Governments And Philanthropy Can’t Address Stalled SDGs Alone

At the Sustainable Development Goals Summit last week, world leaders discussed the many ways in which progress toward the Sustainable Development Goals (SDGs) has slowed, stopped, and in some cases retreated. Halfway to the 2030 deadline, half of the 140 targets are off-track and a third are at or below their 2015 baselines. We must reverse this trend.

Achieving the SDGs is even more critical than in 2015, as the world faces unprecedented shocks. The COVID-19 pandemic has taken almost seven million lives and done incalculable damage to health systems. Climate change threatens billions of livelihoods through extreme weather, rising seas, and changing ecosystems. Global conflict is resurgent, and economic inequality and instability are widespread. 

A worrying increase in maternal deaths after decades of improvement is just one example of how easily progress can be reversed, and our public health networks and infrastructure cannot begin to meet the need.

In short, it is a time for reckoning and for action. A time to acknowledge that achieving the SDGs is not the responsibility of governments and philanthropists alone. We need everyone at the table, from grassroots civil society to academia, the private sector and multilateral finance and banking institutions, if we are going to accelerate progress on the SDGs. 

Unprecedented cooperation

But there are lessons to be learnt in every crisis. On that front, at least, the global public health community is ahead of the curve, with the interrelated crises we face eliciting unprecedented levels of cooperation and data-sharing among public and private, global and local actors. 

This period of deterioration in health services and quality of life for so many has also been one of the most productive periods in research in recent memory. That is especially true when it comes to the complexities of multinational programs and the cascading, multiplicative effects of crisis. 

The need for cooperation is the broadest and most common theme to address at this mid-point in our shared work toward the SDGs. What the last seven years have shown us is that government and philanthropy alone lack the tools, resources and insight needed to achieve change on this scale. While both are indispensable, their efforts must be tightly linked to those of global financial institutions, civil society in every nation, and – perhaps most vitally – local organizations that understand how best to reach and support the most vulnerable members of their communities.  

The flip side of that need for cooperation involves industries that are actively hampering progress toward SDGs. For-profit industries that harm health and the environment can’t be part of the solution as long as they are part of the problem. 

Tobacco offers a clear example; with SDG 3 dependent on reducing rates of smoking, tobacco companies have simply shifted focus away from well-regulated markets to target young people and markets in developing regions. Limiting their access, disinvesting from their companies, and cutting them out of global conversations are just as important as paying for preventive care or addressing the shortage of health care workers.

Reimagining our solutions

The UN has identified 12 high-impact initiatives to boost SDG progress, and these will be a key part of discussions around the summit. Bringing these initiatives from discussion to action will require concerted collaboration and innovative partnerships.

Here are four of the initiatives that illustrate the value of partnerships, how progress or setbacks in one goal inevitably affect the others, and the critical role public health plays across the SDGs.

Scaling up long-term, affordable financing for the SDGs

The best plans and goals are pointless if countries don’t have the means to implement them. In July, UNDP published a policy brief arguing that in many low- and middle-income countries, the debt burden is draining resources that should be invested in achieving the SDGs. In 2022, 25 countries spent more than 20% of government revenues on external debt service; the average low-income country spends 2.3 times more on interest than on social assistance. 

The authors propose adding “debt pauses” to the international financial architecture to give developing economies room to grow—and recover from shocks such as COVID-19—while also improving people’s lives.

Bringing international finance institutions to the table is one example of a potential partnership that could boost progress on SDGs, especially the first one: “End poverty in all its forms everywhere.” And ending poverty is key to progress across the SDGs.

Food systems transformation 

World hunger has increased in recent years, with an estimated 9.2% of the world’s population in a state of chronic hunger in 2022. At the same time, the international development community has been slow to look beyond hunger to malnutrition and food insecurity in all of its forms. 

The high-impact initiative on food systems transformation recognizes that we need to change our food systems, so they provide healthy, nutritious food for all, in line with SDG 2, which seeks to end hunger, achieve food security and improved nutrition, and promote sustainable agriculture.

At Vital Strategies, our Food Policy Program has been supporting our civil society partners in sounding the alarm about the health risks of ultra-processed foods high in salt, fat and sugar that international corporations market mercilessly—including to children—despite the proven health risks. 

These cheap, unhealthy products have made it more difficult for people to consume nutritious, traditional diets. The ubiquitous nature of ultra-processed foods exposes billions of people to a higher risk of noncommunicable diseases, including type 2 diabetes, heart disease, stroke and cancer.

Poor nutrition is responsible for 11 million deaths from NCDs annually, killing more people than tobacco. Our Food Policy team has supported civil society partners in Barbados, Brazil, Colombia, Jamaica and South Africa to work toward proven healthy food policies such as taxes on sugary drinks and front-of-package warning labels on ultra-processed products. These policies are just one component of the food systems transformation that has to happen—but a critical one.

Unlocking the data dividend for the SDGs

Regardless of the issue, “data is the fuel that powers progress across all the SDGs,” and investments in data return an average “dividend” of $32 for every $1 invested. Data is especially important in health. We simply cannot address pressing health challenges without the data to guide us. That is why strengthening data collection and shoring up national civil registration and vital statistics systems is an integral part of Vital Strategies’ work. 

Vital Strategies is proud to be a leader in this kind of big-picture, cross-sector collaborative thinking. We partner and work with governments to expand the use of data to identify problems and potential solutions, particularly concerning equity. 

During the COVID-19 pandemic, Vital’s Data for Health team partnered with 13 countries in rapid mortality surveillance—a way to track the true human toll of the pandemic by comparing recent mortality rates to historic averages. These are the kinds of partnerships that drive real progress, but we need the political leadership and investment to make them happen. 

We also need to invest in gender-based statistics so that government stakeholders can rely on applicable data to build policies and programs that will close gender equity gaps. By applying a gender lens to data collection and analysis, we can address a broad range of gender-sensitive policy issues, such as ensuring that all girls are registered at birth, reducing barriers to reproductive health care and treatment, and preventing gender-based violence. 

In Brazil, for example, Vital Strategies’ research uncovered a hidden epidemic of femicide and domestic violence. By selecting mortality data for which the cause of death was unknown, investigators were able to attribute many of these deaths to gender-based violence. We spotlighted other examples of using data to address violence against women at a VitalTalks event in May, “Can Data End Gender-Based Violence?”  

Pulling together

In a special SDG report released in July, UN Secretary-General António Guterres issued a stark warning: “Unless we act now, the 2030 Agenda could become an epitaph for a world that might have been.” 

Affordable financing and debt restructuring—as described in the SDG Stimulus—top his list of critical actions, along with reforming “our outdated, dysfunctional and unfair international financial architecture.” But the U.N., governments and donors can’t go it alone. 

At the halfway point to 2030 and the SDG deadline, we all need to pull together. Without active participation by all stakeholders, the SDGs will fail. I wish the forecast were brighter. But it is clear. Clear that our current actions are falling short, and this is a critical moment if we are to make the world the safe, healthy, prosperous place that I know it can be, for everyone.

José Luis Castro is the President and CEO of Vital Strategies, where he has led a rapid expansion of Vital Strategies’ portfolio to tackle the world’s most difficult health challenges, primarily in low- and middle-income countries. The organization now works in 73 countries and has touched the lives of more than 2 billion people.

Image Credits: Cia Pak/ United Nations, Vital Strategies.