As a milestone in a long process, the Open Working Group (OWG) mandated by the UN in 2012 to produce a set of proposals for Sustainable Development Goals (SDGs) to succeed the Millennium Development Goals (MDGs) delivered its outcome document “for consideration and appropriate action” by the UN General Assembly (UNGA). The proposal includes 17 development goals (goal 3: “Ensure healthy lives and promote well-being for all at all ages”) and 169 targets. And it is a disappointment.
With its approach to propose goals and targets to be reached “by 2030”, the outcome document is a shopping list of great societal ambitions: “End preventable deaths of newborns and under-five children” (target 3.2); “achieve universal health coverage, including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all” (3.8); “achieve universal and equitable access to safe and affordable drinking water for all” (6.1); “ensure universal access to affordable, reliable, and modern energy services” (7.1)…and so on. I share all these visions and would love to see the world transformed within 15 years into a good one for all, but I cannot see how the structural determinants behind these issues will be changed just by another declaration of intent. The key question of what needs to be done to translate ambitions into action and who is responsible for this remains unanswered. The “means of implementation” targets added to each goal and containing particular interventions within each sector are certainly not sufficient for this purpose.
Is it good or bad that the working group sometimes seems to be afraid of its own courage? For targets such as “end all forms of discrimination against all women and girls everywhere” (5.1) or “eliminate all forms of violence against all women and girls in public and private spheres, including trafficking and sexual and other types of exploitation” (5.2), there is no indication that this should be achieved by 2030.
I do not get further into the specific achievement and failures of the current proposal. You might read it yourself (do it!) or have a look at the analysis by Neva Frecheville. Let me just repeat Richard Horton’s conclusion, referring to the zero draft of the outcome document published already some weeks ago: “Sustainable development? No. Try utopia instead. The SDGs are fairy tales, dressed in the bureaucratese of intergovernmental narcissism, adorned with the robes of multilateral paralysis, and poisoned by the acid of nation-state failure. Yet this is served up as our future. The health goal is a mixture of business-as-usual (the MDGs rebooted), non-communicable diseases and universal health coverage (deservedly new entrants), and a strange assortment of promises about healthy life expectancy, essential medicines, and air pollution. Is this negotiated wish-list really the best we can do?”
Horton then proposes a fundamentally different vision for and approach to sustainability. Other comments insist on development goals rooted in and built around inequality and human rights. However, after two years of the post-2015 process and with its final steps already scheduled, it is not possible any more to admit its failure. Rebooting is no option.
So if we cannot really hope for a good result, is at least the post-2015 process a progress from the past? If you look at the extent of the debate on sustainable development, you might agree. But, after all, the last two years mainly deepened the divide within the development community and its sectors. I expect the winners of the current SDG proposal (and there are many of them seeing their baby – or call it silo – finally given the deserved attention) as well as the losers (and, as you might guess, there are many of them, and the blogs and journals are already full with their complaints) to continue their struggle for a place on the final list of SDGs and targets by lobbying the country representatives at the upcoming UNGA meetings. And what happens with the over 3 Million “civil society voices” collected on an internet platform and with all the outcome documents of hundreds of national and thematic consultations? Let us not confuse such happenings with democratic governance. As long as “poverty continues to be treated more or less as a natural phenomenon, rather than as the result of unequal power relations” (Nadja Meisterhans) and as long as these power relations remain unchallenged at a national and global level, we are far from there.
A luta continua.
Thomas Schwarz, Executive Secretary
Medicus Mundi International Network
- OWG outcome document, 19 July
- “The World We Want 2015” platform
- OWG report shoots but does it score? Neva Frecheville, Cafod
- An alternative model of governance. Nadia Meisterhans, medico international
- Why the Sustainable Development Goals will fail. Richard Horton
- More below, in the MMI updates on twitter and in our thematic guide “Health in the post-2015 UN development agenda”