Abstract

BackgroundThe interconnections between health and the economy are well known and well documented. The funding gap for realizing SDG3 for good health and well-being, however, remains vast. Simultaneously, economic growth, as expressed and measured in SDG8, continues to leave many people behind. In addition, international financial institutions, notably the International Monetary Fund (IMF), continue to influence the economic and social policies that countries adopt in ways that could undermine achievement of the SDGs. We examine the incoherence between the economic growth and health goals of the SDGs with reference to three East African countries, Malawi, Uganda, and Tanzania, where our organization has been working with partner organizations on SDG related policy analysis and advocacy work.ResultsIn all three study countries, some health indicators, notably infant and child mortality, show improvement, but other indicators are lagging behind. Underfunding of the health sector is a major cause for poor health of the population and inequities in access to health care. GDP increases (as a measure of economic growth) do not automatically translate to increases in the countries’ health spending. Health expenditure from domestic public resources remains much lower than the internationally recommended minimum of USD 86 per capita. To achieve this level of health spending from domestic resources only, GDP in these countries would require an unrealistic manifold increase. External aid is proving insufficient to close the funding gap. IMF policy advice and loan conditionality that focus on GDP growth and tight monetary and fiscal targets impair growth in health and social sector spending, while recommended taxation measures are generally regressive.ConclusionsThe existence of the GDP-focused SDG8 can delay efforts towards the achievement of the SDG3 for health and well-being if governments choose to focus on GDP growth without taking sufficient measures to equally distribute wealth and invest in the social sectors, often under the influence of policies advised or conditions put in place by the IMF. Although the IMF has started to acknowledge the importance of social development, its policy advice still adheres to austerity and pro-cyclical economic development harming a country’s population health. To realize the SDGs everywhere, governments should abandon GDP growth as a policy objective and place more emphasis on SDG17 on global co-operation.

Highlights

  • The Sustainable Development Goals (SDGs) of Agenda 2030, in its comprehensive set of goals and indicators, recognize the many interlinkages that exist between various aspects of well-being

  • In this article we explore this incoherence in the SDGs by focusing on three East African countries (Malawi, Uganda, and Tanzania) in which we have been working to support their efforts to improve their health outcomes

  • We argue that the way in which economic growth is being pursued in these three countries, as operationalized in SDG target 8.1, hampers progress on SDG3, to ‘ensure healthy lives and promote well-being for all at all ages’

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Summary

Introduction

The Sustainable Development Goals (SDGs) of Agenda 2030, in its comprehensive set of goals and indicators, recognize the many interlinkages that exist between various aspects of well-being. For instance, poverty reduction and improved health outcomes, Agenda 2030 places strong emphasis on reducing inequities and the need for fairer economic arrangements at the global level. The call for such a comprehensive agenda is not new. Progress towards the Sustainable Development Goals: Report of the Secretary-General Summary [Internet]. Special edition: progress towards the Sustainable Development Goals Report of the SecretaryGeneral [Internet].

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