one indicator:

  • Indicator 4.6.1: Proportion of population in a given age group achieving at least a fixed level of proficiency in functional (a) literacy and (b) numeracy skills, by sex

This indicator introduces us to the concept of fixed level of proficiency. This is a standard of knowledge in a field of learning - in this instance, literacy and numeracy.

To survey the skills of adults, the OECD runs the PIAAC. This stands for Programme for the International Assessment of Adult Competencies. This program can assess adults in literacy and numeracy.

What are the worldwide literacy rates of people between 15-24 years old? As of 2020, disaggregated by sex as defined by the indicator, it's 93% for men and 90% for women, with only a fractional increase since 2015. 

The worldwide literacy rate for males over 15 was 90% in 2020, and 83% for females. But as of 2017, UNESCO has insufficient data across the countries to form a global numeracy rate disaggregated by sex.

SDG Target #4.5

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.5:

By 2030, eliminate gender disparities in education and ensure equal access to all levels of education and vocational training for the vulnerable, including persons with disabilities, indigenous peoples and children in vulnerable situations

Target 4.5 has one indicator:

  • Indicator 4.5.1: Parity indices (female/male, rural/urban, bottom/top wealth quintile and others such as disability status, indigenous peoples and conflict-affected, as data become available) for all education indicators on this list that can be disaggregated

Whilst for this indicator, there isn’t one global parity index for gender equality, disability, and indigenous people. We do have some data for individual countries.

Those with a 2021 gender parity for primary completion lower than 0.8, meaning less 8 girls for every 10 boys, were Yemen, Somalia, and Afghanistan. The latter two had parities closer to 7 girls for every boy.

What about secondary completion? A half-dozen other countries in sub-Saharan Africa with 2021 data had parity rates across the sexes below 7 girls for every 10 boys. The lowest secondary completion gender parities were in Chad and Somalia, where 0.35 girls completed secondary per boy.




SDG Target #4.4

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.4:

By 2030, substantially increase the number of youth and adults who have relevant skills, including technical and vocational skills, for employment, decent jobs and entrepreneurship

Target 4.4 has one indicator:

  • Indicator 4.4.1: Proportion of youth and adults with information and communications technology (ICT) skills, by type of skill 

The mention of ICT’s introduces us to the UN agency specialising in this field, the International Telecommunication Union (ITU).

To measure these skills at the international level, in 2020, the ITU has issued a manual to measure access of individuals and households. This gives us 50 indicators for a variety of ICT skills, grouped into several categories. 

An example is being able to receive and send SMS. Another is using VoIP technologies to make voice calls and send messages over broadband internet.

It’s imperative across countries for individuals and households to have access to and use ICT’s. The world must progress toward greater connection. This is a reflection of the value of digital knowledge and the information societies we’ve become. In this way, telecommunication is key to development. The importance of ICT extends beyond the individual and household to education. It also offers opportunities for governments and enterprises, and the infrastructure for this needs to be there to begin with. 

SDG Target #4.3

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.3:

By 2030, ensure equal access for all women and men to affordable and quality technical, vocational and tertiary education, including university

Target 4.3 has one indicator:

  • Indicator 4.3.1: Participation rate of youth and adults in formal and non-formal education and training in the previous 12 months, by sex

The more training and education undertaken by a population, the greater the participation in the labour force, and for individuals to find employment and avoid unemployment and underemployment in working the number of hours one wishes to.

Worldwide, the enrolment rate for tertiary education as of 2022 was 41%, up from 36% in 2015, at the adoption of the SDGs.

SDG Target #4.2

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.2:

By 2030, ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education

Target 4.2 has two indicators:

  • Indicator 4.2.1: Proportion of children aged 24–59 months who are developmentally on track in health, learning and psychosocial well-being, by sex

  • Indicator 4.2.2: Participation rate in organised learning (one year before the official primary entry age), by sex

The UN agency responsible for monitoring the first indicator for this target is UNICEF (United Nations Children’s Fund), focused upon children. The indicator is served by UNICEF’s Early Childhood Development Index 2030, a tool to measure this indicator’s progress. The science underlying early childhood development has revealed it as a crucial intervention in the effective nurturing and care in a child’s overall development, and the SDGs present an opportunity to expand and implement such findings to the greatest possible scale.

