HEALTH IN THE POST-2015 GLOBAL DEVELOPMENT AGENDA
HEALTH IN THE POST-2015 GLOBAL DEVELOPMENT AGENDA Position Paper
1 IMVF Position Paper
HEALTH IN THE POST-2015 GLOBAL DEVELOPMENT AGENDA
HEALTH IN THE POST 2015 GLOBAL DEVELOPMENT AGENDA Position Paper
Considering that: 1.
4.
The Millennium Declaration, approved in 2000 and materialised in the Millennium Development Goals (MDGs), is a major milestone in Development history. Despite some criticism it was the first time that common, simple and measurable objectives and goals were defined, shared by a great number of countries, allowing for a reference framework for the definition, implementation and evaluation of public policies, namely on Health (MDG 4 - Reduce Child Mortality, MDG 5 – Improve Maternal Health and MDG 6 – Combat HIV/ AIDS, Malaria and other diseases).
Considerable progress was achieved in some MDGs, especially in eradicating extreme poverty and hunger (MDG1), mainly due to positive developments in heavily populated countries and especially in Asia. In 2010, and for the first time since poverty trends started to be monitored, not only did the number of people living in extreme poverty decrease but also the poverty indexes lowered in all developing regions, including sub-Saharan Africa where the rates are usually higher. However, these global data hide great inequality, between countries and within countries. About a billion people continue to live in extreme poverty (the so-called “bottom billion”).
The focus on Health as a fundamental axis of Development is not something new. The Declaration of Alma-Ata, approved at the International Conference on Primary Health Care, which took place in 1978, already called for an urgent solution to establish the promotion of health as one of the priorities of the new international economic order, in order to decrease inequalities between richer and poorer countries. Primary health care, prevention and health education measures were established as viability factors for universal health care, and all governments were declared accountable for the promotion of health. The movement “Health for All by the year 2000” took off and a process of International Conferences on the Promotion of Health started to take place (the first one was held in 1986 and approved the Ottawa Charter, which defined important factors to reach health for all). Taking into account all these processes of debate and thinking, one can consider that that the goals established in the MDGs in 2000 for this sector were not so ambitious or comprehensive, focusing only on specific aspects of health and forgetting the linkages between health and all other global objectives. Even after 12 years of reflexion and dialogue, the Final Declaration of Rio+20 only mentions Health issues very briefly.
3.
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Assessing the progress of these goals, the MDGs on maternal and child health (4 and 5) are the ones that have progressed the less and more unevenly throughout regions. Sub-Saharan Africa continues to register less encouraging indicators than other regions on the Health sector; regarding general access to health care, life expectancy, child mortality, maternal health, sexual and reproductive health and communicable diseases.
The transformation of the world’s geography of poverty, the increase in inequalities (between and within countries), increasing urbanisation and demographic trends present new global challenges, which are determinant for the populations’ health and quality of life. Some challenges are different in developed and in developing countries. In the majority of developed countries the ageing of the population combined with numerous risk factors
2.
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HEALTH IN THE POST-2015 GLOBAL DEVELOPMENT AGENDA
d. A new universal and unified global agenda, with clear goals that provide an answer to Poverty and Development challenges as multidimensional phenomena, involving a balance between economic, social and environmental dimensions, putting people at the core of Development. In this sense, it is especially relevant to fight inequalities and promote equality – of opportunities, of rights, of access and results – in several sectors. e. Pursuing and reinforcing the recognition of Health as a fundamental Human Right, as an issue of social justice and a predominant factor for promoting Development and economic growth. Thus, it is fundamental to have an agenda that defends universal and equal access to Health, assuming that people, their rights and their well-being are the centre of all processes. f. Defining and implementing a global agenda for Health that takes into account not only the proximate causes of disease, but that also acts on the barriers and social, economic and environmental factors that condition the evolution of Health indicators (and that are intertwined with a multiplicity of sectors and policies). In that sense, the new agenda must take into consideration and make explicit those linkages and multidimensionality, while promoting the policies that contribute directly and indirectly to improving Health and wellbeing. g. Defining a specific, comprehensive and highlevel Goal on Health, that goes beyond its transversal nature. As Health is a global concern, the main challenge is in defining an approach, goals and indicators that are simultaneously relevant for all countries and sufficiently flexible to respond to different challenges and problems. h. Implementing a transformative agenda on Health, through the definition of objectives, instruments and mechanisms that focus on the need for structural changes and not only shortterm solutions, namely in what concerns the structuring of national health care systems, the importance of primary health care, the right of
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access to sexual and reproductive health (with proven demographic and economic effects) or the need to apply prevention and health education measures as conductive factors for universalizing the right to Health. a. Having a special focus on investing in women equality, rights and health, for the multiplying effects such investment has on individuals, families and communities’ well-being, as well as on economies and productivity issues. b. Recognizing the need for reinforcing investments on Health Development in the broader scope of Development promotion, including the search for and implementation of innovative financing sources at a national, regional and global levels. c. Promoting larger community empowerment, stronger political commitment from all policy sectors and the existence of a shared commitment between all actors – public entities, private sector, community organisations and international organisations – is still necessary to ensure real progress on responses towards the old and new challenges on Health. The role of each of those actors and their mutual responsibility must be valued and explicit in the new global agenda.
July 2013
ABOUT IMVF Instituto Marquês de Valle Flôr (IMVF) is a private foundation and a Non-Governmental Development Organization (NGDO) that carries out humanitarian aid and economic, cultural and social development cooperation and education. It also conducts studies and produces scientific papers on several fields of knowledge, and promotes and disseminates the culture of countries whose official language is Portuguese.
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