You and the Global Goals

You and the Global Goals: Introduction















On 25 September 2015, all 193 Member States of the United Nations adopted the 17 Sustainable Development Goals (SDGs), aka the Global Goals.
















































This book articulates a path to make these Goals appear manageable, to implement in your life, adapting the 120 indicators used by the SDG Index to the individual level. The scope of the Goals is gargantuan, ill-fitted for individual countries, let alone individual people, implying their international nature.
What follows is a loose method to apply to your life, to keep yourself accountable to your responsibility toward the Goals as a global citizen.
What is sustainable development?
Sustainable development is a way of thinking about and uniting all the complicated, yet intersecting issues we’ll come to explore ahead, centred on three pillars:
Economic growth

Social inclusion

Environmental sustainability









































Three pillars of sustainable development












The genesis of the concept of sustainable development at a UN level is 1972 in Stockholm, where a UN conference linked human development with the environment. 20 years later, in 1992 in Rio de Janeiro, the UN held the Earth Summit, the biggest summit of world leaders at the time, putting environmental sustainability at the forefront. From this summit came three important treaties:
UN Framework Convention on Climate Change (UNFCCC)

Convention on Biological Diversity

United Nations Convention to Combat Desertification (UNCCD)

20 years hence from the Rio Summit, the UN held another conference in Rio in 2012, the United Nations Conference on Sustainable Development. Upon reflection and assessment of the above three treaties ahead of Rio+20, the scorecard of their progress was scathing. It was at this conference the impetus solidified to form what would become the SDGs.
The UN’s primary agenda from 2000 to 2015 was the era of the Millennium Development Goals (MDGs). The concept central to the MDGs was international development, as sustainable development is to the SDGs. In 2000, a summit of world leaders at the UN Headquarters, known as the Millennium Summit, adopted the MDGs.
The MDGs were eight goals, on the topics of:
extreme poverty and hunger

universal primary education

gender equality and women’s empowerment

child mortality

maternal mortality and health

HIV/AIDS, malaria and other diseases

environmental sustainability

global partnership









































The Millenium Development Goals












In 2000, a count of those living within the definition of extreme poverty (which we’ll define in the next chapter) was 1.7 billion. At the end of the MDG period in 2015, this was down by a billion, to 750 million people. China bears most credit for this, from a worldwide height of 2 billion people in extreme poverty in 1990, when two-thirds of the Chinese population lived within the definition of extreme poverty. The period from 1990 to 2015 accounts for approximately 750 million Chinese coming out of extreme poverty to less than 1% of its population.
Though the principles of international development guided the span of the MDGs between 2000 and 2015, a sentiment grew that the MDGs needed to emphasise some key issues. Inequality within countries had become a prevailing concern, as well as strengthening the environmental component of MDG #7. Humans had been making as much money as we could, much of it at the expense of the Earth’s ability to heal itself along the way. Environmental advocates had been crying out about the human effects on nature and ecosystems for decades, but by the 2010s, it was evident the effects were catastrophic. Humanity was edging toward a cataclysm imperilling our species, as well as courting a mass extinction of other species.
In the twilight of the MDG period, the UN was considering what would follow to guide its agenda after 2015, the due date of the MDGs. The conception of sustainable development as the guiding principle for this post-2015 UN agenda took shape.
In September each year, a new session of the UN General Assembly opens to address the forthcoming agenda. The opening session of the UN General Assembly on 25 September 2015 passed a UN Resolution titled Transforming our world: The 2030 Agenda for Sustainable Development. The 2030 Agenda, including the 17 Goals, now guides the UN and its member states between 2015 to 2030.
SDG Index
To better break down how to act on the 17 SDGs, the UN divides the Goals into 169 targets, and below these targets, 236 measurable official indicators. Within this book, we’ll instead use the indicators used by the SDG Index, produced by the Sustainable Development Solutions Network (SDSN).
The SDSN is the greatest source of this book, a knowledge network of universities and research institutes around the world, under UN auspices, chartered by former UN Secretary-General Ban Ki-Moon. Much of this book is a distillation of the SDSN’s SDG Index, to which the world’s foremost academics in their respective fields have lent their knowledge and research efforts toward.
The lead authors for the 2022 SDG Index are Professor Jeffrey Sachs, Guillaume Lafortune, Professor Christian Kroll. Grayson Fuller and Finn Woelm. Also integral to the SDG Index and SDSN legacy is Guido Schmidt-Traub, former SDSN Executive Director, and co-author of the SDG Index reports from its first iteration in 2016 to 2020.
Professor Christian Kroll authored a report alongside the SDSN before the adoption of the SDGs in 2015. With a foreword by Kofi Annan, the format of the report acted as a progenitor and template of the SDG Index. Kroll’s report selected indicators well ahead of the UN, as even the Goals were yet to become official, displaying an index for scores in SDG preparedness for the rich countries.
The 2022 SDG Index consists of 120 indicators corresponding to the 17 Goals, with each country’s indicator scores combined into a composite index score and ranking. The Index score reflects a percentage of progress toward full achievement of all Goals i.e., 100. Therefore Finland, top of the rankings for the 2022 Index with a score of 86.51, is 86.51% of the way toward achieving all 17 SDGs. By contrast, bottom-ranked South Sudan scores 39.05, meaning it has a great distance to get from 39.05% progress toward achieving all the SDGs by 2030.
To illustrate, the SDG Index uses a traffic light system, with green indicating an achievement of the respective Goal, or otherwise being on track to achieve it by 2030. Red is the opposite, being far off course, with major challenges remaining. In between, yellow and orange are gradations of the middle light, orange suggesting further off course than yellow.
Using the example of the first indicator we’ll explore in SDG #1 (% of population living on less than $1.90/day), the bounds for each colour in the SDG Index for this indicator correspond to the below.
















































Paramount to the SDG Index is priority. This colour coding serves to illustrate chromatically where we’re at in our progress, to guide our prioritisation. The importance placed on countries scoring red or orange per indicator or Goal will be an overriding refrain throughout the book. If your country scored green on an indicator, you can put your feet up for that issue, and instead turn to those Goals or indicators for which your country has scored red.
The Global Goals are ambitious in breadth, intimidating at times to what we’re to do in what seems like a tiny frame of less than eight years at the time of writing. The purpose of the SDG Index is to show us which Goals and indicators need our immediate attention and energies, because the gap between where we need to be by 2030 and our present state is too far off course.
I’ll use my two countries of citizenship as an illustration. In the 2022 SDG Index, Australia scored red for:
SDG #2 (Zero Hunger)

SDG #12 (Responsible Consumption & Production)

SDG #13 (Climate Action)

SDG #15 (Life on Land)

Therefore, I focus on these Goals as a matter of prioritisation.
I hold dual citizenship with Malta, so incorporate it into my prioritised, red Goals. In the 2022 Index, Malta scored red for Goals #2, 6, 12 & 14, so I prioritise the extra Goals for which Malta has scored red i.e., Goals #6 and #14.
Some indicators are only for Organisation for Economic Coordination and Development (OECD) countries, which will be represented with an asterisk (*) next to the indicator heading. The OECD countries are often used to refer to the developed, high-income countries. Any further mention of ‘developed’ or ‘high-income’ countries will be synonymous with the high-income OECD members: US, Canada, UK, Australia, New Zealand, Japan, South Korea, Israel, most EU countries, Norway and Switzerland.
The reason why some indicators are OECD-only in the SDG Index is either because they're issues relevant only to high-income, developed countries, or only OECD countries have sufficient data for the indicator.
Many of the SDG Index indicators are appropriate at the national, state or city level, yet this book aims to adapt these indicators to the level of the individual. Implementing the SDGs in our personal lives means familiarising yourself with the underlying topics, and trying to coordinate your action toward implementing and monitoring these indicators.
Assigning individual responsibility is a stark request to place upon the shoulders of our fragile minds. We’re fortunate in the reality that the SDGs are tasks for the world. Yet for the tasks staked in this book, it must begin with you.

Dashboard map for 2022 SDG Index Goal #1 ratings. Data source: sdgindex.org






























You and the Global Goals: SDG #1 - No Poverty















Poverty headcount ratio at $1.90/day (%)
The definition of extreme poverty is an international poverty line, as deemed by the World Bank. The World Bank is an international financial institution within the UN System, with the task to provide loans to developing countries with the goal of poverty eradication. The World Bank measures the international poverty line as living on $US1.90 a day or less, which is less than enough to meet the basic needs of safe drinking water, food at or below subsistence, and access to health and education.
Approximately 740 million people met the definition of living in extreme poverty upon the adoption of the SDGs in 2015, the overwhelming majority living in Sub-Saharan Africa and South Asia. Before the industrial era, beginning in the middle of the 19th century, close to all the human population lived in a state of extreme poverty. Since the turn of the millennium, there has been a steady decrease in the number of people living in extreme poverty, as well as a decrease in the percentage of extreme poverty for the global population.
One of the key reasons for this encouraging drop in extreme poverty rates was the power of the Millennium Development Goals. The sister goal of SDG #1 was MDG #1, to halve extreme poverty levels by 2015, again using the international poverty line measure. The world met MDG #1 five years before its due date in 2010, due to the astounding growth rates of China in the period of the MDGs between 2000 and 2015. This meant MDG #1 saw a billion people lifted from extreme poverty compared to 1990, when almost half the population of developing countries lived under the international poverty line. Yet the three-quarters of a billion still left behind at the end of the MDG period in 2015 is an enormous number of people continuing to live in destitution and penury.
How to measure this Goal’s target to eradicate extreme poverty - those living under $1.90 a day - by 2030? The first indicator in use by the SDG Index is the poverty headcount ratio at $1.90/day.
As of June 2022, 682,614,000 people lived in extreme poverty, with a rate of one person per second escaping extreme poverty, an estimated metric you can view in real-time at the World Poverty Clock website. Yet the target rate to be met for those escaping poverty to eradicate extreme poverty by 2030 is 2.5 people per second. In total, this means the world is off-track by 254,758,130 people. Yet, as some escape poverty, others enter it, with the COVID-19 pandemic impacting progress on this target - though there were signs of slowing progress even before, compounded by conflict and climate change.
In 2015, the world’s extreme poverty rate was 10%, dropping to a low of 8.3% in 2019, then back up to 9.2% in 2020, equated with throwing up to 93 million people back into extreme poverty. This means the global extreme poverty rate rose in 2020 for the first time in over 20 years. The above trend projects 262 million people would still be living in extreme poverty in 2030, missing the extreme poverty eradication target - unless we instead accelerate our efforts between now and 2030.
It’s difficult, verging on impossible, to lift oneself from such an extreme poverty trap. Professor Jeffrey Sachs, co-author of the SDG Index, explains why in his magisterial book, The End of Poverty, using the analogy of the ladder of development. The End of Poverty outlines how we can end extreme poverty as though it were procedural, illuminating how achievable and within reach it is.
Those living in extreme poverty live hand-to-mouth, day-to-day. As such, they fail to produce a surplus e.g., from a crop’s harvest for smallholder farmers, thus without anything to sell to the market for a profit. Due to a high proportion of citizens living by such means in a country, a tax base to draw revenues from is missing. Thus, the government is missing the means to provide healthcare, education, or for any services to increase well-being and relieve extreme poverty. The least developed countries need aid to allow them to get their hand on the bottom rung of the development ladder. Then they have the means to lift themselves out of poverty. Without aid, this cycle will proceed mercilessly, compounded by climate change, disease, famine, demography, etc. The aim of development aid is to improve the economic and social development of humans living in countries which have yet to industrialise and are considered ‘developing’ in the parlance of the field of international development.
Aid has been chronically below the amount promised by developed countries to their developing counterparts for a half-century. Thus, the first task of the reader in high-income countries is to act on behalf of the 682 million living in extreme poverty.
The measure of aid used by the high-income OECD countries is known as ‘official development assistance’ (ODA), a concept defined in 1969 by the Development Assistance Committee (DAC) of the OECD. The DAC consists of 30 OECD members, making up the largest aid donors, as a forum to discuss aid and poverty reduction efforts.









