Worldwide, as of 2022, only 69% of children aged 3 to 5 are on track in health, learning and psychosocial well-being. 

The second indicator for this target looks at pre-school, defined according to UNESCO’s International Standard Classification of Education (ISCED). The ISCED exists to provide uniformity across the different education structures and curricula across countries.

As of 2020, 74% of children at the age of one year before primary entry were enrolled in organised learning, about the same as 2015, at the adoption of the Global Goals. Disaggregated by sex, per the definition of the indicator, the enrolment of both sexes was at parity as of 2022.

SDG Target #4.1

SDG #4 is to “Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.”

Within SDG #4 are 10 targets, of which we here focus on Target 4.1:

By 2030, ensure that all girls and boys complete free, equitable and quality primary and secondary education leading to a relevant and effective learning outcome.

Target 4.1 has two indicators:

  • Indicator 4.1.1: Proportion of children and young people (a) in grade 2/3; (b) at the end of primary; and (c) at the end of lower secondary achieving at least a minimum proficiency level in (i) reading and (ii) Mathematics, by sex

  • Indicator 4.1.2: Completion rate (primary education, lower secondary education, upper secondary education)

Indicator 4.1.1 looks at minimum proficiency levels. This is the benchmark of basic knowledge, as measured by assessments, in this instance, for reading and mathematics. This indicator looks at reading and maths skills at three points: grade 2 and 3, end of primary schooling, and end of lower secondary. Performance level descriptors describe the knowledge and skills demonstrated by students at each. Performance level descriptors help us to assess students across countries.

Let's look at the respective descriptors for each grade.

Reading, grade 2: Being able to read and comprehend familiar written words and extract explicit information from sentences.

Reading, grade 3: Read written words aloud, understanding the meaning of sentences and short texts and identifying the topic.

Maths, grades 2/3: To make sense of, calculate numbers, and recognise shapes.

Reading, end of primary: Interpreting and giving explanations about the main and secondary ideas in different texts and establishing connections between main ideas and their own experiences.

Maths, end of primary: Basic measurement and reading and creating graphs.

Reading, end of lower secondary schooling: Establishing connections of the author’s intentions and reflecting and drawing conclusions based on the text.

Maths, end of lower secondary school: Solving maths problems, using tables and graphs, as well as algebra.

The data for assessing trends in students draws from a half-dozen surveys, some run by UNICEF and UNESCO. UNESCO the UN’s agency focused on education. The purpose of these assessments is to survey the effectiveness of learning outcomes. In some countries, it’s possible for a student to pass through grades without meeting the minimum proficiency levels.

International large-scale assessments test educational outcomes. An example is PIRLS (Progress in International Reading Literacy Study) for reading literacy in grade 4 students.

There are also several large-scale learning assessments at the national and regional level. UNESCO’s office in Santiago houses the bureau focused on education in the Latin American and Caribbean region. This includes the LLECE, the Spanish acronym for the Latin American Laboratory for Evaluation of the Quality of Education. The LLECE runs the ERCE, the Spanish acronym for the Regional Comparative and Explanatory Study, a major large-scale learning assessment for the region.

Other examples of large-scale learning assessments at the regional level include: 

The benefit of these surveys is they serve as tools to provide the evidence which then goes toward making decisions to improve education. This then serves those children not attaining the expected learning outcomes for their grade level.

As of 2019, the proportion of students worldwide at the end of primary education meeting minimum proficiency levels in reading was 58%. This was down 1% since the start of the SDG period in 2015. For maths at the same level, the worldwide share of minimum proficiency was 44%, and 50% for lower secondary in mathematics.

To coincide with the adoption of the Sustainable Development Goals in 2015, the UN released a report, titled Education 2030. The Incheon Declaration and Framework for Action accompanied the report. This declaration's name came from the South Korean city hosting UNESCO’s World Education Forum 2015 conference. Education 2030 is an effort of several UN agencies besides UNESCO, including the UNDP, UNFPA, UNHCR, UNICEF, UN Women, the World Bank Group and ILO. The purposes of the report, as well as the Incheon Declaration and Framework for Action, reinforces the purpose of SDG #2.

