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- 1. HEALTH PERSPECTIVE Dr Vinod Rathod 1st year PG, PSM DMC 11-Jan-16 1
- 2. SUSTAINABLE DEVELOPMENT Sustainable development is development that meets the need of the present without compromising the ability of future generations to meet their own needs. 3 pillars Social Economic Environmental 11-Jan-16 2
- 4. 11-Jan-16 4 MDG 1 MDG 1 MDG 2 MDG 3 MDG 7 MDG 7 MDG 7 MDG 7 NEW MDG 8NEW NEW NEW NEW NEW NEW MDG 7
- 5. WHY SDG? Need for a Post-2015 agenda. Lessons from MDGs Natural calamities. Conservation of future. 11-Jan-16 5 Integration of 3 pillars Involvement of all Continuation
- 6. 11-Jan-16 6
- 7. GOAL 3 “Ensure healthy lives and promote health for all at all ages” Wide sense. 9 targets. 4 ‘means of implementation’ 11-Jan-16 7
- 8. TARGET “by 2030 reduce the global maternal mortality ratio to less than 70 per 100,000 live births.” Continuation of MDG 5. India current 174 per 100,000 live births. 11-Jan-16 8
- 9. TARGET “by 2030 end preventable deaths of newborns and under-five children.” Continuation of MDG 4. 11-Jan-16 9
- 10. 11-Jan-16 10
- 11. TARGET “by 2030 end preventable deaths of newborns and under-five children.” Continuation of MDG 4. Current U5MR is 48/1000 live births. NMR 28/1000 LB. Shift of mortality and morbidity burden pattern. 11-Jan-16 11
- 12. TARGET “by 2030 end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases, and combat hepatitis, water-borne diseases and other communicable diseases.” Expansion of MDG 6. 11-Jan-16 12
- 13. TARGET “by 2030 reduce by one-third premature mortality from non- communicable diseases (NCDs) through prevention and treatment, and promote mental health and wellbeing.” New target. Epidemiological transition. Increasing burden of mental ill-health. 11-Jan-16 13
- 14. TARGET “strengthen prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.” New target. In India, tobacco consumption is responsible for 1/2 of all the cancers in Men and a 1/4 of all cancers in women. 11-Jan-16 14
- 15. TARGET “by 2020 halve deaths and injuries from road traffic accidents.” New target. 1 million Men & 3 lakhs Women die annually on the roads. 8th leading cause of death globally. 11-Jan-16 15
- 16. TARGET “by 2030 achieve universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.” Expansion of Goal 5. 11-Jan-16 16
- 17. TARGET “achieve universal health coverage (UHC), 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.” New target. Similar to “Health for all”. 11-Jan-16 17
- 18. TARGET “by 2030 substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.” New target. 11-Jan-16 18
- 20. “Strengthen implementation of the Framework Convention on Tobacco Control in all countries as appropriate.” India is a signatory. Advocacy toolkit. 11-Jan-16 20 Press release & opinion article Information on tobacco use Tobacco tax as financial tool
- 21. “Support research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration which affirms the right of developing countries to use to the full the provisions in the Trade Related Aspects of Intellectual Property Rights agreement regarding flexibilities to protect public health and, in particular, provide access to medicines for all” 11-Jan-16 21
- 22. “Increase substantially health financing and the recruitment, development and training and retention of the health workforce in developing countries, especially in least developed countries and Small Island Developing States.” 11-Jan-16 22
- 23. “Strengthen the capacity of all countries, particularly developing countries, for early warning, risk reduction, and management of national and global health risks.” 11-Jan-16 23
- 24. GOALS WITH DIRECT LINKAGE TO HEALTH 11-Jan-16 24
- 25. GOAL 1 & 2 Poverty is a major cause of ill health and eradicating poverty will improve health and reduce health inequalities. Food security is a major determinant of health. 11-Jan-16 25
- 26. GOAL 4 & 5 Education is a major determinant of health and can help reduce health inequalities. Gender can be a barrier to access to services resulting in social exclusion and women are at a particular disadvantage in low- and middle-income settings where maternal and reproductive services are limited. 11-Jan-16 26
- 27. GOAL 6 & 7 Water and sanitation are key factors in health and wellbeing and contribute significantly to the reduction in child mortality. Climate change and unsustainable energy use are among the biggest threats to human welfare in the coming decades. 11-Jan-16 27