Map of OECD DAC members












The predominant means of measuring donor amounts is as a percentage of the donor country's gross national income (GNI), a concept like GDP (gross domestic product). Whereas GDP is the value of all goods and services produced in a period, by contrast GNI includes the economic output of foreign residents of the country. The OECD DAC has an official List of ODA Recipients, all the developing countries and territories eligible to receive ODA. Included are dollar flows made via so-called ‘multilateral institutions’ e.g., the World Bank, International Monetary Fund, and UN agencies like UNICEF and the WHO. To count as ODA, donor flows must come from government agencies, and the aim of the flows must be economic development and the welfare of developing countries. They must either be free of the obligation to be repaid, or otherwise loans with much more generous repayment terms than available in the commercial market.
The spending counted toward poverty reduction for ODA includes food aid; basic health; education; water and sanitation; population programmes and reproductive health. Separate, though entwined, to development aid, is humanitarian aid - synonymous with logistical help in the face of disaster or conflict.
The 30 high-income country donors of the DAC spend 0.33% of their collective GNI on ODA - far below the 0.7% of GNI committed by these countries across decades, though reneged upon.
The only 2021 exceptions among the DAC members to meet or exceed the 0.7% commitment were Denmark, Sweden, Norway, Luxembourg, and Germany.
The international agreement whereby high-income OECD countries were supposed to give 0.7% of GNI as ODA goes back to 1970, affirmed in repeated agreements since. This means for every $10 made in high-income countries, for around 50 years now, they’ve committed, yet failed to produce, 7 cents of every $10 for the world's destitute. 7 cents which would otherwise solve extreme poverty by 2030. Instead, like my country Australia, our government, out of our tax revenue, for every $10 of GNI, produces 2 cents for ODA - a 5-cent differential from its pledge. Yet my country, and all other developed countries except five, withhold upon the opportunity to end extreme poverty in a decade. Why dither over 7¢ on every $10?
According to the principles of the poverty trap, 700 million are unable to escape from extreme poverty without this ODA. Their only lifeline from being an orphan of famine or infectious disease is foreign aid. For indicators related to living under the poverty line, it would be insensitive to set the task to readers to try to live above the poverty line. Who is the responsibility falling to? This book, rather than being about the government’s responsibility, is about your responsibility. There’s a solution to this, which is where OECD/DAC country readers come in. The affirmed commitment of 0.7% of GNI represents what the government is to offer in ODA. Whatever the gap between 0.7% and what your country’s government is providing in ODA, your opportunity is to step in to bridge the gap. Of course, as with every action in this book, it requires a scale of near ubiquity to have the desired impact, but the behaviours and attitudes of several million of your compatriots are outside your immediate control. Again, the focus of this book is you, and what change you can affect.
This is to achieve the Goals globally - in a sense, on behalf of the low-income countries, which barring a miracle, appear to be unable to meet the Goals. I’m imploring a mechanism pinning the burden on readers from high-income countries. If you're a reader from one of these countries, in this book, you'll shoulder the burden of your own developed country, as well as of the least developed countries. It will cost you seven cents upon every $10 you make. I’ll come back to this repeatedly, with good reason, as a mechanism to lift the least developed countries to a fighting chance, as their wherewithal makes it an impossibility to do so of their own accord.
Let's say the shortfall of ODA is approximately 0.48% of GNI, as it is as an Australian at the time of writing. Then for every $10 I earn, I should donate 48 cents - put another way, 0.48% of my gross income. I say gross, in contrast to after-tax net income, because in all high-income countries, you’ll be able to deduct the donation from your taxable income.
When you’re taxed by your home country, it’s to affect the greater well-being of the broad populace. Depending on the outlook of the population, it could be to provide a social safety net, or distribute income to the less fortunate, or fund the infrastructure we enjoy. Our ability to earn income benefits from this ecosystem of infrastructure, health care, education, laws, and monetary systems. Yet charitable donations allow you to be your treasurer. You can appropriate what the government was going to otherwise spend, and instead send it as aid abroad to a country teetering on famine.
If everyone in the developed world made up the shortfall from what their country is withholding from aid commitments, extreme poverty will go close to evaporating by 2030. What could be better? People die every day in parching heat, flies all over them, days since they’ve eaten, except some mud and roots of meagre nutritional value - all their siblings already dead from a treatable disease. Those described live so remotely - their only salvation being aid from someone in the developed world preoccupied by Netflix, porn, and Instagram. Dear reader, if you live in a high-income country, you are the only way out for someone in this situation.
Listed below are the least developed countries (LDCs), an official UN designation - countries which readers of the high-income countries will be working on behalf of in much of the pages of this book.





















































































Map of least developed countries (LDCs). Source: https://unctad.org/topic/least-developed-countries/list












The DAC divides the List of ODA Recipients into four categories. Though I’ll continue to emphasise the LDCs, who are the priority by need, the other developing country categories outside of the LDCs category are:









































Source: https://www.oecd.org/dac/financing-sustainable-development/development-finance-standards/DAC-List-ODA-Recipients-for-reporting-2021-flows.pdf












To reinforce, if you live in an LDC, you’re exempt from Goal #1 for this book, though one imagines in your circumstances you’re industrious to better your lot in life. The status quo is unfair. You’re in a sea of a global community who have the ready means to help, but do not, yet you experience the burden. I view it as unjust that a part of the world could live in plenty, with tools available to mitigate others from suffering and dying of preventable disease.
Can extreme poverty prevail in developed countries? Yes, in instances of the homeless, or those living in an isolated indigenous community, where daily income may be less than $US 1.90. Both examples have access to income help in countries with social safety nets. For all these reasons, developed countries have fractional populations living in extreme poverty. If readers from a developed country are out of work for a few weeks or months, and are without income for this period, they have access to a social safety net offered by their government to provide unemployment income assistance. Readers able to access such protections live above the measure of extreme poverty, better characterised by countries without such a safety net.
Who should OECD/DAC country readers be giving 0.7% of their gross income to? I propose a similar list to that used by the DAC, both available on their website:
List of eligible international organisations, including international charities, UN agencies, and a bunch of other options from the private sector, academia, and international organisations.

List of ODA recipients, corresponding to the governments of LDCs, and other low and middle-income countries.

However, any charity operating in the developing world focused on eradicating poverty ought to be suitable, whether focused on health, education, water, and sanitation, etc.
Summary: For OECD country readers, annually give 0.7% of your gross income as aid, aiming to end poverty by 2030.
Poverty headcount ratio at $3.20/day (%)
Another measure of poverty in use is poverty at the rate of US$3.20 a day. Alas, poverty continues once crossing the $1.90 international poverty line. Yet this meagre difference of a threshold of $3.20 is common in lower-middle-income countries, as well as low-income countries who've surpassed the $1.90 a day threshold. This $3.20 poverty line is the subject of our second indicator, aiming again to eliminate the prevalence of those living below it.
23% of the world’s population live under $3.20 a day, in contrast to less than a tenth living under the extreme poverty line of $1.90. This proportion is just less than at the adoption of the SDGs in 2015, when 27% lived under $3.20 a day, down from more than half the global population in 1990. The number of people living under $3.20 is comparable now to the number of people living on $1.90 a day in 1990.
We now know countries with a high prevalence living in extreme poverty are stuck in the poverty trap and require ODA to get out. But countries with a high prevalence of its population living under $3.20 may be a middle-income country. In this instance, whilst foreign aid is certainly welcome, and would accelerate lifting its people from poverty, the country may have the capacity to improve its lot without aid being a prerequisite.
The 0.7% of gross personal income donated as aid from high-income readers will go toward those living under $3.20 a day. But what can readers from middle-income countries off-track for SDG #1 do? For those living below $3.20, the same applies as for those living under $1.90 i.e., the responsibility of achieving these first two indicators is for others on your behalf. Though you experience its burden, it’s instead the responsibility of the high-income countries to care for you.
If you’re a citizen of a middle-income country scoring red for this indicator, earning above what’s equal to $US3.20 a day in your local currency, then I encourage you to donate 0.7% of your gross income toward a charity operating within your country’s borders focused on poverty reduction. For example, if you live in South Africa (a middle-income country), and make $US5,000 a year, find a charity you trust focused on poverty in South Africa and donate $35.
For OECD/DAC readers, you pay 0.7% once, covering all indicators related to poverty. Across the developing world, 0.7% of GNI of the developed world is enough to cover the costs to achieve poverty reduction, hunger elimination, health improvements, and much more, as we’ll come to see. It may become tiresome to hear this refrain, but it will illustrate the bang for our buck, and an incredible bargain.
Summary: For OECD country readers, annually give 0.7% of your gross income as aid, aiming to end poverty by 2030.
Poverty rate after taxes and transfers *
Quite separate from the severe plight of the low and middle-income countries is relative poverty, synonymous with the poverty line of an individual country. The definition of this indicator is the share of the population whose disposable incomes fall below half the median income. Disposable income in this sense means gross income minus income tax. It addresses taxing individuals who have taxable income, then transferring those revenues to the needy in the same country living below the poverty line - a test for the affluent countries to see whether they’re covering their own people living in poverty. Someone in an OECD country may well be living above the international poverty line of $1.90, or $3.20, and a great many multiples of these amounts. But due to their meagre income relative to their compatriots, they’re excluded from full participation in society. The long-term goal for this indicator is 6.1% or less of the population living in relative poverty within the ranks of the respective OECD countries.
I’ll compare the US (scoring red in 2022 for this indicator) with Finland (green). The US poverty rate after taxes and transfers was 18% for 2019, 11.9% above the long-term aim for the indicator. Let's say the US federal and state governments have collected all their taxes for the year. They've done their budget, and made transfers to the budgeted poverty reduction programs, whether welfare in the form of food stamps or cash help. Still, after these transfers, 17.8% of Americans live under half the median.
This suggests a lot of people live in poverty relative to the median of their counterparts, and the government's tax and transfer system is failing to redistribute tax revenue to the poor to lift them above the poverty line. The poor in the developed world have malnourished themselves in a separate way, characteristic of obesity borne of cheap, convenient junk food, rather than emaciation.
Finland has a relative poverty rate of 6.5% as of 2018, on track to achieve the indicator by 2030. Why the gap between the two countries? Remember, whatever the respective income levels are in each country, the measure is half the median income, whatever the income level between countries. The culprit lies within the relative rates of taxation and transfer between the two countries. The Nordic countries are world leaders in taxation and redistribution, with high rates of tax, as well as high rates of those tax takings apportioned to social welfare. Finland’s tax revenue as a percentage of GDP was 42% in 2020, compared to the US’ 25%. For the broad measure of social spending as a percentage of GDP, Finland spends 29.1% compared to the US’ expenditure of 18.7%. So, Finland's government taxes the Finns greater, and their government spends a greater part of the tax revenue than the US on social policies. The effect is a lower relative poverty rate, on par with the long-term goal of this indicator.
Different developed countries have diverse cultures and attitudes towards taxation, differing on how much to transfer such proceeds to the poor. These ingrained cultural attitudes can be tough to shake, despite looking in the face of the obvious benefits of the Nordic countries’ tax rates and social security net.
What to do? The suggested remedy is like the prescription for the first two indicators, calling for a private redistribution of income at your own hands, but within your country’s borders. For our first indicator on extreme poverty, I asked high-income country citizens to give foreign aid abroad, equal to 0.7% of their gross income. My suggestion for those with a high priority of relative poverty rates in their high-income country is to donate to domestic charities focused on poverty reduction. Again, find a tax-deductible charity which has your confidence, and donate. The percentage can be at your own discretion, but a suggestion could be the shortfall percentage between your country’s poverty rate and the long-term objective of 6.1%.
You will have ended up paying this amount in tax anyway, and will get to deduct this donation from your taxable income, but instead hand-pick to where it goes. If you’re living in a country with a red score for this indicator, and you live on less than half the median income, you’re exempt. Donations from your fellow citizens are intended to benefit you, to help you on your way to bringing your income above the threshold of half the median i.e., above your country’s poverty line.
The task of the individual for this indicator is to do the job the government was unable to, whether due to insufficient taxing of the populace, or insufficient transferring of tax revenue to reduce poverty for its citizens, despite the means to do so.
Also, advocate with your government representative to raise the tax rate and apportion more of the government revenue to poverty alleviation.
Summary: For OECD country readers off-track, who are living above your country’s poverty line, donate a percentage of your gross income. A suggestion is an amount equivalent to the shortfall percentage of your country's relative poverty rate and the long-term objective of 6.1%. You will be able to find your country’s relative poverty rate on the SDG Index website, and the median disposable income on the OECD Statistics website.