The aim is to end Learning Poverty, which the World Bank defines as 10-year-olds being unable to read and understand a simple story.

The second indicator for this target looks at school completion of primary, lower secondary and upper secondary.

The completion rate for primary education worldwide was 87% as if 2021, up only 2% since 2015. Lower secondary completion rates were 77% in 2020, again up only 2% since 2015. Global upper secondary completion was 58% as of 2021, up 5% since 2015.

SDG Target #3.d

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SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.d:

Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

Target 3.d has two indicators:

  • Indicator 3.d.1: International Health Regulations (IHR) capacity and health emergency preparedness

  • Indicator 3.d.2: Percentage of bloodstream infections due to selected antimicrobial resistant organisms.

This target and indicators look at the security aspects of health, inclusive of emergency management, aiming to increase the ability of all World Health Organisation member states to prepare for public health emergencies, such as the world has experienced with COVID-19.

Much of how World Health Organisation states-parties are to behave in relation to one another to prevent global pandemics is guided by the WHO’s International Health Regulations, as mentioned in this target’s first indicator. The respective WHO states-parties are obliged to self-report each year on their adherence and capacities for the International Health Regulations.

The self-assessment tool has 15 indications for WHO members, ranging from legislation; financing; zoonotic diseases of human-animal crossover, which account for 75% of emerging pathogens; coordination between countries to notify the WHO of events which pose a global health risk; food safety, and preventing and controlling infections, among others. Further, each country is to post their self-assessment in fulfilling the International Health Regulations online via the public e-SPAR platform.

The second indicator of this target looks at bloodstream infections due to selected antimicrobial-resistant organisms. These organisms include a variety of the bacterium Staphylococcus aureus which is resistant to the antibiotic methicillin, a type of penicillin. Also, the bacterium E. coli. produces an enzyme which is resistant to a type of antibiotics called cephalosporins.

One of the methods clinical laboratories can use to test whether a microorganism may be susceptible to antibiotics is known as a broth microdilution. Antimicrobial resistance occurs when viruses, bacteria, fungi and parasites change in the ways by which drugs once used to treat against them either have less efficacy or no longer work. The greater difficulty caused by treating infections of such microorganisms in turn can be the cause of greater infectivity and spread of disease, as well as the possibility of such diseases being more fatal.

One of the initiatives the World Health Organization exercises against this threat is the Global Antimicrobial Resistance and Use Surveillance System (GLASS) to help countries surveil for such developments of drug resistance in known microorganisms.

For the second indicator of this target, the global share of Staphylococcus aureus infections resistant to methicillin stood at 31% as of 2021, up from 20% in 2016. E. coli infections resistant to cephalosporins stands at a global total of 39% in 2021, up from 35% in 2016, and experiencing an almost doubling in 2018, before coming back down.

SDG Target #3.c

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.c:

Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in the least developed countries and small island developing states.

Target 3.c has one indicator:

  •  Indicator 3.c.1: Health worker density and distribution

According to 2017 data, reflecting only two years after the adoption of the Sustainable Development Goals in 2015, the number of medical doctors per 1,000 people in the world was 1.75. For the low-income countries, this number was 0.32 doctors for every thousand people, in contrast to 3.73 in high-income countries and 1.49 for middle-income countries.

SDG Target #3.b

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.b:

Support the research and development of vaccines and medicines for the communicable and non‑communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.

Target 3.b has three indicators:

  • Indicator 3.b.1: Proportion of the target population covered by all vaccines included in their national program.

  • Indicator 3.b.2: Total net official development assistance (ODA) to medical research and basic health sectors.

  • Indicator 3.b.3: Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis.

First of all, what is the Doha Declaration, as mentioned in the body of the target. This refers to an agreement made in Doha, Qatar at the Fourth Ministerial Conference of the World Trade Organization in 2001. The World Trade Organization is the world’s peak international organisation for international trade, and though it works alongside the UN, is independent of it. 

