The goals are set the targets laid out The fighting

The goals are set; the targets laid out. The fighting is over. In just over a week\'s time, heads of state worldwide will commit to the , with its 17 Sustainable Development Goals (SDGs) and 169 associated targets. Country representatives will resolve to do everything from ending poverty and hunger everywhere by 2030 to recognising the importance of sport in sustainable development. There will be no doubt be relief, euphoria, and celebrations. But what happens next? Come Jan 1, 2016, what will countries be doing differently? The Millennium Development Goals and their numerical targets were global in nature and not meant to be achievable by every individual country, but they were inevitably taken as such, leaving countries that had no realistic hope of achieving the targets to do as best they could. The sense of futility inherent in this sort of arrangement must have been hard to overcome. As we now know, the SDGs will also be numerical and global in nature, as in “By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births”. Taking maternal mortality as an example, studies have already suggested how the feeling of futility for countries could quite easily continue. One showed that, even if all low-income and middle-income countries were able to equal the aspirational rates of decline in maternal mortality seen in the best-performing such countries between 1990 and 2013, fewer than half would meet the Commission on Investing in Health\'s more conservative maternal mortality target of 90 per 100 000 livebirths. Another confirmed that, if every country progressed from 2010 to 2030 at the same rate as the top performer in the region between 1990 and 2010, only six of 43 sub-Saharan African countries would reach the SDG target of 70 per 100 000 livebirths. Suggestions on how to guide national policy makers have been made. raised the idea of setting individually designed and tracked 5-year milestones for countries, informed by their initial maternal mortality rate. Countries with ratios lower than 100 per 100 000, for example, could focus on purchase Obeticholic Acid subgroups within which the maternal mortality ratios are higher than the national one. have proposed individualised targets based on each country\'s past progress and projected economic growth. Yet the draft 2030 Agenda document merely encourages in the vaguest of terms “all member states to develop as soon as practicable ambitious national responses to the overall implementation of this Agenda”.
Validation of model predictions against real-world data is worthwhile, yet few have been able, or are brave enough, to actually do it. Thankfully, in Jeffrey Eaton and colleagues have stepped up to the challenge, using ten models calibrated to data from 2002–12 to predict HIV prevalence in South Africa in 2012 before the release of estimates from the national household survey done in 2012.
In , Kenneth Hill and colleagues present the first empirical analysis of global mortality levels and numbers of deaths in children aged 5–14 years. Assessments of mortality in this age range have been neglected until recently, because this is when human mortality risks reach their minimum levels through the lifespan. However, interest in older children and adolescence has increased, because evidence exists that mortality rates in this age range have not declined as fast as for the under-5 age range. Age 5–14 years represents an important period of social and educational development and the onset of puberty, and the older adolescent age group 15–19 years is also the period of transition to adult risk exposures (eg, driving, alcohol and drugs, reproductive risks, workplace risks, etc). Both WHO and UNICEF have published major reports about adolescent health and mortality. Existing global estimates rely heavily on model life-tables that are calibrated with mortality rates from children (<5 years) and adults (15–59 years) as inputs, so the Article by Hill and colleagues that compares these global estimates (which underpin estimates of deaths and causes of deaths in older children from the UN and the Institute for Health Metrics and Evaluation [IHME]) with the empirical evidence from a very large amount of survey data plus census data for China, is of substantial interest. The investigators extend the analysis of birth-history data obtained in 194 Demographic and Health Surveys in 84 countries to estimate mortality risks for children in the age groups 5–9 and 10–14 years.