Si Yafei, Guo Lei, Chen Shu, Zhang Xinyu, Dai Xiaochen, Wang Daniel, Liu Yunguo, Tran Bach Xuan, Pronyk Paul Michael, Tang Shenglan
Melbourne School of Population & Global Health, The University of Melbourne, Parkville, Victoria, Australia.
Global Health Research Center, Duke Kunshan University, Kunshan, China.
PLoS Med. 2025 Apr 21;22(4):e1004551. doi: 10.1371/journal.pmed.1004551. eCollection 2025 Apr.
The Sustainable Development Goals (SDGs) articulate an ambitious global agenda and set of targets to achieve by 2030. Among the health-related SDGs, many formidable challenges remain in settings like the Association of Southeast Asian Nations (ASEAN) which face wide-ranging social, economic and health inequalities. In advance of the 2030 horizon, charting the trajectory of the health SDGs is critical for informing policy and programmatic course corrections to advance health and well-being among ASEAN's 10 member countries with its 667 million people.
We used estimates from the Global Burden of Disease (GBD) Study 2021 and surveillance data to identify 27 health-related SDG indicators. The indicators were classified into 7 thematic areas: (i) nutrition, (ii) maternal, child and reproductive health (MCH), (iii) infectious diseases, (iv) non-communicable diseases (NCDs), (v) environmental health, (vi) universal health coverage (UHC), and (vii) road injuries. We developed an attainment index ranging from 0 to 100 for each SDG indicator by referencing the SDG targets and projected their progress to 2030. We find an overall positive progress towards the health-related SDG targets in ASEAN from 1990 to 2030. At the aggregate level by 2030, 2 member countries, Singapore and Brunei, are projected to achieve their targets (attainment score ≥ 90). At a wider regional level, ASEAN is projected to make substantial progress in nutrition, MCH, and UHC, with a majority of countries projected to come close to or achieve their targets. However, progress is projected to be slower in the areas of reducing the incidence of infectious disease (i.e., HIV and AIDs, hepatitis B, TB, and neglected tropical diseases), NCD-related mortality and its risk factors (i.e., harmful alcohol use and smoking), environment-related mortality and its risk factors (i.e., unsafe water and poor hygiene, and air pollution), and road injuries. Substantial disparities are identified in the region, with Singapore, Brunei, Malaysia and Thailand generally performing better than elsewhere. A limitation of our study was its reliance on historical trends which may not fully capture future political, social, or technological changes.
As a regional bloc, ASEAN faces persistent challenges in achieving health-related SDG targets by 2030, with unequal progress between countries. Moreover, epidemiological transitions and worsening environmental threats further compound potential gains. At the country level, efforts to enhance health system financing, quality and equity will need to be coupled with wider approaches that address structural drivers of disease. Furthermore, coordinated regional efforts will be essential to effectively respond to emerging threats posed by pollution and environmental risks.
可持续发展目标（SDGs）阐明了一项宏伟的全球议程及一系列到2030年要实现的目标。在与健康相关的可持续发展目标中，东南亚国家联盟（东盟）等地区仍面临诸多严峻挑战，这些地区存在广泛的社会、经济和健康不平等问题。在2030年之前，描绘健康可持续发展目标的轨迹对于为政策和项目调整提供信息至关重要，以便在东盟10个成员国及其6.67亿人口中促进健康和福祉。
我们使用了《2021年全球疾病负担研究》的估计数据和监测数据来确定27个与健康相关的可持续发展目标指标。这些指标被分为7个主题领域：（i）营养，（ii）孕产妇、儿童和生殖健康（MCH），（iii）传染病，（iv）非传染性疾病（NCDs），（v）环境卫生，（vi）全民健康覆盖（UHC），以及（vii）道路伤害。我们通过参考可持续发展目标的目标为每个可持续发展目标指标制定了一个从0到100的达标指数，并预测了它们到2030年的进展情况。我们发现东盟从1990年到2030年在与健康相关的可持续发展目标方面总体上取得了积极进展。到2030年，在总体层面上，预计新加坡和文莱这两个成员国将实现其目标（达标分数≥90）。在更广泛的区域层面，预计东盟在营养、孕产妇和儿童健康以及全民健康覆盖方面将取得重大进展，大多数国家预计将接近或实现其目标。然而，预计在降低传染病（即艾滋病毒和艾滋病、乙型肝炎、结核病以及被忽视的热带病）发病率、与非传染性疾病相关的死亡率及其风险因素（即有害饮酒和吸烟）、与环境相关的死亡率及其风险因素（即不安全的水和不良卫生条件以及空气污染）以及道路伤害方面的进展将较为缓慢。该地区存在显著差异，新加坡、文莱、马来西亚和泰国总体表现优于其他地区。我们研究的一个局限性在于其依赖历史趋势，这可能无法完全捕捉未来的政治、社会或技术变化。
作为一个区域集团，东盟在到2030年实现与健康相关的可持续发展目标方面面临持续挑战，各国之间的进展不均衡。此外，流行病学转变和日益严重的环境威胁进一步加剧了潜在收益的复杂性。在国家层面，加强卫生系统融资、质量和公平性的努力需要与解决疾病结构驱动因素的更广泛方法相结合。此外，协调一致的区域努力对于有效应对污染和环境风险带来的新威胁至关重要。