The focus of the declaration  for this target is on the TRIPS Agreement, an international treaty which stands for Agreement on Trade-Related Aspects of Intellectual Property Rights. The TRIPS Agreement is an annex of the Marrakesh Agreement establishing the World Trade Organization, signed in the Moroccan city in 1994. One of the key relationships between the World Trade Organization and the UN in relation to the TRIPS Agreement is via the World Intellectual Property Organization, one of the UN specialised agencies

This Marrakesh Agreement was the result of the so-called Uruguay Round of multilateral trade negotiations, within the framework of another international treaty, the General Agreement on Tariffs and Trade (GATT) designed to reduce or remove international trade barriers, tariffs and import quotas. 

In turn, the lengthy Uruguay Round of international trade negotiations, drawn out over 1986 to 1994, resulted in the establishment of the World Trade Organization to replace the GATT, with the Marrakesh Agreement acting as one of the WTO’s founding documents.

To turn back to the TRIPS Agreement, this WTO treaty relates to the enforcement of intellectual property rights worldwide, both for authors of creative works, and all manner of copyrights, patents and trademarks. 

The nature of the Doha Declaration is to recognise the importance of public health of developing countries, and least developed countries in particular, who are at the frontline of infectious epidemics such as HIV/AIDS, malaria and tuberculosis. 

As it applies to the TRIPS Agreement, the Doha Declaration on the TRIPS Agreement and Public Health makes it clear public health ought to take precedence over intellectual property, and though intellectual property rights is an important aspect of drug discovery, it should be balanced with the prices with which such medicines are made available in the poorest countries.

Within the definitions of our first official indicator for this target regarding vaccine coverage, we’re looking at the vaccines recommended by WHO and UNICEF, including two doses of measles, a full schedule of HPV, three doses of pertussis, and the toxoid vaccines of tetanus and diphtheria, whereby the toxins from bacteria are weakened. Also included is an immunisation for pneumococcal disease.

Looking at progress for this indicator, as of 2021, 81% of the one-year-olds worldwide have been immunised with the DPT vaccine, a 4% decrease since 2015, at the adoption of the SDGs. 71% of children worldwide had been vaccinated for measles as of 2021, up from 63% in 2015. 51% of one-year-olds had been vaccinated for pneumococcal disease in 2021, up from 38% in 2015. Worldwide, 12% of adolescent girls had been vaccinated for HPV as of 2021, up from 9% in 2015.

For the second indicator relating to ODA given to medical research and health, we can measure this via OECD data. Within the OECD is the DAC, or Development Assistance Committee, consisting of the high-income donor countries. Using this data, reported via the OECD’s Creditor Reporting System, we can see, for each donor, what amounts each year have been given of their total official development assistance flows to which sectors. In this instance, we want to see how many millions of US dollars have been given to the basic health sector and medical research.

Now is also an opportunity to look at the regions within which the World Health Organization divides its operations among its Member States, as the data for the final indicator is disaggregated into these regions to show access to essential medicines. These World Health Organization regions are:

These essential medicines are defined by the World Health Organization into the WHO Model Lists of Essential Medicines, including the Essential Medicines for Children, selected by the World Health Organization’s Expert Committee on Selection and Use of Essential Medicines. The intention is for sufficient quantities of essential medicines to be available at health facilities for affordable prices, per the defined dosages. Such medicines can be out of reach of the daily wages of some living below national poverty lines, earning the lowest pay for unskilled work in the labour market.

SDG Target #3.a

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.a:

Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

Target 3.a has one indicator:

  • Indicator 3.a.1: Age-standardized prevalence of current tobacco use among persons aged 15 years and older

The World Health Organisation FCTC, or Framework Convention on Tobacco Control, is an international treaty overseen by the World Health Organisation, adopted in 2005 at the 56th World Health Assembly, which exists alongside the Protocol to Eliminate Illicit Trade in Tobacco Products, a treaty aiming to eliminate the illicit trade of tobacco. Another program within the WHO working toward raising awareness of tobacco’s threats and ways to reduce it’s use is the Tobacco Free Initiative.

