Assessing health SDG impact: A year later


Each year, leaders from around the world converge in New York City in the US for the United Nations General Assembly (UNGA).

The ongoing 71st session of the UNGA which started on 13 September followed the 70th anniversary year of the UN, a good year for multilateralism, that saw the high-profile adoption of the 2030 Agenda and the Sustainable Development Goals (SDGs)—which replaced the Millennium Development Goals (MDGs), the Paris Agreement on Climate Change, the Third International Conference on Financing for Development and the adoption of the Sendai Framework for Disaster Risk Reduction

SDGs marked a turning point in the way broad and global issues are addressed—although it remains to be seen what impact they will have on humanity.


The 71st session had a task to review on what has been achieved and how countries have begun the implementation of SDGs.

Even though all goals are equally important, they cannot be achieved if the nationals of the member states are not healthy.

SDGs cover a number of important social and developmental areas, including climate change and resilience, global health and economic empowerment.


There are 17 goals that include 169 targets. SDG Goal Three focuses on global health, and it includes 13 targets. According to the World Health Organisation (WHO), “Almost all of the other 16 goals are directly related to health or will contribute to health indirectly.”

Malawi health system is among those which have lots of shortfalls ranging from lack of quality health care due to poor patient-doctor ratio, inadequate drugs and medical supplies, corruption, drug theft and lack of sophisticated treatment equipment among others.

One of the targets for SGD Goal Three specifically targets the global epidemics of Aids, tuberculosis (TB), malaria and neglected tropical diseases. The goal commits to ending these epidemics by the year 2030.

One of the TB-related factors not present in the goals is the need to address antimicrobial resistance (AMR) — the spread of strains of disease that are resistant to standard treatments. AMR has emerged as an urgent global health challenge that could prevent many countries from achieving the health-related SDGs.

According to National TB Control Programme 2011 survey, the country reports 28 cases of MDR TB in a year, meaning this type of TB is an emerging problem for Malawi, adding that its prevalence rate is at five percent.

Citizen News Alliance (CNS) brief for journalists indicates that to address the global challenge posed by AMR, today, 21 September, 2016 during the General Assembly, the UN will host a high-level meeting on AMR. This will be a key moment for mobilising international action against multi-drug-resistant TB.

Executive Director for Uganda International Union against Tuberculosis and Lung Disease (The Union), Doctor Anna Nakanwagi-Mukwaya notes that there is slow progress in the decline of the disease to meet SDGs by 2030.

She says, in the last decade, much more funding was provided for TB control but the decline in incidence was only two percent per year.

“Surveys done in the last two years have shown much higher prevalence rates of TB compared to what was estimating for many countries, most especially in the sub-Saharan Africa. Sub-Saharan Africa is still driving the TB epidemic,” Nakanwagi-Mukwaya says.

She says the systems in many countries are very poor and cannot support meaningful reduction of TB, malaria and anti-microbial resistance, saying: “TB and malaria control cannot be achieved within poor health systems. Unfortunately, so much attention and funding is focused on individual disease programmes and not health systems strengthening.”

She recommends that to rapidly reduce the TB incidence, there is need to reduce new HIV incidence and treat all people living with HIV with antiretroviral (ARV) treatment.

“Provide more support from national budgets and donors to strengthen health systems and therefore implement innovative interventions to increase access to TB services within slums, urban and hard-to-reach populations and in the end treat them. Surveys have shown that men are missed by many,” Nakanwagi-Mukwaya says.

Executive Director for Health and Rights Education Programme, Maziko Matemba, says Malawi has good representation at international level when it comes to adopting universal issues such as SDGs.

“But implementation is largely a problem because we have inadequate resources allocated to our health sector. I have noted that very few internationally committed goals and policies are achieved. Even our own local policies, we are not able to achieve them. It is high time we changed the way we do things in order to achieve not only the SDGs but even local policies and goals,” he says.

The journalists’ brief says for TB, countries can take an important step towards addressing drug resistance. In May this year, WHO endorsed a new shortened treatment regimen for MDR-TB.

This new nine-month treatment is substantially shorter and easier to tolerate than the previous 24-month regimen. In order for the new regimen to reach patients in need, countries must now adopt the nine-month regimen into clinical guidelines, train health workers to deliver the new regimen and ensure adequate supplies of quality-assured medicines are available.

Within Goal Three, a particular emphasis is placed on child health, maternal health, and, finally, HIV/Aids, malaria and other diseases, including TB.

Although TB prevalence declined by 41 percent between 1990 and 2013, an estimated 1.5 million people died of TB worldwide in 2014, according to WHO.

The CNS brief points out that with HIV on the decline globally, TB is now the world’s deadliest infectious disease. The world needs greater emphasis on combating drug resistance in order to reach its goal of TB eradication.

Another important global health-related target in Goal Three is number 3.8, which aims to extend universal health care, worldwide, by 2030.

Achieving universal health care would mean that communities have convenient access to quality treatment, prevention services and care for common diseases, including TB and illnesses associated with HIV. As a result, transmission of the disease would slow, providing improved protection to individuals and communities.

SDG Goal Three targets

— 3.3 By 2030, end the epidemics of Aids, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.

— 3.4 By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

— 3.8 Achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

— 3.a Strengthen the implementation of the World Health Organisation Framework Convention on Tobacco Control in all countries, as appropriate.

— 3.c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing states.

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