Dashboard map for 2022 SDG Index Goal #2 ratings. Data source: sdgindex.org






























You and the Global Goals: SDG #2 - Zero Hunger















Prevalence of undernourishment (%)
The aim by 2030 is to achieve zero hunger as part of SDG #2. As of 2020, a tenth of the global population, equal to 811 million, experienced hunger and undernourishment. Due to the effects of COVID-19, the number of people suffering acute hunger may have doubled by the end of 2020, and may also have pushed up to 132 million into chronic hunger. The global proportion of those living in hunger has been decreasing, though the total number of those living in a state of hunger has risen - the main causes due to climate, conflict and recessions.
This indicator’s definition is the portion of the populace unable to meet dietary energy requirements for a year or more, defining energy requirements as maintaining body functions, health and normal activity. As with ending extreme poverty, this indicator aims for a 2030 goal of eliminating undernourishment, aligned with Goal #2 (Zero Hunger).
SDG #2 flows on from SDG #1, implying the interrelationship between poverty and hunger. One of the reasons for this is the poor are among the most sensitive to fluctuations in food prices. Undernourishment is often due to geographical isolation. Hunger affects the most vulnerable regions of the world, represented by the LDCs, landlocked developing countries, and small island developing states.
Hunger, in the context of sustainable development, is different from the sensation of being less than satiated. In the context we’re looking at, it’s the global leading cause of death, to be unable to meet the essential nutrients humans need to sustain healthful lives over a long period. The global areas most vulnerable to acute hunger are those experiencing wars, pandemics and extreme weather. Undernourishment is a diet with insufficient nutrients, meaning calories providing us with energy. The right biochemical combination allows for proper metabolism in the form of proteins, carbohydrates, fat, vitamins and minerals. At the extreme of undernourishment is starvation, as well as micronutrient deficiency, when an individual is experiencing the undernourishment of a particular vitamin or mineral.
Many of us are familiar with the heart-rending images of starving children. The medical term, marasmus, is often characterised by the wasted mass of emaciation from energy deficiency, occurring from a diet of starchy carbohydrates offering little nutritional value. We recognise the symptom of distended abdomens, caused by a swelling of fluid retention, and a liver overwhelmed with fatty deposits. Sufficient calories, but protein deficiency, causes this condition, termed kwashiorkor.
A clear remedy to preventing and reducing undernourishment is food aid in the form of dietary supplements to fortify food with micronutrients.
Aid can assist the development of sanitation systems to ensure drinking water and sewage remain separate, which can otherwise lead to infectious diseases causing undernourishment. This can also lead to dehydration, further exacerbated if the drinking water is contaminated by infectious pathogens.
For readers from high-income countries, your commitment is to give 0.7% of your gross income as foreign aid. This captures the necessary expenditure to help low-income countries scoring red for this indicator. The remedy once again lies in the wealth transfer from those with means to those without. Foreign aid satisfies this, with food aid a component of ODA. Ensure whichever charity you’ve donated the 0.7% of your gross income to also includes a food aid component, whether famine relief, or more long-term remedies ensuring food security. This could even mean sharing technologies with communities for more productive food yields.
What about readers from middle-income countries which scored red or orange? Is it too much to ask of the nourished citizenry of these countries to make up the shortfall? If this is you, ask yourself if this is workable or realistic. Cash amounts might seem burdensome, but food aid to a food bank - even giving first-hand - may feel less of a big ask. In any regard, to remedy this, the ultimate responsibility should live with the DAC countries. The priority of their aid dollars will be the LDCs, but will touch any developing country experiencing the serious malady of undernourishment.
Summary: For OECD country readers, annually give 0.7% of your gross income as aid, aiming to end undernourishment by 2030.
Prevalence of stunting in children under 5 years of age (%)
This indicator, like the one before, considers the effects of undernourishment manifesting in the form of stunting for children under 5. Again, the 2030 goal is 0%, ending stunting for kids under 5. Stunting is the prevention of the development of height in a child due to malnutrition, often caused by diarrhoea or infection by parasitic worms. Open defecation in the absence of toilets and sewage systems creates such conditions. 149.2 million children under 5, or 22% of all children, suffer from stunting, down a quarter from 2015.
Stunting occurs for two-fold reasons. One is due to lack of food, overlapping with the undernourishment indicator. Another reason is enough food, but the inability of a child under 5 to absorb the nutrients due to ongoing infections drains the body of more nutrients than it absorbs. Such infections are common in environments with poor sanitation, explored in SDG #6 (Clean water and sanitation).
The promotion of breastfeeding in these early years from infancy is especially important, though there may be misconceptions in some developing countries about the importance of breastfeeding. Mothers may substitute baby formulas, mixed with contaminated water. Furthermore, if the mother’s undernourished, it makes sense her ability to breastfeed is also affected.
If you’re a mother in a country off-track to achieve this indicator, the WHO encourages breastfeeding instead of formulas for the best nutrition in infants. If a medical professional has indicated to you to use formula rather than breastfeed, then observe this expert medical advice. Note, the above only applies to countries experiencing a high proportion of stunting, indicating unsanitary water sources are being mixed with formula. Otherwise, it’s between you and your doctor or maternal nurse whether you choose to breastfeed.
As much as possible in your circumstances, assure your own nutrition during pregnancy and breastfeeding years. Even if you’re considering planning for a family, this pre-natal period will affect the stunting potential of the child. Further yet, responsibility for the encouragement of breastfeeding extends to employers, as well as societal and cultural attitudes in public and private toward breastfeeding.
Also of immense importance is the period when a mother weans a child from breastfeeding. Whether this is due to the birth of another child, the mother must ensure the weaned child transfers to a balanced diet i.e., enough vitamins, minerals, proteins, and fats. This is of emphasis as children may be weaned onto African staples such as cassava, yams, and plantains - all starchy carbohydrates missing critical nutrients.
For parents of children in these countries scoring red for this indicator, be mindful of risks for children around the water they drink or play nearby, which may be subject to contamination of infectious diseases. This may be a particular challenge for slum dwellers. Also, if you live in a malarial zone, use bed nets and other means of prevention where available.
Another factor in stunting is the age of marriage and childbirth for girls. Cultural attitudes surrounding this may often be strong and difficult to break down. But looking at it from the perspective of the child's health, the younger a bride and mother, the less chance the mother has to develop her healthfulness and ability to sustain a dependent infant.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, aiming to end stunting worldwide by 2030.
For developing country readers off-track for the Goal/indicator:
Delay marriage and childbirth to adulthood.

For prenatal, pregnant, and breastfeeding mothers:

ensure infants are breastfed

ensure weaned children transition to a balanced, nutritious diet

ensure your own health and nutrition

For parents and carers of children under 5, monitor children near unsanitary points.

Prevalence of wasting in children under 5 years of age (%)
This measure is like the previous, substituting stunting for wasting, whereby muscle and fat waste away from the body. The long-term global goal is to eliminate wasting for kids under 5, down from current levels of 7%, or 45.4 million children, though it’s anticipated 15% more children will experience wasting due to the current pandemic.
Famine is an obvious cause of wasting in children. The arid band of the African Sahel and Arabian Peninsula has been at significant risk of acute famine, and will continue to be because of climate change.
As with stunting, infections can hinder the intake of essential nutrients in children, lost to diarrhoea or other symptoms of diseases such as tuberculosis and HIV/AIDS.
What can each of us do to end wasting in children under 5? You know the refrain by now: for high-income countries, as wasting is a feature of extreme poverty and LDCs, your foreign aid will go toward remedies for wasting - crucial in instances of acute famine. Such occurrences call for external help from a region unable to produce enough food for sustenance.
What of readers in countries scoring red for this indicator, thus with a priority for action? This indicator applies to parents, or whoever has responsibility for the care of a child under 5. For these readers, the guidance is the same as the prior indicator.
Please consult a medical professional - where available - for what constitutes healthy nutrition for a child under 5. Dismayingly, many of the regions experiencing wasting are those with insufficient health coverage, as we’ll see in the next chapter.
Summary: For OECD country readers, annually give 0.7% of your gross income as aid, aiming to end wasting worldwide by 2030.
Prevalence of obesity, BMI ≥ 30 (% of adult population)
We associate the prevalence of malnutrition as described in the prior indicators within the developing world. Yet some developing countries are beginning to see another form of malnutrition far more common in the developed world i.e., the inverse of undernourishment - overnutrition, overeating and obesity.
The body mass index (BMI) is a height-to-weight value, with a BMI of 30 meaning 30kg per square metre, the threshold for diagnosis from overweight to obese. To achieve this indicator by 2030, the aim is a prevalence of obesity in the adult population of 2.8% or less. Obesity is a strong risk factor for cancer, alongside cardiovascular disease and diabetes.
Processed food consists of a sea of carbohydrates, fats, and sugars, without the accompanying fibre, putting tremendous stress on our liver, an organ under-appreciated for its value in sustaining our health. The NOVA food classification, endorsed by the UN, can act as a guide to classifying ultra-processed foods, often identifiable by being in packaging, in contrast to “real food”.
The four categories of NOVA are below:
















































We're looking to encourage the first grouping, only use the second and third categories in spare quantities when cooking at home, or in the case of processed meats, omitting altogether. Plus, we’re aiming to cut the last category from our diets altogether.
The necessity of fibre has given way to sugars in the modern diet, leaving our intestinal bacteria unfed, unable to carry out the symbiotic role of assuring our metabolic health. In some countries, the prevalence of food deserts is a reality, characterised by cheap fast food, and a dearth of fresh produce. This is especially harmful to lower socio-economic segments of society, who may yet be educated about what constitutes good nutrition, or the harmful effects of bad nutritional choices.
The human mind is vulnerable to the sophisticated tactics of advertisers peddling obesogenic food and drink. For this, you can target your enmity to the most powerful, who derive their strength from their marketing prowess e.g., Nestlé, Mars, PepsiCo, Coca-Cola, Kraft Heinz/Mondelez.
Beyond the malnutrition aspect of accumulating excess body fat are more holistic factors resulting in unwanted weight gain, including:
links between obesity and depression

genetic predispositions

the side effects of prescribed medications

endocrine disorders

past traumatic experiences manifesting in food addictions

Additional to the NOVA system, below are two great dietary guidelines for healthy, sustainable diets. The first is the evidence-based Harvard Healthy Eating Plate, illustrated below:









































Copyright © 2011 Harvard University. For more information about The Healthy Eating Plate, please see The Nutrition Source, Department of Nutrition, Harvard T.H. Chan School of Public Health, http://www.thenutritionsource.org and Harvard Health Publications, health.harvard.edu.












Also recommended is the EAT-Lancet Commission’s report entitled Healthy Diets from Sustainable Food Systems. The basic precepts of this report are:
double the global consumption of fruits, vegetables, nuts, and legumes by 2050

halve red meat and sugar by 2050

It’s easy to remember to halve one type of food, and double another - a diet rich in plant-based foods with fewer animal-based foods. This is to afford us a planet for future generations with healthy land and a nourished population, curbing the prevalence of preventable diseases. As the EAT-Lancet Commission states:
“Food is the single strongest lever to optimise human health and environmental sustainability on Earth.”
What if you have a BMI below 30, but live in a country scoring red on this indicator? Your part to play is to encourage those in your household, social circle, and loved ones to exercise and eat a healthy diet.
For those with a BMI of 30 or more, use your GP if you live somewhere with access to healthcare, as you can go on this path with support. Medications or surgery may also be worth considering in consultation with your doctor.
Summary:
healthy diet, heeding the Harvard Healthy Eating Plate

regular exercise

halve red meat and sugar and double fruits, vegetables, nuts, and legumes

Human trophic level (best 2-3 worst)
Trophic levels tell us how energy intensive the food we consume is, measuring the content in our diets of other animals, in contrast to plant-based foods. The higher the rank on the food chain, the higher the human trophic level. This is because growing an animal requires far more energy compared to plant food. As an example, a cow may live off pasture or feed grain, and due to its size, requires a lot of it. If the cow eats grains, farmers use the land to grow animal feed at the expense of land used to grow food for humans. The land could even otherwise be forest, and once was, before being cleared for grazing. Once humans slaughter the cattle to eat beef, the amount of energy which has gone into the life of these ungulates - weighing almost a ton - is vast.
Humans are a combination of herbivorous and carnivorous, rather than the apex predators we may think of ourselves. Whereas a fox’s diet is exclusive to eating herbivores, instead humans are akin to pigs and anchovies in the global food web.
For this indicator, we’re aiming for a long-term goal of a trophic level of 2.04, with the global human median at 2.21 in 2009. Below’s an example of the respective levels:
Trophic level 1: plants and algae, metabolising via photosynthesis

Trophic level 2: herbivores

Trophic level 3: carnivores

Trophic level 4: carnivores who eat other carnivores

Apex predators: without natural predators

An example of what the 2030 objective of a human trophic level of 2.04 looks like is Burundi, which had a plant-based diet at the year of measure. Whereas Iceland, with the highest human trophic level of 2.58, had a diet split between fish and meat for one half, and plants for the other. To reach this indicator’s long-term goal you can aim for a similar diet mix as Burundi.
Take the following from Albert Einstein, synonymous with intelligence, but far more, humanity:
“Nothing will benefit human health and increase the chances for survival of life on Earth, as much as the evolution to a vegetarian diet.”
If you’re serious about this indicator, and Goal #2 of sustainable food systems in general, you’ll find a way to make your diet all plant-based. If you think your doctor might disagree, check with them e.g., if you’re anaemic, they might say you need to continue to eat meat when you feel weak. Taking cues from Burundi, we need only 96.7% of the population on board to meet the indicator’s goal - rather than everyone - so we have room for those with medical or nutritional reasons to eat animals.
Summary: Plant-based diet, targeting a national human trophic level of 2.04 by 2030.
Cereal yield (tonnes per hectare of harvested land)
For this indicator, we're aiming for 7 tonnes per hectare of harvested land by 2030. A hectare is 10,000 square metres, almost equal to a rugby field, or the grass interior of an athletic track. This indicator measures dry cereal grains (wheat, oats, maize/corn, rice, rye, barley, millet, and sorghum), in contrast to hay or grazing grasses used as feedstock for agricultural animals.
Agriculture is an aspect of sustainable development undervalued for its impact on all facets of human life. The cultivation of crops, rather than always being inherent to human culture, sprang forth when humans shifted from hunter-gatherer lifestyles. Settling into the land in fixed civilisations, humans tilled the land to make it arable to sow seeds, producing crop harvests to a surplus level beyond mere subsistence. Agriculture has since shifted from smallholdings to industrialised farms, characterised by crop monocultures bred through science for optimal traits.
This indicator is asking us to increase crop yield for food security for countries off-track. Yet making this balancing act trickier is the trend of human overpopulation at unsustainable levels, especially true in countries facing the most acute food security challenges.
Sustainable food systems - and SDG #2 as whole - can be intransigent to deal with, due to the complexity of diverse types of soil and terrestrial conditions for growing different crops. What’s good for northern England or southeast Australia might be less successful in equatorial Africa or the steppes of Central Asia, rather than a catch-all solution to improve global cereal yields. What can be universal though is the contribution of aid to finance improvements in technology transfer, in the form of innovative agricultural techniques.
Once again, the high representation of LDCs scoring red for this indicator invites DAC readers to reinforce the need for giving 0.7% of gross income as aid.
The affluent among us have the tools and knowledge to share the greatest advantages known to humankind. Technologies and knowledge need to be transferred to boost cereal yield in these regions, as well as to mitigate climate change by curbing our greenhouse gas emissions. The industrialised countries bear responsibility for a large concentration of such emissions, yet the harshest effects of warming will befall the rich world far less than developing counterparts. Smallholder farmers will experience the brunt, isolated from best practices, proffering staple crops for themselves. Climate variability is an inescapable facet of crop cultivation - true since the genesis of the Agricultural Revolution millennia ago. Yet the volatility of weather patterns will only become more turbulent due to climate change. Crop resilience is now a crucial, added consideration, which farmers can help by using resilient seed varieties and other practices.
Consistent with sustainable agriculture, we need to reconsider flooding the global ecology with fertilisers, overburdening the nitrogen cycles, pressing against many planetary boundaries. Though we need to boost cereal yields when lagging, rather than doing this at all costs, it must be consistent with the best agricultural practices and knowledge.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, targeting a global cereal yield of 7t/ha of harvested land by 2030.
For all readers, decarbonise your life.
Sustainable Nitrogen Management Index (best 0-1.41 worst)
The Sustainable Nitrogen Management Index is a score combining two measures:
nitrogen use efficiency

land use efficiency, measured by crop yield (explored in the prior indicator)