In the West, we’re most  familiar with tobacco in the form of cigarettes, but let’s take a look around the world to see how different cultures adapt the plant from the nightshade family  belonging to the genus Nicotiana. According to the definitions of this target and its indicator, tobacco includes such applications as Indonesian kretek, which is blended with cloves, and snus, popular in Sweden and Norway, which is a form of dipping tobacco, placed between the lip and the gum, similar to naswar in Afghanistan, or toombak in Sudan. Dipping tobacco poses a threat of cancer of the mouth and throat.

Smokeless forms of tobacco go by many names throughout India and South Asia. One of these is gutkha, a combination of tobacco and calcium hydroxide; catechu, which is an extract from the tree Senegalia catechu; nuts from the areca palm tree; and leaves of the betel tree. Though smokeless, these products still pose a medical threat and can cause cancer. This preparation can also be made without tobacco, whereby it’s known as paan, or betel nut chewing, though still poses a cancer risk without the inclusion of tobacco.

The indigenous Yup’ik people of Alaska and Russian Far East use a smokeless tobacco product known as iq’mik, which poses a risk of heart disease, stroke and metabolic disorders such as diabetes and liver disease.

The FCTC reports on global progress to lower the trends of the prevalence of tobacco use. This data shows the global share of tobacco use is 22% as of 2020, not much further down than rate of 24% at the time of the SDGs adoption in 2015.

SDG Target #3.9

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.9:

By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

Target 3.9 has three indicators:

  • Indicator 3.9.1: Mortality rate attributed to the household (indoor) and ambient (outdoor) air pollution.

  • Indicator 3.9.2: Mortality rate attributed to unsafe water, sanitation, and lack of hygiene.

  • Indicator 3.9.3: Mortality rate attributed to unintentional poisoning.

Exposure to PM2.5, or particulate matter of a diameter of 2.5 micrometres or less, from both outdoors and household air pollution, poses great risks to health worldwide. Much of the culprit of household air pollution is due to the use of 2.4 billion people worldwide cooking using open fires or stoves burning biomass, kerosene or coal, resulting in an estimated 3 million annual deaths. The saddest facet of these deaths is such individuals simply wish to have access to energy, but the only form affordable and accessible to them compromise their air quality, and affect their health. 

The air in people’s home’s is killing millions, attributable to the burning of solid cooking fuels like wood, despite it being since the times of the earliest humans. Other fuels which put populations at risk in the home from burning are animal dung, charcoal, agricultural waste, and inefficient kerosene stoves.

Some of the causes of deaths which put populations at risk from long-term exposure to ambient fine particulate matter can be caused by conditions affecting the blood flow and blood vessels in the brain, and problems due to narrowed arteries in the heart, which supply blood to the heart’s muscles. Such risks of the burdens of disease from exposure are due to behaviours, environments and occupations..

To help measure this, the World Health Organization’s Global Health Estimates are used, which separate deaths by country and cause.

Mortality from inadequate water, sanitation and hygiene is most observed in low- and middle-income countries, which we’ll explore in greater detail when looking at SDG #6 (Clean Water & Sanitation).

As of 2019, the global death rate from household and ambient air pollution stands at 104 per 100,000 people; 18 deaths per 100,000 from unsafe water, sanitation and hygiene, and 1 death from unintentional poisoning per 100,000.

SDG Target #3.8

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.8:

Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

Target 3.8 has two indicators:

  • Indicator 3.8.1: Coverage of essential health services.

  • Indicator 3.8.2: Proportion of population with large household expenditures on health as a share of total household expenditure or income

Because of the inherent inequality of extreme poverty, of which 712 million people live below $2.15 a day as of 2022, those living in such destitution are often excluded from healthcare coverage. Instead, the international community needs to finance healthcare services of those countries unable to use their own resources, and protect the most vulnerable from what could be devastating costs.

