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The Sustainable Development Goals (SDGs), adopted by the UN General Assembly in September 2015, embody a One-Health strategy—healthy people living on a habitable planet. Extending beyond the social development emphasis of the Millennium Development Goals (MDGs), which accelerated progress globally, though unequally, the SDGs also encompass a range of environmental and economic goals, with a health goal that is far more comprehensive than the infectious diseases and maternal/child health focus of the MDGs.

To be achieved, the SDGs require resources and political commitment that is yet to be demonstrated. With a cost that could reach $5 trillion for the SDGs overall, achieving health targets will require a mix of increase domestic resources, including taxes on unhealthy foods and products, international assistance, and innovative financing. Annual reviews should identify and monitor threats to the SDGs, both internal contradictions and contradictory government policies such as discriminatory laws, and the necessary rights-based pathways forward. To improve accountability, health information systems with disaggregated data should be prioritized, along with independent monitoring and key governance indicators. Ambitious national benchmarks, drawing on WHO strategies and action plans, could provide markers of success for presently vague health targets.

Three early indicators of progress on the health SDGs could be: 1) whether countries establish clear policies on universality, encompassing all people without discrimination, identifying and prioritizing populations with the least access; 2) whether universal health coverage fully incorporates population health; and 3) whether countries provide rapid and sustained increased funding for such necessities as adequate sanitation and nutritious food. A Framework Convention on Global Health, a global health treaty based in the right to health, could fill in critical gaps in the SDGs, creating accountability through capacity-building and compliance-enhancing mechanisms, establishing a financing framework, and ensuring right to health assessments and health in all policies. It could help establish a path forward based on equity and the right to health that would be truly transformative.

Publication Citation

314 (24) JAMA 2621 (2015)