The UN’s Sustainable Development Goals (SDGs), adopted in 2015, provide an international framework to move by 2030 toward more equitable, peaceful, resilient, and prosperous societies—while living within sustainable planetary boundaries. As the UN celebrates its 75th anniversary and a third of the SDG timeline has passed, The Sustainable Development Goals Report 2020—prepared by the UN Department of Economic and Social Affairs in collaboration with experts and international agencies— tells a story of tentative but insufficient progress, and warns of the regressive impact of the coronavirus pandemic.

According to the report, COVID-19 threatens to reverse the progress of SDG 3, which aims to ensure healthy lives and wellbeing for all. During the crisis, 70 countries have halted childhood vaccination programmes, and in many places, health services for cancer screening, family planning, or non-COVID-19 infectious diseases have been interrupted or are being neglected. Health service disruptions could reverse decades of improvement, warns the report. Allowing people to slip through these service gaps could affect population health for years to come.

Even before COVID-19 the world was off track to end poverty by 2030 under SDG 1, with projections suggesting that 6% of the global population would still be living in extreme poverty in 2030. Now, an estimated 71 million additional people could be living in extreme poverty due to COVID-19. Although income inequality has been falling in some countries, a global economic recession in the wake of the pandemic could push millions back into poverty and exacerbate inequalities. The most susceptible groups are being hit hardest by the pandemic, threatening SDG 10. Similarly, the ambition under SDG 2 to end hunger was faltering before COVID-19—the population affected by food insecurity had risen between 2014 and 2018—but the COVID-19 crisis has added to pressure on production, supply chains, and household incomes, with the poorest being most affected. Access to water and sanitation (SDG 6) remains a major health issue. 2·2 billion people remain without safe drinking water and the COVID-19 crisis has highlighted lack of access to sanitation for billions.

Tackling global poverty and water and food scarcity is intrinsically linked to mitigating climate and land-use change. However, as the SDGs report shows, the world is off track to meet the goals toward environmental sustainability encompassed by SDGs 7–9 and 11–15. Most countries are not meeting their commitments to limit greenhouse gas emissions. We are in danger of missing targets to improve urban environments by reducing the number of people living in slums, increasing access to public transport, and reducing air pollution. Aims towards sustainable and inclusive economic growth, energy provision, and infrastructure development had all been falling short before COVID-19 and face considerable setbacks in the shadow of an economic recession.

The aim of SDG 4—to achieve inclusive and equitable access to education—also looks likely to be missed, with a projection that more than 200 million children will still be out of education by 2030. Most of the world’s children have been deprived of formal education during the COVID-19 outbreak—a legacy that could threaten the SDGs’ underlying ambition to leave no one behind. The world has made progress on SDG 5’s gender equality goals, with fewer girls being forced into early marriage and more women entering leadership roles. However, women’s wellbeing has suffered during the COVID-19 outbreak, with incidences of domestic violence increasing by 30% in some countries and a greater demand on women for unpaid care work.

Finally, reaching the SDGs will be impossible without international cooperation. The political tensions stoked by COVID-19 and a trend toward hardening of national borders could threaten SDG 16 to promote peace and safety from violence and SDG 17 to strengthen international partnerships.

Achieving the transformative vision of the SDGs by 2030 requires a major realignment of most countries’ national priorities toward long-term, cooperative, and drastically accelerated action. For António Guterres, UN Secretary-General, “Everything we do during and after this crisis must be with a strong focus on building more equal, inclusive and sustainable economies and societies that are more resilient in the face of pandemics, climate change, and the many other global challenges we face.” The intersecting challenges of health and sustainability might never have been clearer: an opportunity not to be missed.