Nitrogen use efficiency is often correlated with environmental performance, so we could consider the Sustainable Nitrogen Management Index as a measure for sustainable agricultural practices. The 2030 aim is for a Sustainable Nitrogen Management Index score of 0. The global map of scores for this indicator puts the whole global population off-track, except Paraguay and Ireland, who are on track.
Whilst there’s an economic imperative in agriculture for higher yields, we're attempting to conserve the soil to allow its continued use in future seasons. To grow in the soil, plants need nutrients, in the form of minerals such as carbon, oxygen, hydrogen, phosphorus, potassium, nitrogen and sulphur. Soil’s constituents are carbon-based organic matter, 'organic' meaning any compound containing carbon and hydrogen. These ingredients support life, alongside sunshine and water, via the process of photosynthesis.
To aid this process of nutrition for the soil, humans add fertiliser, to fertilise the conditions for life to occur in the soil. Fertilisers tend to focus on three ingredients needed by soil: nitrogen, phosphorus, and potassium. In the early era of agriculture, manure and compost served as fertilisers, as did blood meal and fish meal, by-products of animal and fish slaughter, as well as crop rotation to help manage the nutrients.
The invention of a chemical process would usher in the intensive agricultural practices now pervasive. The Haber-Bosch process was monikered after its inventors, German chemists Fritz Haber, and Carl Bosch. The Haber-Bosch process allowed for the synthesis of ammonia, a compound of nitrogen and hydrogen.
We want to use an efficient amount of nitrogen, at the same time compromising as little as possible on crop yield. Conventional farming tends to use too much nitrogen, risking harmful runoffs, but organic farming uses nitrogen too. This is tricky, because there’s a strong link between the amount of nitrogen used and the yield. Nitrogen is necessary for the soil to harbour the conditions for growth. But we’re aiming for sustainability, rather than high yields at all costs to the environment, risking our future food security. Sustainable agriculture ensures use of nitrogen is in harmony with the nitrogen cycle of the planet. If we need less agricultural produce, because we’re wasting less, and we need to grow less feedstock for livestock, then we ought to have enough yield.
Excess nitrogen use in agriculture is a driver of climate change. Also, the surface runoff results in dead zones of eutrophication in bodies of water, robbing conditions for life. Excess nitrogen erodes the long-term biology of the soil, threatening biodiversity and destroying habitats. All this puts us at perilous risk of food insecurity. Business-as-usual farming today may very well lead to our inability to feed ourselves long-term.
But without the legacy of the Haber-Bosch process, could humanity sustain the global food system feeding 8 billion mouths? In 2015, of a global population of 7 billion people, chemical fertilisers supported 3.84 billion. Before the innovation of the Haber-Bosch process, the entirety of the global population of 1.65 billion had little choice but to support themselves with natural fertilisers.
Could the global population today survive on organic food? Let’s weigh up some points:
Conventional farming offers a higher yield, but the soil quality is poorer.

Organic uses less energy, is better for biodiversity, and minimises water pollution.

Organic farming is more profitable, yet both methods are on par with costs to producers.

Organic far outperforms conventional ecosystem services provided.

Organic edges out conventional farming for employment of workers, and is far superior in protecting workers from harmful pesticides, and minimising pesticide residues.

Organic farming outperforms conventional farming in adverse weather conditions.

Living off organic is more within reach if you reduce food waste, and reduce your meat and dairy consumption, which would reduce the need to grow feedstock. Studies show we can feed a projected scenario of 9.6 billion people in 2050 with the necessary yield if we shift to a vegetarian or vegan diet.
We’re striving for sustainable agriculture, whether organic or some other form e.g., permaculture, local food, Slow Food. The food system must be sustainable, inclusive of food distribution, diets, and food waste. There ought to be a guiding principle of sustainability of our food systems. It’s an open-ended exploration of ideas and improvement of behaviours central to our lives, yet very much shaped by a lifetime of habit, as well as cultural or familial attitudes.
Very few of you will be farmers, weighing up how much nitrogen you use. Most of us live in urban environments, where our food production needs are met by someone else, exchanging money we’ve earned doing another occupation, rather than having to till fields each day. The consideration of nitrogen in your day-to-day experience in likelihood appears distant and far-flung.
Yet sustainable agriculture is a gargantuan issue - the most ambitious of all, surpassing decarbonising the global energy system. If you know the food which you’re sourcing is grown with sustainable agriculture techniques, whatever its method, this is encouraged alongside organic food. Keep in mind an attitude toward sustainable food systems, inclusive of distribution and waste. Be curious, and be dubious of where your food is coming from. Explore and educate yourself over a lifetime to improve your knowledge around this most important facet of our lives.
Summary:
plant-based diet

end food waste

eat local produce

eat organic food, or food grown by sustainable agriculture methods

Exports of hazardous pesticides (tonnes per million population)
This indicator aims to end by 2030 the export of pesticides deemed hazardous to human health.
Pesticides can be chemicals or biological agents intended to kill or repel the lifeforms it targets e.g., plants, insects, rodents, microorganisms, fungi.
Yet these same agents can also be poisonous to species other than those it intends to target, e.g., humans, bees, plants, or other wildlife. Pesticides are another contributor to the negative environmental effects of agriculture. Due to cycles of pesticides in the flow of agriculture, they make their way into the lives and bodies of humans via runoff of water from the soil surface following rain and storms.
If you work in the chemical export industry, you’d be aware of which chemicals fall within those deemed hazardous by the Rotterdam Convention. For casual readers, there’s only a couple household names among these e.g., DDT and asbestos. Many of these pesticides are hazardous to human health, either because they’re carcinogens, disrupt your endocrine system, or are persistent organic compounds, affecting us by resisting degradation in the environment.
Summary:
End exports of hazardous pesticides by 2030.

As an alternative:

use biological pest control

adopt integrated pest management methods

Yield gap closure (% of potential yield) *
This indicator measures the percentage of a country’s potential yield in the three annual crops using the most land area, aiming to close the gap in the actual yield to 77% of this potential yield.
Using Australia as an example, the percentage of yield in its top three crops, according to land area use, was 47% in 2015. Phrased another way, the field for these three crops was half its potential. For Australia to close this gap to achieve the indicator, it would need a yield of 77% for the three largest crops by land area used: wheat, barley and canola.
My ideas around the solution to this indicator are the most extreme in this book. For the 2022 SDG Index, there’s only data for some European countries, the US and Australia, so my wild idea ought to only affect a small portion of readers. My recommendation is for those countries scoring red for this indicator to reduce, or eschew altogether, the consumption or use of the top three crops by land area.
Your initial reaction might be, “This guy wants me to go plant-based - now he’s taking staple crops out of the equation?! What, he wants to protect the feelings of the barley grains too?”
In an OECD country, a farmer has access to best practice agricultural tools and techniques, but humankind still depends on the good charity of Mother Nature. Thus, I’ve placed liability downstream to the consumer.
What does this look like? Using the example of Australia, this would mean abstaining from wheat, barley, and canola. There are alternatives, notably rye. Yet if Australians substituted rye for wheat at a similar scale, we’d be in the same situation. One of the issues with the predominance of wheat is the lack of variability in crops, or the prevalence of monoculture, inclusive of wheat’s varieties like spelt and durum. Wheat might be central to an Australian diet, or a Western diet in general, but our digestion systems are unevolved to digest it, hence the prevalence of gluten intolerances. Processed wheat is the true culprit, which we’ve already seen from the harms of processed food. When wheat is refined beyond its whole grain form, stripped of its fibre, it's worthless. In Australia, can we bridge the yield gap for wheat for the long-term aim whilst its end uses are being processed to offer little nutritional value?
For those unable to fathom a life without wheat, you could consider ensuring any wheat you consume is wholegrain and organic. This seems an acceptable compromise, and sets a good example for others. Wheat stripped of the fibre of its whole grain form includes the ultra-processed foods listed earlier. All of these are contributing to unsustainable agricultural practices or are a form of food waste in the sense the whole grain is hulled. What’s left is a foodstuff devoid of nutritional value, other than empty calories.
The other top two crops in Australia by land area are barley and canola. Barley is the main constituent of beer. In Australia, there are good beers free of barley, which anyone on a gluten-free diet would know about, and which most liquor stores stock - if not, you can buy a carton from the brewers online. In Australia, beer seems a national pastime, yet ought naff cultural traditions get in the way of sustainable development?
Canola has other uses besides food, but for this indicator, if you’re Australian, use a substitute. Many kinds of margarine and other foodstuffs list ‘vegetable oils’ in their ingredients as a catchall, which may well include canola. You could prioritise products you know exclude canola, or abstain from margarine altogether.
Readers from the countries scoring red for this indicator will need to research their respective countries’ top three crops by land area, and make the call whether it’s a crop they could live without, or seek out an organic alternative.
Summary: For readers in countries off-track:
Research your country’s top three crops by land area

Either:

Seek alternatives to consuming these three crops until your country returns to 77% of potential yield by 2030

