The Sustainable Development Goals (SDGs) have positioned themselves as a worthier and mightier successor to the Millennium Development Goals (MDGs). By broadening the scope and vision of targets to be achieved, they have thrust an inspiring onus on member nations to maximize the potential of holistic development for their populations. Sure-footed, purposive and accountable national and local level actions on commitments by governments for the 2030 SDG agenda are inevitable to ensure their fruition. Tracking the progress towards the achievement of these targets is besieged with challenges on the account of indicators pre-defined internationally and collating and relating national data sets to align with these indicators for reliable and meaningful information.
Sustainable Development Goal 3 (SDG 3) aims at ensuring healthy lives and promoting well-being at all ages. Through the purview of 13 targets and 27 indicators it attempts to address the wide spectrum of public health concerns across the globe encompassing areas such as maternal and child health, non-communicable diseases and extending upto health information systems research and development. Nations have been reporting their progress on SDG 3 through the annual Voluntary National Reviews (VNR’s) submitted to the High Level Political Forum (HLPF)on Sustainable Development. These provide valuable insights to the status of health programs in nations, innovative actions adopted to facilitate achievement of targets and trajectories to be charted ahead.
WHO has reviewed the status of 31 health and health–related indicators in World Health Statistics 2016 and updated the information in World Health Statistics 2017. It identifies that major challenges remain in terms of reducing maternal, newborn and child mortality, improving nutrition, ensuring universal access to sexual and reproductive health and rights, and making further progress in the battle against communicable diseases such as HIV/AIDS and other sexually transmitted infections, tuberculosis, malaria, neglected tropical diseases and hepatitis.
That millions of mothers continue to have unsafe pregnancies is re-enforced by high maternal mortality rates prevalent in Sub-Saharan Africa and South Asia. Newborns in these regions face equal threats of survival upto 5 years of age. Despite global trends of decline in HIV/AIDS, Tuberculosis and Malaria, Sub-Saharan Africa and South Asia continue to bear the maximum burden of these cases. Low and middle income countries contribute to 80% of the global mortality on account of non-communicable diseases. Substance abuse persists to position itself as a major public health concern and mortality on account of suicides continues to rise. Road traffic accidents have accounted for the highest number of deaths in the age group between 15-49 years. Adolescent girls in two-thirds of the world do not have adequate access to contraceptive measures to prevent undesirable pregnancies, thereby endangering their health and lives. While low and middle income nations continue to explore strategies for Universal Health Coverage (UHC), health expenditure of their citizens is primarily characterized by out-of-pocket expenditure. Deaths due to unintentional poisoning have seen a welcome 33 percent reduction globally over the past two decades. States have strived to strengthen legislative and additional measures to combat tobacco consumption but obtaining reliable estimates on factual global prevalence remains tricky. While external research and developmental funding continues to swell for key communicable and non-communicable diseases (NCDs), a host of others with significant mortality and morbidity rates remain neglected. A lot needs to be done further to enable equitable access to essential and life-saving drugs in their generic forms. Shortage of health human resources exist in over 40 percent of nations globally. Emergency preparedness of nations towards health risks remains inconsistent across the globe.
Appreciating the complexities involved in aligning the efforts carried out by nations for achieving the SDG’s, the World Health Organization (WHO) has laid down six-lines of action for member States to enable the same. These are monitoring health related SDG’s, health system strengthening for Universal Health Coverage, health equity, sustainable health financing, innovation and research and development. Countries need to ensure the implementation of routine, comprehensive health examination surveys to ensure the availability of robust and reliable data. Committed and coordinated investments in health governance and financing; health workforce, medicines and other health technologies; and health information systems can facilitate meaningful strengthening of health systems.It is imperative to obtain data for key disadvantaged subgroups within countries and health inequality measures calculated .Public financing should constitute the core of all efforts towards UHC. Research and Development needs to be guided by factual scenario of public health burden in nations, inclusive of other contributors to mortality within NCDs and neglected tropical diseases. Cross-sectoral convergence will form the bedrock of sustainable health and well-being. Leadership would constitute the most crucial factor for the realization of all of the above. It is therefore binding upon countries and their leadership to imbibe the enormity of the task ahead of them and seize the opportunity to steer purposive, consistent and accountable actions for nearing towards the 2030 targets.
My co-authored paper along with Dr. Balakrishna Pisupati of FLEDGE will be published soon that focuses on gaps in the current indicator framework and how actions can be better coordinated and monitored at national and local levels.