According to the World Health Organisation, the measure of coverage for essential health services includes 14 indicators for:

  • Family planning

  • Pregnancy care

  • Child immunisation

  • Treatment of children

  • Tuberculosis

  • HIV/AIDS

  • Malaria

  • Water, sanitation and hygiene

  • Hypertension

  • Diabetes

  • Tobacco

  • Hospital access

  • Health workforce

  • Health security

These respective indicators form an aggregate index of coverage of essential health services, on a scale of 0 to 100, the measure used for indicator 3.8.1.

The second indicator for this target measures the proportion of household income spent on healthcare, using a method used by the UN called Classification of Individual Consumption According to Purpose (COICOP), which categorises the purpose of household expenditure, including health care goods and services.

By this measure, two thresholds are used to measure financial hardship, the lower one for 10% of household income spent on healthcare, and the higher threshold for a quarter of household income spent on healthcare.

For the purposes of Indicator 3.8.2, this measure is used at a population level to measure the percentage of people meeting either the lower or higher thresholds of 10 or 25% household income spent on healthcare, placing them at financial risk to pay for their healthcare needs. 

As of 2021, the world result for the index of coverage of essential health services stands at 67 out of a score of 100, still far from the 2030 goal of universal health coverage, the aim of SDG #3 overall.

As of 2019, the share of the world population with more than a quarter of household expenditure spent on health stands at 3%.

SDG Target #3.7

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.7:

By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs

Target 3.7 has two indicators:

  • Indicator 3.7.1: Percentage of married women ages 15–49 years whose need for family planning is satisfied with modern methods of contraception.

  • Indicator 3.7.2: Adolescent birth rate (aged 10–14 years; aged 15–19 years) per 1,000 women in that age group.

This target links both to Target 3.8, which we’ll look at next, relating to universal healthcare coverage, as well as Target 5.6, under the gender equality Goal for universal sexual and reproductive health.

The UN agency overseeing sexual and reproductive health is the UNFPA, otherwise known as the UN Population Fund, as well as the Population Division of the UN Department of Economic and Social Affairs.

To help meet the rights to access affordable and quality sexual and reproductive health services and information, the World Health Organisation has published a Family Planning guidance handbook for use by health care professionals about providing contraceptive methods and services in low- and middle-income countries, including for those adolescent and women at high risk of the HIV epidemic.

One example of a method profiled in the Family Planning handbook is the mini-pill, also known as norethindrone, a birth-control pill belonging to the class of medications called progestins, which are synthetic compounds which act like the steroid hormone made by the body called progesterone to maintain pregnancy and prevents further ovulation. 

The consequences of failing to acknowledge the unmet demand for contraceptives in the least developed countries put these regions at further risk of food insecurity due to the population explosion it invites, which will require even greater levels of foreign aid to feed more mouths. 

The phenomenon by which fertility rates are reduced in the least developed countries, in turn slowing down the rapid rise of populations, is known as the ‘demographic transition’. Meeting family planning and contraceptive needs is a key pillar of this transition in countries which already often lack healthcare coverage, and are characterised by high maternal and child mortality rates, sometimes also accompanied by high HIV rates. 

This brings us to the second indicator for this target, regarding adolescent birth rates. The global agenda for this intersection of population and development is epitomised in the Programme of Action, adopted at the International Conference on Population and Development in Cairo in 1994.

One of challenges of measuring the ages of mothers giving birth in the regions experiencing the highest rates of adolescent fertility rates are they’re sometimes out of reach of civil registration of live births.

As of 2023, 77% of the share of women throughout the world’s family planning needs were met, still short of the universal access objective of target #3.7. 

The adolescent birth rate, as of 2023, is 1.5 births per 1,000 to 10-14-year-olds worldwide.






SDG Target #3.6

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.6:

By 2020, halve the number of global deaths and injuries from road traffic accidents 

Target 3.6 has one indicator:

  • Indicator 3.6.1: Death rate due to road traffic injuries

According to WHO data, as of 2019, the death rate from road traffic injuries has reduced only 0.3 per 100,00 people worldwide, from 17 deaths per 100,000 in 2015, clearly missing this target for 2020, 10 years ahead of the SDGs in total.

