High-Level Panel Research Articles

Health in the post-2015 agenda: perspectives midway through.

On September 2014, the United Nations General Assembly (UNGA) will evaluate the proposals of the UN Open Working Group (OWG) for the Sustainable Development Goals (SDG) in the Post-2015 Agenda, which also includes a health goal. The final version of these goals will be approved at the 2015 UNGA. The document is the convergence of several processes implemented by the United Nations General Secretariat and the UNGA since the conclusion of the United Nations Conference on Sustainable Development, the Rio+20 Conference, such as the Global Consultation and Dialogue 2 and the High-Level Panel of Eminent Persons.

ERT Challenges in the Post-2015 Era

This paper provides a background to the on-going discourse on post-2015 global development agenda. It mentions key points from the UN Secretary General's report on MDG progress and the process of formulating the future development agenda. The recommendations of the High Level Panel on post-2015 agenda and the work of the Sustainable Development Solutions Network (SDSN) are examined from the perspective of Education for Rural Transformation (ERT). It is concluded that the premise and rationale of ERT has received scant attention in the future development agenda discourse. The arguments regarding the pertinence of ERT in combating poverty and promoting sustainable development are noted, drawing on the recent UNESCO- INRULED study on this topic.

The post-2015 debate and the place of education in development thinking

As the end date for the Millennium Development Goals approaches so the focus on goals, visions and policies for development after 2015 becomes ever heightened. However, there has been relatively little engagement by educational research community in these debates. What then is being written about education in the key post-2015 documents? How is education's role in development conceptualised by those most central to shaping new accounts? I explore these issues through an analysis of a key text on post-2015, the High Level Panel Report of May 2013 (UN HLP, 2013), and an exploration of a year's worth of posts on 30 prominent blogs and websites discussing post-2015 matters. This leads me to two further, interlinked questions: what are the implications of potential marginalisation and irrelevance from these debates for the field of international education and development research? What are the potential dangers for the field of closer engagement in these debates and their growing use of social media? The academic international education and development community may be more comfortable in keeping these policy debates at a distance, but this may play against the strong educational research drive to engage in social science that makes a difference. If there is to be engagement with post-2015 then alternative ways of developing practices of research, action and dialogue need further strengthened. This may include interdisciplinary dialogues around such issues as early childhood development, the role of professions in development or environmental sustainability. Engagement with the post-2015 debate would also require a careful analysis of how best to engage with the instrumentalised accounts of education that are dominant in the policy-advocacy arena. This would entail more strategic positions on the uses and dangers of social media. At the same time, engagement with development studies as well as the development policy community requires a reappraisal of epistemological and methodological stances.

Potential Contribution of DIAS toward Sustainable Development Goals from The Report of the High-Level Panel of Eminent Persons on Post-2015 Development Agenda

Potential Contribution of DIAS toward Sustainable Development Goals from The Report of the High-Level Panel of Eminent Persons on Post-2015 Development Agenda

Millennium Development Goal 6: AIDS and the International Health Agenda

Millennium Development Goal (MDG) 6, ‘to combat HIV/AIDS, malaria and other diseases’, is unique among the MDGs because it emerged in the context of unprecedented prior international mobilization, especially around HIV/AIDS, thus both reflecting and facilitating an expanding international health agenda. MDG 6 built on the idea of “health as development”, originally articulated at the 1978 conference on primary health at Alma-Ata, but was profoundly shaped by the political traction and fund-raising successes of AIDS activism and the international AIDS response. This underpinned the expansion of MDG 6 targets to include antiretroviral treatment, helped forge partnerships to reduce the prices of antiretroviral treatment and essential medicine, thereby contributing to MDG 8 (“building partnerships for development”) and, in high HIV-prevalence regions, also to MDGs 4 and 5 (maternal and child health). The UN High-Level Panel on the post-2015 development agenda recommends setting country-level health targets to achieve healthcare for all. Targets can help citizens hold governments to account by providing a focus for mobilization and a yardstick to measure progress. The data collection and policy monitoring pioneered by UNAIDS, and the involvement and support for civil society organizations achieved through the AIDS response, must be continued for this broader health agenda to succeed.

Back to the future: what would the post-2015 global development goals look like if we replicated methods used to construct the Millennium Development Goals?

