World Health Statistics 2023. Monitoring health for the SDGs
Introduction
The 2023 World Health Statistics edition reviews more than 50 health-related indicators from the Sustainable Development Goals (SDGs) and WHO’s Thirteenth General Programme of Work (GPW 13). The report consists of three chapters, complemented by an annex table presenting the latest available data.
- Chapter 1 discusses key issues and trends in global health, including the latest trends in maternal and child mortality; major noncommunicable diseases (NCDs) and the related risk factors, including alcohol; the COVID-19 pandemic; and climate change and health.
- Chapter 2 summarizes global and regional trends in the health-related SDGs in areas of infectious diseases; child malnutrition and anaemia among women; injuries and violence; environmental risks; and universal health coverage (UHC) and health systems.
- In chapters 1 and 2, country-focused stories are presented to highlight efforts undertaken to address various health issues.
- Chapter 3 then looks to the future through the lens of global life expectancy and NCDs.
The information presented in World Health Statistics 2023 is based on data available from global monitoring as of late April 2023. These data have been compiled primarily from databases managed by WHO or United Nations partner entities and supplemented with data and analyses from peer-reviewed publications.
Summary
COVID-19 cost in lost lives and health progress
The report documents updated statistics on the toll of the pandemic on global health, contributing to the ongoing decline in progress towards the SDGs. During 2020-2021, COVID-19 resulted in a staggering 336.8 million years of life lost globally. This equates to an average of 22 years of life lost for every excess death, abruptly and tragically cutting short the lives of millions of people.
Since 2000, there are significant improvements in maternal and child health with deaths falling by one-third and one-half, respectively. The incidence of infectious diseases such as HIV, tuberculosis (TB) and malaria also declined, along with a lowered risk of premature deaths from NCDs and injuries. Together, these contributed to an increase in global life expectancy from 67 years in 2000 to 73 years in 2019.
However, the pandemic has put many health-related indicators further off-track and contributed to inequalities in access to high-quality health care, routine immunizations and financial protection. As a result, improving trends in malaria and TB have been reversed, and fewer people were treated for neglected tropical diseases (NTDs).
The World Health Statistics is WHO’s annual check-up on the state of the world’s health. The report sends a stark message on the threat of noncommunicable diseases, which take an immense and increasing toll on lives, livelihoods, health systems, communities, economies and societies,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
The report calls for a substantial increase in investments in health and health systems to get back on track towards the Sustainable Development Goals.”
Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization
NCDs – an ever-increasing health threat for future generations
Despite overall health progress, the share of deaths caused annually by NCDs has grown consistently and is now claiming nearly three quarters of all lives lost each year.
If this trend continues, NCDs are projected to account for about 86% of the 90 million annual deaths by mid-century; consequently, 77 million of these will be due to NCDs – a nearly 90% increase in absolute numbers since 2019.
Stagnating progress calls for acceleration
More recent trends show signs of slowdown in the annual rate of reduction (ARR) for many indicators. For example, the global maternal mortality ratio needs to decline by 11.6% per year between 2021 and 2030 to meet the SDG target. Similarly, the net reduction in TB incidence from 2015 to 2021 was only one-fifth of the way to the 2025 milestone of WHO’s End TB Strategy.
Despite a reduction in exposure to many health risks – such as tobacco use, alcohol consumption, violence, unsafe water and sanitation, and child stunting – progress was inadequate and exposure to some risks such as air pollution remains high.
Alarmingly, the prevalence of obesity is rising with no immediate sign of reversal. Furthermore, expanded access to essential health services has slowed compared to pre-2015 gains, coupled with no significant progress in reducing financial hardship due to health-care costs. This drastically limits governments’ ability to achieve Universal Health Coverage by 2030.
The COVID-19 pandemic is an important reminder that progress is neither linear nor guaranteed,” warns Dr Samira Asma, WHO Assistant Director-General for Data, Analytics and Delivery for Impact.
To stay on track towards the 2030 SDG agenda, we must act decisively and collectively to deliver a measurable impact in all countries.”
Dr Samira Asma, WHO Assistant Director-General for Data, Analytics and Delivery for Impact
This year’s World Health Statistics report includes for the first time a dedicated section on climate change and health.