- 28. GOAL 8 & 10 Access to gainful employment and decent working conditions determine mental and physical well-being for families, young people and adults. Socioeconomic inequalities are strong determinants of health inequalities. Equitable policies that reduce socioeconomic inequalities can help reduce health inequalities. 11-Jan-16 28
- 30. 11-Jan-16 30
- 31. WHAT NEXT? All the 3 pillars of sustainable development should be integrated in every plan of action to achieve the targets. Raising awareness about the SDGs among the public. The direct involvement of communities in the agenda setting process. Financial and technical support by the developed world. 11-Jan-16 31
- 32. WHAT NEXT? To continue the work on MDGs. Need to focus on 4 aspects Continuous sustainability assessments. NCDs RTA Substance abuse Disaster risk reduction 11-Jan-16 32
- 33. IMPACT? World will be watching how India implements. Impetus to UHC. ‘Triple burden of diseases’ ‘Getting to Zero’ Improved sanitation. Improved Occupational health. 11-Jan-16 33
- 34. CONCLUSION Although there is only one goal for health in SDGs, it contains broader targets as compared to the MDGs. All pillars of sustainable development should be integrated in every target to be achieved. The new Government of India has adopted the principle of Sabka Sath, Sabka Vikas (“Together with All, Development for All”), and stated that the “first claim on development belongs to the poor.” This is an opportune moment to take bold and corrective measures; and to secure the country’s future with inclusive and sustainable development. 11-Jan-16 34
- 35. 11-Jan-16 35
- 36. REFERENCES 1. World commission on environment and development, our common future(1987) 2. United Nations General Assembly. Resolution Adopted by the General Assembly on 10 September 2014. 3. India and MDGs, towards sustainable future for all, report by UN ESCAP(Economic & social commission for Asia and Pacific),2015. 4. India and sustainable developmental goals, policy brief, the energy & research institute, nov 2013. 5. Review of targets for the sustainable developmental goals, ICSU;ISSC 6. Health in the sustainable development goals: ready for a paradigm shift? Kent Buse and Sarah Hawkes 11-Jan-16 36
- 37. 11-Jan-16 37
Editor's Notes
- - Unlike the MDGs, UN GA consulted 20 countries called as Rio20+ conference to formulate these goals. – attended by >100 countries. –OWG formed to lay down these goals. – in sept 2015.
- - Concept of sustainable development not new, defined way back in 1987. -It contains 2 key concepts: the concept of ‘needs’, in particular, the essential needs of the world’s poor, to which overriding priority should be given; and the idea of limitations imposed by the state of technology and social organization on the environment’s ability to meet present and future needs. – all 3 pillars i.e., social, economic & environmental are important for sustainable development. –simultaneous development 3 pillars.
- Mdg had 8 goals and 18 targets.
- - 1 goal for health only. – sdg goal 1&2 = mdg goal 1; sdg goal 4 = goal 2; sdg goal 5 = goal 3; sdg goal 6,7,11,12,13= goal 7; sdg goal 17 = goal 8. new goals introduced are 8,9,10, 14, 15 &16. – special importance this time to oceans and world peace(9 nuclear countries).
- - Previously imp only to child and mothers, whereas now all age groups covered.
- - Wide sense, as there is no target group identified, health and well being have a general meaning. - But, owg has given targets which more or less tries to cover major aspects of health. - Means of implementation is going to guide the policy makers in achieving the targets.
- - maternal mortality has decreased substantially over the past 25 years ), but the current global rate (210 deaths per 100,000 live births) is still off-track for reaching the target, and there are significant intra- and inter-country variations. – india 174 per 100,000 live births.
- 44% of all under-5 deaths occur in the first month of life. —a group that was not specifically recognized in the MDGs. a Lancet Commission highlighted that an under-5 mortality rate of 16/1000 live births should be achievable in most low- and middle-income countries (compared to the current rate in developing countries of 99/1000 live births).