BackgroundThe Millennium Development Goals (MDGs) were ‘top-down’ goals formulated by policy elites drawing from targets within United Nations (UN) summits and conferences in the 1990s. Contemporary processes shaping the new post-2015 development agenda are more collaborative and participatory, markedly different to the pre-MDG era. This study examines what would the outcome be if a methodology similar to that used for the MDGs were applied to the formulation of the post-2015 development goals (Post-2015DGs), identifying those targets arising from UN summits and conferences since the declaration of the MDGs, and aggregating them into goals.MethodsThe UN Department of Economic and Social Affairs (DESA) list of major UN summits and conferences from 2001 to 2012 was utilised to examine targets. The DESA list was chosen due to the agency’s core mission to promote development for all. Targets meeting MDG criteria of clarity, conciseness and measurability were selected and clustered into broad goals based on processes outlined by Hulme and Vandemoortele. The Post-2015DGs that were identified were formatted into language congruent with the MDGs to assist in the comparative analysis, and then further compared to the 12 illustrative goals offered by the UN High-Level Panel of Eminent Persons on the Post-2015 Development (High-Level Panel) Agenda’s May 2013 report.ResultsTen Post-2015DGs were identified. Six goals expressly overlapped with the current MDGs and four new goals were identified. Health featured prominently in the MDG agenda, and continues to feature strongly in four of the 10 Post-2015DGs. However the Post-2015DGs reposition health within umbrella agendas relating to women, children and the ageing. Six of the 10 Post-2015DGs incorporate the right to health agenda, emphasising both the standing and interconnection of the health agenda in DESA’s summits and conferences under review. Two Post-2015DGs have been extended into six separate goals by the High-Level Panel, and it is these goals that are clearly linked to sustainable development diaspora.ConclusionsThis study exposes the evolving political agendas underplaying the current post-2015 process, as targets from DESA’s 22 major UN summits and conferences from 2001 to 2012 are not wholly mirrored in the HLP’s 12 goals.

Crossfire: ‘Feasible or not feasible: the application of impact evaluations in WASH programming’

Dear Eddy, I firmly believe that the age of water, sanitation, and hygiene has dawned. WASH has never been so high on the political agenda. As we set our sights and ambitions much higher, towards a world in which everyone has access to safe drinking water and no one defecates in the open within the next 20 years, we need a number of major shifts in the way we do business. One of these shifts is improving how we deal with evidence and impact evaluations are an important weapon in achieving this. Like many colleagues, you must feel very satisfied reading the report of the UN Secretary-General’s High-Level Panel on the post-2015 framework. I am referring to the proposed standalone goal for water and sanitation, and the clear influence of the JMP (Joint Monitoring Program) process – of which you were an integral part – in setting the targets. This is a big change from even five years ago, when it would have been

Sexual and reproductive health and rights in the evolving post-2015 agenda: perspectives from key players from multilateral and related agencies in 2013

This paper reports the views of participants from key multilaterals and related agencies in the evolving global negotiations on the post-2015 development agenda on the strategic location of sexual and reproductive health and rights. The research was carried out in June and July 2013, following the release of the report of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda, and comprised 40 semi-structured interviews with 57 participants and two e-mail respondents. All respondents were responsible for the post-2015 health and development agenda, or the post-2015 agenda more broadly, within their organisations. The interviews provide an insight into the intention to ensure that sexual and reproductive health and rights are integrated into the post-2015 trajectory by key players who sit at the interface of UN and Member State interaction. They reveal both an awareness of the shortcomings of the Millennium Development Goal process and its impact on advocacy for sexual and reproductive health and rights in early post-2015 engagement, as well as the vulnerability of sexual and reproductive health and rights in the remaining phases of post-2015 negotiations. Recent events bear these concerns out. Ensuring sexual and reproductive health and rights are included in the final post-2015 outcome document in the time remaining for negotiations, will be anything but a “doddle”.

Measuring disparities in sanitation access: does the measure matter?

