SIXTY-EIGHTH WORLD HEALTH ASSEMBLY Provisional agenda item 14.2
A68/14 24 April 2015
Health in the post-2015 development agenda Report by the Secretariat 1. In resolution WHA67.14 the World Health Assembly, recognizing the importance of implementing relevant internationally agreed commitments, urged Member States to ensure that health is central to the post-2015 development agenda; to ensure that the post-2015 development agenda will accelerate and sustain progress towards the achievement of health-related Millennium Development Goals (MDGs); to incorporate into the post-2015 development agenda the need for action to reduce the preventable and avoidable burden of mortality, morbidity and disability related to noncommunicable diseases and injuries while also promoting mental health; to promote universal health coverage (UHC); and to emphasize the need for multisectoral actions to address social, environmental and economic determinants of health. 2. In that resolution the Health Assembly also requested the Director-General to continue active engagement with ongoing discussions on the post-2015 development agenda, in order to ensure the centrality of health in all relevant processes; and to continue to inform Member States and provide support, upon request, on issues and processes concerning the positioning of health in the post-2015 development agenda. 3. Against this background, the present report summarizes the process of crafting the post-2015 development agenda, including the course of action that will lead to the adoption of a new set of goals for sustainable development during 2015.
TOWARDS THE POST-2015 DEVELOPMENT AGENDA 4. The process up to April 2014 was summarized in a report to the Sixty-seventh World Health Assembly.1 As part of a wide-ranging global consultation, the Open Working Group of the General Assembly on Sustainable Development Goals (OWG), consisting of representatives of Member States of the United Nations, in August 2014 proposed 17 sustainable development goals (SDGs) with 169 associated targets (Annex 1).2 The proposed SDGs are supported by the three pillars of sustainability: economic development, environmental protection and social equity. In particular, they embrace the principles of the 1992 Rio Declaration on Environment and Development. Furthermore, they recognize that poverty eradication is one of the greatest challenges facing the world today and a prerequisite for sustainable development.
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Document A67/20. See United Nations General Assembly document A/68/970 and Corr.1, annex.
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5. In its resolution 68/309 of 10 September 2014, the United Nations General Assembly decided that that the proposal of the OWG shall be the main basis for integrating sustainable development goals into the post-2015 development agenda, while recognizing that other inputs will also be considered, in the intergovernmental negotiation process at the sixty-ninth session of the General Assembly. 6. In the scheme proposed by the OWG, health is positioned as one of the 17 SDGs, with the overarching goal to “Ensure healthy lives and promote well-being for all at all ages”. This overarching health goal has nine targets: three related to the MDGs, three on noncommunicable diseases and injuries, and three that are cross-cutting or focused on systems, including UHC, universal access to sexual and reproductive health care services, and reduced hazards from air, water and soil pollution.1 7. While the single health goal captures the key aspects of achieving good health, health is closely linked to many of the other 16 proposed goals. For example, health is a contributor to, and a beneficiary of, poverty reduction, hunger relief and improved nutrition, safer cities, lower inequality, sustainable consumption, affordable and clean energy, the management of toxic chemicals, clean water and sanitation, efforts to combat climate change, and the conservation of aquatic and terrestrial ecosystems. In addition, health statistics are key metrics of progress towards sustainable development because good health and well-being, in the fullest sense, depend on a wide range of economic, environmental and social improvements. 8. The dialogue on development was drawn together in the synthesis report, The road to dignity by 2030, which the UN Secretary-General presented to the General Assembly in December 2014.2 The synthesis report presents a vision that Member States can take forward in negotiations leading to the United Nations summit for the adoption of the post-2015 development agenda in September 2015. At this summit, world leaders are expected to agree on an historic and far-reaching 15-year programme of work aimed at ending poverty and transforming lives while protecting the planet. 9. The synthesis report sets out the requirements for a realistic yet ambitious outcome from the special summit: an inspirational vision of the future, made plain in a declaration; a practical plan for that declaration, laid out in an integrated set of goals, targets and indicators; adequate means to implement the plan and a renewed global partnership for development; and a mechanism to ensure that promises become actions, with a framework to monitor and review implementation. 10. The synthesis report also identifies six essential elements to frame and reinforce the sustainable development agenda. These focus on: ending poverty and fighting inequalities; ensuring healthy lives; growing a strong, inclusive and transformative economy; promoting safe and peaceful societies and strong institutions; protecting our ecosystems for all societies and our children; and catalysing global solidarity for sustainable development. 11. In December 2014, the General Assembly outlined the negotiating process for the post-2015 development agenda, co-chaired by the Permanent Representatives of Ireland and Kenya. The first two sessions in this process took place by 25 February 2015. In the first, stocktaking session, held on 19–21 January 2015, Member States agreed on the need to clearly communicate what the post-2015 development agenda seeks to achieve in a way that is concise, compelling and understandable to the public. Public communication should be visionary and inspiring, focusing on people and the planet, with extreme poverty at the core. There was broad support for maintaining the 17 goals and associated targets 1 2
See also document A68/13. United Nations General Assembly document A/69/700.
