This week’s brief reviews a selection of reports and articles released around the 71st World Health Assembly, which took place in Geneva, Switzerland, from 21-26 May 2018. The publications examine how the international community is taking steps to contextualize health efforts and accelerate progress towards SDG 3 (ensure healthy lives and promote well-being).

The World Health Organization (WHO) released its annual report titled, ‘World Health Statistics 2018: Monitoring health for the SDGs.’ The report examines global and regional health trends against the SDGs, connecting areas of progress and challenges to specific targets and indicators, primarily under Goal 3. The report also offers insight as to where data gaps exist. It contains data on 36 SDG indicators for which sufficient data are available, out of more than 50 indicators on health contained in the global SDG indicator framework. In cases where official SDG indicators or their definitions are still being refined, or where baseline data is lacking, proxy indicators are used and noted for certain countries or cases. The indicators are reviewed along seven thematic areas: reproductive, maternal, newborn and child health; infectious diseases; noncommunicable diseases (NCDs) and mental health; injuries and violence; universal health coverage (UHC) and health systems; environmental risks; and health risks and disease outbreaks.

These themes are closely aligned with those used to capture the key issues under Goal 3 in the advance version of the UN Secretary-General’s 2018 report on ‘Progress Towards the SDGs.’ That report, which provides snapshots of each SDG ahead of the HLPF session to review implementation of the 2030 Agenda, notes that while “many more people currently have healthy lives than they did in the past decade,” concerted effort is required in the demographics and regions that have been left behind, to reduce premature deaths and preventable diseases.

WHO’s dashboard allows users to view global and country-specific progress on 22 health-related SDG targets.

In addition, the WHO report identifies challenges on selected issues, including essential health services coverage, cholera and youth obesity. It also highlights the three strategic priorities of the WHO’s 13th General Programme of Work for 2019-2023, which are intended to help countries meet the SDGs’ health targets. The priorities are: achieving universal health coverage; addressing health emergencies; and promoting healthier populations. The 2018 release also features a World Health Statistics data visualizations dashboard. The dashboard allows users to view global and country-specific progress on 22 health-related targets of the SDGs.

Also addressing data and health efforts, a paper written for the Bill and Melinda Gates Foundation by Navika Harshe explores ‘Data Needs for SDGs.’ Harshe notes that although the SDG indicators are created to facilitate global comparison, many countries do not collect the requisite data. For example, China has not conducted health surveys since 2005, and data on HIV/AIDS in India is “described as sketchy.” While changes to collection and other methodologies can break down barriers to data availability, the data themselves may also change. Harshe highlights a need for consistency across variables to ensure comparability over time. On the monetary costs of data collection, Harshe cites studies that extrapolate from MDG monitoring costs. They estimate total funding needs for measuring the SDGs over their entire 15-year lifetime at USD$254 billion. Harshe offers examples of streamlined data collection in the health sector, one of which is health workers in Uganda using SMS surveys to alert authorities on disease outbreaks, once detected.

SDG target 3.8 is focused on achieving universal health coverage, but what “universal” requires may differ by geographic context and local needs. WHO published a list of diagnostic tests considered to be essential components of UHC, providing guidance to Member States seeking to define UHC interventions. It notes that country programs should decide which tests are ultimately selected and implemented based on contextual needs and priorities. Similarly, a New York Times article on the release calls on countries to take action, cautioning that the publication of “a list in Geneva will not magically make malaria test kits available in Vietnam.”

Contextualizing health delivery is also the subject of an Overseas Development Institute (ODI) briefing paper on community involvement in SDG prioritization and delivery, particularly for Goal 3. The paper, titled, ‘Contextualising the SDGs to Leave No One Behind in Health,’ presents a case study from Zimbabwe. The authors define contextualization as “the process by which communities and community actors are involved in achieving goals from conceptualization to implementation, in partnership with [a variety of stakeholders].” The paper distinguishes contextualizing from localizing, noting that the latter term is problematic due to ill-defined boundaries of what is local, as well as a tendency to focus on cities or only local authorities.

The ODI paper makes a case for “collaborative rationality” whereby disparate stakeholders are brought together through shared platforms to articulate a common position. In doing so, the paper identifies how community health priorities and needs can link to targets under the SDGs, particularly Goals 3 and 6 (clean water and sanitation). The authors’ research on the Zimbabwe case study finds that contextualization can 1) streamline and focus efforts; 2) engage senior decision-makers and clarify priorities; and 3) generate momentum to sustain implementation efforts, even in constrained contexts.

The integral nature of water and health is further explored in a WaterAid report on ‘Transforming Health Systems: The vital role of water, sanitation and hygiene’ (WASH). The report provides a snapshot of successful WASH interventions, but notes that more work is needed. WaterAid calls on governments, donor agencies and NGOs to integrate WASH in healthcare facilities, measure WASH systems to expand the evidence base on success, finance WASH initiatives and coordinate efforts across not just government ministries, but sectors. A more detailed write-up on the SDG Knowledge Hub is forthcoming.

On SDG target 3.3, which aims to end AIDS, tuberculosis, malaria and other epidemics, a brief posted by the Council on Foreign relations asks whether the impact of the US President’s Emergency Plan for AIDS Relief (PEPFAR) is fading. Launched in 2003 with US$15 billion over a five-year period and aligned with MDG 6 (on combatting HIV/AIDS, malaria and other diseases), PEPFAR was “the largest commitment ever made by any country to fight a disease.” The brief notes that the programme has been highly successful. Tens of millions of people have been treated, tests rendered number well into the hundreds of millions, and infection rates of women and young girls in ten African countries have been reduced by 25-40%. However, the brief finds, 15 years later, funding and momentum to continue the fight are stagnating at a time when eliminating HIV/AIDS demands additional support.

A Devex article also looks into PEPFAR’s past successes and coming challenges in today’s political context. It notes that without continuing to provide funding and push further to fully eradicate HIV/AIDS, demographic challenges – particularly the growing at-risk populations of adolescent girls in sub-Saharan Africa – pose a threat that may enable the disease to spread, negating previous progress.

Additional issues of the SDG Knowledge Weekly can be found here.