The International Center for Equity in Health (ICEH) stands out among the contributors to the Countdown to 2030 report, published by The Lancet this week, which tracks global progress in health and nutrition for women, children, and adolescents, with a special focus on Sub-Saharan Africa. The 2025 edition delivers a detailed analysis of achievements and unresolved issues, underlining the central role of equity and service quality in health outcomes.

ICEH’s Professor Aluisio J.D. Barros is one of the lead authors of the report and coordinated the development of Section 3, focused on coverage and equity. Researchers Cesar Victora, Cauane Blumenberg, Leonardo Ferreira, Franciele Hellwig, and Ghada E. Saad, also from the ICEH and the Postgraduate Program in Epidemiology at UFPel, co-authored the report.

The findings from Section 3 reveal that while coverage of essential maternal, neonatal, and child health (MNCH) interventions has continued to increase during the Sustainable Development Goal (SDG) period (2016–2023), the pace has slowed compared to the Millennium Development Goal (MDG) era. Notably, West and Central Africa showed an exception to this trend, achieving accelerated gains in the SDG period.

Importantly, the report documents significant reductions in wealth-based inequalities in health coverage across most low- and middle-income countries—progress largely driven by faster improvements among the poorest populations. However, subnational disparities remain stark, with roughly half of the countries experiencing increasing geographic inequalities. These inequities highlight the urgent need for context-specific policies to ensure that progress reaches all population groups.

ICEH also supported the development of novel indicators, such as ANCq+—a content-qualified measure of antenatal care—and co-coverage metrics for maternal and newborn health. These tools allowed for deeper insights into quality of care, which remains difficult to assess in many countries due to limited data. Results suggest overall improvements in care quality, but highlight that key groups, such as adolescents, continue to face lower access to services like family planning.

One area of concern is the persistent underuse of caesarean sections among the poorest women in low-income countries, contrasted with overuse in upper-middle-income settings. This imbalance reflects both unmet needs and the inefficient allocation of health resources—an issue that calls for a stronger emphasis on quality and emergency obstetric care.

Alongside the report, The Lancet also published a Comment titled “Broken Promises: The USA Foreign Aid Freeze Threatens Women’s, Children’s, and Adolescents’ Health”, coauthored by the report’s lead authors, including Aluisio Barros. The comment issues a stark warning: abrupt and large-scale cuts in foreign aid, particularly from the U.S., pose a severe threat to access to life-saving health services in many low- and middle-income countries. The authors argue that these funding cuts undermine years of progress in maternal and child health and could result in increased mortality—especially among the poorest and most vulnerable. They call for renewed international solidarity and sustainable financing to protect hard-won gains.

Read the full report in The Lancet

Read the Comment Broken Promises