The purpose of SDG 3 is to ‘Ensure healthy lives and promote wellbeing for all at all ages’.
SDG 3 contains 13 targets which South Africa measures and reports on annually. These targets were developed to help us achieve SDG 3 by 2030. The purpose of our 12 tips is to explain what each of the targets is and to provide useful insights from work that is being done which is helping to achieve them. We also share South Africa’s progress on achieving each target and highlight areas where you can get involved.
To hear an overview of SDG 3 and get ideas on how you can join the journey as we make it happen, we invite you to listen to our podcast with Dr Flavia Senkubuge.
Dr Senkubuge is a specialist in public health medicine, president of the Colleges of Medicines of South Africa, chair of the WHO African Advisory Council on Research and Development, and vice-president of the African Federation of Public Health Associations. In this podcast, she shares knowledge and insights on SDG 3 that she has been obtained from her career of excellence in the field:
https://soundcloud.com/saica_sa/sdg-3-dr-flavia-senkubuge.
The following summary of South Africa’s progress on achieving each SDG 3 target to date will give us a starting point:
| TARGET # | DESCRIPTION | SA STATUS
(PER 2019 COUNTRY REPORT) |
| 3.1 | By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births
|
Maternal mortality:
121 (2016) per 100 000 live births
|
| 3.2 | By 2030, end preventable deaths of new-borns and children under 5 years of age with all countries aiming to reduce neonatal mortality to at least 12 per 1 000 live births and under-5 mortality to at least as low as 25 per 1 000 live births
|
Neonatal mortality:
21 (2016) per 1 000 live births Under-5 mortality: 42 (2016) per 1 000 live births
|
| 3.3 | By 2030, end the epidemics of AIDS (0 per 1 000), tuberculosis (0 per 100 000), malaria (0 per 1 000) and neglected tropical diseases, and combat hepatitis (0 per 100 000), waterborne diseases and other communicable diseases
|
New HIV infections:
1 (2017) new infection per 1 000 uninfected population TB incidence: 567 per 100 000 (2017) Malaria incidence: 1,4 per 1 000 (2018) Hepatitis B mortality: 0,5 per 100 000 (2015)
|
| 3.4 | By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and wellbeing
|
Mortality rates attributed to cardiovascular disease, cancer, diabetes and chronic respiratory diseases have remained relatively stable between 2011 and 2016
For 2016 these rates were: · Cardiovascular disease: 11% · Cancer: 7% · Diabetes: 4% · Chronic respiratory diseases: 3%
In 2013, the suicide mortality rate was on the increase, but it declined in 2015 when it was 1,3 per 100 000
|
| 3.5 | Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and the harmful use of alcohol | Harmful use of alcohol:
7,27 litres per capita (2017)
The harmful use of alcohol resulted in 3 million deaths (5,3% of all deaths) worldwide in 2016
|
| 3.6 | By 2030, halve the number of global deaths and injuries from road traffic accidents
|
The death rate due to road traffic injuries decreased from 27,5 deaths per 100 000 in 2010 to 24,9 in 2017. The target is to halve the 2010 rate − that is, the target is 13,75 deaths per 100 000
|
| 3.7 | By 2030, ensure universal access to sexual and reproductive healthcare services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
|
Use of modern contraception methods: 75,7% (2016) was the percentage of women of reproductive age (aged 15−49 years) who had their need for family planning satisfied with modern methods
Adolescent birth rate per 1 000 females: Girls aged 10−14: 0,6 (2017) Girls aged 15−19: 46,2 (2017)
|
| 3.8 | Achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable medicines and vaccines for all
|
The 2019 Country Report provides no status for this target, but a 2019 media article reported that less than 20% of our population of 58 million could afford private healthcare, while the majority have to queue at understaffed state hospitals short of equipment[1]
|
| 3.9 | By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
|
Mortality from unintentional poisoning in 2011 was 0,2 per 100 000 and also 0,2 per 100 000 in 2015
|
| 3.a | Strengthen the implementation of the World Health Organisation Framework Convention on Tobacco Control in all countries, as appropriate
|
The prevalence of tobacco use by persons 15 years and older was:
Males 42% (1998), declined to 37,3% (2016) Females 11% (1998), declined to 7,8% (2016)
