<div dir="ltr"><div dir="ltr"><div class="gmail_default" style="font-size:large"><h1 dir="ltr" style="line-height:1.38;margin-top:10pt;margin-bottom:10pt" id="gmail-docs-internal-guid-b869ee4e-7fff-77b6-8375-a2d7f434c441"><span style="font-size:16pt;font-family:"Trebuchet MS";color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">PHM Comment</span></h1><h2 dir="ltr" style="line-height:1.38;margin-top:10pt;margin-bottom:10pt"><span style="font-size:13pt;font-family:"Trebuchet MS";color:rgb(0,0,0);background-color:transparent;font-weight:700;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">SDG shortfalls point to core contradiction</span></h2><h1 dir="ltr" style="line-height:1.38;margin-top:10pt;margin-bottom:10pt"><span style="font-size:16pt;font-family:"Trebuchet MS";color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Notes for discussion at WHA72, WHO, end May 2019</span></h1><div><font size="2">(The links refer to documents in the WHO website)</font></div><div><font size="2"><br></font></div><div><span style="background-color:rgb(255,255,0)"><font size="2"><font size="4">Your feedback welcome; to be sent to David Legge <<a href="mailto:dlegge@phmovement.org">dlegge@phmovement.org</a>></font></font><br></span></div><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="background-color:rgb(255,255,0)"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"></span></span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Part I of </span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">A72/11</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> is a burning indictment of the health consequences of the prevailing global governance regime. Likewise the more detailed figures provided in </span><a href="https://www.who.int/gho/publications/world_health_statistics/2018/en/" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">WHS18</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> and the actual 2030 targets here.   </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Part I of </span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">A72/11</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">needs to be read far more widely than just within WHO.  Health science students and practitioners should read this and ask why. Journalists should read and ask why. Parliamentarians should read and ask why.</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Unfortunately </span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">A72/11</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> does not seek to explain the looming shortfalls in the SDG targets. </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Various reports including the </span><a href="http://sdgindex.org/" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">SDG Index and Dashboard</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> report show that no country is on track to achieve the SDGs by 2030. In fact the number of people living in poverty in Africa is increasing; likewise the number of children who are stunted. Global maternal mortality (now 216 per 100,000 live births) is unlikely to reach the target of 70 by 2030 if the rate in Africa remains high (currently 542). </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Part II lists a range of WHO programs, projects and engagements and seeks to demonstrate how, through these activities, WHO is contributing to the achievement of the SDGs. Many of these are admirable initiatives and WHO staff are to be congratulated for their commitment and achievement. </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Unfortunately, despite these valiant efforts, in many areas the shortfalls with respect to achieving the health related targets are growing. </span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">A72/11</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> does not seek to explain these widening shortfalls.  Simply listing all of the activities which WHO is contributing to is not enough. </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">The key to understanding the widening shortfalls in achievement is the contradiction between the humanistic aspirations of the SDGs and the dynamics of liberalised transnational capitalism. </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt;margin-left:36pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Simply measuring poverty distracts attention from the distribution of global wealth and global income and the dynamics which maintain extreme inequalities of wealth and income;</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt;margin-left:36pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Simply measuring stunting distracts attention from the world food system including protection and price supports in the rich world; the capture of arable land, water, and energy to over-feed the rich; the global structures which drive small farmers off their land.</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt;margin-left:36pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Simply measuring health care impoverishment distracts attention from the global forces, political and economic, which extract the wealth of resource rich countries leaving governments without the fiscal capacity to underwrite health care costs; which enforce high prices of medicines in order to maintain pharma profits and export earnings.   </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt;margin-left:36pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Simply noting the impact of global warming on food production and environmental disaster distracts attention from the corporate and political forces seeking to prevent and defer action on greenhouse gas emissions. </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">The SDGs provide an inspiring vision of ‘the world we want’. However, they also serve to distract attention from the economic and political forces which are preventing the realisation of this vision. In effect they are helping to maintain an appearance of good faith and commitment on the part of those who are in effect working to prevent the achievement of the goals. This is the legitimation function of the SDGs. </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">PHM urges member state delegates to speak truth to power at the Health Assembly.</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">PHM urges health activists around the world to raise public awareness and lobby their governments around the disaster that is looming behind the language of ‘sustainable development’.  Key talking points in such advocacy include: </span></p><ul style="margin-top:0pt;margin-bottom:0pt"><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">insist on naming liberalised transnational capitalism as a failed economic system (driving widening inequality, deepening the imbalances between productive capacity and consumption, increasing financial fragility and deepening our peonage to the banks through increasing debt);</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">insist on naming neoliberalism as a policy package (austerity, small government, privatisation, tax competition and corporate privilege) being implemented in order to protect the transnational corporations and preserve the privileges of the transnational capitalist elite;  </span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">recognise the contradictions between the neoliberal program on the one hand and the goals of reducing poverty, promoting Health for All, and mitigating climate change on the other;</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">reject the bizarre assumption that the SDGs can be paid for through increased economic growth (as measured by GDP) without attention to the harms or benefits of the market transactions so measured;</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">insist on the need for a New International Economic Order as called for in the 1978 </span><a href="https://www.who.int/publications/almaata_declaration_en.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">Alma-Ata Declaration</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> (and completely ignored in the October 2018 </span><a href="https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">Astana Declaration</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">);</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">insist on naming the xenophobic backlash, and the populist demagoguery which is stoking it, as barriers to effective action on the SDGs; and</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">continue to denounce the restrictions imposed on WHO’s capacity and its voice by the donor chokehold and the ACs freeze.