SDGs: big agenda, big opportunities for India
The year 2016 marks an end of the era of Millennium Development Goals (MDGs), which drove the global development agenda since the new millennium. The MDGs have paved the way for Sustainable Development Goals (SDGs) that the world will strive to achieve over the next fifteen years. It is an opportune moment to reflect on the successes and the lessons learnt from the MDG era and the possible way forward for achieving the ambitious and inclusive agenda of SDGs in the health sector.
Lessons learnt
First, high-level political commitment globally and nationally drove much of the progress towards MDGs. We need nothing less for the SDGs.
Second, while MDGs helped improve the overall health of nations, the focus was on the aggregate targets ignoring inequities within countries. To understand the real progress and challenges there is a need to disaggregate data by gender, economic status and geographical area.
Thirdly, neither the economic benefits of good health nor the direct financial consequences of ill-health were sufficiently captured by MDGs. We know that nations require a healthy population to prosper. When people do fall sick, high out-of-pocket expenditures on healthcare lead to financial hardship and diminish the ability of the population to contribute to the economy. In India, nearly 60 million people fall into poverty just paying for healthcare, while many more abstain or delay seeking healthcare due to financial difficulties.
Fourthly, MDGs did not capture the importance of prevention, early detection and response to disease threats. The growing noncommunicable disease (NCD) epidemic and consequent premature deaths could be prevented by reducing lifestyle risk factors, specifically tobacco use, food intake, inactivity, and alcohol consumption. In addition, diseases like SARS, Ebola, MERS and Zika pose threats to global health security and have the potential to cripple countries. MDGs missed this important issue.
Lastly, it is not only about ‘more money for health, but also more health for money’; the MDGs focused on addressing specific disease and symptoms, which led to fragmentation, duplication and inefficiencies in the health systems. WHO estimates that nearly 20-40 per cent of all health resources are wasted.
The way forward
Unlike MDGs, which had three dedicated health goals, the SDG agenda has only one health goal (SDG-3) which aims to ‘ensure healthy lives and promote well-being for all in all ages’. The 13 broad targets under health goal are in-tune with current global epidemiological reality. Besides the unfinished MDG agenda of reducing maternal and child mortality and tackling the communicable disease, the SDG-3 also aims to tackle the epidemic of NCDs, substance abuse and ill-effects of environmental hazards. Health is also interlinked to several other SDGs related to poverty, gender equality, education, food security, water sanitation etc.
The unprecedented scope of SDGs provides immense opportunity to bring health at the centre of economic growth agenda, which is PM Modi’s topmost priority. Universal Health Coverage (UHC), which is an explicit target under SDG-3, can act as the anchor to guide and inform SDG goals in health.
It is interesting that these thoughts have their roots in what was envisioned by Mahatma Gandhi. He said, “Recall the face of the poorest and weakest man you have seen, and ask yourself if this step you contemplate is going to be any use to him.” It is this thinking, which was reflected in the MDGs and is now even more central in the SDGs.
Towards sustainable development
India can progress towards sustainable development in health if it follows the following five steps.
First, health must be high on the national and state agenda, as it is the cornerstone for economic growth of the nation. This requires high political commitment and collective long-term efforts by ministries beyond the Ministry of Health to invest in health. The proposal in India’s draft National Health Policy 2015 to raise public to health expenditure to 2.5 per cent of the GDP by 2020 is commendable.
Second, India should invest in public health and finish the MDG agenda through further improvements in maternal and child health, confronting neglected tropical diseases, eliminating malaria, and increasing the fight against tuberculosis. For all these challenges, it is clear what needs to be done; programmes and interventions need to be taken to scale, with a central emphasis on equity and quality of services.
Third, accelerate the implementation of universal health coverage. UHC is important to prevent people slipping into poverty due to ill health and to ensure everyone in need has access to good quality health services. To complement tax revenue based health financing, incremental expansion of prepayment and risk pooling mechanisms such as Social Health Insurance are worth considering. UHC is at the core of SDGs and in the interest of people and governments.
Fourth, build robust health system in all aspects and strengthen both the rural and urban components, with comprehensive primary health care at its centre. Given the magnitude of the private sector in India, more effective engagement with private healthcare providers is vital. Appropriate contracting modality, which is an important feature under the Social Health Insurance or RSSY, can be worked out and private sector can be instrumental in complementing the public sector as demonstrated by different country experiences, including Thailand and Philippines.
Finally, develop a strong system for monitoring, evaluation and accountability. It is absolutely essential to regularly review and analyse the progress made for feeding into policy decisions and revising strategies based on the challenges.
In conclusion, the SDGs have the potential to create a world where no one is left behind.
The SDGS also make it possible to achieve what the WHO constitution mandates: attainment by all peoples of the highest possible level of health.
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- Lowering Emissions by Accelerating Forest Finance (LEAF) Coalition, a collective of the United States, United Kingdom and Norway governments, came up with a $1 billion fund.
- LEAF is supported by transnational corporations (TNCs) like Unilever plc, Amazon.com, Inc, Nestle, Airbnb, Inc as well as Emergent, a US-based non-profit.
- The world lost more than 10 million hectares of primary tropical forest cover last year, an area roughly the size of Switzerland.
- Ending tropical and subtropical forest loss by 2030 is a crucial part of meeting global climate, biodiversity and sustainable development goals. Protecting tropical forests offers one of the biggest opportunities for climate action in the coming decade.
