PHM-Exch> Progress stalls on health-related SDGs

[Claudio Schuftan]

From: David <dlegge at phmovement.org>


WHA recognises that the world is not on track to meet the health-related
SDG targets

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<https://mailchi.mp/ef04e622d401/progress-stalls-on-health-related-sdgs?e=916df65fd1>
Progress stalls on health-related Sustainable Development Goals The
unfortunate truth, confronting the recent World Health Assembly, is that
the world is not on track to meet the health-related SDGs.

The widening gap between the promise and the reality was spelled out
clearly in the report prepared by the WHO Secretariat (A72/11 Rev.1
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=5996f9c949&e=916df65fd1>)
which systematically reviewed progress – and the lack of it - across a
broad collection of health-related targets.

The data presented in the official report was echoed in many of the
interventions by member states during the discussion:

   - that the family planning needs of 208 million women are still unmet is
   unacceptable (EU);
   - progress on malaria and multi-drug resistant TB has stalled (Canada,
   EU, Australia);
   - less than adequate progress in NCDs, HIV/AIDS, TB, infant and maternal
   mortality rates (Barbados);
   - inequalities in access to health care and immunisation (Zambia);
   - half of the world’s population do not have full coverage of essential
   health services and just under 100 million are pushed further into poverty
   because of their expenditure on health (EU);
   - unaffordable prices a huge barrier to access to medicines illustrated
   with Hep C (DiNDI);
   - exponential increase of environmental threats such as air, water and
   soil pollution, hazardous chemicals (EU, Canada);
   - climate change (Thailand, Sweden, EU, Canada);
   - water and sanitation (Zambia, EU).

Perhaps the most dramatic picture of the looming failure of the
health-related SDGs was in a document published by WHO in December 2018 (Are
we on track?
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=6f4bcfa17e&e=916df65fd1>)
which compares promise and projection for core SDG indicators: maternal
mortality, infant mortality, TB and malaria incidence, access to modern
methods of contraception, UHC service coverage, unsafe sanitation, and
child stunting.
  New Global Action Plan for health-related SDGs There is very little in
the official reports which explains the shortfalls in the health-related
SDGs, nor were there any insights offered by member state contributions to
the discussion at the WHA.

However, one positive development, which was widely commended during the
discussion, was the proposed Global Action Plan for Healthy Lives and
Well-being for All
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=9b7e637646&e=916df65fd1>
sponsored by 11 global health agencies, including Gavi, the Global Fund,
the Global Financing Facility, UNAIDS, UNDP, UNFPA, UNICEF, Unitaid, UN
Women, the World Bank and WHO. These agencies have been brought together by
WHO, with the support of the presidents of Norway, Germany and Ghana, with
a view to 'accelerating' progress in relation to the health-related SDGs.

The draft Global Action Plan (GAP), which is scheduled to be launched at
the UN General Assembly in September, is structured around three 'strategic
approaches': align, accelerate and account.

*Align* reflects a commitment by the participating agencies to work more
closely together, particularly at the country level, to achieve the
health-related SDGs.

*Accelerate* includes seven cross-cutting areas ('accelerators')
comprising:

   1. Sustainable financing
   <https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=b0120b94b7&e=916df65fd1>
   2. Frontline health systems / Primary Health Care
   <https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=9b4fae5858&e=916df65fd1>
   3. Community and civil society engagement
   <https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=d4a7a1ac36&e=916df65fd1>
   4. Action on the social, political, commercial and environmental
   determinants of health
   <https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=9db3dbe87f&e=916df65fd1>
   5. R&D, innovation and access
   <https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=77fa3445c5&e=916df65fd1>
   6. Data and digital health
   <https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=26f9fd1727&e=916df65fd1>
   7. Innovative programming in fragile and vulnerable states and for
   disease outbreak response
   <https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=5300226a6b&e=916df65fd1>

*Account* refers to the setting of common 'milestones' for health-related
SDG targets.

Among the member states supporting the proposed plan at the WHA were
Canada, China, the EU, Ethiopia, Australia, Germany, Japan and Thailand.

The sole exception was the USA which took offense at the use of the term
'plan' which apparently should only be used for documents which are
explicitly endorsed by member states.
  Fundamental contradictions WHO's Director-General, Dr Tedros, has staked
his legacy on achieving the health related SDGs which he has positioned as
one of the three main priorities of WHO's new program of work
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=6dbda75979&e=916df65fd1>,
his 'triple billion' commitment:

   - Achieving universal health coverage – 1 billion more people benefiting
   from universal health coverage;
   - Addressing health emergencies – 1 billion more people better protected
   from health emergencies;
   - Promoting healthier populations – 1 billion more people enjoying
   better health and well-being.

Dr Tedros is to be commended for committing to outcomes rather than
programs and for harnessing the resources and reach of the 11 participating
agencies to this end.

However, while the Sustainable Development Agenda for 2030 is an inspiring
document there are deep contradictions between the vision of the SDGs and
the daily dynamics of liberalised transnational capitalism: its inability
to act on climate change, its dependence on exploitative trade and
investment relationships, its failure to regulate tax evasion / avoidance,
its cultivation of widening inequality, its macro instabilities, and its
implication in imperial bullying.

The Global Action Plan is a good initiative but much deeper reform will be
needed if we are to achieve 'the world we want'.

For full coverage of the WHA debate over the SDGs see the PHM item
commentary
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=7af00fd1bc&e=916df65fd1>,
which includes the WHO watchers' notes of the debate. Access all of the
papers and debates from the World Health Assembly from the WHO Tracker at
who-track.phmovement.org/wha72
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=16e8c591ae&e=916df65fd1>.
Review previous Update Reports here
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=462d53ab41&e=916df65fd1>.

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