The latest global initiative to address the vast inequalities in the world, including health inequalities, is the 2030 Agenda for Sustainable Development. Also known as the Sustainable Development Goals (SDGs), this agenda has 17 goals that were adopted in September 2015 by all UN Member States, with a rallying call to “leave no one behind”.
To know whether anyone is being left behind, the SDGs need an accountability system that includes monitoring and evaluation. To that end, the campaign has developed 232 targets, and each target has at least one indicator on which all countries must measure and report. In SDG3 (health for all), there are 13 targets and 27 indicators, covering a wide spectrum of health measures from maternal and neonatal mortality to traffic accident deaths and HIV incidence, to name just a few.
However, indicators and their measurement are contentious subjects because they can result in unintended consequences. For example, before the SDGs there were the Millennium Development Goals (MDGs) that covered the years 2000-2015, and had similarly aspirational objectives to halve global poverty and achieve various health and other social targets. Arguments have been made that poorly chosen MDG indicators diverted attention from other critically important life saving programmes. Case studies presented in a compelling ‘Power of Numbers’ series led those editors to conclude that “target-setting is a valuable but a limited and blunt tool, and that the methodology for target-setting should be refined to include policy responsiveness in addition to data availability criteria.”