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Health and development agenda

Guru Prasad Mohanta, Babita Sarangi and P. K. MannaThursday, January 28, 2016, 08:00 Hrs  [IST]

The world leaders joined together at the United Nations (UN) Sustainable Development Summit at New York during 25-27 September 2015 to adopt new development agenda known as Sustainable Development Goals (SDGs). 193 world leaders committed to achieve sustainable development in three important dimensions: economic, social and environmental in a balanced and integrated manner. Commitment for ambitious 17 goals with 169 targets is an agenda for development for the next 15 years.  The first line of the preamble of the sustainable development document ‘Transforming our World: The 2030 Agenda for Sustainable Development’ says “This agenda is a plan of action for people, planet and prosperity’.  Though agenda are much diversified, the plan is to finish the unfinished agenda of millennium development goals (MDGs) adopted 15 years ago and coming to an end with the year end of 2015.

Enjoyment of highest attainable standard of health has been accepted universally as one of the fundamental rights and is the focus point under development agenda for sometimes now. Major efforts have been made to reduce morbidity and mortality at least on vulnerable population groups: poor, women and children. Reduction in under five mortality, reduction in maternal mortality, access to reproductive healthcare, and reversing the spreading of HIV/AIDS, Tuberculosis and Malaria were three health related goals under millennium development goals adopted in 2000. Out of eight millennium development goals, health was exclusively focused in three goals: Goal 4, Goal 5 and Goal 6. Now the world leaders have decided to supersede millennium development goals by sustainable development goals with sustainable development goals being effective from January 1, 2016.

Sustainable development goals are little different from earlier millennium development goals. While developing millennium development goals, the member states were not taken into confidence in designing the goals and targets. But sustainable development goals are developed through a series of consultation among the member countries. Millennium development goals focused on need of developing and poor countries, while sustainable development goals are meant for everyone and have a holistic approach to achieve the goals to make the planet a better place to live.

There have been paradigm shifts in disease burden of many countries. Once the infectious diseases used to be the world’s biggest killers, but now there have been changes in major causes of deaths and illness. The availability of effective antimicrobials and public health measures like immunization has significantly redressed these issues. Socio-economic development and improvement in general longevity have brought different dimensions to the illness and mortality. Non-communicable diseases and injury are now bigger threat to human health.

The sustainable development goal – 3 exclusively plans to achieve healthy lives and promote well being of all ages. This it-self is a paradigm shift from millennium development goals where focus was on specific groups: mother and children health; and on specific diseases: HIV/AIDS, Malaria, and TB. Now sustainable development goals covers all other aspects of health too like mental health, health for all age groups including elderly populations. The goal has 9 targets with four mechanisms of implementations. These 9 targets are: reduce the global maternal mortality ratio to less than 70 per 100,000 live births; reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births; end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases; reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being; Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol; ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes; achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all; and substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination by 2030; and halve the number of global deaths and injuries from road traffic accidents by 2020. The 4 mechanisms are: strengthening of implementation of World Health Organization’s frame work on tobacco control; supporting research and development of vaccines and medicines with improved access within the frame work of IPR; substantially increasing investment in health sector with increased trained health workforce; and strengthening the warning and management system of health risks. Among the four mechanisms, IPR provision associated with innovation often threatens access to new medicines and vaccines. Many anti-cancer drugs and drug treatment of hepatitis C are live examples of un-affordability.   Even there are issues of monopolistic pricing of new drug in America. The new effective treatment for hepatitis C costing $1000 per pill for 12 weeks treatment is beyond the reach. While negotiating for stringent IPR protection, public health provision like compulsory licensing needs to be preserved.


Though apparently it looks that the health is not given due share as the health focus is reduced from ‘3 out of 8 goals in millennium development goals’ to ‘1 out of 17 sustainable development goals’. In reality, almost every one of the 17 sustainable development goals has direct link with the health of the people or will contribute to health indirectly. The single health goal “ensure healthy lives and promote well being for all at all ages” has link with other goals. World Health Organization has already formulated its task in the light of new developmental agenda and now it is the turn of member states to initiate the process of developing strategies and allocating resources to strengthen health system to achieve the much ambitious developmental goals by 2030.

(Authors are with Department of Pharmacy, Annamalai University, Annamalai Nagar – T N 608 002)

 
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