As the reality of 2015, and the deadline for Millennium
Development Goals (MDGs) gets closer and closer, it’s time for those proponents
of global development to evaluate the changes seen under the MDG era and start
thinking towards the future towards new goals and strategies.
The general consensus as far as the effectiveness of the
MDGs is- and get ready for it to be vague- that we still have a lot of work to
be done. Criticisms, of course, vary, and some critics looking towards 2015 are
focused on the strategies used to meet goals for the purposes of improvement,
while others scrutinize the goals themselves and how they could more accurately
represent both universal and country-specific needs post-2015. Still another
group chooses to discuss the relevance of having a program liked the MDGs,
we’ll return to that later.
The MDGs are a broad set of goals cover an impressive range
of social, economic, and biological initiatives that are necessary for
lessening inequality and improving lives on a global scale. They require an
incredible amount of work to be done on every organizational level imaginable,
and incorporate a diverse cross-section of fields. Arguably though, the public
health sector both affects and is affected by each of the goals, and it’s no
coincidence that the public health community
As discourse progresses on the post-2015 agenda, what role
will the global public health community play in setting the agenda?
This is the essential question, and a movement is growing to
make Universal Healthcare (UHC) the common standby.
Within that discussion, it has become clear that there is no
dearth of precedents for UHC as a global policy. In descriptions of basic human
rights employed in a legal sense in many state documents as well as
international definitions (see: The U.N. Charter and the Declaration of
Universal Human Rights or their citations in many U.N. resolutions and
satellite organizations) adequate health and sanitation and access to
healthcare services and sanitary resources fall well within the tent of
accepted tenants.
However, one issue follows, and that is not whether or not
UHC falls within the boundaries of human rights, but rather the question of
what falls within the boundaries of UHC.
Global criticism of UHC points out that if the goals of UHC
are to improve all around equity of access to healthcare services, there are
plenty of precedents for governance and regulatory actions parading under the
banner of UHC that fall short of those goals. A common occurrence is UHC models
that raise universal quality but fail to address gaps in access among different
groups, or models that preserve inequality by relying heavily on the private
sector to provide resources and services.
In many circles there is a call for leadership in developing
more specific expectations for UHC programs and a tighter framework that aligns
goals with methods. Returning to the question of whether or not the MDGs were
appropriate, efficient, and successful when it came to making positive strides
towards global development, I’m not sure. However, I feel confident that as an
internationally recognized program with the strong backing of the U.N., the
MDGs have an incredible potential for setting the development, and therefore
the global public health, agenda for the post-2015 era. Efforts to set a
positive agenda would be best served trying to find a more efficient structure
for realizing the MDGs.
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