Initiatives to monitor progress in health interventions like sanitation are increasingly focused on disparities in access. We explored three methodological challenges to monitoring changes in sanitation coverage across socio-economic and demographic determinants: (i) confounding by wealth indices including water and sanitation assets, (ii) use of individual urban and rural settings versus national wealth indices and (iii) child-level versus household-level analyses. Sanitation coverage by wealth for children and households across settings was estimated from recent Demographic and Health Surveys in six low-income countries. Household assignment to wealth quintiles was based on principal components analyses of assets. Concordance in household quintile assignment and estimated distribution of improved sanitation was assessed using two wealth indices differing by inclusion or exclusion of water and sanitation assets and independently derived for each setting. Improved sanitation was estimated using under five children and households. Wealth indices estimated with water, and sanitation assets are highly correlated with indices excluding them but can overstate disparities in sanitation access. Independently, derived setting wealth indices highly correlate with setting estimates of coverage using a single national index. Sanitation coverage and quintile disparities were consistently lower in household-level estimates. Standard asset indices provide a reasonably robust measure of disparities in improved sanitation, although overestimation is possible. Separate setting wealth quintiles reveal important disparities in urban areas, but analysis of setting quintiles using a national index is sufficient. Estimates and disparities in household-level coverage of improved sanitation can underestimate coverage for children under five.

MDGs and NTDs: Reshaping the Global Health Agenda

The United Nations (UN) Millennium Development Goals (MDGs) expire in 2015. A high-level panel, appointed to discuss the global development agenda post-2015, reported back in May 2013 with its recommendations. These are likely to prove extremely important for determining the global health budget over the coming decade. Who the “winners”—those who will benefit from UN endorsement and enhanced funding—and the “losers”—those not receiving such recognition or resources—will be in the new agenda is not yet decided, but certain parties hope that this time around NTDs will gain a special mention. The MDGs, established in 2000, gave a new prominence to the health issues affecting the poor. However, the spotlight they provided was restricted and derived from a top-down process of deliberation, rather than informed by inclusive analysis and/or a thorough prioritisation of development needs. Subsequently, the narrowly focused and largely sector-specific MDGs left gaps in coverage and failed to realise synergies between the foci covered by the goals (education, health, poverty, and gender) [1]. MDG 6 in particular—“combat HIV/AIDS, malaria and other diseases”—sidelined many of the communicable and non-communicable diseases that perpetuate the cycle of poverty in developing countries. And yet, the very act of naming HIV/AIDS and malaria raised the profile of these diseases immeasurably. It stimulated a reconfiguration of official development assistance for health. Global health initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and the President's Emergency Plan for AIDS Relief (PEPFAR) ushered in an era of vertical aid on an unprecedented scale and diverted resources away from existing health programmes [2]. In this funding climate, diseases were pitted against one another and advocacy groups were left to argue that it was their disease being referred to in the ambiguous wording “other diseases.” In this respect, the case of tuberculosis is instructive; the success of the tuberculosis campaigning was such that it is now widely assumed that it too received a special mention in the MDG 6. Of course, parallel to this misapprehension, tuberculosis was considered so central to the GFATM that it was even incorporated into the name; the extent to which this is due to lobbying or to the specific interactions between HIV/AIDS and tuberculosis has not been established. Clearly, however, effective networking and alliance building can blur the boundaries of the MDGs and raise the profiles of diseases.

Post-2015 education recommendations of the High-Level Panel: joint comments of the Basic Education Coalition and the Global Campaign for Education-US

As part of the ongoing planning and debate around the next set of global development goals to replace the expiring Millennium Development Goals, in July 2012 the UN Secretary General commissioned ‘...

The Responsibility to Protect Questions and Answers?

The traditional Westphalian concept of sovereignty implies non-interference in the domestic affairs of a State by another State or group of States and finds expression in Article 2(7) of the Charter of the United Nations. The preoccupation with sovereignty evident in these provisions was very much the agenda of the twentieth century. As the twenty-first century began, however, questions were asked about the scope of concept of sovereignty not only as a result of the growing emergence of international human rights but, more significantly, the need for a more coordinated international response to various humanitarian crises of the 1990s. The focus on sovereignty had not prevented the UN from engaging in humanitarian intervention but what was different for the twenty-first century was the perceived need to establish a series of principles that would guide such intervention to ensure consistency in UN action. A starting point for this search for principles was the 2001 Report of International Commission on Intervention and State Sovereignty (ICISS), an initiative of the Canadian Government advocating the R2P principle. The Report is discussed in Part II, before the focus shifts to the UN with a discussion of the 2004 Report of the High-Level Panel on Threats, Challenges and Change, the Secretary-General’s Report on the Millennium Declaration and the results of the 2005 World Summit which are all addressed in Part III. Part IV examines the implementation of the emerging principle both generally through the Resolutions of the Security Council on the protection of civilians and the application of R2P to the situations arising in Sudan, Myanmar/Burma, Kenya, Cote d’Ivoire and as a result of the Arab Spring. The Conclusion offers some answers to the questions arising from the responsibility to protect.

