WHO’s analysis, Health in 2015: From MDGs [Millennium Development Goals] to SDGs, took in global health trends since 2000 and assessed the potential challenges stretching out over the next decade and a half, providing guidance and suggestions for actions that different member states need to undertake in order to achieve the 17 new SDGs. These are predominantly health-related and designed to be both broader and more ambitious than the previously agreed MDGs. While a number of the global targets were missed, great strides have been made in the areas of child and maternal mortality, HIV, malaria and TB over the last fifteen years.
One of the new goals is to ‘ensure healthy lives and promote wellbeing for all at all ages’, and ‘universal health coverage [that] cuts across all of the health-related goals’. “It is the lynchpin of development in health,” said the WHO’s assistant director general of health systems and innovation Dr Marie-Paule Kieny, “and reflects the SDGs’ strong focus on equity and reaching the poorest, most disadvantaged people everywhere.”
Key areas identified by the WHO include reproductive, maternal, new-born, child and adolescent health; infectious diseases (including neglected tropical diseases); non-communicable diseases such as cancer, diabetes and heart disease; mental health and substance abuse; injuries and violence; and the aforementioned universal health coverage. Air pollution, road traffic injuries and hepatitis were just some of the other areas that the WHO says need to be addressed in order to improve global health standards.
“One of the biggest challenges will be measuring progress across a staggering number of targets,” said Dr Kieny, “particularly with the lack of health data in developing countries. As the global agency with the mandate to cover the whole health agenda, WHO will take a leading role in supporting countries to set their own national targets and strategies, advising on best-buy interventions, defining research priorities and monitoring progress in achieving the health-related SDGs.” This year will see the WHO publish the first of a new series of annual reports on SDGs, which will set a baseline for action and measure progress.
Meanwhile, an international commission assembled in the wake of last year’s Ebola epidemic has said that billions of dollars will be required in order for the world to be sufficiently prepared for a future global health crisis, whether that involves the reappearance of Ebola or bird flu or a fast-moving virus such as Zika, or something new. The commission, a 17-member international group called the Commission on a Global Health Risk Framework for the Future, published its report in January in the New England Journal of Medicine, and makes a number of sweeping recommendations. For example, it says that nations need to make major improvements to their public health capabilities and infrastructure, with a common standard needing to be adopted by 2020; that international leadership is needed for proper preparedness and swift responses; and that scientific and technological developments need to be properly funded and prioritised to combat infectious diseases. The World Health Organization’s capabilities, resources, leadership and independence also need to be boosted, and nations need to be held properly accountable for making improvements to their health systems.
Margaret Kruk, who is associate professor of global health at Harvard T.H. Chan School of Public Health, was one of the report’s independent reviewers. “The Ebola crisis has spawned a huge amount of reflection in the global community,” she said, adding that while many countries have said that they would make rapid improvements to their public health systems, ‘very few have delivered, and there’s been no really serious monitoring of this in the past’. “So the new report’s focus on implementation and measurement is really important,” she said. “There’s a clear message to countries at risk for pandemics that they have to get their house in order if they want more grants and loans from the international community. If ministers of finance – who determine health budgets and health investments – see a threat to their financing, they’re much more likely to take action.”
Kruk hopes that while, in the past, reports like this have sunk without a trace, ‘the visibility of this issue is so high that this report has a better chance than most of retaining relevance and hopefully guiding action’. “Hopefully, when the next global health crisis occurs, the world will be better prepared,” she concluded.