- Tropical forests are massive carbon sinks and by investing in their protection, public and private players are likely to stock up on their carbon credits.
- The LEAF coalition initiative is a step towards concretising the aims and objectives of the Reducing Emissions from Deforestation and Forest Degradation (REDD+) mechanism.
- REDD+ was created by the United Nations Framework Convention on Climate Change (UNFCCC). It monetised the value of carbon locked up in the tropical forests of most developing countries, thereby propelling these countries to help mitigate climate change.
- It is a unique initiative as it seeks to help developing countries in battling the double-edged sword of development versus ecological commitment.
- The initiative comes at a crucial time. The tropics have lost close to 12.2 million hectares (mha) of tree cover last year according to global estimates released by Global Forest Watch.
- Of this, a loss of 4.2 mha occurred within humid tropical primary forests alone. It should come as no surprise that most of these lost forests were located in the developing countries of Latin America, Africa and South Asia.
- Brazil has fared dismally on the parameter of ‘annual primary forest loss’ among all countries. It has lost 1.7 mha of primary forests that are rich storehouse of carbon. India’s estimated loss in 2020 stands at 20.8 kilo hectares.
- Between 2002-2020, Brazil’s total area of humid primary forest reduced by 7.7 per cent while India’s reduced by 3.4 per cent.
- Although the loss in India is not as drastic as in Brazil, its position is nevertheless precarious. For India, this loss is equivalent to 951 metric tonnes worth carbon dioxide emissions released in the atmosphere.
- It is important to draw comparisons between Brazil and India as both countries have adopted a rather lackadaisical attitude towards deforestation-induced climate change. The Brazilian government hardly did anything to control the massive fires that gutted the Amazon rainforest in 2019.
- It is mostly around May that forest fires peak in India. However, this year India, witnessed massive forest fires in early March in states like Odisha, Uttarakhand, Madhya Pradesh and Mizoram among others.
- The European Union’s Copernicus Atmospheric Monitoring Service claimed that 0.2 metric tonnes of carbon was emitted in the Uttarakhand forest fires.
- Implementation of the LEAF Coalition plan will help pump in fresh rigour among developing countries like India, that are reluctant to recognise the contributions of their forest dwelling populations in mitigating climate change.
- With the deadline for proposal submission fast approaching, India needs to act swiftly on a revised strategy.
- Although India has pledged to carry out its REDD+ commitments, it is impossible to do so without seeking knowledge from its forest dwelling population.
Context:-
At the recently concluded Leaders’ Summit on Climate in April 2021, Lowering Emissions by Accelerating Forest Finance (LEAF) Coalition, a collective of the United States, United Kingdom and Norway governments, came up with a $1 billion fund plan that shall be offered to countries committed to arrest the decline of their tropical forests by 2030.
[wptelegram-join-channel link=”https://t.me/s/upsctree” text=”Join @upsctree on Telegram”]What is LEAF Coalition?
Why LEAF Coalition?
Brazil & India
According to the UN-REDD programme, after the energy sector, deforestation accounts for massive carbon emissions — close to 11 per cent — in the atmosphere. Rapid urbanisation and commercialisation of forest produce are the main causes behind rampant deforestation across tropical forests.
Tribes, Forests and Government
Disregarding climate change as a valid excuse for the fires, Indian government officials were quick to lay the blame for deforestation on activities of forest dwellers and even labelled them “mischievous elements” and “unwanted elements”.
Policy makers around the world have emphasised the role of indigenous tribes and local communities in checking deforestation. These communities depend on forests for their survival as well as livelihood. Hence, they understand the need to protect forests. However, by posing legitimate environmental concerns as obstacles to real development, governments of developing countries swiftly avoid protection of forests and rights of forest dwellers.
For instance, the Government of India has not been forthcoming in recognising the socio-economic, civil, political or even cultural rights of forest dwellers. According to data from the Union Ministry of Tribal Affairs in December, 2020 over 55 per cent of this population has still not been granted either individual or community ownership of their lands.
To make matters worse, the government has undertaken systematic and sustained measures to render the landmark Scheduled Tribes and Other Traditional Forest Dwellers (Recognition of Forest Rights) Act, 2006 ineffective in its implementation. The Act had sought to legitimise claims of forest dwellers on occupied forest land.
Various government decisions have seriously undermined the position of indigenous people within India. These include proposing amendments to the obsolete Indian Forest Act, 1927 that give forest officials the power to take away forest dwellers’ rights and to even use firearms with impunity.
There is also the Supreme Court’s order of February, 2019 directing state governments to evict illegal encroachers of forest land or millions of forest dwellers inhabiting forests since generations as a measure to conserve wildlife. Finally, there is the lack of data on novel coronavirus disease (COVID-19) deaths among the forest dwelling population;
Tardy administration, insufficient supervision, apathetic attitude and a lack of political intent defeat the cause of forest dwelling populations in India, thereby directly affecting efforts at arresting deforestation.
Way Forward
Tuntiak Katan, a global indigenous leader from Ecuador and general coordinator of the Global Alliance of Territorial Communities, aptly indicated the next steps at the Climate Summit:
“The first step is recognition of land rights. The second step is the recognition of the contributions of local communities and indigenous communities, meaning the contributions of indigenous peoples.We also need recognition of traditional knowledge practices in order to fight climate change”
Perhaps India can begin by taking the first step.