New Voices in Global Health

The World Health Summit, held in Berlin, celebrates its fi fth anniversary this year. It has survived all the dangers of early childhood. Indeed, earlier this year the fi rst regional meeting of the World Health Summit took place in Singapore. During this gathering, the University of Makerere, Uganda, became the fi rst member of the M8 Alliance from sub-Saharan Africa. The M8 Alliance is a collaboration between academic health centres, universities, and national academies. Its vision is to harness academic excellence to improve global health. Following a successful fi rst event in 2012, The Lancet, together with the M8 Alliance, issued a further call for abstracts to fi nd the most inspiring “New Voices in Global Health”. Young researchers from 39 countries have submitted 122 abstracts. Five outstanding abstracts for oral presentation and 13 abstracts for poster presentation at the Summit have been chosen through careful peer review. This booklet contains those 18 abstracts. This year’s topics range from short message services to improve infant feeding practices in China, to a global economic and epidemiological analysis of investments in cholera vaccines; from research on universal health coverage in the Palestinian territory, to a key question for all of us: can we change research to change health? Research is also the focus of WHO’s World Health Report 2013, which will be presented and discussed at the Summit. Choosing the theme of “Research for Universal Health Coverage” is timely, since the UN is moving towards the fi nal stages of devising a post-2015 framework. The report of the HighLevel Panel on the Post-2015 Development Agenda proved that the global health community still needs to do considerably more work to ensure that health is fi rmly anchored in life after the Millennium Development Goals. This year, the Summit welcomes the contribution of Jose Manuel Barroso, President of the European Commission. In his message, Barroso notes that “there is no better indicator of the true wealth of a society than the state of its health systems, their eff ectiveness and inclusiveness”. The World Health Summit 2013 will focus on this interplay between health and prosperity, development and inequality, research and education, and on the role of health in all aspects of foreign policy. The voices we showcase here will send out strong signals that a new generation of scientists has already embraced and responded to this urgent call.

Health rights in the post-2015 development agenda: including non-nationals

With the approach of the September 2013 meeting of the United Nations General Assembly on the post-2015 Development Agenda, the health and intersectoral development goals have become the subject of considerable debate. Little of this debate has to do, however, with how the “right to the highest attainable standard of health” applies to non-nationals – i.e. people who live in a country without being its citizens and hence without access to health system benefits. The right to health obligates governments to facilitate access to health care to non-nationals and nationals alike. This is not simply a matter of human rights: it is a global development imperative. Today there are 214 million international migrants – far more than ever recorded – and millions more are experiencing forced migration and displacement.1,2 This massive movement of people across borders is linked to factors such as globalization, climate change, poverty, poor governance, conflict, education, economics, labour trends, transportation and technology.3,4 Further intensification of this trend is forecast: By 2050, the number of migrants could reach 405 million – with 25 million to 1 billion of them projected to be “environmental migrants”.5 These figures are offset by the predicted increase in the world’s population to at least 8.92 billion by 2050.6 Unprecedented numbers of non-nationals – with varying legal status – pose challenges to low- and high-resource states’ responsibilities, resources, distributive justice mechanisms and long-standing Westphalian systems and structures. The large demographic influence that cross-border movement will have in shaping tomorrow’s world is noted in key post-2015 reports.7,8 Awareness of this influence is reflected in the High-Level Panel of Eminent Person’s post-2015 transformative agenda of “leaving no one behind” and in the United Nations Secretary-General’s call for “a life of dignity for all”.7,9 Ensuring that governments apply new development goals and targets to all, including non-nationals, who are often the most vulnerable and marginalized social group, is an overriding challenge. Most countries regularly exclude non-nationals from the protection afforded by right-to-health laws, yet under international law, countries are required to protect the right to health of all people within their borders and to fulfil minimum core obligations vis-a-vis basic primary health care, essential medicines, and non-discriminatory access to health facilities, goods and services. However, the de facto reality is very different, as exemplified by Australia’s limiting of tuberculosis treatment for Papuans along its Queensland border;10 Spain’s exclusion of undocumented migrants from testing and treatment for human immunodeficiency virus infection;11 and Kenya’s High Court decision that the right-to-health “law” in the nation’s Constitution is a matter of policy for its nationals only.12 The denial of preventive and curative care is frequently tied to policies regulating cross-border movement.11 Underlying statist traditions – health as security and foreign policy “metaphors”13 and anti-immigrant policies – abound, mixed with global financial crisis shockwaves. Escalating unemployment and nations’ fiscal tightening, including downsizing of the health workforce, are pressing concerns rendering the extension of health-care entitlements to non-nationals of little interest to governments keen on securing the popular vote. This is especially so when electorates question the “universal” nature of their state’s “universal” health-care coverage – or want to see it implemented more effectively. There are other aspects to be considered: what type of services would be available to non-nationals; who would be eligible; how would service implementation be measured; and, most importantly, who would pay. On a positive note, several countries in varying stages of development are extending social protection, including health-care benefits, to non-nationals. Thailand is a notable example.14 Partnering with health economists to show that such a measure can be beneficial in terms of equitable national development might be a way forward. High-level rhetoric around population dynamics in the post-2015 agenda is welcome, for the global community cannot continue to ignore the in-country inequities related to present and future large-scale human movement. As right-to-health lawyers, we submit that the discourse surrounding the post-2015 development agenda must progress to expressly include non-nationals. Realizing global goals for all rather than some will arguably be a truly transformative, paradigm shift. However, key issues pertaining to citizenship, population dynamics and interrelated health and human rights are likely to remain the elephant in the room in this iteration of global policy-making.