For this issue and all other areas timely, reliable and disaggregated data are critical to track progress and improve national and global health policies.
2023 World Health Statistics key messages on alcohol
- Since the beginning of the millennium, the world has seen notable improvements in population health globally. As child mortality halved, maternal mortality fell by a third, the incidence of many infectious diseases – including HIV, tuberculosis and malaria – dropped, and the risks from dying prematurely from noncommunicable diseases (NCDs) and injuries declined, global life expectancy at birth rose from 67 years in 2000 to 73 years in 2019. These achievements are consistent with the progress made in areas that influence health – from improved access to essential health services to reduced exposure to health risks, including tobacco use, alcohol consumption and child undernutrition.
- However, the rapid progress commonly observed for many of these indicators in the era of the Millennium Development Goals has markedly stalled since 2015, challenging the timely attainment of the Sustainable Development Goal (SDG) targets by 2030. This is evidenced by the falling annual rate of reduction in indicators such as the maternal mortality ratio, under-five and neonatal mortality rates, premature mortality from major NCDs, and suicide and road traffic mortality rates. Almost halfway through the SDG era, some of these indicators are far from reaching the midpoint of the required trajectories to reach their respective SDG targets.
- In addition, despite reduction in exposure to many health risks – such as tobacco use, unsafe water and sanitation, and child stunting – progress is inadequate. Risk exposure remains high, especially for factors such as alcohol consumption and hypertension where declines began only in recent years. Alarmingly, the entire global population (99%) breathes unhealthy levels of fine particulate matter, and the prevalence of obesity is moving in the wrong direction with no immediate sign of reversion.
Major NCD risk factors
Due to economic, social and cultural factors, there have been significant changes in the profiles of risk factors – including behaviour-related factors such as smoking, alcohol use, physical activities and diet, metabolic-related factors such as obesity and hypertension, and environment-related factors such as air pollution, water and sanitation. These are discussed at length in other chapters of the 2023 World Health Statistics report and, along with demographic changes, have led to the diverse patterns of changes in NCD outcomes.
NCDs are the result of a combination of genetic, physiological, environmental and behavioural factors. Modifiable behavioural risk factors include alcohol consumption, tobacco use, physical inactivity and an unhealthy diet. Metabolic risk factors include raised blood pressure, overweight and obesity, hyperglycaemia (high blood glucose levels), and hyperlipidaemia (high levels of fat in the blood).
Alcohol consumption
Total alcohol per capita (15+ years) consumption has declined at global level since 2015, following an overall increase in 2005–2010 and a plateau in 2010–2015.
Total consumption was 5.5 litres of pure alcohol per capita (persons aged 15 years or older) in 2019.
The trends were not uniform across WHO regions. While the European and African regions experienced sizeable decline in per capita consumption by 17% and 18% respectively between 2000 and 2019, there has been stagnation in the Region of the Americas and substantial increases in per capita consumption in the South-East Asia and Western Pacific regions (of 112% and 40% respectively).
- Despite the decline, men and women in the European Region still had the highest consumption – 14.9 litres per capita in men and 4.0 litres per capita in women.
- Per capita consumption in the Region of the Americas was 11.9 litres in men and 3.3 litres in women, while in the Western Pacific Region it was 9.6 litres in men and 2.5 litres in women.
- The lowest per capita consumption was in the Eastern Mediterranean Region with 0.5 litres in men and 0.1 litres in women in 2019.
Globally, men consumed nearly four times more pure alcohol per capita than women did – namely, 8.7 (UI: 7.7–9.9) litres versus 2.2 (UI: 1.9–2.5) litres in 2019. The greatest gaps between the sexes (male-to-female ratio) were observed in the Eastern Mediterranean Region (8.1) and South-East Asia Region (5.1), and the lowest ratio was in the Region of the Americas (3.7) and the European Region (3.7).
NCDs and mental health conditions
Although effective treatments exist for substance use disorders, treatment coverage is very low.
Fewer than 1 in 5 people receive treatment for alcohol use disorders – less than 1 in 10 in in low- and lower-middle-income countries – and about 1 in 8 of those with drug use disorder.
Even fewer people with substance use disorders receive minimally adequate treatment: only about 7% globally and 1% in low- and lower-middle income countries.
