Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs): Addressing Unfinished Agenda and Strengthening Sustainable Development and Partnership

Abstract

Introduction International development agenda has been actively led by the United Nations (UN) and its technical agencies and funds from their inception in the late 1940s. Till 1990s, the approach was fragmented and disjointed initiated by its specialized agencies or funds at various World Summits and Conferences to address three dimensions of development — economic, social, and environmental. The Millennium Declaration and Millennium Development Goals (MDGs) saw the convergence of development agenda of United Nations Development Programme (UNDP); United Nations Environment Programme (UNEP); World health organization (WHO); United Nations Children's Fund (UNICEF); United Nations Educational, Scientific and Cultural Organization (UNESCO); and other development agencies.(1) Recently adopted Sustainable Development Goals (SDGs) reflect further strengthening convergence of the development agenda. The SDGs also strengthen equity, human rights, and nondiscrimination. Progress in MDGs and Build Up to SDGs The MDGs generated new and innovative partnerships, galvanized public opinion, and showed the immense value of setting ambitious goals. By putting people and their immediate needs at the forefront, the MDGs reshaped decision-making in the developed and developing countries alike. It helped to lift more than one billion people out of extreme poverty, to make inroads against hunger, to enable more girls than ever before to attend school, and to protect our planet. Yet inequalities persist and the progress has been uneven. The world's poor remain overwhelmingly concentrated in some parts of the world. Several women continue to die during pregnancy or from childbirth-related complications. Progress tends to bypass women and those who are lowest on the economic ladder or are disadvantaged because of their age, disability, or ethnicity. Disparities between rural and urban areas remain pronounced.(2) India has made a substantial improvement in MDGs but the progress is mixed. The under-five mortality rate (U5MR) has come down from 126 (1990) to estimated 48 not reaching the target of 42 by 2015. However, the estimated child deaths have come down from 3.36 million (1990) to 1.2 million (2015) that translates to 3,300 child lives saved every day! U5MR in India is still above the world average (43), and is higher compared to Sri Lanka (10), Nepal (36), and Bangladesh (38). Infant mortality and neonatal mortality rates have come down to 38 (target 27) and 28 from 88 and 57, respectively.(3) India achieved a maternal mortality rate (MMR) of 167 (2011-2013) and expected to reach 140 in 2015 down from 437 in 1990, which is well above the target of 109.(4) If we go by the latest UN estimates of MMR of 560 in 1990,(5) the target should be 140 and India is on track to achieve this target. The target of safe drinking water has been achieved in rural areas and is likely to be achieved in the urban areas as well. The target of sanitation is likely to be achieved in urban areas and missed in rural areas.(5) The SDGs and Targets To create a new, people-centered, development agenda, a series of global consultations were conducted both online and offline. Civil society organizations, citizens, scientists, academics, and the private sectors from around the world were all actively engaged in the process. The SDGs include 17 goals and 169 targets.(6) Indicators are expected to come out in March 2016. The 17 goals in abridged form are as follows: No poverty; Zero hunger; Good health and well-being; Quality education; Gender equality; Clean water and sanitation; Affordable and clean energy; Decent work and economic growth; Industry, innovation, and infrastructure; Reduce inequality; Sustainable cities and communities; Responsible consumption and production; Climate action; Life under water; Life on land; Peace, justice, and strong institutions; and Partnership for the goals. Detailed goals and indicators are at https://sustainabledevelopment.un.org/?menu=1300. The targets are aspirational and global and that each government will set its own national targets taking into account the national circumstances. The SDGs can be broadly divided into three categories: First, an extension of MDGs that includes the first seven SDGs; second group is inclusiveness (jobs, infrastructure, industrialization, and distribution). It includes goals 8, 9, and 10; and the third group is on sustainability and urbanization that covers the last seven goals: sustainable cities and communities, life below water “consumption and production; climate action; resources and environment; peace and justice; and the means of implementation and global partnership for it”. Health goal The third SDG — “ensure healthy lives and promote well-being for all at all ages” — is wider-ranging compared to the health goals in MDGs that were limited to child and maternal mortality and communicable diseases. The social determinants of health though not spelled as such but are addressed through Goals 1 (poverty), 2 (hunger), 4 (education), 5 (gender equality), 6 (clean water and sanitation), 7 (affordable and clean energy), 8 (decent work and economic growth), 9 (industry innovation and infrastructure), 10 (reduced inequalities), 11 (sustainable cities and communities), 12 (responsible consumption and production), 13 (climate action), and 16 (peace, justice and strong Institutions). Health targets The health goal has nine targets and four subpoints.(6) The first three targets are continuation of MDGs, the next three are on no communicable disease (NCD), and the last three are mixed. Nine health targets and four sub-points are as follows: Reduce the global maternal mortality ratio to below 70/100,000. Reduce neonatal mortality to below 12/1,000 and U5MR to below 25/1,000. End the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases. Reduce by one-third premature mortality from noncommunicable diseases. Strengthen the prevention and treatment of substance abuse. Halve the number of global deaths and injuries from road traffic accidents (by 2020). Ensure universal access to sexual and reproductive health-care services. Achieve universal health coverage. Reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination. Four subpoints are: Strengthen the implementation of the WHO Framework Convention on Tobacco Control. Support the research and development of vaccines and medicines. Substantially increase health financing and the recruitment, development, training, and retention of the health workforce. Strengthen early warning, risk reduction, and management of health risks. Difference Between SDGs and MDGs SDGs benefit from the valuable lessons learned from MDGs. These also carry forward the unfinished agenda of MDGs