- 44% of all under-5 deaths occur in the first month of life. —a group that was not specifically recognized in the MDGs. a Lancet Commission highlighted that an under-5 mortality rate of 16/1000 live births should be achievable in most low- and middle-income countries (compared to the current rate in developing countries of 99/1000 live births).
- Commitments to tackle water-borne diseases, for example, will tackle the 3.6% of the global burden of DALYs associated with diarrhoeal diseases - infections which are particularly burdensome in children and neonates, with half a million deaths per year in this age group. Tackling the neglected tropical diseases will potentially reduce an important source of disability and chronic illness in many regions. From 1990–2010 the burden of most infectious diseases fell, but Years of Life Lost (YLL, a summary measure of premature mortality) due to AIDS and TB rose substantially, particularly in low-income countries.
- NCDs which are responsible for two of every three deaths worldwide. Among the top 20 causes of YLL estimated in 2010, 7 were due to NCDs – including 2 of the top 3 (ischaemic heart disease ranks number 1 and stroke ranks third). This ambitious target also includes addressing the increasing burden of mental ill-health (depressive and anxiety disorders together account for 3.6% of the global burden of disease, and rates of self-harm are increasing and account for 1.5%), and the more nebulous concept of ‘well-being’ – commonly used in public discourse, but with little global agreement on its meaning, measurement or determining factors.
- ” These conditions have a significant impact on health outcomes; particularly alcohol which accounted for 2.7 million deaths and around 4% of all disability adjusted life years lost (DALYs) in 2010. - Indian Sikh Guru Gobind Singh - "Wine is bad, Indian hemp (bhang) destroys one generation, but tobacco destroys all generations".
- Every year an estimated 1 million men and 300,000 women die on the roads – making this the 8th leading cause of death globally, and the 10th leading contributor to DALYs .
- The burden of disease associated with unprotected, unwanted or non-autonomous sexuality is significant: an estimated 12% of couples have an unmet need for family planning; globally there are 500 million new sexually transmitted infections every year; cervical cancer is the fourth most common cause of cancer death among women worldwide; and an estimated 30% of women have experienced physical and/or sexual violence from an intimate partner.
- This target represents an important addition to the agenda and has widespread backing from countries and global health institutions. The recent Ebola virus outbreak has highlighted the deficit in strong health systems coverage and access in many countries – systems that will be needed to achieve many of the other SDG targets. The ambition to shift inefficient and unjust out-of-pocket expenditure for health services to financial risk pooling arrangements aims to put an end to catastrophic payments to meet health needs which are estimated to push over 100 million people below the poverty line every year. Vaccines have been identified by most analysts as a ‘best buy’ not only in global health but in development more broadly with benefits estimated at 5–15 times higher than costs. – hfa attainment of a level of health that will enable every individual to lead a socially and economically productive life.
- In 2010, an estimated 3.5 million deaths (4.3% of global DALYs) were attributable to household air pollution, and a further 3.1 million deaths (3.1% of global DALYs) were due to ambient particulate matter air pollution, both ranking in the top 10 attributable risk factors for ill-health worldwide. Less is known about the global health burden associated with water and soil pollution or hazardous chemicals – including risks and intergenerational risks from the nuclear industry.
- - Advocacy toolkit in oct 2015.
- - Public Health expenditure india 1.05% of GDP in 2013. oop expenditure 4.4%
- India being a disaster prone country where floods, earthquakes are frequent, strengthening of warning systems very much necessary.
- BPL is an economic benchmark and poverty threshold used by the GOI to indicate economic disadvantage and to identify individuals and households in need of govt assistance and aid. – about 30% in india fall bpl. – based on calories adult urban 2100, rural 2400. – based on income Rs. 558 per capita per month. - food security is the availability at all times of adequate world food supplies of basic foodstuffs to sustain a steady expansion of food consumption and to offset fluctuations in production and prices. Granaries 10,000 years old.
- India is set to achieve; to reduce maternal mortality by three quarters (Goal 5); control of the spread of deadly diseases such as HIV/AIDS, malaria and tuberculosis (Goal 6); has halved the proportion of population without access to clean drinking water (Goal 7). But India is lagging behind reducing child and infant mortality (Goal 4); and improving access to adequate sanitation to eliminate open defecation (Goal 7).
- - 3 pillars viz., social, economic, environmental.