The recent opening of the United Nations General Assembly represents a key milestone in the development of the Sustainable Development Goals (SDGs), which will take over from the Millennium Development Goals (MDGs) at the start of 2016. In front of the Assembly will be the Outcome Document of Open Working Group on Sustainable Development Goals, which has been labouring away on these new global goals since March 2013.
The MDGs are regarded as being successful because they are relatively few in number (8) and had a similar low number of targets (21) to measure the achievement of the goals. The MDGs were relatively simple to understand and could be relatively easily measured (e.g. Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate). It is a well-understood principle in management that you need to develop a few key objectives that everyone can easily understand and then have clear indicators that measure performance against these objectives – but also support the objectives and don’t have unforeseen consequences. The more complex the system of objectives, targets, measures becomes, the less the implementers are able to understand it in the whole. They then either ignore it completely, focus only on a few ones that they either understand or have a particular interest in, or try to game the system.
The SDGs look like they run the risk of being overly complex. The Outcome Document now proposes 17 Goals, with 169 (!) Targets. Goal No. 17 (Strengthen the means of implementation and revitalize the global partnership for sustainable development) has 19 targets ! The Sustainable Development Solutions Network has proposed that these can be reduced to 10 Goals, which gets us closer to the MDG level (see http://unsdsn.org/resources/goals-and-targets/). Each should only have a few targets (ideally less than 5) to ensure that the focus is on the really critical things that will bring real change. The fear is that the targets will either become too vague that they will be unmeasurable or that the consensus target will be of the lowest common denominator and so not properly address the key issue. The “rush to the bottom” problem is greatest in climate change. For health, the main concern is the lack of focus and the spreading of resources too thinly. The health MDGs focused strongly on the three target diseases of malaria, HIV, and tuberculosis. In so doing they managed to really direct resources on these three key diseases for the low-income and lower-middle-income countries. We can now see the results of this targeted investment as the numbers of HIV and malaria infections are now really declining. Just at the point where, in the case of malaria, we can see a real opportunity to eliminate the disease as a public health hazard, the SDGs may divert attention away (and with it resources) and undo all the good work that has been achieved in the last 15 years. The proposed Goal 3 on health is now looking to address not only the key infectious diseases but child and maternal mortality, hepatitis, water-borne diseases, other communicable diseases (in addition to HIV, TB, and malaria), non-communicable diseases, mental health, substance abuse (including tobacco and alcohol), road traffic accidents, sexual and reproductive health care, access to universal healthcare, and illness and death from pollution. This smacks of trying to get everything on the agenda and an inability to prioritise the really key issues. This is not to say that any one of these health-related issues is not important in some part of the world. But what message does it send to political leaders when they have to start making decisions on allocating resources? Surely the community of world experts can come up with a more focused set of key priorities and set these out in a smaller group of goals that it will be easier to get people to coalesce around.
Although malaria remains clearly identified in proposed Goal 3.3, there is now a much harder task for the global malaria community to persuade the key global funders and national governments to target resources towards this disease. The calls recently both from the Gates Foundation and the Malaria Elimination Group to accelerate the efforts to eliminate malaria by 2050 will be put at risk by this reduction in focus seen in the draft SDGs. The malaria community has been rather slower than other interest groups in getting across its message about how malaria can contribute to the broader goals. There needs to be an increased effort to ensure that this message gets across coupled with more work to persuade the people who will finally approve the SDGs to ensure they are realistic and actionable.
But the bottom line of this comment is that in their current form the SDGs look to be too unfocused, may be unworkable, and may not really contribute to the overall objective of sustainable development for all.
The Open Working Group’s recommendations are available here: Outcome Document