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Critical perspectives on SDG 3

This week we have seen how health is fundamental to the achievement of sustainable development. We have also explored how many of the other SDGs are intertwined with SDG 3.

For example, we saw that health and well-being cannot be achieved without peace (SDG 16). SDG 2 (Zero Hunger) is also interlinked with achieving health in places like Uganda.

We have also seen the how important child and maternal health is for communities around the world, and considered what the future of healthcare will bring.

But it is important to think critically about SDG 3.

Is SDG 3 too limited?

Health is a very broad concept. Think for a moment what good health means to you, to your family, to your friends.

In fact, health is a human right that we can read in the UN Universal Declaration of Human Rights (1948)

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services.”

SDG 3 doesn’t focus on all aspects of health and it would be very difficult to capture every aspect. Instead SDG 3, as with the other goals, is a political agenda led by the UN with the support of all the governments of the world. Choices have been made about what to prioritise. This is a necessary part of setting a common agenda, but leaving out some aspects of health could cause problems in the future.

SDGs and resources

Prioritising some aspects of health over others will always disadvantage some people. It’s true that the SDG framework, like the MDG framework before it, will provide a clear focus for the concentration of resources and efforts up to 2030.

Some stakeholders will be satisfied that their interests are adequately represented by this agenda, while others will be extremely concerned by the exclusion of other challenges.

For example, the MDGs were critiqued by the wider health community for adopting a narrow focus on specific diseases, most notably HIV, TB, and malaria. This provoked the adoption of the term “Neglected Tropical Diseases’” by those who were very concerned that progress on tackling other diseases would take a back seat. However, this focus allowed for great progress in tackling HIV, TB, and malaria with a global decline of 45% in new HIV infections since 2000.

Image from The Global Fund which highlights that 9.2 million people are on anti-retro viral drugs for HIV, 15.1 million people have received TB treatment, and 659 million mosquito nets have been distributed. © The Global Fund (2016) Results Report. The Global Fund. Accessed 12/07/2017

The focus has since been broadened out in the SDGs, which now include the “Neglected Tropical Diseases” and NCDs as well as maintaining targets to improve the rates and impact of AIDS, TB, and malaria.

Will SDG 3 leave people behind?

One advantage of the SDGs is that they draw a line in the sand. Earlier this week we discussed some of the ways we measure health, and the importance of having a baseline to judge the impact of our efforts to tackle health challenges. We will continue to use key metrics like life expectancy, and the prevalence and incidence of various diseases, in order to see whether the SDGs actually make a difference. As well as quantitative measures and measuring progress towards the health targets, we discussed the need to find ways to ensure that the quality of people’s’ lives improves as we achieve the health SDGs. In Week 4, we will be looking at measuring impact in more detail.

We also saw how an increase in a country’s GDP is associated with improved health as measured by life expectancy.

However, distribution of resources within a country is crucial – the wealthy can be healthy while the poor suffer within the country, and sometimes even the same neighbourhood. As we seek to achieve the health targets we must keep in mind the overall agenda of the SDGs “that no-one will be left behind.”

In seeking to achieve good health for all we are facing several different types of problems. We already have some of the solutions, but we need to ensure that everyone can access them

For example, we know that ARV medication can enable those infected with HIV to achieve almost a normal life expectancy. However, some people still die from AIDS in our world as they do not have access to these medicines.

What challenges will the future hold?

There are other challenges that we don’t yet know how to solve. As we started to consider the future of health and healthcare, we saw a landscape of evolving threats like antibiotic resistance. We also saw the power of evolving solutions like personalised medicines. We need to learn together how to solve tough challenges, and how to tackle as yet unknown challenges that will emerge.

It is in light of these unknown challenges that SDG 17 becomes crucially important.

“Strengthen the means of implementation and revitalise the global partnership for sustainable development.”

Image of SDG 17 - a venn diagram on blue background

It is through a combination of collectively finding new solutions and ensuring nobody is left behind that we will ultimately achieve good health. SDG 3 provides us with a good, if imperfect, framework to work together towards this essential human goal.

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This article is from the free online course:

Achieving Sustainable Development

Trinity College Dublin