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What about a health systems development goal for Post-2015?

credit: irene nobrega

The continued spread of Ebola in West Africa has both exposed problems with the international response and the existing state of healthcare in Liberia, Sierra Leone and Guinea. The difference between the experience in those countries and Nigeria is stark. The larger neighbor managed to immediately isolate and track down people who contracted Ebola when a man with the virus entered the country. All people who came in contact with him and the people infected were tracked down immediately.

For that reason, a large outbreak was avoided and Nigeria says that the problem is under control. That stands in contrast with Guinea. The first case can be traced back to December 2013, but attention was garnered a few months later. Reports made its way to appropriate authorities, people were treated and by the middle of 2014 it was thought that the outbreak had run its course. Sadly, that was not the case. The inability to reach people infected and some unwillingness to go to hospitals led the outbreak to continue quietly and grow out of control.

Global health experts have pointed to the problem as evidence that more investments need to be made in health systems. That is that more money needs to go to supporting health care workers, building hospitals, improving training and more of the things that support a well-functioning healthcare system in a country. Doing so will help prevent future health crises, like the West Africa Ebola outbreak, and lead to fewer preventable deaths.

That is one of the main conclusions from a research paper published by the British medical journal, The Lancet. In it, a group of leading global health experts analyzed what it would take to reduce the number of premature deaths by 40%, from 2010 to 2030. That is in part driven by the ongoing discussions about the goals that will replace the Millennium Development Goals when they expire at the end of next year.

“For communicable, maternal, and child mortality, a grand downward convergence between rates in different countries could be largely achieved through health-system strengthening plus scale-up of proven, affordable health interventions and relevant research and development,” conclude the authors.

The target for reducing premature deaths is one that the authors think could help countries take steps towards initiatives and reforms that will improve the health of all of their citizens. The world already saw the under-70 age-standardised mortality rates decreased 19% in the period between 2000 and 2010. The report concludes that it stands to reason that improving upon that pace for two decades could see a total decrease of 40%, especially since low and middle income countries saw rates fall much more quickly than their high-income counterparts.

The trick will be getting agreement. As study points out, there are a lot of ways that groups are interpreting the possible third goal for the Post-2015 goals, that will focus on health. They include:
Health SDG

“Returning to the 2016–30 SDG for health, whatever is proposed should balance aspiration with technical feasibility, and should engender better vital statistics. The current proposal for SDG3 could be accompanied by something that is in part quantitative, feasible and measurable, such as “Avoid 40% of the premature deaths in each country, and improve health care at all ages”, especially if this is accompanied by appropriate subtargets,” conclude the authors.

Maybe the health crisis in West Africa, caused by the Ebola outbreak, will lead people to pick up the torch.


About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]