Do MDGs Matter? India's Development Trajectory in the 21st Century

Current discourse on post‐2015 development goals needs to be situated in the context of the influence of MDGs in shaping national policies and programmes. In this article, India's development trajectory and its impacts are critically analysed to demonstrate the near absence of influence of MDGs discourse on Indian development planning or outcomes. The analysis also focuses on the political economy of India's development trajectory and identifies absence of governance reforms as the key deficit in meaningful impacts on the lives of people in India. In sharp contrast to the High Level Panel's recommendations on post‐2015, the author proposes an alternative set of goals focusing on reforming governance in India.

The world we want: an end to child marriage

With discussions underway about a post-2015 development framework, we have a unique opportunity to envisage the world we want by 2030. Recommendations made to date by the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda (HLP) and the UN Secretary-General Ban Ki-moon, and in the discussions of the open working group, have emphasised the need to ensure the empowerment, wellbeing, and social protection of the world's most vulnerable people.

Global Partnership: Thoughts on a new leitmotif for international politics

In this essay, former federal president of Germany Horst Kohler presents the main findings of the report of the High-Level Panel on the Post-2015 Development Agenda and discusses the implications of ‘global partnership’ for international politics. He analyses four key concepts of politics: sovereignty, legitimacy, national interests and common values, all of which are needed to be revisited in order to meet the immense social, economic and ecological challenges in this century of interconnectedness.

An Integrated Vision for Peace and Development? Building on the High Level Panel's Report

At the end of May 2013, the High Level Panel of Eminent Persons on the Post-2015 Development Agenda (HLP) published its report ‘A New Global Partnership’. The report moved forwards the debate on th...

Resources: Organisational Responses to the Post-2015 High Level Panel Report

Resources: Organisational Responses to the Post-2015 High Level Panel Report

The Science of Sustainability

The question of what can be achieved in 1000 days has preoccupied kings, queens, presidents, and, very recently, the Secretary-General of the United Nations (UN). Ban Ki-moon has not only appealed for a last big push to reach as many as possible of the UN's Millennium Development Goals (MDGs) by the deadline of 31 December 2015, he is advocating the establishment of objectives that should succeed the MDGs as well. Strong clues about the shape of the post-2015 agenda can be found in two recent reports, one published last month by a High-Level Panel * convened by Ban Ki-moon and chaired by the presidents of Indonesia and Liberia and the prime minister of the United Kingdom, and the other released this month by the Sustainable Development Solutions Network. † Both reports list the eradication of poverty as the number-one priority and set out complementary goals concerned with gender equality, education, health, food, water and sanitation, climate change, energy, employment, natural resources, governance, peace, and finance. These reports are unlikely to be the last contributions to the debate, but the proposed goals represent a call to action for the science community.