SDG Target #3.5

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.5:

Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

Target 3.5 has two indicators:

  • Indicator 3.5.1: Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders

  • Indicator 3.5.2: Alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol

The UN agency overseeing the topic of substance abuse is the UNODC, or the UN Office on Drugs and Crime, as well as the WHO. There are three main International Drug Control Conventions:

On the treatment side of the topic of substance abuse, the WHO and UNODC have formulated a set of International Standards for the Treatment of Drug Use Disorders to support UN Member States to treat drug use disorders in an ethical, evidence-based way. To support member states' in relation to alcohol use, the World Health Organisation has published the International Guide for Monitoring Alcohol Consumption and Related Harm.

The World Health Organisation collects data for all Member States for per capita alcohol consumption for those aged over 15, with the leaders being Romania, Georgia and Czech Republic, with between 13-15 litres of pure alcohol per capita. The WHO and UNODC further estimate over 2 billion people worldwide drink alcohol.

SDG Target #3.4

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.4:

By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

Target 3.4 has two indicators:

  • Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease 

  • Indicator 3.4.2: Suicide mortality rate 

Non-communicable diseases are those diseases for which a pathogen is not responsible for the transmission of the disease, infecting the host, such as parasites. As indicator 3.4.1 makes clear, the most well-known non-communicable diseases are those affecting the heart and blood vessels, diabetes, cancer, and respiratory diseases such as chronic obstructive lung disease. To measure well-being, or quality of life, and the mental aspects thereof, the official UN indicator for the total opposite of wellbeing, suicide, is used as the measure.

To measure both indicators in this target, the World Health Organisation compiles mortality data within its Mortality Index, based upon the reporting of Member States. Complementing SDG #3 in the fight against non-communicable diseases is the NCD Global Monitoring Framework, which like the SDGs, is a framework of goals and indicators adopted by the member countries of the WHO’s World Health Assembly in 2013 for the prevention and control of non-communicable diseases.

As of 2019, the expected share of deaths of non-communicable diseases for the world is 18%, down 1% from 2015, far from the target to reduce by one-third premature mortality from non-communicable diseases.

The global suicide rate in 2019 is 9.1 deaths per 100,000 people, down only by a fraction since 2015, however target 3.4’s wording of “promoting mental health and wellbeing” does not provide a target with which this indicato should be reduced by.

SDG Target #3.3

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.3:

By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.

Target 3.3 has five indicators:

  • Indicator 3.3.1: Number of new HIV infections per 1,000 uninfected population

  • Indicator 3.3.2: Tuberculosis per 100,000 population

  • Indicator 3.3.3: Malaria incidence per 1,000 population

  • Indicator 3.3.4: Hepatitis B incidence per 100,000 population

  • Indicator 3.3.5: Number of people requiring interventions against neglected tropical disease 

Looking first at HIV/AIDS, this infection is caused by a type of retrovirus characterised by its ability to survive inside its hosts for long incubation periods. The nature of retroviruses is they copy their RNA into the DNA of a host, thus changing the genome.  

The UN agency overseeing the HIV/AIDS pandemic is the Joint UN Programme on HIV/AIDS, or UNAIDS for short, and is a joint effort of several UN agencies. 1.5 million people contract AIDS per year, resulting in 680,000 deaths in the latest year of data, with 38 million people living with the virus. A High-Level Meeting on AIDS declared the UN’s intent to end AIDS by 2030, in alignment with SDG Target #3.3. However another major pandemic, COVID-19, has slowed progress, with a current global rate of 0.19 new HIV infections per 1000 uninfected people, short of the 2030 goal for elimination of HIV. 

Turning next to tuberculosis, this is caused by infection of a pathogenic bacteria called Mycobacterium tuberculosis, transmitted between people via respiratory means. The bacteria causes 10.6 million people a year to fall ill, killing 1.6 million people in 2021. 

Within the World Health Organisation, the Global Tuberculosis Programme works toward ridding the world of TB from its current world level of an incidence of 127 TB cases per population of 100,000, down from 142 per 100,000 in 2015 at the start of the SDG period, and 174 in 2000, at the beginning of the MDG period. This was encapsulated in MDG #6 to “combat HIV/AIDS, malaria and other diseases”, and which aimed to halve the incidence of AIDS, malaria and TB by 2015, and reverse their incidence.

