Political determinants of Sustainable Development Goals

Abstract

We read with interest the article by the GBD 2016 SDG Collaborators1GBD 2016 SDG CollaboratorsMeasuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016.Lancet. 2017; 390: 1423-1459Summary Full Text Full Text PDF PubMed Scopus (196) Google Scholar (Sept 16, p 1423), which presents a comprehensive analysis of the potential gaps and gains in the health-related Sustainable Development Goals by 2030. Among the issues that caught our attention when reading the Article was the fact that, if current trends continue, Latin American countries will not fulfill the sustainable development goal for teenage pregnancy. Remarkably, data show that underperformance on adolescent pregnancy in Latin America happened despite positive developments towards meeting family planning needs and universal health coverage goals. This projection for adolescent pregnancy concurs with other reports showing Latin America as the only region globally where adolescent pregnancies are not decreasing,2Loaiza E Liang M Adolescent pregnancy: a review of the evidence. United Nations Population Fund, New York2013Google Scholar and provides strong evidence for the need for in-depth analysis of political determinants of health. Over the past two decades, a massive wave of pro-family mobilisation has swept Latin America. An example of this new wave of conservative mobilisation is the campaign against so-called gender ideology in school curriculums. Ministers of Education from Brazil (2015), Colombia (2016), and Peru (2017) faced strong disapproval, including rallies from conservative groups, who opposed the inclusion of gender and sexual education in school curriculums. In Colombia, the Minister of Education (Gina Parody) lost her job. In Peru, Jaime Saavedra and his successor, Marilú Martens, were censored by the majoritarian conservative parliament. In Brazil, school material prepared by the Ministry of Education, which addressed diversity and homophobia in schools, was recalled after strong pressure from conservative and evangelical congressmen. Since then, the fight to eliminate gender and sexual education from national plans of education has intensified. In September, 2017, the Brazilian Supreme Court authorised religious teaching in public schools.3Supremo Tribunal FederalSTF conclui julgamento sobre ensino religioso nas escolas públicas.http://www.stf.jus.br/portal/cms/verNoticiaDetalhe.asp?idConteudo=357099Date: Sept 27, 2017Google Scholar In many countries in Latin America, protests against sexual education and other anti-gender and anti-abortion-inspired mobilisations have become the core of political opposition.4Rodriguez de Assis Machado M Aves Maciel D The battle over abortion rights in Brazil's state arenas, 1995–2006.Health Hum Rights. 2017; 19: 119-132Google Scholar Understanding the political determinants of health, including the new wave of conservative mobilisation, is necessary to evaluate the effect on women's and adolescents' most basic human rights and on the Latin American political process. This evaluation requires a fuller understanding of the backlash against sexual and reproductive rights in Latin America over the past few years. Regressive legislation has been approved in some countries. Enforcement of criminal law on abortion in El Salvador and Mexico has generated perverse outcomes for vulnerable women. Women are forced to carry to term and give birth to fetuses that have no chance of survival outside the womb.5Viterna J Bautista JSG Pregnancy and the 40-year prison sentence: how “abortion is murder” became institutionalized in the Salvadoran judicial system.Health Hum Rights. 2017; 19: 81-93Google Scholar Furthermore, girls as young as 9 and 10 years old, who have been impregnated through sexual assault, are forced to carry to term pregnancies that their small bodies simply cannot sustain without dire health consequences. Banning gender and sexuality education in the curriculum denies us the opportunity to prevent gender-based violence, to promote gender equality, and to implement measures to prevent adolescent pregnancy. These measures are crucial to reach the health-related Sustainable Development Goals. We declare no competing interests. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. Full-Text PDF Open AccessFamily planning: accelerating the way aheadThe latest figures and progress of the Family Planning 2020 (FP2020) global partnership were released in its annual report on Dec 5. FP2020 The Way Ahead, together with a related research paper by Niamh Cahill and colleagues published online in The Lancet, paint a mixed picture. By July, 2017, more than 309 million women and girls of reproductive age in the 69 FP2020 focus (the world's poorest) countries are using modern methods of contraception. That figure is 38·8 million more than at the start of the FP2020 initiative in 2012. Full-Text PDF