A Healthy Mind in a Healthy Body: Towards universal healthcare

Written By Arvind Ravikumar

The third Sustainable Development Goal (SDG3), as adopted in the 2015 UN General Assembly meeting, strives to “ensure healthy lives and promote well-being for all at all ages” by 2030. There are nine targets specified under this goal that can be broadly classified into four categories: (1) decreasing maternal and child mortality, (2) reducing the incidence of diseases, (3) reducing human-caused mortality including substance abuse and road-traffic incidents, and (4) expanding access to affordable health care. Compared to prior efforts, SDG3 provides renewed focus on issues like substance abuse, mental health and affordable health-care for all – issues that affect the developed world as much as the developing world. The SDG3 builds on and expands the health-focused millennium development goals that were adopted in 2000. Indeed, the world community has made significant progress in reducing child mortality, maternal mortality, access to reproductive health, and reducing the incidence of HIV/AIDS and tuberculosis. However, many of these reductions are far from the targets established in the MDGs – for example, maternal mortality has reduced from 386 deaths per 100,000 live births in 1990 to about 216 in 2015, significant but far short of the target of 70 maternal deaths per 100,000 live births. More importantly, progress has been uneven, especially across the poorest and the most disadvantages populations in the world.

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Worldwide maternal mortality rate: Number of maternal deaths per 100,000 live births (Source: Wikipedia)

Progress toward any of these goals is only as good as the monitoring mechanisms in place. In this context, the SDGs differ markedly from the last decade’s MDGs because of the development of sustainable development goal indicators – these ‘indicators’ refer to various statistical health data that track progress and keep various countries accountable. A thorough global database on these specific indicators and other metrics is already available. And that highlights one of the major problems in all global development goals – the lack of institutional support and robust data collection from many regions (especially in parts of Oceania, and sub-Saharan Africa) hinders any attempt to track progress. Lessons from other global governing bodies like the World Trade Organization (WTO) could help – one way would be to develop regional expertise within the UN to help developing countries better monitor their efforts.

This goal to improve health outcomes through specific and measurable targets might make the issue seem tractable. However there are important challenges in the years ahead that are exacerbated by globalization and improved mobility. For example, road-accident related fatalities have been increasing in the developing world because of economic development. Record numbers in global mobility will simultaneously increase the risk of spawning epidemics like Ebola or Zika, which would demand a robust and rapid global response to contain its spread. The rapid urbanization in developing countries like China and India will further strain urban infrastructure – without massive investments, urban pockets are in danger of becoming hot beds for water-borne and other communicable diseases. And finally, the recent uptick in global conflicts has resulted in over 60 million people being displaced – a number not last seen since World War II. Any global effort to improve health-care will need to be coordinated with other goals that directly affect health outcomes.

While there are many targeted policies that will directly influence healthcare and wellbeing, it would be naïve to assume that improving global health standards is not dependent on progress across many of the other SDGs. For example, access to clean water and improved sanitation (SDG #6), especially in rapidly developing urban areas in Asia and Africa, can significantly reduce the incidence of many communicable diseases. A growing body of research also show that the physical and social environment (SDG #11) can influence the life expectancy at birth – such stark differences can even be seen in the developed world. Recent experiences in reducing the prevalence of AIDS or improving access to reproductive health-care have shown how unequal progress has been – big gaps exist between the poorest and the richest households, between men and women, and between rural and urban regions. Progress even in regional health outcomes would be strongly tied to success in reducing inequalities (SDG #5, #10) and increasing girls’ educational attainment (SDG #4).

Ultimately, the biggest test for the success of any of these programs comes in the form of investments required – capital to the tune of trillions of dollars will have to be mobilized over the next 15 years, largely through public finance and aid. Recent rounds of talks have ended without any concrete commitments in the part of the developed nations. It is not yet clear if equitable mechanisms to fund massive improvements in infrastructure and health-care initiatives across large parts of sub-Saharan Africa and Asia will be available.

 


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Arvind graduated with a PhD in Electrical Engineering from Princeton University in 2015 and is currently a postdoctoral researcher in Energy Resources Engineering at Stanford University. His professional interests currently lie at the intersection of energy, climate change and policy. Arvind is an Associate Editor at Highwire Earth. Follow him on Twitter @arvindpawan1.

A World Without Hunger

Written by Matt Grobis

Safe, nutritious, and sufficient food, all year, for all people: the United Nation’s second Sustainable Development Goal aims to transform the world’s agriculture and distribution of food by 2030. With 800 million people suffering from hunger – more than 10% of the world’s population – food and agriculture are key to achieving the entire set of sustainable development goals.

Currently, there exists enough food to supply every person on the planet with a nutritious diet. Yet, large imbalances in access to this food also exist. This is often due to the cycle of poverty: people in poverty cannot afford nutritious food, which weakens them and then limits their ability to earn enough money to escape poverty. The results can be devastating. Poor nutrition is responsible for nearly 45% of deaths in children under 5, as well as causing a quarter of the world’s children to be stunted, or unable to develop normally.

Feeding future generations is similarly troubling. We have dedicated approximately 11% of the world’s land surface to agriculture (1.5 billion hectares), but to feed an expected 9 billion people in 2050, we will have to expand our global food production by 60%. Where will this land come from? We can work to improve crop yield from existing land, but the Food and Agriculture Organization (FAO) cautions that in many cases, local socioeconomic conditions “will not favor the promotion of the technological changes required to ensure the sustainable intensification of land use.” In other words, we can increase our food yield, but do we have the infrastructure in place to do it sustainably?