for continuity and sustain the momentum generated while addressing the additional challenges of inclusiveness, equity, and urbanization and further strengthening global partnership by including CSOs and private sector. They reflect continuity and consolidation of MDGs while making these more sustainable by strengthening environmental goals. There are seven major differences in MDGs and SDGs; MDGs were drawn up by a group of experts in the ‘basement of UN headquarters’ whereas SDGs have evolved after a long and extensive consultative process including 70 Open Working Groups, Civil Society Organizations, thematic consultations, country consultations, participation of general public through face-to-face meetings and online mechanisms and door to door survey; While MDGs were focused with only 8 goals, 21 targets and 63 indicators, SDGs include 17 goals with 169 targets. An expert analyses by noble laureates at Copenhagen consensus, suggest that if the UN concentrates on 19 top targets, it can get $20 to $40 in social benefits per dollar spent, while allocating it evenly across all 169 targets would reduce the figure to less than $10. Being smart about spending could be better than doubling or quadrupling the aid budget;(7) MDGs had a focus on developing countries with funding came from rich countries. All countries, developed or developing, are expected to work towards achieving SDGs; The pillars of human development, human rights and equity are deeply rooted in SDGs and several targets seven explicitly refer to people with disabilities, six to people in vulnerable situations, and two to non-discrimination. These were not even mentioned in the MDGs; (iv) MDGs had 3 direct health goals, 4 targets and 15 indicators with emphasis on child, maternal mortality and communicable diseases. SDGs have one comprehensive goal emphasizing well-being and healthy living including NCDs; MDGs had a time span of 25 years though adopted in 2002 baseline data for the year 1990 was used and some of the baselines were revised subsequently which shifted ‘the goal post’. For the SDGs, the baseline is from 2015 estimates. It may be revised as more recent data becomes available; SDGs include a vision of building vibrant and systematic partnerships with private sector to achieve sustainable development. It builds on, UN Compact which was launched in year 2000 and IMPACT 2030; MDGs had no concrete role for the Civil Society Organizations (CSOs), whereas SDGs have paid attention to this right from the framing stage itself with significant engagement of civil society actors. The CSOs can play an important role to hold governments accountable at the local level. Challenges The four major challenges that need to be addressed for achieving the SDGs are as follows: Some of the SDGs that have been costed show that the cost of the SDGs is huge. The rough calculations have put the cost of providing a social safety net to eradicate extreme poverty at about $66 bn a year,(8) while annual investments in improving infrastructure (water, agriculture, transport, and power) could be up to a total of $7 tn globally. A major conference on financing for the SDGs, held in the Ethiopian capital Addis Ababa in July, failed to ease concerns that there will not be enough funds to meet the aspirational nature of the goals. It included a recommitment to the UN target on aid spending 0.7% of gross national income (GNI) set more than 40 years ago. Multilateral banks committed $400 bn;(9) Maintaining peace is essential for development. A threat to international peace and stability by nonstate actors is emerging as a major factor for both developed and developing countries. The recent crisis in Syria has forced 12 million people to leave their homes and made them refuges. Measuring progress: A number of targets in the SDGs are not quantified. The indicators for measuring progress have not yet been identified. Even if they limit to two indicators per target there will be 338 indicators to monitor and report. “Having 169 targets is like having no targets at all.”(10) Measurability will depend on the availability of data and capacity to measure them. Accountability: There was a lack of accountability for inputs into MDGs at all levels. This challenge needs to be addressed in SDGs. At the international level, most of the developed countries have not met the target of allocating 0.7% of GNI to international aid in the last 40 years. The lack of priority in funds allocation within country budget has also been a problem during MDGs. Similar lack of accountability exists at ministry, state, and local administration level. If we take SDGs seriously the accountability needs to be strengthened at all levels. India and SDGs The momentum created by MDGs in India needs to be sustained with focus on completing the unfinished task of MDGs. India-specific goals, targets, and indicators along with the roadmap to achieve these should be drawn up by the concerned ministry and states and union territories (UTs). One major challenge will be to fund these goals. It is also important to estimate the budget required and to find out from where these funds will come. The preliminary estimates from global meetings suggest mobilizing required resources is going to be a major challenge. The need to establish a system of collecting relevant data to monitor the progress is vital to achieve these goals, targets, and indicators that are much larger in numbers compared to MDGs. The reliance on data from surveys needs to be minimized. The health goal will need a major effort in addressing noncommunicable diseases and accidents and injuries while sustaining efforts to address maternal and child health and nutrition. Conclusion MDGs helped in mobilizing international community, leaders, politicians, civil society and sectoral ministries, and departments to focus on achieving these time-bound and measurably goals. We may not have achieved all these goals but have made a substantial progress in saving lives and improving quality of lives of millions of people within the country and globally. India has not made progress commensurate with its economic and technological might and needs to do more. MDGs have been easy to relate, understand, communicate, implement, and monitor, whereas SDGs, though to some extent, are a continuation of MDGs, yet suffer from the weakness of being too many and unwieldy to implement and monitor. This has probably resulted from large consultative process where everyone wants to see their areas of interest included. Providing required funding to these a reality remains a challenge. There is a need to improve accountability from international level to local level. The next 15 years is likely to see unprecedented mobilization of resources and efforts to make the world a better place to live for “we the people”, especially the marginalized and disadvantaged groups.