Buy organic forms of these crops

Dashboard map for 2022 SDG Index Goal #3 ratings. Data source: sdgindex.org






























You and the Global Goals: SDG #3 - Good Health and Well-being















Maternal mortality rate (per 100,000 live births)
This indicator measures the estimated number of women between the ages of 15 and 49 dying from pregnancy-related causes whilst pregnant, or within 42 days of the pregnancy’s termination. The long-term aim is 3.4 deaths from these causes per 100,000 live births. Globally, the estimated maternal mortality ratio was 211 per 100,000 live births as of 2017, well above the long-term goal.
The maternal mortality rate is a proxy for the quality of a healthcare system. Complications due to pregnancy and childbirth can be common, but with proper care, healthcare professionals can handle difficulties, preventing the worst outcomes. Without proper healthcare available, it’s more difficult to prevent, diagnose and treat any complications arising due to pregnancy.
The LDCs and sub-Saharan Africa and mostly off-track on this measure, with the rest of the world on track, an illustration of the link to insufficient health care.
The same is true here for other indicators already mentioned which have a strong correlation between a red score and LDCs i.e., OECD countries will shoulder the responsibility on behalf of the LDCs in the form of giving 0.7% of gross income as foreign aid. This giving will afford an army of skilled birth attendants in rural areas, as well as affording medical techniques taken for granted in the developed world e.g., blood transfusions, asepsis and preventive prenatal care. A skilled health attendant can curtail these risks by caring for the mother during the pregnancy, childbirth, and postpartum period, including any postpartum bleeding or obstructed labours.
If aid flows to the LDCs and other aid recipient countries, the global maternal mortality rate can drop, achieving a measure which had a dedicated Millennium Development Goals (MDG #5 - Improve maternal health).
Summary: For OECD country readers, annually give 0.7% of your gross income as aid, aiming to reduce the global maternal mortality rate to 3.4 per 100,000 live births by 2030.
Neonatal mortality rate (per 1,000 live births)
This indicator measures the number of newborns per 1,000 live births who die within 28 days following birth, with a long-term aim of a neonatal mortality rate of 1.1 per 1,000 live births.
Causes of infant mortality in the first 28 days include deprivation of oxygen; congenital birth defects; prolonged labour; infection; low birth weight and poor sanitation.
The absence of healthcare raises the risk factors for neonatal mortality. As with the prior indicator, such is the priority of infant mortality, it warranted its own Millennium Development Goal (MDG #4 - Reduce child mortality).
The correlation between extreme poverty and high birth rates also exacerbates neonatal mortality. As we reduce extreme poverty, birth rates will in turn reduce, as is the demographic trend observed worldwide. Therefore, we must encourage gender equality, women’s empowerment in the labour force, as well as educating girls.
The 2022 SDG Index map for this indicator is uniform with the prior indicator, again highlighting the link between mortality rates for both mothers and neonates. Again, there’s a strong correlation between LDCs and those countries with red scores.
Thus, the responsibility again lies with the OECD countries to finance improvements in healthcare in the LDCs. The 0.7% of gross income of OECD citizens will finance the outreach of a mass workforce of skilled community health workers, with resources on hand to meet the needs of rural areas.
Summary: For OECD country readers, annually give 0.7% of your gross income as aid, aiming to reduce the global neonatal mortality rate to less than 1.1 per 1,000 live births by 2030.
Mortality rate, under 5 per 1,000 deaths
The distinction between this indicator and the previous is age - this indicator measures the number of children under 5 per 1,000 who’ll die before reaching age 5. The long-term aim for this indicator is 2.6 deaths for children under 5 per 1,000, down from the 2019 rate of 37.7. As such, this measure of children under 5 also includes neonatal and infant mortality.
The leading causes are premature births and infections, especially pneumonia, diarrhoea and malaria. But the prevention measures are alike to the two prior indicators i.e., we need to finance public health needs. Most child deaths are preventable, and cheap to treat and prevent, yet the cost is irrelevant without the meagre funding forthcoming. We therefore need to fund vaccines, antibiotics, mosquito nets, fluid replacement, promotion of breastfeeding and handwashing, as well as improved sanitation and drinking water facilities.
A meagre 0.7% of your income will make you a literal hero, saving lives - without a cape, cowl or superpowers - just a bank account, a charity, and a device to make the donation. Rather than treating a diarrheal infection or making the trip to Africa, you pay someone to do it on your behalf, then get to go to bed knowing you’ve saved the lives of helpless children.
Summary: For OECD country readers, annually give 0.7% of your gross income as aid, aiming to reduce the global under-5 mortality rate to less than 2.6 per 1,000 live births by 2030.
Incidence of tuberculosis (per 100,000 population)
This indicator estimates the number of cases per 100,000 people with either new or relapsed cases of TB, inclusive of cases for those also living with HIV. The long-term goal is 0 cases of TB per 100,000, from a current global rate of 127 per 100,000 in 2020.
TB’s an infectious disease caused by a bacterium, Mycobacterium tuberculosis affecting the lungs. Symptoms include coughing bloody mucus, fever, and night sweats, though TB cases can be asymptomatic whilst contagious. The bacterium spreads by aerosol droplets micrometres wide.
Before the COVID-19 pandemic, TB was the highest cause of death from an infectious disease. A quarter of the global population may carry the disease in its latent form, with an annual rate of new infections of 1%. An estimated 10 million people have active cases worldwide, resulting in 1.5 million deaths, close to half occurring in Southeast Asia, and a quarter in Africa. TB is a disease of poverty, exacerbated by slum living, as well as malnutrition and poor sanitation conditions.
As suggested in the indicator’s definition, cases of TB often occur alongside HIV/AIDS. We’ll address HIV/AIDS in a later SDG #3 indicator, but taking preventive measures for HIV infection will affect the degree to which one may be at risk of TB.
In many countries, the diagnosis and testing of TB can be difficult, slow, or unavailable. Many poor countries, or poor parts of middle-income countries, are without affordable x-ray facilities, or affordable and accessible testing based on sputum cultures or other means.
A preventive measure is keeping from contact with known TB cases. You’ll be at greater risk if your immune system is low, a risk factor often caused by the generalities of poverty. Enter the responsibility of high-income readers to improve poverty in all its dimensions via aid.
Prevention is difficult, due to the poverty conditions TB thrives in, so treatment may be our best option. The vaccine for TB is the most widely used in the world, with an estimated 88% of all children vaccinated for TB, though the vaccine has less than complete efficacy.
TB can be treated with antibiotics, but resistance has become an issue with a growing prevalence of drug-resistant cases. TB carries with it many factors affecting successful prevention and treatment, sometimes with complexity on a scale addressed by public health efforts of national governments, or international agencies like the WHO.
For new cases of active TB, the patient should seek medical care where available, to undergo a regimen of antibiotic medications for up to six months. For recurrent cases of TB, a medical professional will need to find out which antibiotics in a treatment regimen are proving resistant. Testing may need to investigate whether the strain of TB in one’s system is multi-drug resistant, whereby the patient may need the other antibiotics in their regimen which are yet to prove resistant for a longer course up to 1-2 years.
If you’re finding it challenging to scrounge enough money to feed your family and yourself, having ready access to testing and treatment - if paid out of pocket, in contrast to government-funded - could be crippling to a household. You see how important it is for us to fund organisations like the WHO to carry out the work either households or national governments are unable to. Humanity has been battling TB since antiquity - a formidable foe. But we can manage TB at the population level if resourced and financed, as the rich countries did within their societies. The aid dollars we’ve been discussing from our rich country readers are going to go toward TB to aid public health efforts. The path to achieving the long-term aim of this indicator lies in the larger vantage of SDG #3 i.e., healthcare for all.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, aiming to end TB by 2030.
For developing country readers:
vaccinate for TB, including your children

if symptomatic, seek diagnosis if available and affordable

if diagnosed, seek treatment, where available and affordable

New HIV infections (per 1,000 uninfected population)
The issue of HIV, alongside malaria, had its own Millennium Development Goal, MDG #6 (Combat HIV/AIDS, malaria, and other diseases). This indicator is aiming to eliminate new infections by 2030.
In the past decade, global deaths from AIDS have halved, yet can still kill a million people a year. In some countries, AIDS is the leading cause of death, resulting in a quarter of all deaths. The highest concentration of new HIV cases is in sub-Saharan Africa, below the equator. Several of the southernmost African countries are now middle-income countries e.g., South Africa, Namibia, and Botswana, yet each are very much in the grip of HIV/AIDS.
A cure is yet to be discovered, but the treatment or management of HIV/AIDS, when financed and resourced, is encouraging, via the use of antiretroviral drugs. These drugs are inexpensive to manufacture, but even their modest cost may be high for households living in extreme poverty. A national healthcare budget must cover the cost of these drugs, though when national governments are too poor to do so, we turn to the international donor community to step in.
For middle-income countries with high rates of new HIV infections, the message is the same as public health promotion efforts. We first need to acknowledge the infection known as AIDS is caused by a virus, therefore is a transmissible infection, spread via blood, semen, vaginal lubrication, and pre-ejaculate. The use of condoms, whether one’s sexual partner is a known carrier of the virus or unknown, is essential. A diagnosis of HIV/AIDS can be sought via a sample of either blood serum, saliva, or urine. If one suspects they may have had a sexual encounter with a carrier of the virus, it’s an opportunity to prevent further spread, and to receive management of the worst effects of AIDS if transmission has occurred. If you’re a carrier of the virus, and planning a family, transmission can occur to the baby via the course of pregnancy, childbirth, and the expression of breastmilk. If you suspect you may have been exposed to the virus, and are in a region where the following is available and affordable, you could use the treatment known as post-exposure prophylaxis, which could prevent exposure to the virus from turning into AIDS.
Though a vaccine is yet to be discovered for HIV/AIDS, with financing for medical research, a breakthrough may occur before 2030. Antiretroviral drugs are available for treatment for those who've received a diagnosis of HIV/AIDS.
For OECD readers, it’s time to mobilise your 0.7% of gross individual income. Some circumstances of poverty offer more of a fertile ground for the virus’ spread than in more affluent countries. Immune systems are already low for those living with malnutrition or absent healthcare, compounding the effects of a virus targeting the immune system. We’ve seen earlier how active infection by TB puts individuals living with HIV/AIDS at increased risk. Subpar sanitation conditions in medical settings could further place individuals at risk of transmission. Also, many sub-Saharan African countries may have cultural or religious attitudes hindering the use of condoms. As such, public health promotion efforts need funding to reach these communities to overcome stigmas and misperceptions.
Universal health care, per the aims of SDG #3, must be made available and affordable to all. Healthcare systems can then observe signs and symptoms, health promotion efforts can mitigate transmission via behavioural change, and we can champion the further financing of medical research.
This is an issue of financing. From the financing everything flows - from research, prevention, and treatment. We can end new cases of HIV/AIDS by 2030, but the key variable is the dollars.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, aiming to end new cases of HIV by 2030.
For developing country readers:
use condoms

if you suspect you may have been exposed to HIV, get tested

if you receive a positive diagnosis, seek treatment with antiretroviral drugs, where affordable

Age-standardised death rate due to cardiovascular disease, cancer, diabetes, or chronic respiratory disease in adults aged 30-70 years (%)
Whereas TB and HIV are infectious diseases, involving the spread of a pathogen, the diseases for this indicator are all non-communicable diseases (NCDs), with altogether different risk factors.
Let’s profile the diseases to see what you can do to protect against dying from them before you turn 70, per the aim of this indicator.
Cardiovascular systems circulate blood throughout our bodies, transporting nutrients, hormones, and oxygen to and from cells, as well as aiding in our immune system, regulating our body temperature, and maintaining homeostasis.
Cardiovascular diseases are the leading cause of death in the world, by quite a margin, followed by cancer, then respiratory disease and diabetes, all of which we’ll soon address. Cardiovascular diseases manifest in many forms, from the restriction of blood supply in the arteries of the heart, caused by a build-up of plaque. This can hinder blood flow to the heart, which can result in a heart attack. Stroke is the hindrance of necessary blood flow to the brain, depriving the death of some brain cells.
Causes of cardiovascular disease include high blood pressure, which you can be alerted to by a sphygmomanometer, the inflatable cuff fitted to your arm by doctors and nurses. Smoking is a cause, as is lack of exercise, obesity, high cholesterol, poor diet, drinking too much alcohol, and diabetes.
How do you prevent cardiovascular disease? Abstain from smoking, eat healthily, drink alcohol in moderation or abstain altogether, and exercise. These are hackneyed commonplaces, seeming so obvious and simple, yet they so easily elude us, essential for healthy functioning. Depending on your doctor’s advice, you may need treatment to address high blood pressure.
The second-leading killer worldwide is cancer, the abnormal growth of cells into neighbouring tissues, which can then metastasise throughout the body. This contrasts with benign tumours, which leave neighbouring cells alone. The drivers of this disease are known as carcinogens, which include tobacco smoking, the cause of close to a quarter of all cancer deaths. Other major causes match with the risk factors for cardiovascular disease, including obesity, diet, sedentary lifestyles, alcohol abuse and radiation.
70% of all cancer deaths occur in low and middle-income countries. A third of the prevalence of cancer in these countries is due to hepatitis, the human papillomavirus, and a couple other bacterial and viral infections, including HIV. Less robust access to diagnosis and treatment in developing countries exacerbates this, where presenting to a medical professional in the late stages of cancer is a sad commonplace. Developed countries enjoy coverage of 90% comprehensive treatment of cancer, whereas low-income countries can only expect 15%.
Cancer screening, where recommended by public health authorities for your given age or sex, is important to adhere to. Our less affluent counterparts may be missing access to such regular screening, as is promoted in many developed countries. The success of screening is one of the reasons death rates from cancer have dropped in the developed world. Medical imaging technologies are expensive, but seek cancer screening if you have affordable access. Otherwise, the foreign aid spoken about throughout this book allows for the universal uptake of screening before 2030.
To limit your exposure to carcinogens, you can limit your alcohol intake, as alcohol is a Group 1 carcinogen, alongside processed and red meats. What risk factors can we mitigate in our personal lives as preventative measures? Early detection is important, where your healthcare system is capable, as is appropriate treatment and care.
Eat fruits, vegetables and whole grains, and exercise regularly.

Get vaccinated against human papillomavirus and hepatitis, if you have access in your country.

Limit overexposure to the Sun, or occupational radiation exposure.

Limit exposure to carcinogenic chemicals and agents common in some occupations, including outdoor and indoor pollution.

Seek preventive screening, where available in your country. This is of urgency for cervical Pap tests and mammography screenings for breast cancer.

The ethanol in alcoholic drinks metabolises into the carcinogen acetaldehyde. Consider what effects alcohol has, and whether it’s worth putting yourself and your loved ones at the tragic scene of your deathbed. If, in this example, and of tobacco smoking, you feel it’s beyond you to quit this addictive practice, chat to your GP - it’s what they’re there for.

