Measuring the Post-2015 Sustainable Development Goals

The post-2015 SDGs show many points of convergence with the UHC agenda, but also some clear differences. The post-2015 agenda as adopted in the UN special session in September 2015 has 9 aims and 17 goals. Of the 17 SDGs, only one is directly dedicated to health, which states ‘Ensure healthy lives and promote well-being for all at all ages’. This goes beyond maternal and child survival and vertical disease control programmes that characterized the MDGs. However, all the health-related MDGs remain in the SDG list, although now ‘reduced’ to subgoals or targets as they are named. In addition, there are at least seven other SDGs that relate to key social determinants of health. The third SDG related to health has nine targets, each underlying a significant public health informatics challenge, and four more which are described as ‘targets for means of implementation. The eighth of these targets is to ‘Achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality, and affordable essential medicines and vaccines for all’. The nine targets related to health outcomes and outputs and the four related to means of implementation are presented in Table 8.1:

Table 8.1 Sustainable Development Goals: the nine sub-goals of Goal-3

Target 1

By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

Target 2

By 2030, end preventable deaths of newborns and children under 5 years of age

Target 3

By 2030, end the epidemics of Aids, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases

Target 4

By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment, and promote mental health and well-being

Target 5

Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse, and harmful use of alcohol

Target 6

By 2020, halve the number of global deaths and injuries from road traffic accidents

Target 7

By 2030, ensure universal access to sexual and reproductive healthcare services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

Target 8

Achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality, and affordable essential medicines and vaccines for all

Target 9

By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil production and contamination

Targets

Targets for means of implementation:

a

Strengthen the implementation of the world Health Organization Framework convention on Tobacco control in all countries, as appropriate

b

Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the agreement on Trade-related aspects of Intellectual Property rights regarding flexibilities to protect public health, and in particular, provide access to medicines for all

c

Substantially increase health financing and the recruitment, development, training, and retention of the health workforce in developing countries, especially in the least developed countries and small island developing states

d

Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction, and management of national and global health risks

As compared with the MDGs, the SDGs are vastly expanded across sectors including in all 169 targets. In fact, most of the critiques of the SDGs are claiming that the number of targets are too high: when you try to do everything, you end up achieving nothing. The Economist calls them the 169 commandments, and recommends them to follow Moses and prune them to 10 commandments: ‘aimed squarely at reducing poverty, boosting education (for example, extending girls’ schooling by two years) and improving health (say by halving the rate of malaria infection)’ (The Economist 2015).

Previously we discussed some of the complexities of measuring UHC. But in the post-2015 list, that is only one of the nine sub-goals, and the other eight, which include with some modification all the health-related MDGs, are all challenging. Some common informational requirements emerge. First, lessons from measuring the MDGs, an important part of this book, remains valid; second is improved cause-of-death reporting, which requires more robust CRVS data. The third is improved inputs from disease surveillance systems for morbidity reporting. And fourth is improved quality of information from service delivery points of both primary and secondary care. And finally, there is the need for much better inter-sectoral reporting, such as finance, environmental pollution, transport, and others.

 
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