WHO Report Examines Health Achievements, Future Challenges For Implementation Of SDGs

From the United Nations Millennium Development Goals to the Sustainable Development Goals, what are the main achievements in health and what are the main challenges for the next 15 years? That is the question the World Health Organization sought to answer in a new publication issued yesterday.

During an 8 December press briefing, Ties Boerma, director of information evidence and research at the WHO, said 2015 is a special year as it is a pivotal year between the MDGs and the SDGs.

The WHO publication “Health in 2015: from MDGs to SDGs,” presents the data and analysis for key areas outlined in the SDGs, such as infectious diseases including HIV, tuberculosis, malaria, hepatitis and neglected tropical diseases; noncommunicable diseases (NCDs) including heart disease, cancer and diabetes; and universal health coverage.

The first agenda was a “poverty agenda,” he said. The SDGs in contrast are for all countries, not just developing countries, and for all people of all ages. They address the economic, social and environmental dimensions of development, he said.

Great progress in health has been achieved since the beginning of the MDGs, he said, citing a 53 percent reduction in child mortality as an example, and progress in the fight against HIV.

Success in health is the result of combined factors such as: a sharp rise in funding, which reached US$35 billion a year, although it has levelled off in most recent years; collaborative efforts such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance; and new medicines, he said. However, health systems in developing countries remain weak, he added.

Boerma said the WHO should play a major role with others in reviewing progress and look at what issues are needed to improve implementation of the agenda.

The report, called the first of its kind at WHO, includes 35 “snapshots” on issues such as tuberculosis or road traffic injuries, showing what happened in the last 15 years, what has led to success, what are the main challenges now and what the new SDGs agenda say about this.

Intellectual Property Part of Health Agenda

One specific target under the health goal, Target 3b, deals with the issue of IP and access to medicines, so it is quite prominent in the SDGs. “We see it very much as an integral part of this agenda,” he said, adding that access to medicines is necessary to achieve the goal of universal health.

Answering a question on the importance of R&D in the next 15 years, for example in the quest for new antibiotics, or drugs for neglected diseases, he said antimicrobial resistance is a concern of everyone, it is a global issue and needs to be addressed in several sectors. In the SDGs there is no specific target on antimicrobial resistance, he noted.

On neglected diseases, Boerma said the WHO would launch next month the Global Observatory on Health Research and Development, which came out of many years of discussion at the annual World Health Assembly. That can be used to generate evidence on whether or not the gap is closing on R&D investments and results for the neglected diseases, he said.

On a question about the rising prices of new medicines, such as oncology and hepatitis C medicines, and biotherapeutics, he said, “if medicines are not affordable by the governments or for individuals one cannot come closer to the goal of universal health coverage.”

Universal health coverage means receiving the services people need without incurring financial ruin, he explained. “One interesting lesson of the last 15 years,” he said, “is HIV antiretroviral drugs, because when they came on the market, they were not affordable. Civil society played an enormously critical role in bringing down the prices, a hundred fold in a period of ten years or so.”

“Will the same happen to all the other drugs which are too expensive?” he asked. “Of course there will always be price reductions, how big they are is an issue.”

“Governments will have to deal with the issue that technological advances can be made but at what costs and with what population health gains,” Boerma added, and there are difficult choices to be made with ageing populations making that even more difficult.

Health target in SDG 3 read as follows: “Support the research and development of vaccines and medicines for the communicable and noncommunicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.”

The report notes that “the failure to complete the Doha Round, and the increase in mega-regional trade agreements such as the Trans-Pacific Partnership (TPP) and European Union–United States agreements, could strengthen intellectual property protection in ways that could undermine access to medical products.”

On neglected diseases, the report says, “The profit motive for innovation has provided inadequate incentives for research and development (R&D) into the medical products needed to prevent and treat the diseases that especially afflict the poor. Tensions remain between the system of intellectual property protection for pharmaceutical products on the one hand and international human rights obligations and public health requirements on the other.”

 

Image Credits: Catherine Saez