Diabetes is a modern-day disease of our behaviours and poor choices. I’ve said enough elsewhere in these pages about the perils of processed food and refined sugar playing havoc with our insulin response. I recommend Dr Robert Lustig’s illuminating book Metabolical, if you’re curious for a deeper dive. We can characterise a healthy lifestyle by a healthy diet, high in fibre and whole grains, with sparing to zero consumption of refined sugars. Limiting ultra-processed carbohydrates and saturated fats is essential. These diet choices are healthy for people and the planet, as is regular exercise. It’s simple, but is why we underestimate the benefits of such healthful habits. If we eat well and exercise, we ought to keep our body weight in a healthy range, which otherwise would become another diabetes risk factor. As Lustig says, the simple mantra to curb metabolic diseases like diabetes is to “protect the liver and feed the gut”. The latter means to eat high-fibre foods, which feed the bacteria coexisting in our intestines’ walls, which digest the fibre before the rest of our body has the chance. Protecting the liver means avoiding processed foods and refined sugars, which put a strain on the functions of the liver, sometimes overwhelming it, leading to the accretion of fatty deposits. Drink alcohol in moderation, or abstain altogether, with your liver’s health in mind. Abstain from eating refined sugar, white carbohydrates, and saturated fats, and please abstain from eating foods containing all three - such concoctions together are like the nutritional equivalent of a speedball.
This indicator focuses on chronic forms of respiratory disease, rather than short-term occurrences, such as the common cold, flu, or COVID-19. Chronic forms include asthma, emphysema and chronic bronchitis. Smoking is a controllable risk factor, though less controllable is air pollution, plus exposure to occupational chemicals and dust. There’s yet a cure to many forms of chronic respiratory disease, but treatments can dilate airways to aid shortness of breath.
You can attempt to limit exposure to harmful particulate matter in the air around you, if you’re aware of it, by limiting the release of particulate matter, whether indoor, outdoor, of an occupational nature, or in a residential setting. Any dust or fine matter suspended in the air is putting you at risk. Dust may seem innocuous, as it’s all-pervading, but is often harmful. Our foreign aid from OECD readers will finance the adoption of cooking methods for those living in poverty, as many cooking methods used among the extreme poor are a cause of indoor pollution from the fumes of biomass, accompanied by poor ventilation. You already know smoking tobacco is harmful to health. You may be unable to control genetic factors, but you can control the degree to which you expose yourself to further risk of the above causes of chronic respiratory disease.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid.
For developing country readers:
mitigate the risk factors

if experiencing symptoms, seek diagnosis

if diagnosed, seek treatment, where affordable and available

Age-standardised death rate attributable to household air pollution and ambient air pollution (per 100,000 population)
We touched on the issue of air pollution as a cause of death in the prior indicator, in the context of it being a risk factor and a carcinogen. This indicator targets a mortality rate caused by air pollution of 0 per 100,000 population by 2030.
We see household air pollution in developing countries using biomass as cooking fuel in the form of wood, charcoal, dung, or crop residues left over in an agricultural field after the harvest. The exhaust gas from combusting these fuels contains particulate matter: microscopic particles suspended in the air, such as carbon monoxide, nitrogen dioxide, sulphur dioxide and a bunch of organic pollutants.
By contrast, ambient air pollution in the atmosphere has adverse consequences to human health, as well as the Earth’s climate when in the form of nitrous oxide, methane, carbon dioxide and chlorofluorocarbons. We know carbon dioxide is a driver of climate change, affecting the natural environment, destroying habitats, and hurting human health. Chlorofluorocarbons result in the depletion of the ozone. Many of the above chemical substances are also toxic to the organisms absorbing them. Ambient air pollution can cause acute respiratory tract infections, and is also a risk factor for cardiovascular disease, including stroke and lung cancer, in addition to evidence of its relationship between depression and prenatal development. We’ve known for a long time that air pollution in all its guises is damaging for human health. But the death toll has become startling, estimated to kill 7 million people a year, as well as costing the global economy $5 trillion, with an estimated 90% of the global population breathing dirty air.
The data we’re looking at combines deaths from ambient and indoor air pollution, but we can estimate the high death rate in sub-Saharan Africa is due to dirty cooking stoves. The global development community has been seeking to remedy this with the distribution of clean cooking stoves to the world’s poorest to prevent these needless deaths. Pneumonia is still the world’s biggest killer of children by infectious diseases, for which indoor air pollution is a risk factor.
The LDCs are short of the domestic resources to resolve this of their own accord, and will need help to reinforce their budgets. Aid workers can try to help ease the adoption of clean cooking and heating stoves in homes. What if you’re a reader from an LDC, or anyone living in a country scoring red or orange for this indicator, and are combusting solid biomass in your home? Please attempt to ensure there’s enough ventilation to keep combustion from polluting the surrounding environment of the living space. Some of the above-mentioned chemicals are microscopic, so even in the absence of smoke, there can be a danger - carbon monoxide being a good example of an invisible killer. We’re pinning our hopes to achieve the clean cooking stove issue via the international donor community paying for this on behalf of the extreme poor. Whatever the suite of solutions, we’ll return to this in Goal #7 (Affordable and Clean Energy).
What can we do about ambient air pollution? What we pollute in the immediate vicinity will be lurking in the nearby atmosphere - yet over time, we share the same air. In other chapters, we’ll look further at the effects of many of these air pollutants, and we’ll see throughout the coming indicators the degree to which we ought to be curbing carbon dioxide emissions. In the chapters for SDG #12 and 13, we’ll see how industry ought to curb its emissions of sulphur dioxide, nitrous oxide and carbon dioxide.
Some simple individual solutions include:
Eschew internal combustion vehicles, assisting in the phase-out of fossil fuel vehicles toward electric vehicles.

Prioritise more sustainable transport modes, including cycling.

Limit air travel until aviation fuel becomes less polluting.

Adopt a lifestyle more characterised by localism, reducing your need for transport.

Use electricity generated from clean, renewable energy, including heating.

For anyone running or managing an industrial operation, control devices should be of priority for the consideration of human health. If you live in a democracy and have a representative elected on your behalf, you can write to them to affirm your request for stringent air quality laws.
We know for the LDCs, our 0.7% foreign aid from OECD readers will help finance solutions to the main source of indoor air pollution.
The OECD countries are all on track for this indicator, and may in some cases have more stringent air quality laws. A health care system resourced and financed to treat diseases born of airborne pollutants is a vital factor in their success, despite playing their part as sources of air pollution in faraway countries.
Summary:
For all readers, be mindful of emissions contributing to ambient air pollution:
greenhouse gases

ozone

particulate matter (PM2.5)

sulphur dioxide

For OECD country readers, annually give 0.7% of your gross income as aid, aiming to end deaths from air pollution by 2030.
For developing country readers, use clean cooking fuels, where available and affordable.
Traffic deaths (per 100,000 population)
This indicator aims by 2030 for 3.2 deaths or less from traffic per 100,000 people.
To mitigate the risks of vehicle collisions, you can:
Drive free from the influence of intoxicating substances.

Remain focused from mobile phone distractions.

Follow the rules of the road, including observing speed limits.

Ensure while driving to have a clear distance ahead of the vehicle in front of you.

Be mindful of poor vision or a disability, if this may have progressed since you last underwent a driving test - pertinent for those of old age.

Be mindful of your disposition whilst driving, including if you find yourself irritable.

Consider what is, or is not, displayed in your side-view mirror.

Be careful in low visibility through the windshield in fog conditions.

As a driver in society, adopt a culture of safety, for yourself and others.

Wear seatbelts.

If riding a motorcycle, be mindful of the necessary safety precautions, including personal protective equipment.

What of the lack of universal health care in poor countries with high traffic fatality rates? Some of these deaths could have been prevented had enough medical care been available, keeping a road-related injury from being fatal. We’ve already seen how donor help goes a long way toward building up healthcare systems so medical access is universal, which could bring down traffic fatality rates.
You’re attempting to lower traffic fatalities which you as an individual reader have the power to control, but if you feel concerned about a certain stretch of road as it relates to safety, you may wish to alert this to the attention of the local road authority. They may very well remedy this upon your request if it poses a risk to road safety. If you work in the automotive industry at any level, be mindful of risks in the production or design process which could endanger drivers.
Driving a vehicle at a speed of 60km/h or more is a big responsibility for anybody getting behind the wheel. You must drive safely and accommodate your capacity for human error, as well as be aware of the fallibility of other drivers, pedestrians, cyclists, or motorcyclists.
Summary: Drive safe, heeding the above points, aiming to reduce national traffic deaths to less than 3.2 per 100,000 population by 2030.
Life expectancy at birth (years)
The fuller description of this indicator is the average years an infant can expect to live if exposed to age and sex-specific death rates in the country of their birth, aiming for a life expectancy of 83 by 2030. The global average is 73 as of 2022.
Most of the developed countries are on track for the 2022 SDG Index, with a glaring exception of the US, where life expectancy is falling. The priority countries are the LDCs, with low life expectancy in poor countries due to the demographic effects of high child mortality.
Let’s compare Angola and Afghanistan as examples to examine causes of death in countries both scoring red in the 2022 Index. Both have life expectancies at birth of 63 using 2019 data, both stagnating in their progress.
















































We see in Afghanistan a combination of deaths through communicable diseases, perinatal and non-communicable diseases, as well as collective violence due to war. The top six leading causes of death in Angola were all either communicable or perinatal.
Both countries have a need to address poverty - requiring enough nutrition, healthcare systems, and water and sanitation to meet their basic needs. Otherwise, infectious diseases and diseases of poverty will continue to remain rooted, and we can expect the life expectancy of these countries to continue to stagnate.
Nature has spared Afghanistan from the Petri dish of infectious diseases endemic to much of the tropical LDCs such as Angola. Still, Afghans have had to contend with what seems like an ongoing war, with one aggressor or another for decades to centuries. Such conditions make for less than fertile ground for a healthcare system to take root, or for an upward trajectory of life expectancy.
What can readers do vis-a-vis our LDC compatriots? The foreign aid we’re donating will lift them from poverty in all its dimensions, inclusive of financing health for all. What can readers do for poor countries in conflict, like Afghanistan or Yemen? If you believe your government is perpetuating such conflict for cynical ends, you can contact them to declaim against their tacit or overt support for such conflicts at the expense of the citizenry.
What about middle-income country readers? The quality and accessibility of healthcare where you live may be beyond your scope to control, though seeking medical attention where available may be within your control. The simplest route is a healthy life, characterised by a healthy diet, regular exercise, and limiting or eliminating harmful behaviours like alcohol abuse and smoking. Be a little more mindful of the leading causes of death in your country which you may be most vulnerable to in your circumstances. You can check what those top causes are on the WHO website. From there, you can discover what the risk factors are for those causes, ensuring you’re limiting any behaviours which may speed up their effect on your health and lifespan. It’s likely the leading causes of death in middle-income families will be non-communicable - if so, it’ll be worthwhile to revert to the earlier indicator relating to NCDs, and what you can do to mitigate their onset.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, aiming for a global life expectancy at birth of 83 years by 2030.
For middle-income country readers:
healthy diet