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proposed by the OWG. Member States agreed that the means of implementation – financing, capacitybuilding, technology transfer – should match the ambitions of the SDGs and targets. Member States also agreed that the September 2015 outcome will incorporate a political declaration, the SDGs and associated targets, the means of implementation, and a framework for monitoring and accountability. 12. The second session of intergovernmental negotiations, held on 17–20 February 2015, focused on the Declaration, including a “chapeau” to accompany the goals, targets, means of implementation and monitoring framework. Debate around the draft discussion document covered the following broad themes: the need to show how the three pillars of sustainable development are interdependent; managing the transition from MDGs to SDGs; framing the SDGs in a simple and compelling way, for example in terms of “people, planet, partnership and prosperity”; the need for a strong representation of topics including inequality, gender, women, youth, resilience, migration and climate change; and similarly for the themes of transparency, universality, multidimensionality, sustainable production and consumption. From the health perspective, the Declaration should capture the main themes of the health goal, plus the role that health plays more generally in sustainable development. A first draft of the Declaration is expected by the end of April, and will be subject to negotiations in June and July. 13. The intergovernmental negotiating process will continue until the end of July 2015. At the session from 23 to 27 March, the focus was on indicators for the SDGs and targets. On 20 –24 April, Member States will consider the means of implementation and the global partnership for sustainable development. A review of progress will be held on 18–22 May. The final three sessions on 22–25 June, 20–24 July and 27–31 July will conclude intergovernmental negotiations on the outcome document. 14. The question of how to finance the new sustainable development agenda is a key consideration for Member States and will be a central subject for discussion at the Third International Conference on Financing for Development, to be held in Addis Ababa, Ethiopia on 13–16 July. A major challenge is to align financing to achieve the SDGs at both global and national levels. 15. The United Nations Statistical Commission has been tasked with developing an indicator framework for monitoring progress towards the SDGs and targets. The Commission and its working mechanisms were requested to support this process by proposing indicators, and a provisional list was developed by February 2015. Because the 17 SDGs include 169 targets, and some targets have several components, such a process results in a large number of global indicators. In addition, there might be national, regional, and sectoral or thematic indicators. Several Member States have voiced concern about the large number of indicators resulting in an excessive national reporting burden, and have expressed a preference for a smaller and more manageable number. The Statistics Division of the United Nations Department of Economic and Social Affairs has subsequently announced its intention to aim for a shortlist of between 100 and 120 core indicators. 16. The process of choosing a shortlist of indicators inevitably means that some will be discarded. In the area of health, where several MDG-related targets and indicators are to be carried forward, care must be taken not to lose valuable new work done on noncommunicable diseases and injuries, on universal health coverage, and on the social and environmental determinants of health. World Health Assembly resolutions provide some guidance to aid choice, but these resolutions contain many targets and indicators related to health. The process of choosing key indicators is unlikely to be finalized before the March 2016 session of the Statistical Commission, although December 2015 has been mentioned as a target date for setting the core indicators.
ACTION BY THE HEALTH ASSEMBLY 17. The Health Assembly is invited to note the report. 3
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ANNEX SUSTAINABLE DEVELOPMENT GOALS (SDGS) PROPOSED BY THE OPEN WORKING GROUP OF THE GENERAL ASSEMBLY (OWG) Goal 1 Goal 2 End poverty in all its forms everywhere End hunger, achieve food security and improved nutrition and promote sustainable agriculture Ensure healthy lives and promote well-being for all at all ages Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all Achieve gender equality and empower all women and girls Ensure availability and sustainable management of water and sanitation for all Ensure access to affordable, reliable, sustainable and modern energy for all Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation Reduce inequality within and among countries Make cities and human settlements inclusive, safe, resilient and sustainable Ensure sustainable consumption and production patterns Take urgent action to combat climate change and its impacts Conserve and sustainably use the oceans, seas and marine resources for sustainable development Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels Strengthen the means of implementation and revitalize the global partnership for sustainable development = 4
Goal 3 Goal 4
Goal 5 Goal 6 Goal 7 Goal 8
Goal 9
Goal 10 Goal 11 Goal 12 Goal 13 Goal 14
Goal 15
Goal 16
Goal 17
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