The Millennium Development Goals (MDGs) adopted in 2000 formed a time-bound global blueprint to set a course for improved health, economic growth and education for all.
The targets set for health – slashing child and maternal mortality rates and moving closer to ending epidemics of AIDS, TB and malaria – were, according to criticism that accompanied their 15 years of implementation, unrealistic, especially for sub-Saharan Africa. The needed investments to achieve sustained and substantive progress towards these targets were inadequate: not in terms of financial resources, or of human resources, or of an enabling policy environment.
So back to the drawing board we went, for what was hailed as a much more participatory, inclusive and consultative process to come up with the Sustainable Development Goals (SDGs): the framework for the next 15 years of action in development. Where there were eight goals, now there are 17. And only one of them – with 12 targets – is focused exclusively on health: to ensure healthy lives and promote wellbeing for all, at all ages.
Where the MDGs were criticized as unambitious and narrow, the SDGs are broad, contextual and exceedingly aspirational. There remains, however, much to learn from the MDGs in order to apply their lessons to the next generation of development scholarship and implementation.
Global goals, national achievements
Global cooperation is no longer an aspiration; the increasingly connected world we live in means that true collaboration is possible and necessary to achieve common goals, and the partnership to achieve the MDGs illustrates this. We have witnessed the success in mobilizing resources to fill the ‘war chest’ for AIDS, TB and malaria that is the Global Fund: a $4 billion annual multilateral financing mechanism. Initiatives to support universal primary education and global initiatives to protect natural resources and the environment are other examples of this new collaboration of equals that recognizes that pollution, conflict and disease do not stop at national borders.
New applications of these lessons have come quickly; whether it is the migration crisis that shows no signs of abating, the spread of epidemic diseases such as Zika in the Americas or Ebola in West Africa, the response to health challenges has drawn in actors from across the globe. Under the MDG era, the global cooperation provided a form of peer-assessment that achieved a stature never seen before. Countries were able to make comparisons amongst themselves, using the same indicators over the same period. As a result there is now increased interest in national survey results on health and socio-economic development in countries.
The new focus on indicators and surveys did, however, reveal the glaring holes in some countries’ ability to collect, manage or analyze data – leaving them behind in the measurement of their own progress. One of the biggest challenges in measuring a country’s progress towards the MDG indicators was the lack of appropriate data, particularly vital statistics. People are born, live a full life, and die without being recorded in government statistics. And even with collection of service data – either at the school or health facility level – there is no guarantee that those data are properly utilized.
For sub-Saharan Africa not to be left behind, there must be better investment not only in the technology to digitize records but also in the development of indigenous capacity to routinely collect, analyze and use data.
Going forward
Better data management is only one area where smarter, more strategic investments must be made. Though developing countries are surging ahead economically, their investments in infrastructure and system spending has not kept pace. This has widened the inequity within countries and left the poorest and most vulnerable with a services deficit. Not only are the facilities in decay but the human resources available to provide services are wanting, especially in the most compromised areas.
Global economic crises have further constrained the donor landscape, meaning there is less in the development partner pocketbook than there was in the past. Countries must do their own part – and own their own budgets on key issues – to ensure that progress towards the SDGs are met. This is where evidence plays a critical role in helping countries to prioritize; an example is the World Health Organization’s so-called ‘Best Buys’ for non-communicable disease. These are smart investments in prevention, education and detection that research has demonstrated will pay off in the long run.
Multiple players working toward common goals: The MDGs success stories have demonstrated what can be achieved in working together. This, we hope is an incentive for more players coming on board in the new dispensation. Partnerships in financing, science, information and technology transfer, and security, should be the cornerstone of the new development agenda. Approaching developmental issues in a holistic manner as opposed to segmentation along sectors should be promoted due to the inherent interdependencies and potential synergies that can be harnessed.
Governance and accountability: It has been noted that even in the poorest of countries, where there is good leadership and accountability, progress has been made. Going into the SDGs, governments in SSA should be more prepared and interested in being active partners than was the case 15 years ago. This commitment should be reflected in their actions. Lack of accountability for results and resources at national and global levels has been one of the weaknesses of the MDGs. We need to do all the things by all concerned, that will help countries move forward and avoid those that have perennially bedeviled the African continent including bad governance, corruption, and lack of accountability. We should not bask in the glory of some of the MDG achievements or cry over what we have failed to achieve. We should take the lessons forward, and allow no room for failure.