Challenges and solutions for developing countries in promoting global health and achieving SDG 3

Abstract

The Sustainable Development Goal 3 (SDG 3), introduced by United Nations and supported by World Health Organization to ensure healthy lives and promote well-being for individuals of all ages, has become increasingly challenging to achieve. The COVID-19 pandemic has disrupted healthcare systems and overwhelmed medical resources, intensifying health inequalities worldwide. As a result, achieving SDG 3 has become more complex and difficult than ever before.¹ The current state of global health reflects significant issues and gaps in achieving the SDG 3 targets. For instance, the global maternal mortality ratio, which only slightly decreased from 227 to 223 per 100,000 live births between 2015 and 2020, indicates insufficient progress towards the target of 70 per 100,000 by 2030. Additionally, while the under-five mortality rate dropped to 37 per 1,000 live births in 2022, and neonatal mortality decreased to 17 per 1,000 live births, significant disparities remain. The high rates of communicable diseases, with 1.3 million new HIV infections and 249 million malaria cases in 2022, highlight persistent global health threats. Drug treatment coverage fell from 11% in 2015 to under 9% in 2022, and vaccination rates for diphtheria, tetanus, pertussis and measles remain below pre-pandemic levels.² These figures emphasize the need for intensified global efforts, increased investment, and focused interventions to address these disparities and achieve the SDG 3 targets.  

Despite significant efforts and advancements by developed nations, the overall state and dynamics of global health are suboptimal. The focus on specific health-related challenges in these countries often overshadows critical issues in developing regions, such as the lack of new treatments for tuberculosis.³ This phenomenon impedes the collective effort required to address the global health inequities and delays progress toward achieving SDG 3 targets. The COVID-19 pandemic has demonstrated the interconnectedness of the world and shown that without active and robust participation from developing countries, achieving global health targets is extremely difficult.^4,5

However, involving low- and lower-middle-income countries (LICs and LMICs) in building a more resilient global health framework is a gigantic task that requires addressing the unique challenges these nations face in achieving SDG 3.⁶ These countries are struggling with a range of health-related challenges, including poverty, inadequate access to clean water, maternal and child health issues, and increasing prevalence of infectious and non-communicable diseases.⁷ Additionally, access to healthcare is uneven, leading to significant disparities among different population groups, particularly in rural areas.^8,9

A major hurdle in these countries is poor governance, which obstructs effective health management and appropriate resource allocation.¹⁰ This issue is further aggravated by the inadequate healthcare infrastructure, including insufficient facilities, outdated equipment, and a significant shortage of skilled health workers, resulting in compromised quality of care.^11,12 A key factor exacerbating the situation is brain drain, driven by low salaries, poor working conditions, and limited career advancement opportunities, which compel healthcare workers to leave their home countries.¹³ Financial constraints exacerbate these problems, limiting the capacity to invest in and sustain essential health services.¹⁴ Additionally, despite facing significant challenges in achieving the SDGs, LICs and LMICs contribute minimally to research on local issues related to achieving the SDG 3 targets, highlighting a global misalignment.¹¹  The existing health data from local research in LMICs often raises concerns about quality and accuracy, making it risky to rely on outdated or unreliable information for aggregation, estimation, and modeling.^12,15-18

Addressing these complex challenges requires a coordinated strategy that leverages local strengths and fosters international cooperation. Advancing global health in developing countries demands a comprehensive approach, incorporating innovation, local research, and effective collaboration. The post-pandemic era calls for systematic solutions through reclassifying SDG priorities, coordinating resources, and promoting collaboration across economic, technological, cultural, and political sectors.¹⁹

Prioritizing local research and development is essential for tailoring interventions to the specific health needs of LICs and LMICs, where health issues may differ significantly from those in higher-income countries.¹¹ Local research can provide valuable insights into the unique health challenges faced by communities. While, regional and multinational collaboration can strengthen the disease control, facilitate knowledge sharing, and promote collective solutions to common problems.²⁰

Innovative financing mechanisms and broader access to affordable health insurance can significantly improve service delivery.²¹ Additionally, strengthening health information systems, and supporting local innovations tailored to specific needs can drive further progress.⁵ Tackling health inequities and investing in preventive care are crucial for reducing disparities and enhancing overall health outcomes.²² Such comprehensive efforts not only benefit local health systems but also make meaningful contributions to global health.

No doubt, the journey toward achieving SDG 3 is loaded with challenges, particularly for developing countries. However, by strengthening healthcare systems, implementing good governance, fostering local research, and embracing international cooperation, these nations can overcome their own health challenges and make substantial contributions to the global health progress. The global community must recognize that the health of the world is interconnected, and the success of SDG 3 hinges on our collective efforts to support and uplift the most vulnerable populations.