The world benefits from efforts such as the End TB Transmission Initiative, as part of the Stop TB Partnership, administered by the UN. Other impressive organisations in the fight against TB as well as AIDS, which are often co-morbidities alongside one another, include the The Global Fund to Fight AIDS, Tuberculosis and Malaria, Unitaid and IFFIm, in partnership with Gavi, the Vaccine Alliance.

One of the main strategies the WHO endorses for combating TB is DOTS, which stands for directly-observed treatment, short course, whereby a healthcare worker watches the patient take their dose. Immunisation with a TB vaccine is a widespread method of prevention. However, hampering global efforts to control and prevent TB are strains of TB resistant to drugs developed to treat the disease.

Alongside AIDS and TB, in 2020 there were 241 million cases malaria, resulting in 627,000 deaths. The mosquito-borne disease affects Africa to a disproportionate level, where it’s home to almost all cases and deaths. In the effort to end the malaria pandemic, the world is still shy of the mark, with an incidence of 59 new cases per 1,000 of the global population.

The following indicator focuses upon hepatitis B. Hepatitis is a disease characterised by inflammation of the liver. Hepatitis B is a viral type of hepatitis, caused by infection of the hepatitis B virus. Immunisations are an effective tool deployed worldwide to prevent the spread of the hepatitis B virus. The world isn’t too far away from eliminating this disease, with less than 1% of children under-5 worldwide testing positive for an active case of hepatitis B.

For the final indicator of this target, we look to neglected tropical diseases, which are infectious diseases common to developing countries in the tropics and subtropics of Africa, Asia and the Americas. So what are these neglected tropical diseases we’re aiming to control by 2030?

These include about 20 infectious diseases, so let’s parse through some which may be less than household names, many of which are water-borne diseases:

  • Lymphatic filariasis is caused by parasitic worms, microscopic in size, affecting the lymphatic system.

  • Schistosomiasis is another infection caused by parasitic worms

  • Soil-transmitted helminthiasis is a disease caused by another parasitic worm, in this case observable to the human eye, infecting the intestines, and transmissible via soil contaminated by these type of worms called helminths

  • Onchocerciasis, a disease of the eyes and skin, also caused by a worm

  • Buruli ulcer, an infection of the skin caused by a type of bacteria

  • Chagas disease, transmitted via a bug carrying a parasite called Trypanosoma cruzi

  • African sleeping sickness, also known as human African Trypanosomiasis, is similar to Chagas. Both are due to parasites belonging to the genus Trypanosoma, in this instance the species Trypanosoma brucei.

  • Leishmaniasis, a parasite spread by sandflies

  • Mycetoma, a bacterial and fungal infection, spread by the skin’s exposure to soil or water containing the bacteria or fungus causing this disease

  • Yaws, a chronic skin infection, resulting in small lumps and ulcers on the skin

  • Dracunculiasis, caused by the worm-like parasite species Dracunculus medinensis, also known as Guinea worm, so named because of the Gulf of Guinea in West Africa, where it was once prevalent.

  • Echinococcosis, caused by parasitic worms of the genus Echinocococcus. 

Also included among the neglected tropical diseases, is snake envenoming, caused by the toxins from a snakebite.

Various medications treating infection by some of the aforementioned parasitic worms include diethylcarbamazine, albendazole, mebendazole and praziquantel.

One of the preventive strategies endorsed by the WHO for some of the neglected tropical diseases caused by helminth worms is preventive chemotherapy, which is the safe administration of a medicine to a whole population susceptible to infection by these worms.

Progress made in lowering the number of people requiring interventions against neglected tropical disease has been slight over the span of the SDG period, down only 60 million since 2015 to its current total of 1.73 billion.

As with all SDG #3 targets, the provision of universal health care is a catch-all solution to almost all facets of achieving health and well-being for all, including ending the epidemics at the core of Target #3.3.