In September, the Bill and Melinda Gates Foundation released the inaugural “Goalkeepers” report – an annual update aimed at accelerating progress toward achieving the Sustainable Development Goals (SDGs). The report tracks 18 data points selected from the 244 indicators in the SDGs that are “fundamental to people’s health and wellbeing.”

The report includes graphs of the progress made so far on the 18 indicators, and how this progress will accelerate or decline depending on funding. These graphs represent three different scenarios: a best case where investments increase, a status quo case where investments hold at current levels, and a worst case where investments are reduced.

At the beginning of the report, Melinda Gates calls out child mortality as one of the most emblematic indicators of them all. In recent years, an estimated 100 million childhood deaths have been averted, due in large part to vaccines and improved newborn care practices. As the graph above shows, these developments have helped reduce the number of under-5 deaths per 1,000 live births from 85 in 1990 to 38 in 2016. If global investment increases, this number could drop to as low as 19 deaths per 1,000 live births by the year of 2030. If investments decrease, progress would slow so that there would be 31 deaths per 1,000 live births.

Recent studies estimate that 1.5 million of the children who will die next year will die from diseases that can be prevented with vaccines. Many countries, including Bangladesh, Honduras and Tanzania, immunize more than 90 percent of their children, but there are still nearly 20 million children in the world who aren’t immunized at all. This in part explain why measles, preventable with a vaccine that costs less than 20 cents, still kills almost 150,000 children every year. 

The burden of such vaccine-preventable diseases is disproportionally felt by less prosperous countries. Populations in countries with a low socio-demographic index – those with lower income per capita, education attainment and total fertility rate – are less likely to be covered by lifesaving vaccines. In the years ahead, global health leaders must tackle lingering inequities by increasing efforts to improve access to vaccines in historically neglected communities.

When it comes to achieving these goals, Bill and Melinda Gates maintain that “progress is possible, but not inevitable.” The Gates Foundation has committed to releasing this report on an annual basis until 2030 to identify where progress is being made, and where the global health community must increase efforts in order to achieve the SDGs. The question this report ultimately poses is, now that we know what it takes to provide millions of people the opportunity to thrive, do we have the commitment to see that become a reality?


Photo and graphs courtesy of the Bill and Melinda Gates Foundation