1.
Global Health and the SDGs – an
interdisciplinary perspective
Andy Haines

2.
Progress on the Millennium Development Goals --%
improvement in relation to targets for selected indicators
(100% means target is met)

3.
Country progress in reducing
under-five mortality (MDG4)
24
37
18
0
10
20
30
40
On Track Insufficient
progress
No progress
NumberofCountdownCountries
(n=74)
African Countries
Eritrea
Ethiopia
Liberia
Malawi
Tanzania
Countdown to 2015, report June 2012, Figure 3, progress updated for 2012
28 are African
countries
49%
in
Africa
All are African
countries

4.
Millennium Development Goals – despite the successes
there were limitations
1. Around half of current MDG indicators not reported by many
countries
2. Fragmented approach--nothing on inequalities, access, NCDs,
injuries, human rights
3. Limited focus on environmental health
4. A top-down process with main focus on low income countries

5.
17 goals and 169 targets

6.
Synthesis report of the UN Secretary General

7.
Indicators
 Management tool for countries
 ‘Report card’
 Invest in national statistical systems, household surveys,
Big Data, remote sensing
 Allow for disaggregation e.g. spatially,
socioeconomically, gender, age etc.
 Data for Core indicators should be widely available,
reliable, good coverage etc

8.
Development of indicators-- UN
Statistical Commission
 Of the 304 proposed provisional
indicators, 50 indicators (16 per cent)
were evaluated as feasible, suitable
and very relevant (rating AAA)
 39 indicators (13 per cent) received
the rating BAA, meaning that those
indicators were considered only
feasible with strong effort, but suitable
and very relevant

9.
‘Health is a precondition for and an outcome
and indicator of all three dimensions of
sustainable development.’

10.
Global Burden of Disease 2010
12Lim et al 2012

11.
1.1 By 2030 eradicate extreme poverty for all people
everywhere (less than $1.25 a day )
1.2 reduce at least by half the proportion or people at all ages
living in poverty according to national definitions
1.3 Implement nationally appropriate social protection systems

12.
Childhood (<5) Stunting de Onis M, et al. (2013);

13.
64
36
20
80
Percentage change in yields to 2050
-50 -20 0 +20 +50 +100
UN Devt Prog, 2009
Plus climate-related:
• Flood/storm/fire damage
• Droughts – range, severity
• Pests (climate-sensitive)
• Infectious diseases (ditto)
CLIMATE CHANGE: Poor Countries Projected to Fare Worst
MODELLED CHANGES IN CEREAL GRAIN YIELDS, TO 2050

14.
End Hunger, improve nutrition –potential indicators
 % below minimum dietary energy (MDG)
 % lacking essential micronutrients (tbd)
 % Stunting in children <5
 % Obesity/Overweight ( also integrates physical activity)
 Household Dietary Diversity score (tbd)

15.
A focus on Universal Health Coverage
Historical background:
Alma Ata Declaration of 1978
2005-12: all nations have
made the commitment to
achieve universal health
coverage
"everyone should have
access to the health
services they need without
risk of financial ruin or
impoverishment"

16.
Health Care- selected targets OWG goal 3
₋ Achieve universal health coverage (UHC) including
financial protection and family planning
₋ Maternal deaths: Target MMR of 70/100,000 live births
(Lancet, UNICEF)
₋ Child mortality/infant mortality: End preventable
deaths
₋ End epidemics of HIV/AIDS, TB, malaria, water-borne
and neglected tropical diseases
₋ Non-communicable disease mortality: Reduce by one
third
₋ Mental Health

17.
 Life expectancy
– widely available but slow to
respond and does not assess health.
 Healthy Life Expectancy
– less but increasing availability.
More holistic ( indicator 32)
The Economist
Integrating health indicator

18.
 6.1 Achieve universal and equitable access to safe
and affordable drinking water
 6.2 Achieve access to adequate and equitable
sanitation and hygiene for all, and end open
defecation (modified MDG indicators urban/rural)
 6.3 Improve water quality by reducing
pollution....and increasing safe reuse by x% globally

19.
 By 2030, ensure universal access to affordable,
reliable and modern energy services
 modern cooking indicator 55
 access to reliable electricity indicator 56
 deep decarbonization strategy indicator 82

20.
Estimates of air pollution deaths
( WHO 2014, Lim et al LANCET 2012 ;380;)
 Ambient particulates
~3.7 m deaths p.a.
 Household from solid
fuels ~4.3 m deaths p.a.
 Around 7 million in total
 Tropospheric Ozone
~ 150 k deaths p.a.

21.
Health and Environment, IGU Warsaw
2014 28

22.
 Halve deaths from road injuries /100000 pop
 Mean urban fine particulate air pollution levels
 Proportion of urban journeys/ km by public transport/
walking or cycling.
 Urban green space per capita

23.
Housing Goal 11.1 2030, ensure access for all to
adequate, safe and affordable housing and basic services, and
upgrade slums
Proportion of population in slums/informal settlements. indicator 72
http://laughingsquid.com/biolite-clean-burning-wood-fired-
stoves-that-generate-electrcity/
solar-aid.org
www.gatesfoundation.org

24.
Disasters OWG Goal 11.5
 by 2030 significantly reduce the number of
deaths and the number of affected people
and decrease by y% the economic losses
relative to GDP caused by disasters,
including water-related disasters, with the
focus on protecting the poor and
vulnerable .

25.
13.1 Strengthen resilience and adaptive capacity to
climate-related hazards and natural disasters
mobilizing $100 billion annually by 2020 to address the
needs of developing countries for mitigation actions.....

26.
Criticisms of the SDGs
ICSU/ISSC
•Lack of hard quantitative language.
•Lack of integration - goals presented in ‘silos.’
Danger of trade offs e.g. between overcoming
poverty and moving towards sustainability.
•“The ‘ultimate end’ of the SDGs in combination
is not clear, nor is how the proposed goals and
targets would contribute to achieve that
ultimate end,”
Recommended meta-goal be “a prosperous,
high quality of life that is equitably shared and
sustained.”

27.
Figure
The Lancet Global Health 2015 3, e251-e252DOI: (10.1016/S2214-109X(15)70112-9)
Copyright © 2015 Waage et al. Open access article published under the terms of CC BY Terms and
Conditions
Framework for examining interactions
(Waage et al Lancet Global Health 2015)

28.
Interdisciplinary research linking health,
development and sustainability should-
Address policies that:
 reduce environmental change and improve health
( heath co-benefits)
 and/or increase resilience of populations to adverse
environmental conditions
 reduce inequities and address socio-economic
determinants
http://www.usclimatenetwork.org/climate-change-101/Climate-Risks-and-Preparedness