From MDGs to SDGs: approach to achieving health-related goals

The MDGs were critiqued for allocating resources towards disease-specific vertical programs with few efforts to improve health systems. In contrast, the health-related SDG 3 takes a more systems and determinants-based approach and aims to achieve its targets through working with other sectors.

Another distinction between the MDGs and SDGs is the target population of the global health agenda. The MDGs targeted health issues that are more prevalent in developing countries and were set in a “rich countries aiding poor recipients” context. The SDGs, in contrast, call for addressing inequalities and strengthening the capacity of all countries to address global health risks that transcend national borders.

The shift in global funding priorities

The launch of the MDGs led to a substantial increase in global health funding, particularly to health issues (e.g. HIV/AIDS) directly linked to the MDGs.

Figure 1: Health Focus areas of Development Assistance for Health 1990 -2015

However, the allocation of direct Development Assistance for Health has plateaued (figure 1) in the past five years. According to the Institute for Health Metrics’ Financing Global Health 2015 report, the reduction of contributions by some donors, while others increased their funding, is the reason behind the plateau. This change in donors’ profile also affected global health funding priorities. The surge funding is linked to specific priorities such as health systems strengthening and universal health coverage rather than direct program funding. These priorities are more in line with SDG 3 as compared to the health-related MDGs.

During the third International Conference on Financing for Development in 2015­­­­, areas such as education and climate change received more attention than direct funding for health. This indicates the need for more innovative global health approaches that span multiple sectors to secure funding health-related projects in the upcoming years.

MDGs and global health degree programs

Global health related degrees in the United States of America – as one of the countries providing graduates to the global health job market – have been on the rise for the past 15 years (figure 2). The surge in global health degrees seems to follow the trajectory of the adoption and implementation of the MDGs. Possibly because achieving the MDGs required an increase in the workforce or due to the increased flow of funding which led to an expanded job market.

Figure 2: Increase in number of Global Health initiatives between 2000 -2012

 One can assume that the global health degree programs incorporated MDGs-related competencies to improve the competitiveness of their graduates in the global health job market. Moreover, the Center for Strategic and International Studies cites increased funding for global health as one of the reasons for the increase in global health programs in the past 15 years. All of the above poses the question whether the shift in funding priorities will have an effect on the structure of global health programs.

The SDGs and the next step in Global health education

Questions about whether global health training aligns with real world applications are not new. In 2010, the Lancet commission on the education of health professionals called for a global reform including education for public health professionals to address the challenges of the 21^st century. The adoption of the SDGs – transitioning global health priorities and funding – might just be the push needed for such reform.

While a comprehensive assessment of global health degrees will likely be a lengthy process, programs can take a few steps to transition from MDGs to SDGs approach. One option is to prepare students– through collaborating with programs that are not historically linked with health such as engineering–for careers that are increasingly framed in an inter-sectoral approach to health. Moreover, programs can offer courses on emerging global health issues that span boarders such as climate change. Finally, as actors call for more accountability for SDGs, global health programs can also put more emphasis on courses that provide monitoring and evaluation skills.

Global Health education and developing countries

Global health revolves – at least theoretically – on issues transcending national borders. However, global health degrees – following the MDGs – mostly target developing countries. The disparity between the focus of global health education and where it is mostly offered – in institutions in developed countries – is one of the obstacles to fully achieve the goals of global health. Such disparity can be partially mitigated through adding a local perspective by experts from developing countries.  Moreover, one of the aims of SDGs is training local healthcare workforces. Hence, a long term goal to transform global health education through the establishment of global health education institutions within developing countries is in line with the SDGs.