</span></p></li></ul><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">These issues are all strikingly absent from </span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">A72/11</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">. </span></p><h2 dir="ltr" style="line-height:1.38;margin-top:10pt;margin-bottom:10pt"><span style="font-size:13pt;font-family:"Trebuchet MS";color:rgb(0,0,0);background-color:transparent;font-weight:700;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Internal contradictions</span></h2><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">In previous commentaries we have focused on the contradictions within and across the SDGs themselves.  These remain important. </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">See </span><a href="https://docs.google.com/document/d/1Hy64u7j2T6f0flFdxglfh_-UKwLJd7vu7_0vktnWftk/edit?usp=sharing" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">PHM comment on Item 31.2 at WHA69</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> which highlighted:</span></p><ul style="margin-top:0pt;margin-bottom:0pt"><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Goal 12 which promises sustainable consumption and production but lacks any drivers to achieve this;</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Goal 8 which promises high rates of economic growth but ignores the contradictions between economic growth and ecological sustainability; and</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">the contradictions between the SDGs and the real effects of ‘free trade’;</span></p></li></ul><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">See also </span><a href="https://docs.google.com/document/d/1710S9ZzSn5W_g1Y6H5sdQ-PHjcaByPqn4Ant8K9rCeA/edit?usp=sharing" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">PHM comment on Item 16.1 at WHA70</span></a><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> which highlighted:</span></p><ul style="margin-top:0pt;margin-bottom:0pt"><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">the need for a real world ‘theory of change’ regarding how the SDGs could be achieved;</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">the dangers of the drive towards ‘multi-stakeholder partnerships’, as in SDG17.16 and 17.17, which projects universal beneficence and completely ignores the Trojan horse functions of many such ‘partnerships’;</span></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">the importance of following the health implications of </span><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:italic;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">all</span><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> of the SDGs.</span></p></li></ul><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">Two of the chapters in the current Global Health Watch</span><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> also carry powerful criticisms of the SDGs:</span></p><ul style="margin-top:0pt;margin-bottom:0pt"><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">A1: </span><a href="https://phmovement.org/wp-content/uploads/2018/07/A1.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">Sustainable Development Goals in the age of Neoliberalism</span></a></p></li><li dir="ltr" style="list-style-type:disc;font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">A2: </span><a href="https://phmovement.org/wp-content/uploads/2018/07/A2.pdf" style="text-decoration:none"><span style="font-size:11pt;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline;white-space:pre-wrap">‘Leave No One Behind’ — are SDGs the way forward?</span></a></p></li></ul><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">SDG8 proposes that the cost of meeting the rest of the goals will be met through ‘sustained per capita economic growth’.  GHW comments that the assumed metric, GDP, is a measure of market transactions regardless of their contribution to ecological sustainability or human development (or health). Manufacturing and deploying weapons of mass destruction makes a powerful contribution to GDP.  </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">SDG8 calls for full employment (Target 8.5) and for ‘higher levels of economic productivity’ (‘increase in real GDP per employed person’). This combination of targets ignores the role of productivity increases (as measured) in creating unemployment!  Conventional economic theory assumes that the labour displaced by increased productivity will simply be re-employed in new forms of better-paying work. What such theory disregards is the massive displacement of agricultural labour from ‘increased productivity’ in agriculture and the huge mobilisation of Third World workers (displaced from agriculture) in global manufacturing: “too many workers competing for too few jobs to produce too many goods or services for too few consumers with too little income to afford them without increasing their already high levels of personal debt”.  </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">GHW5 also comments on the continuing call for increased ‘development assistance’ as a key pathway to funding the SDGs. This strategy has failed to impact on sustainable development over several decades even while fragmenting health systems and placing huge administrative burdens of governments.  Meanwhile no action is proposed on tax evasion through transfer pricing and tax havens nor on the pressures of tax competition and corporate tax extortion which have held back tax revenues and public spending. </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">GHW5 also comments on principle of reciprocity (non-discrimination) in the current regime of trade agreements; a principle which treats poor countries the same as rich countries despite massive differences in economic and political power. The New International Economic Order, which features in the Alma-Ata Declaration (and is notably missing from the 2018 Astana Declaration), envisaged discrimination in favour of developing countries to be structured into a rules based trading regime. Not only are modern trade agreements non-discriminatory (in the sense of including few or no provisions for ‘special and differential treatment’) but they discriminate blatantly in favour of the rich countries through extreme IP provisions, regulatory harmonisation and investor protection.  </span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap">GHW5 also addresses the difficult topic of population control. It is established that family sizes fall with economic development and the provision of social protection. However as population levels level or fall in the rich countries the call is increasingly heard for encouragement for population growth through fertility and (selective) immigration. GHW5 labels this as a Ponzi population policy:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:10pt;margin-left:36pt"><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:italic;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> Its argument is that, with population aging, immigration and/or incentives for larger families should be encouraged to re-swell a comparatively shrinking working age cohort (those between 15 and 64 years).The economic rationale is that the taxes collected from the productivity of the working age population is needed to pay for the services and pensions of a proportionately greater and increasing number of elderly.That makes sense, perhaps, for the short-term. But fast forward 40 or 50 years, and the re-swelled working age cohort has itself become elderly (and far more numerous), requiring an ever larger expansion in the base of the working age population.And so on, and on, and on. </span><span style="font-size:11pt;font-family:Arial;color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"> </span></p><h1 dir="ltr" style="line-height:1.38;margin-top:10pt;margin-bottom:10pt"><span style="font-size:16pt;font-family:"Trebuchet MS";color:rgb(0,0,0);background-color:transparent;font-weight:400;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre-wrap"><br></span></h1></div></div></div>