regular exercise

be mindful of risk factors

Adolescent fertility rate (births per 1,000 females aged 15 to 19)
This indicator aims for 2.5 births per 1,000 women aged 15 to 19 by 2030, down from a global rate of 41.5 in 2019.
The 2022 map for this indicator shows a split result across the world, half the globe scoring green, the other red or orange. Close to the entirety of Latin America scores red or orange, as has sub-Saharan Africa, and about 10 countries across Asia.
In developing countries facing challenges on this indicator, teens falling pregnant may often have gotten married, seen as a good thing to the broader society and family. Yet many of these countries face issues with malnutrition and under-developed healthcare access - compounding any complications with the pregnancy, threatening maternal and infant mortality.
This issue is acute in sub-Saharan Africa, where we can expect a demographic explosion throughout this century. Elevated levels of extreme poverty will result in high birth rates due to anticipated high rates of child mortality by families. What is the solution to curbing such a demographic explosion? The region is already unable to support its existing population due to the depredations of extreme poverty, yet is expected to add up to a billion more souls to share in its already slim domestic resources.
Interweaving with Goal #5, the key is for teenage girls to remain longer in education, and to value them as staples of the labour market. We can encourage their value to society, so families see their greater worth by working or studying, rather than marrying young and starting a family. This is especially true between 13 and 19 years of age, when young women may yet feel they have the resources to care for themselves.
Cultural attitudes will differ wherever in the world one finds high rates of teenage pregnancy, and to shift these attitudes can be difficult. But we’re only looking to influence the sample size of one i.e., you. You need to reconcile any attitudes you may hold related to your society’s traditional practices and mores with those of the SDGs.
This indicator resides within Goal #3 because there are risks with teenage pregnancy of low birth weight, preterm births, seizures in the mother from high blood pressure, anaemia, lack of access to prenatal care, and developmental psychology issues of the child.
We need to emphasise educating girls, and lift them from poverty. We know by now our DAC readers will transfer foreign aid to reduce the conditions of poverty, which can also finance comprehensive sex education and access to birth control.
Core to this is keeping girls in education, a sentiment at the heart of Goal #4. The opportunity cost to the economy is a woman lost to the labour market as a wage earner for her family and self.
If you’re a reader in a middle-income country off-track, you may have better access to resources than a counterpart living in extreme poverty. The most valuable forms of prevention of teenage pregnancy are sex education and birth control. Be forthright with yourself within your conscience - there is a real-world imperative to bring teenage pregnancy rates down. We must decide which takes precedence: is it our pre-existing beliefs, or the principles of sustainable development, ensuring human health? There’s room to try to find compromise in a way allowing for your conscience to be at relative ease.
Global adolescent fertility rates are at present incompatible with public health. At the heart of any reservations about sex education and birth control is an overarching concern for the sanctity of human life - yet the greatest expression of this sentiment is to compromise on what we thought we valued in the sacrifice of what is healthiest.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, aiming to reduce the global adolescent fertility rate to 2.5 births per 1,000 females aged 15-19.
For developing country readers, encourage women to wait until adulthood for marriage and childbirth, prioritising labour force participation and education.
Births attended by skilled health personnel (%)
This indicator reflects a crucial necessity of all the indicators thus far explored relating to maternal and infant health. The goal by 2030 is for all births to be attended by healthcare workers skilled in care during pregnancy, childbirth, and the postpartum period. This could include midwives, medical doctors, obstetricians or nurses. All can respond to any complications related to the pregnancy, offering prenatal care in a doctor’s clinic, hospital, or even a home.
As of 2018, skilled health personnel attend 80% of global births. Off-track in the 2022 SDG Index is most of the African continent, South Asia, and several Southeast Asian and Latin American countries. This indicator is very much consistent with Goal #3 to offer healthcare for all, as birth attendants are often the very first step in the beginning of a new life.
Those countries with major challenges remaining for this indicator need more robust healthcare. We could train a vast labour force in each of these lagging countries, and mobilise them to ensure all receive healthcare - the crucial factor is financing to build the network.
The key task for most readers will be to assist those living in extreme poverty in rural areas. Sometimes this means in middle-income countries with patches of dislocated, remote populations - like Bolivia, the Philippines, Morocco, or Guatemala - all scoring red for this indicator. In 2020, the split between births attended by skilled health personnel was 70% rural versus 90% urban. Our foreign aid must reach these isolated mothers. Further, the governments of these countries must prioritise their domestic resources to ensure they offer healthcare to all corners, inclusive of skilled birth attendants attending all births by 2030.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, aiming for all births to be attended by skilled health personnel by 2030.
For developing country readers, if you’re an expecting reader, ensure a skilled health professional attends your birth, even if the skilled professional is in tandem with a traditional birth attendant.
Surviving infants who received 2 WHO-recommended vaccines (%)
The aim by 2030 is for all infants under 12 months of age to receive their first dose of the measles shot, as well as the third dose of the DPT vaccine, which combines diphtheria, pertussis (aka whooping cough) and tetanus.
The 2022 scores display most of the LDCs and countries in conflict facing challenges on this indicator, as well as any middle-income countries. The WHO estimates 20 million infants have insufficient access to vaccines.
In the instance of LDC countries off-track, we expect DAC readers will pick up the slack to finance this gap to reach 100% coverage by 2030. This includes costs for production, distribution, and administration of the vaccines to infants. We’re inviting a swath of the global population to fall through the cracks when a healthcare system could otherwise offer them coverage. Producing these specific vaccines is an affordable cost to developed world readers - but it is beyond reach for those living at or below subsistence. The developed world also needs to foot the remaining bill for the training or wages for those administering the vaccines.
If you're a parent or guardian in a middle-income country, and have affordable access to the measles and DPT vaccines, please immunise your child with these WHO-recommended vaccines. It may well be that your country’s national routine immunisation program for infants is sub-par. If so, you can contact a government representative to request a more robust national immunisation program, though you otherwise may need to seek out such immunisations out-of-pocket.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, aiming for all surviving infants to receive the 2 WHO-recommended vaccines by 2030.
For middle-income countries off-track, vaccinate your infants younger than 12 months with the measles and DPT vaccines.
Universal health coverage (UHC) Index of service coverage
UHC cuts to the core of Goal #3 in its entirety, aiming for healthcare and well-being for all, with this indicator measuring this with the objective for UHC by 2030.
The indicator includes treatment of the following within the definition of UHC: reproductive, maternal, newborn and child health; infectious diseases and non-communicable diseases.
What can you do to ensure UHC in countries off-track? By now, readers might be able to answer themselves given the hint of the link between LDCs and low UHC. Nevertheless, LDC and lower-middle-income country governments need to mobilise as much of their domestic resources as possible to ensure UHC for their citizens. Although of greater emphasis, we know, is foreign aid. UHC requires money to train personnel, and develop the infrastructure of a health system accessible and affordable to all. Rather than DAC citizens financing the healthcare systems of the neediest countries in perpetuity, LDCs will gain a grasp on the bottom rung of the development ladder with aid, and can then climb up further rungs.
All these countries lagging on the indicator for meeting the aim of UHC by 2030 will have their heads above the poverty line to finance UHC, if high-income country readers meet aid commitments between now and 2030. Fostering the scale, skills, and quality of care necessary everywhere is a complicated, challenging task - but it’s fundamental to the precepts of wellbeing at the core of sustainable development. It requires significant effort, much expertise, a skilled workforce, and the financing to pump the lifeblood through all these much-needed possibilities. We first need to give priority to the most disadvantaged, who are the furthest from coverage.
Summary: For OECD country readers, annually give 0.7% of your gross income as aid, aiming for UHC by 2030.
Subjective well-being (average ladder score, worst 0-10 best)
This is one of my favourite indicators, drawing upon the World Happiness Report (WHR), published by the SDSN since 2012, and co-edited by SDG Index co-author Jeffrey Sachs. The WHR, rather than measuring the value of a country’s output by economic means such as GDP or GNI, instead measures the happiness of the citizenry i.e., GNH (gross national happiness). Bhutan pioneered the metric, including GNH in the country’s constitution in 2008.
Running an economy and society around the idea of happiness used to seem naive - now happiness is in the realm of measurable science, due to the work of the WHR, and the body of work it draws upon.
The WHR offers an index, akin to the SDG Index, based on ladder scores i.e., a measure of 0-10. Surveyors ask respondents how they perceive the well-being of their life, 10 being the highest score.
The long-term aim for this indicator is a score of subjective well-being of 7.6 out of 10. Compared to Finland, the #1 ranked country in the 2022 WHR with a score of 7.8, 7.6 makes for a lofty ambition. Below Finland, only Denmark and Iceland scored 7.6 or over in the 2021 data.
We can rank countries upon their sample size’s score for happiness. There’s a good parallel between the countries topping the WHR’s rankings and those of the SDG Index. The Nordic countries are luminaries in each, Finland taking the top prize for both in 2022. (Although my understanding is the Finns would object to this as ludicrous, and would be more content with the wooden spoon for the measure).
Below are the top 10 rankings of the 2022 WHR and 2022 SDG Index.
















































You can check your happiness by asking yourself the same question the Gallup World Poll employs for subjective well-being: How do you rate your life, 10 being the best, 0 the worst?
Whatever your score, rather than being static, can be improved upon. How do you make yourself happier? It seems an existential question, but you can keep six explanatory factors - measured by the WHR - in mind to cultivate:
GDP per capita

Social support

Healthy life expectancy

Freedom to make life choices

Generosity

Perceptions of corruption

I’ll use my home country of Australia to expand on how the six explanatory measures constitute a happiness score. Australia’s subjective well-being score is 7.1. This is akin to asking an average Australian, “What do you give your life out of 10?”, their response being approximately 7. Of this score of 7.1 out of 10, the below pie chart displays the explaining variables contributing toward this score, the white slice representing the gap between 7.1 and a perfect score of 10.









































Data source: (Helliwell et al., 2022)












Life is more complicated than six explanatory variables, but if you want to make some headway toward boosting your self-reported measure of subjective wellbeing for your life, a place to start could well be:
attempting to increase your income

strengthening or broadening your social ties, including support of others

practise a healthy lifestyle to maximise your lifespan spent in health, free of disease or disability

donate monthly to charity, per the definition of the generosity measure

They may seem simple prescriptions, but try them first, then check in with your ladder score to see if it nudges the needle. Rather than expecting to go from 7 to 9 overnight, it’ll be more incremental and moderate, though progress worth maximising, nevertheless.
All of Africa and South Asia score red for this indicator, as do any LDCs outside those regions, as well as several Middle Eastern countries either in conflict, or bordering a country in conflict.
Afghanistan is the lowest ranking country in the 2022 WHR, a country in conflict at the time of data collection, scoring 2.4 out of 10. The WHR breaks down this score of 2.4 into the explaining variables illustrated in the below pie chart.









































Data source: (Helliwell et al., 2022)












For the LDCs scoring red on this indicator, high-income country readers need to mobilise their foreign aid to boost, over time, the GDP per capita of the LDCs, to better the score of the strongest of the six explaining variables.
Two of the explaining measures further outside our control are the freedom and corruption measures - influential as they are due to the powerlessness one may feel. Like the GDP per capita explanation measure, if it’s too challenging for you to increase income due to external circumstances, this is a cause for poor well-being.
Incorporating all the topics already discussed relating to the Goal #3 indicators will contribute toward the healthy life expectancy explanatory variable. Better yet, if you have affordable access to a mental health professional, like a psychologist, put them to work. Go to your GP first to set off on this path if you think it might be suitable, which your subjective well-being score may well suggest. You may need medical attention for disorders of emotion, cognition, mood or personality. If you live in an LDC, it’s improbable you can afford a psychologist, if there are many in your country at all, but the purpose of SDG #3 is ‘Good Health and Well-being’, which means aiming for everyone to have such access by 2030.
Summary:
For all readers, maximise the explaining variables within your control, aiming for a subjective well-being score of 7.6 by 2030:
offer social support, defined as the ability to rely on someone in a time of need

give to a charity monthly

attempt to increase your income

visit a mental health professional, if affordable and accessible

For OECD country readers, annually give 0.7% of your gross income as aid.
Gap in life expectancy at birth among regions (years) *
This measures the difference in highest and lowest life expectancy between a country’s regions, aiming to narrow the gap to be non-existent by 2030 - ensuring we leave no one behind due to where they live in the country. For this indicator, the OECD countries scoring red are Canada, Colombia, Australia, Turkey and France.
In Canada, this means the gap between the life expectancies of the country’s provinces and territories. In Canada, the highest province or territory for life expectancy is Ontario, the lowest being the northernmost territory, Nunavut, comparable to the life expectancy of Tajikistan.
There’s only one hospital in Nunavut, with 35 beds for the population of 37,000, compared to 17,000 beds in Ontario. Whilst 11% of Ontarians smoke, the Nunavummiut rate is 65%. Between 2000-2007, the age-standardised suicide rate was 71 per 100,000 population, compared to 7 per 100,000 in Ontario, ten times higher. If Nunavut were an independent country, it would have the highest suicide rate in the world. The runner-up is another ethnic Inuit territory, Greenland, separated from Nunavut by the Baffin Bay and Davis Strait. Furthermore, a third of Nunavut Inuit attempt suicide.
The high suicide rates in Nunavut are due to a variety of mental afflictions characterised by a severe emotional reaction to an event, the catalyst of which can be by a variety of conditions, including abuse, neglect, unemployment, school dropout and relationship conflicts.
Inuit in the Canadian Arctic are also eating foods low in nutrient density compared to the amount of energy in foods i.e., the ultra-processed foods explored in the SDG #2 chapter. The Inuit are eating less traditional food, and little fresh fruit and vegetables, reflecting the food insecurity of communities only accessible by air. Furthermore, a third of Inuit children lived below the poverty line in the territory. The reasons for poor nutrition could range from behavioural reasons linked to a legacy of colonial trauma, as well as the general food insecurity reasons synonymous with isolation. Differentials in the life expectancies of indigenous people are common in colonial-settler countries, further evidenced by Australia’s red score for this metric. To remedy the above, the Government of Canada’s Nutrition North Canada works to make nutritious food more accessible and affordable.
Let’s use the same mechanism we have for OECD countries toward LDC countries, whereby the fortunate apportion their relative prosperity to the less fortunate among us i.e., directing the attention of Ontarians to the health outcomes in Nunavummiut.
Summary: For countries off-track, residents of regions with the highest life expectancy can donate to a charity focused on health operating in the region with the lowest low expectancy. The aim is to eliminate the gap in life expectancy at birth among the regions by 2030.
Gap in self-reported health status by income *
This indicator traces health inequalities within countries, on this occasion based on income. It considers those within a country who self-report their health to be ‘good’ or ‘very good’, comparing the poorest fifth to the richest fifth. The goal by 2030 is to close the gap between the upper and lower quintiles’ self-reporting of health. Only the Czech Republic and Baltics states have scored red in the 2022 SDG Index.
We’ll deal with income inequality with a much greater focus in Goal #10 (Reduced Inequalities), but social inclusion is central to all Goals, as well as the concept of sustainable development overall. The Czech Republic is an equal country according to income equality metrics, and its relative equality keeps its SDG Index score amongst the world’s highest. The three Baltic countries are a mix of income equality, though each is off-track to varying levels.
We’re looking at health equity in this indicator, and the social determinants of health. Health inequalities and diseases among the poor could be borne by those who are ageing, lack shelter, have poor sanitation, face social exclusion, or are unemployed, leading to higher levels of chronic conditions and death. Why does this occur? It could result from childhood development, education levels, the time someone spent in the labour force, as well as the type of employment, and healthcare available across their lifetime. Gender inequality, as well as ethnic and racial prejudices, can also be drivers of health inequity, or may arise between those living in metropolitan areas compared to isolated communities, as seen in the regional indicator before. Gaps can also occur due to the health policies of different governments, and social norms surrounding health behaviours.
The Czech Republic and the Baltics have public health insurance, which ought to capture the poor, but is resulting in the poor still self-reporting worse health. Identifiable to the above countries is the post-Soviet nature of each - all either former Soviet republics, or within the Eastern bloc.
To focus on Estonia, self-reporting on health seems consistent with other post-Soviet states, which could be a vestige of the legacy of the heavy industry of communism. Poor self-reporting of health also correlates with low education levels, and for men, living in rural areas. Russian citizenship forms a quarter of the Estonian population, who may import their poor health and NCD outcomes to the more developed Baltics. Research shows being of Russian nationality, as well as education levels of Russian women, have a negative effect on Estonian self-reported health. The research observed another correlation, of an individual's locus of control affecting self-reporting. This could be a by-product of coming of age under the rule of a one-party socialist state, atop actual poor health status. Another correlate was the emotional distress of transitioning from communism to a market economy, a dislocation experienced in all former Soviet and Eastern bloc countries to varying degrees.
To offer a contrast, Estonia and its neighbour across the Baltic Sea, Finland, share similar socioeconomic patterns of health, but self-reporting on health is much poorer in the former. Education may be the key determinant, accompanied by limitations on making healthy decisions, or a sense of the potential for social mobility.
Summary: For readers in countries off-track, and in your country's top income quintile, compensate for the lower income quintile by donating to charities operating within your country focused on health and/or poverty. The aim is to close the gap in self-reported health status by income by 2030.
Daily smokers (% of population aged 15 and over) *
Most OECD countries are close to on track for this indicator in the 2022 SDG Index. The aim by 2030 is for the percentage of people over age 15 smoking daily to be a tenth of the population.
Smoking is the leading preventable cause of death worldwide. The prevalence of tobacco use is higher for those experiencing mental disorder, alcoholism, physical dependence on drugs and homelessness.
If you can avoid using tobacco in adolescence, all the better. If you want to choose to achieve this indicator more than you want to smoke, first contact your GP. Nicotine is such an addictive substance, that you’ll need medical help. Unless you reckon your neural circuitry can outwit the chemistry of nicotine by going cold turkey, you have access to medication and nicotine replacement therapies. You might baulk at the idea of medication, but it means substituting one chemical you heretofore had welcomed into your body for another. Nicotine withdrawal will be an unwelcome experience for you, and those around you, with the attendant anxiety and depression it could induce. There are all manner of alternative ways of ceasing smoking which you might care to try alongside consultations with your GP e.g., acupuncture, hypnosis, herbal medicine, smokeless tobacco, aversion therapy, or even vaccines.
Summary: Quit smoking, aiming for 10.1% or less of the national population aged 15 and over to be daily smokers by 2030.

