Fourteen years ago, leaders from across the world came together at the United Nations headquarters in New York to pledge their efforts towards achieving eight targets for global development. Together, these targets became known as the millennium development goals or MDGs (with three of them directly devoted to a health objective).
Since then, The BMJ, along with other publications and organisations, has scrutinised these goals. We’ve analysed the likelihood of achieving these goals—ruminating on the great challenges they present, and the actions that could advance their attainment. Equally, we’ve flagged up the MDGs’ success stories, such as when the goal for access to safe water was achieved five years early.
More recently, we’ve begun thinking about life after 2015, when the time allotted for the MDGs to do their thing runs out. Last year, Charles Kenny from the Center for Global Development examined the lessons we’ve learnt from the MDGs, and suggestions for the post 2015 development agenda.
Now comes an editorial, in which Gavin Yamey and colleagues look at the first draft for a new set of sustainable development goals.
These new goals—there are currently 17 of them in the draft, containing 164 targets—will have a 2030 end date. But after looking at the first draft—written by an intergovernmental open working group—Yamey and colleagues find there’s room for improvement.
The authors still find points to praise, picking apart the draft with a bit more optimism than a recent article in the Lancet managed to achieve, which branded the draft goals as utopian “fairy tales, dressed in the bureaucratese of intergovernmental narcissism.” (And that’s just the first paragraph).
Yamey and colleagues applaud the draft’s “strong focus on women, climate change, and the importance of technological innovation for human development.” But at the same time, they acknowledge that in trying to please everyone, the draft reads like a long wish list. And wishes don’t make a great starting point for actionable, achievable targets, as Yamey et al outline in their editorial.
Take, for example, target 3.2, to end preventable deaths of newborns and children under 5, or target 3.3, to end the epidemics of AIDS, tuberculosis, and malaria. The editorial’s authors are left scratching their heads at these targets, having found “no research showing that we can ‘end’ these health crises within just 15 years.”
Yamey et al suggest that “a more valid approach is to model the trajectory of mortality to 2030 under different degrees of health sector investment.” They point to modelling work done by the Commission on Investing in Health, which predicted the effect on mortality of scaling-up existing and new tools for HIV, tuberculosis, malaria, maternal and child health, and neglected tropical diseases. The results of this modelling work suggest that a scale-up of this nature could see death rates from these conditions in poor countries fall to rates seen today in high performing middle income countries by 2030. This would mark substantial progress, but it would still not be the zero of the draft’s aspirations.
Yamey and colleagues are hopeful that these failings can be addressed in the draft’s revisions over the next year. And, with the new set of sustainable development goals due to be debated during the UN General Assembly starting on 24 September 2014, we definitely haven’t heard the last word on this.
Kelly Brendel is assistant web editor, The BMJ.