Expanded health systems for sustainable development

Abstract

Since the United Nations (UN) launched the 2030 Agenda for Sustainable Development in 2015, the global health community has grown accustomed to the new catalog of 17 Sustainable Development Goals (SDGs, 2016–2030), and even to the criticism that has been leveled at numerous imprecise targets. SDG 3 makes universal health coverage (UHC, Target 3.8) central to achieving the principal health goal of healthy lives and well-being for all at all ages, and sets targets for reducing the burden of noncommunicable diseases and injuries, a conspicuous omission from the Millennium Development Goals (MDGs, 2000–2015) which focused on maternal and child health and major communicable diseases. But the greater ambition of the 2030 Agenda is to anchor health in development, recognizing that good health depends on and contributes to other development goals, underpinning social justice, economic prosperity, and environmental protection. These aspirations have been frequently voiced but scarcely pursued, and the SDGs are often treated simply as a checklist of new goals and targets. Yet their potential is far greater—collectively they should be a force for discovery of new ways to achieve better health and well-being. To this end, the legacy of the MDGs, and the structure of the SDGs, lead to a testable proposition for research: Advance health and development by expanding the scope and enhancing the effectiveness of the systems and services that prevent and treat illness. At stake is the question of how to accelerate gains in health through broad-based sustainable development, building on successes and compensating for weaknesses of targeted, time-limited health programs.