|
| 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 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
|
Gradual increase in vaccine uptake from 2010 to 2017. This can be seen by the change in the
proportion of the target population covered by all vaccines included in their national programme: 2010: DTP: 68,9% Measles: 68,4% Pneumococcal conjugate: 52,1% HPV (2015): 64% 2017: DTP: 84,1% Measles: 77,6% Pneumococcal conjugate: 78,8% HPV: 61,4%
Proportion of health facilities with core essential, affordable medicines available on a sustainable basis: 74,2% (2013), increased to 90% in 2018
|
| 3.c | Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing states
|
The 2019 Country Report provides no status for this target, but the WHO’s website states that they estimate a projected shortfall of 18 million health workers by 2030, mostly in low- and lower-middle-income countries. They further state that there is a chronic underinvestment in education and training of health workers in some countries and also a mismatch between education and employment strategies in health systems
|
| 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
|
Measured on 13 core capacities which each received a 100% rating in 2018.
The 13 core capacities are national legislation, policy and financing, coordination and national focal point communications, surveillance, response, preparedness, risk communication, human resources, laboratory, points of entry, zoonotic events, food safety, chemical events and radionuclear emergencies. It is noted that even though they received an assessment rating of 100% each in 2018, South Africa was not 100% prepared when COVID-19 happened
|
Impact of COVID-19 on South Africa’s progress
SDG 3 has been one of the ‘hardest hit’ goals during COVID-19. Not only has our general population experienced the tragedy of losing loved ones from this pandemic, but some of our brave healthcare workers on the front lines sadly lost their lives, too.[2] These losses have increased staff shortages in the sector.
In addition to the above tragic situation, through its urgent requirement for facilities, equipment and medication, COVID-19 has taken certain resources away from other disease prevention and management programmes that were already stretched, such as those for malaria, HIV/AIDS and tuberculosis. The pandemic has also caused a rise in mental health problems and because of this even greater resource shortage, these problems are not receiving all the help and treatment they so desperately require.[3]
The UN further confirms this situation when they inform us that COVID-19 could reverse decades of improvements made on each of the SDG 3 targets.[4] It specifically highlights how it is expected to lead to an increase in the number of
- Deaths of children under 5 years old
- Children not receiving all the vaccinations they need[5] (including vaccinations for measles, diphtheria and polio), and
- Deaths from communicable diseases
Although the impacts of COVID-19 have largely been negative, there have been some positives which are important to also take note of. Dr Nicholas Crisp, National Health Insurance (NHI) fund developer and consultant at the Department of Health, says that COVID-19 has had some benefits in that it has accelerated the move to an NHI in that it has helped our government to learn new lessons around staffing, health and safety and health products, as well as helping to build a more competent digital system.[6]
It is great to hear that there are some benefits from COVID-19 and that not all has been negative. However, South Africa still sits with many of the problems it had previously faced (some of which have now been magnified) that led to and keep on maintaining a persistent shortage of healthcare resources.
We need to think in new and creative ways in order to achieve this SDG’s targets by 2030. It is going to take all of us working together to get there and we are honoured to have you join us on this important journey.
[1] https://www.meinsurancereview.com/News/View-NewsLetter-Article?id=47898&Type=Africa.
[2] https://home.kpmg/ie/en/home/insights/2020/05/COVID-19-sdgs-cant-be-under-lockdown-too-sustainable-futures.html.
[3] https://www.mdpi.com/2071-1050/12/13/5343.
[4] https://sdgs.un.org/goals/goal3.
[5] https://news.un.org/en/story/2020/04/1062622.
[6] https://businesstech.co.za/news/lifestyle/430618/south-africa-faces-massive-healthcare-worker-shortage/
