HEALTH IN THE POST-2015 GLOBAL DEVELOPMENT AGENDA

1 IMVF Position Paper

HEALTH

IN THE POST-2015 GLOBAL

DEVELOPMENT AGENDA

Position Paper

HEALTH IN THE POST-2015 GLOBAL DEVELOPMENT AGENDA

2 IMVF Position Paper

HEALTH IN THE POST 2015

GLOBAL DEVELOPMENT AGENDA

Position Paper

Considering that:

1.

The Millennium Declaration, approved in 2000 and

materialised in the Millennium Development Goals

(MDGs), is a major milestone in Development

history. Despite some criticism it was the first time

that common, simple and measurable objectives and

goals were defined, shared by a great number of

countries, allowing for a reference framework for

the definition, implementation and evaluation of

public policies, namely on Health (MDG 4 - Reduce

Child Mortality, MDG 5 – Improve Maternal Health

and MDG 6 – Combat HIV/ AIDS, Malaria and other

diseases).

2.

Considerable progress was achieved in some MDGs,

especially in eradicating extreme poverty and hunger

(MDG1), mainly due to positive developments in

heavily populated countries and especially in Asia. In

2010, and for the first time since poverty trends

started to be monitored, not only did the number of

people living in extreme poverty decrease but also

the poverty indexes lowered in all developing

regions, including sub-Saharan Africa where the

rates are usually higher. However, these global data

hide great inequality, between countries and within

countries. About a billion people continue to live in

extreme poverty (the so-called “bottom billion”).

3.

Assessing the progress of these goals, the MDGs on

maternal and child health (4 and 5) are the ones

that have progressed the less and more unevenly

throughout regions. Sub-Saharan Africa continues to

register less encouraging indicators than other

regions on the Health sector; regarding general

access to health care, life expectancy, child

mortality, maternal health, sexual and reproductive

health and communicable diseases.

4.

The focus on Health as a fundamental axis of

Development is not something new. The

Declaration of Alma-Ata, approved at the

International Conference on Primary Health Care,

which took place in 1978, already called for an

urgent solution to establish the promotion of health

as one of the priorities of the new international

economic order, in order to decrease inequalities

between richer and poorer countries. Primary health

care, prevention and health education measures

were established as viability factors for universal

health care, and all governments were declared

accountable for the promotion of health. The

movement “Health for All by the year 2000” took off

and a process of International Conferences on the

Promotion of Health started to take place (the first

one was held in 1986 and approved the Ottawa

Charter, which defined important factors to reach

health for all). Taking into account all these

processes of debate and thinking, one can consider

that that the goals established in the MDGs in 2000

for this sector were not so ambitious or

comprehensive, focusing only on specific aspects of

health and forgetting the linkages between health

and all other global objectives. Even after 12 years of

reflexion and dialogue, the Final Declaration of

Rio+20 only mentions Health issues very briefly.

5.

The transformation of the world’s geography of

poverty, the increase in inequalities (between and

within countries), increasing urbanisation and

demographic trends present new global challenges,

which are determinant for the populations’ health

and quality of life. Some challenges are different in

developed and in developing countries. In the

majority of developed countries the ageing of the

population combined with numerous risk factors

HEALTH IN THE POST-2015 GLOBAL DEVELOPMENT AGENDA

4 IMVF Position Paper

d. A new universal and unified global agenda, with

clear goals that provide an answer to Poverty

and Development challenges as

multidimensional phenomena, involving a

balance between economic, social and

environmental dimensions, putting people at the

core of Development. In this sense, it is

especially relevant to fight inequalities and

promote equality – of opportunities, of rights,

of access and results – in several sectors.

e. Pursuing and reinforcing the recognition of

Health as a fundamental Human Right, as an

issue of social justice and a predominant factor

for promoting Development and economic

growth. Thus, it is fundamental to have an

agenda that defends universal and equal access

to Health, assuming that people, their rights

and their well-being are the centre of all

processes.

f. Defining and implementing a global agenda for

Health that takes into account not only the

proximate causes of disease, but that also acts

on the barriers and social, economic and

environmental factors that condition the

evolution of Health indicators (and that are

intertwined with a multiplicity of sectors and

policies). In that sense, the new agenda must

take into consideration and make explicit those

linkages and multidimensionality, while

promoting the policies that contribute directly

and indirectly to improving Health and well-

being.

g. Defining a specific, comprehensive and high-

level Goal on Health, that goes beyond its

transversal nature. As Health is a global

concern, the main challenge is in defining an

approach, goals and indicators that are

simultaneously relevant for all countries and

sufficiently flexible to respond to different

challenges and problems.

h. Implementing a transformative agenda on

Health, through the definition of objectives,

instruments and mechanisms that focus on the

need for structural changes and not only short-

term solutions, namely in what concerns the

structuring of national health care systems, the

importance of primary health care, the right of

access to sexual and reproductive health (with

proven demographic and economic effects) or

the need to apply prevention and health

education measures as conductive factors for

universalizing the right to Health.

a. Having a special focus on investing in women

equality, rights and health, for the multiplying

effects such investment has on individuals,

families and communities’ well-being, as well as

on economies and productivity issues.

b. Recognizing the need for reinforcing

investments on Health Development in the

broader scope of Development promotion,

including the search for and implementation of

innovative financing sources at a national,

regional and global levels.

c. Promoting larger community empowerment,

stronger political commitment from all policy

sectors and the existence of a shared

commitment between all actors – public entities,

private sector, community organisations and

international organisations – is still necessary to

ensure real progress on responses towards the

old and new challenges on Health. The role of

each of those actors and their mutual

responsibility must be valued and explicit in the

new global agenda.

July 2013

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ABOUT IMVF

Instituto Marquês de Valle Flôr (IMVF) is a private foundation and a Non-Governmental

Development Organization (NGDO) that carries out humanitarian aid and economic, cultural and

social development cooperation and education. It also conducts studies and produces scientific

papers on several fields of knowledge, and promotes and disseminates the culture of countries

whose official language is Portuguese.