These are formidable challenges that require fast, efficient, and long-lasting solutions. By no exaggeration, the wellbeing and lives of billions of people – both present and future – depend on the actions taken to address hunger. The UN has therefore made ending world hunger a priority. “We can no longer look at food, livelihoods and the management of natural resources separately,” the FAO wrote in their 2016 bulletin Food and Agriculture. “A focus on rural development and investment in agriculture – crops, livestock, forestry, fisheries and aquaculture – are powerful tools to end poverty and hunger, and bring about sustainable development.”

A World Without Hunger
Mud stoves in Darfur, Sudan. Promoted by the Food and Agriculture Organization of the United Nations since the 1990s, these stoves decrease the need for fuelwood, a limited resource that can be dangerous to gather. Photo credit: plancanada.ca

How can we address problems as pervasive as hunger, when those problems are intimately linked with Earth’s other greatest challenges, such as poverty and climate change? For the FAO, the answer is to find solutions that address as many of these challenges simultaneously. In Darfur, Sudan, for example, the FAO is working to introduce fuel-efficient stoves that reduce the need for fuelwood, the principal source of energy that is becoming an increasingly limited natural resource. Women must travel far from home to collect fuelwood, which decreases the time they can invest in childcare, work, or education while also exposing themselves to the risk of physical or sexual violence. Mud stoves, on the other hand, require less fuelwood and produce no smoke. The local production of these stoves generates income for women.

“Tackling hunger and malnutrition is not only about boosting food production, but also to do with increasing incomes, creating resilient food systems and strengthening markets so that people can access safe and nutritious food even if a crisis prevents them from growing enough themselves.”
– Food and Agriculture Organization of the United Nations, Food and Agriculture

For Darfur, fuel-efficient stoves not only improve food security, hence addressing the UN’s second sustainable development goal of eradicating hunger. They also help decrease poverty (SDG #1), and they promote health and wellbeing (#3), gender equality (#5), affordable and clean energy (#7), climate action (#13), and protecting life on land (#15). Addressing the world’s largest challenges will require such multifaceted approaches.

 

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Matt Grobis is a 4th-year PhD candidate in Ecology and Evolutionary Biology and the Managing Editor of Highwire Earth. He researches the collective dynamics of fish schools in response to predation risk. Follow him on Twitter @mgrobis.

Empowering Communities and Building Resilience: The United Nations’ strategy to eradicate poverty

Written by Julio Herrera Estrada

The beginning of 2016 marked the start of the Sustainable Development Goals (SDGs) that were agreed upon by the United Nations last September. These 17 goals, broken into 169 specific targets, are set to last through 2030 and address a wide range of interrelated issues such as poverty alleviation, improved health and education, gender equality, sustainable use of natural resources, and biodiversity conservation. The SDGs replaced the eight Millennium Development Goals (MDGs) that lasted from 2000 to 2015. Many of the MDGs were successfully met, but huge gaps still remained on issues including access to drinking water, income inequality, and gender inequality (here’s the final report).

The first goal in both the MDGs and the SDGs focuses on poverty. The initial goal was to help at least half of the people who had less than US$1.25 per day (the definition of extreme poverty) rise above that threshold between 1990 and 2015. This goal was successfully met as the proportion of extreme poverty was cut from 49% to 14% by 2015. SDG #1 now calls for reducing this proportion to zero as well as addressing poor communities above the extreme poverty line. Moreover, this goal raises two key needs:

  1. Empowerment of communities to have the ability to rise from poverty, and
  2. Building communities’ resilience against climate, social, and economic shocks

Seeking countries to take ownership of this SDG and acknowledging that poverty looks differently around the world, it encourages each country to use their own definitions of poverty and to design “nationally appropriate social protection systems.” It suggests countries to ensure that poor communities have access to basic social services, financial services, property rights, sustainable livelihoods, and entrepreneurial opportunities. While there is also a call for increasing mobilization of resources towards poverty alleviation and the creation of a supportive international environment, the United Nations is encouraging development from within.

Empowering Communities and Building Resilience: The United Nations' Strategy to Eradicate Poverty
Source: Pixabay.com

In this context, resilience is the ability of people and communities to reduce their exposure and vulnerabilities to natural hazards such as droughts and floods, or economic or social shocks. This is an important aspect to address, given that a recent report by the World Bank found that climate change related hazards would push back 100 million people below the extreme poverty line by 2030, if development efforts do not take them into account and emphasize building resilience.

The good news is that this framework to combat poverty in the next 15 years is addressing the roots of the problem and is treating it as a multi-faceted issue where advances in gender equality, employment, social services, and infrastructure are also recognized as critical. Nevertheless, the resources needed to achieve this goal will put it in conflict with the SDGs that address the conservation of our climate and the planet’s natural ecosystems. There is little doubt that huge strives in creativity, innovation, and will to change some of our habits will be needed if we are to achieve all 17 SDGs.

 

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Julio Herrera Estrada is a 5th year PhD Candidate in the Environmental Engineering and Water Resources Program, and the Editor-in-Chief of Highwire Earth. His research focuses on the mechanisms and human impacts of droughts, and the policies that can help make our resource management sustainable and resilient. Follow him on Twitter @JulioSustDev.