Dashboard map for 2022 SDG Index Goal #4 ratings. Data source: sdgindex.org






























You and the Global Goals: SDG #4 - Quality Education















Participation rate in pre-primary organized learning (% of children aged 4 to 6)
This indicator defines pre-primary as one year before primary school entry.
Over the past decade, based on research, the recognition has grown as to the importance of early childhood education as among the most important for a child's development to help them thrive later in life.
Many of the countries off-track for the indicator are LDCs - the same countries off-track for the following indicators for primary and secondary schooling. More striking however are the middle-income countries off-track, in the Middle East and North Africa, as well as several post-Soviet states.
Summary:
For OECD country readers, annually give 0.7% of your gross income as aid, aiming for all children aged 4-6 to participate in pre-primary organised learning by 2030.
For developing country readers off-track with children aged 4 to 6, enter your child in early childhood education, where available and affordable.
Net primary enrollment rate (%)
This indicator measures the percentage of school-age kids enrolled in primary school, consistent with the singular target of MDG #2, aiming for 100% enrollment by 2030.
For MDG #2, the aim from the previous 15-year period preceding the SDGs focused upon universal primary education, which reached a primary school net enrolment rate in the developing regions of 91% by 2015. This was an increase of 8% from the beginning of the millennium, with a 20% rise in sub-Saharan Africa during the same period, but still leaving 57 million primary school aged children out of school worldwide in 2015.
As we saw above, the gap to 100% primary enrolment is small, though still in the tens of millions in total numbers. The countries facing major challenges on this indicator are consistent with the Sahel, as well as Syria and neighbouring Jordan, the latter in likelihood due to the presence of Syrian refugees.
Will aid alone make for a 100% net primary enrolment? If we regard the countries with major challenges for this indicator, there are other factors at play, complicating the path to universal primary enrolment e.g., disease, cultural attitudes toward girls’ education, and effects of climate change. As with all issues we’re looking at, each application in a different culture and environment entails trial and error, with the MDG period displaying the challenges facing development in sub-Saharan Africa.
Summary:
For OECD country readers, affirm your annual commitment to give 0.7% of your gross income as aid, aiming for 100% net primary enrolment rate by 2030.
For developing country readers with school age children, enrol your child in primary education, where affordable and available.
Lower secondary completion rate (%)
Here, the distinction is made between enrolment to completion, in this case lower secondary, rather than primary, again aiming for 100% by 2030. The 2020 world total shows a rate of 77% lower secondary school completion.
Lower secondary is the seventh to ninth years of education, with completion of the ninth year classified as ‘basic education’. Upper secondary education begins in the tenth year of education, before any tertiary education. Lower secondary education is a human right, enshrined in the UN Convention on the Rights of the Child, ratified by every UN member state except the USA.
You know by now what you must do if you’re a reader from a DAC member on behalf of the LDC countries with major challenges remaining on this indicator. But what of the middle-income countries? Many of the middle-income countries scoring red for this indicator are on the DAC’s List of ODA Recipients, and there are segments of the population in these countries affected by extreme poverty.
What if you’re a reader from a middle-income country, and your national government fails to ensure your right to accessible and available education, per the Convention on the Rights of the Child?
We all must observe this treaty on behalf of children, obliged to act in their best interests. This means to attempt to provide for your child’s basic needs, to ensure a life of opportunity and social mobility. Anything short of the completion of a basic education (primary and lower secondary education) risks dislocating your child from society.
Summary:
For OECD country readers, affirm your annual commitment to give 0.7% of your gross income as aid, aiming for a 100% lower secondary completion rate.
For developing country readers:
For parents with children enrolled in lower secondary education, ensure your child completes lower secondary.

For adults yet to complete basic education, complete lower secondary education.

Literacy rate (% of population aged 15 to 24)
The definition of literacy for ages 15 to 24 is the ability to read and write a short, simple statement on everyday life, with an understanding of this statement, aiming for 100% literacy by 2030.
We know from our Goal #4 results that LDCs have major challenges remaining, and we know the remedy for the LDCs on this indicator.
Pakistan, a middle-income country, should have a literacy rate above LDC countries. Pakistan’s Constitution codifies the obligation for the state to provide free and compulsory education for all. Yet 22.8 million children, or 44% of the population of school age, are out of school. How do the Pakistani government expect to see any economic growth with such a dismal literacy rate?
Regional differences are one reason, as is gender, a phenomenon popularised by Malala Yousafzai. Pakistan’s north-western border region with Afghanistan offered refuge to the Taliban insurgency, along with their accompanying attitudes toward female education. Further, literacy in the tribal areas of this region is low compared to the country’s metropolises, and national government spending on education is a disappointing 2.9%.
In a country with widespread illiteracy, can prosperity be around the corner, or ever be in reach? Pakistan is an Islamic republic (which differs from a theocracy), combined with a patriarchal societal structure. Pakistan thus leaves half of society on the sideline, when it could be participating in the economy, and educated to a tertiary level, beyond mere literacy.
Addressing any Pakistani readers, I acknowledge 5% of Pakistanis live below the international poverty line of $1.90 a day. This country, with a population nearing a quarter of a trillion, is wanting. Yet the escalator to even a modicum of meeting basic needs, as well as climate change resilience, is education. Without advancing on Goal #4, Pakistan holds the potential to find itself in a similar standard of living in decades to come.
The nature of the country’s values places Islamic principles central, as the state religion, per the Constitution. Pakistani laws must be in harmony with the Quran, and the traditions and practices of Muhammad via constitutional bodies. Yet the government of Pakistan must weigh the advice of these, whilst considering its obligations under the Convention on the Rights of the Child. The same applies to Pakistani citizens. Article 18 of the Universal Declaration of Human Rights enshrines freedom of religion. Two other UN member states are Islamic republics, and a little under 30 UN member states explicate Islam as the state religion within their respective constitutions. Each UN member state must balance their respective state religion with being a party to international treaties. If you’re a Pakistani parent of a child, there is a need to compromise. This may mean acknowledging the limitations of your own education. Enquire within yourself whether those who’ve passed their wisdom on to you could be of a limited education themselves. Humans are fallible, even well-intentioned pious people.
If you find yourself in this scenario, you have a choice to make, which might place you between your religion and the importance of literacy and education. You may perceive the two as incompatible. If you were God, setting the precepts for the humans you created, would you inscribe into the programming of life to keep half of your creations in depravity of knowledge? I expect you’d have the sense to blanch at any belief suggesting as much. You believe in a God who wants the best for everyone. Any suggestion otherwise is due to the interpretation passed down by fallible humans.
Summary: For OECD country readers, affirm your annual commitment to give 0.7% of your gross income as aid, aiming for a 100% literacy rate of the global population aged 15-24 by 2030.
Tertiary educational attainment (% of population aged 25-34) *
Most OECD countries are close to on track for this indicator, aiming for 52.2% of the population aged between 25 and 34 to complete some tertiary education i.e., universities and vocational schools, resulting in an academic certificate, diploma or degree.
If you’re in a country with challenges remaining for this indicator, and between the ages of 25 and 34, consider applying for and completing some tertiary education. Even a certificate at a vocational school ought to provide valuable skills to boost your income in the workforce.
Summary: For readers in countries off-track, aged 25 to 34, complete tertiary education, aiming for 52.2% of the national population aged 25-34 to attain tertiary education by 2030.
PISA Score (worst 0-600 best) *
PISA is the Programme for International Student Assessment, an initiative of the OECD. PISA assesses 15-year-old school students by a standardised test, showing how these students are approaching the end of their compulsory, basic education in lower secondary school. The fields assessed are mathematics, science and reading, averaged to give the PISA score. The 2030 aim for national PISA scores is 525.6, out of the best score of 600.
The Chinese cities of Beijing, Shanghai, and the provinces of Jiangsu and Zhejiang topped all three categories, followed by Singapore in all three categories. Macau, a Chinese city, placed third in all categories, with nearby Hong Kong fourth for mathematics and reading. This strong representation by China is notable for a developing country, in contrast to an OECD country.
The OECD countries off-track are middle-income countries, therefore for parents of 15-year-olds in these countries, encourage your children to focus on their academic performance.
Summary: For readers in countries off-track, who are parents of a child who will be 15-years-old at the time of the next PISA in 2025, encourage your child’s academic performance, aiming for a national PISA score of 525.6.
Variation in science performance explained by socio-economic status (%) *
This indicator measures the extent a student is doing poor in science class because of low socioeconomic status. The long-term objective for the indicator is an 8.3% variation or less in science achievement on the PISA explained by socio-economic status.
What can we expect to see at the lower end of the income and wealth spectrum within a country? Members of the household may be at greater risk of mental illness and/or substance abuse. If a caregiver is in poor health, it's probable to have detrimental effects on a student’s educational attainment. Economic inequality has many negative effects, among them spillover effects on population health. Poorer households may have different parenting styles, sometimes characterised by fewer instances of joint attention in a learning environment. Some households in OECD countries may be lacking an internet connection, a car, a quiet place to study, or a desk and books for schoolwork. All these can hinder a fertile environment in the home for parents to interact with their children and foster learning.
Two countries scored red for this indicator - France and Hungary. The variation in socioeconomic status on science performance for both these countries was 20% - in France's case, a gap of 108 points out of a PISA best score of 600. This is believed to be due to disadvantaged 15-year-olds having lower ambition relative to their academic performance. Only four-fifths in this category expect to complete tertiary education compared to high-achieving, advantaged counterparts - the same being true in Hungary.
In Hungary’s instance, it could be due to the structure of the secondary education model of selective schools, a model shared with neighbouring countries scoring orange for the indicator e.g., Germany, Belgium, Luxembourg, the Czech and Slovak Republic’s, and Switzerland.
The abovementioned European countries divide their secondary education system into gymnasium schools and vocational schools to train students for a trade. Students who’ve completed the ninth year of compulsory education can then join the workforce. We can see how a student from a working-class background may believe themselves to feel destined along this path, or otherwise may relate closer to an aptitude for a vocational trade familiar within their family, and may perceive little incentive to perform well in science.
This may be limiting in some countries though, as the demand for a labour force steeped in STEM subjects (science, technology, engineering, and mathematics) rewards these disciplines with wages and profits. What does this imply about the many streams of secondary education i.e., gymnasium schools and vocational schools? Does it disincentivize scientific performance for lower socioeconomic students? It's possible, if we look at the countries that are off-track for this indicator, yet many of these are the same countries doing best on the SDG Index overall. Furthermore, some European countries using the gymnasium model are on track for this indicator e.g., Finland.
Following lower secondary education in a collège, the French equivalent of the gymnasium is the lycée, in preparation for the baccalauréat . Within the baccalauréat, there are three streams divided by academic discipline, as well as the alternative of the vocational school for apprenticeships. In Hungary, the gymnasium system prevails in preparation for university, as well as ‘secondary vocational school’ and ‘vocational school’.
Summary: For readers in countries off-track:
who are parents of a child who will be 15-years-old at the time of the next PISA in 2025, and are at the lower end of the socioeconomic spectrum in your country, encourage your child’s academic performance in science

of high socioeconomic status, seek out a charity operating within your country focused on supporting education for those of low-socioeconomic status

Underachievers in science (% of 15-year-olds) *
This indicator measures the portion of students scoring below level 2 in the PISA for the science component, equal to 409.54 points out of the total 600. The aim by 2030 is for 10% or fewer OECD country students to score less than 409.5 points on the next PISA in 2025.
Level 2 means a student has “adequate scientific knowledge to provide possible explanations in familiar contexts". To compare to level 1, “students have such a limited scientific knowledge that it can only be applied to a few, familiar situations."
The countries scoring red are the middle-income OECD countries, plus Greece and Israel - both high-income countries, but the latter includes the lower-income Palestinian territories.
What if you live in an OECD country off-track, and suspect your child, who will be 15-years-old at the time of the next science PISA in 2025, may have a learning disability or ADHD? Consult a GP or paediatrician, in consultation with your child’s school. See if special attention in the classroom can remedy potential setbacks, and if the health and education system offer access to extra resources.
Summary: For readers in countries off-track, who are parents of a child who will be 15 years old at the time of the next PISA in 2025:
encourage your child’s academic performance in science

if symptoms of a learning disability or ADHD exist, seek a diagnosis with a GP or paediatrician, in consultation with your child’s school to seek special attention in the classroom