This article was originally published on Politics Home.
Charles Nelson, the Chief Executive of non-profit organisation Malaria Consortium, sets out the challenges governments will face when implementing the Sustainable Development Goals.
With the Sustainable Development Goals set to be adopted at a UN summit in at the end of this month, Governments are considering how they will be implemented when they come into force at the beginning of 2016.
The SDGs are wide-ranging and hugely ambitious, seeking to end poverty and hunger, whilst promoting health, education and peace.
The challenge for global policy makers, and the organisations on the ground, is to make these admirable ideas a practical reality.
For Charles Nelson, the Chief Executive of Malaria Consortium, a non-profit organisation which will help to drive the necessary changes, there are a number of factors which will affect the success of this endeavour.
Mr Nelson suggests that although how much money is allocated to the cause is crucial, it is also important to consider how effectively this money is used.
Setting out the role the UK can play, he says: “Clearly it is perceived in governmental terms that it is more efficient to give larger grants to multilaterals. Therefore it is crucial to hold those multilaterals to account, ensuring good stewardship of that money. That is something the UK Government should take a more active role in.
“We should also be supporting recipient countries in developing their national plans – I think the Government can really support that effectively, not only at a governmental level but also in way that is more hands on.
“In terms of advocacy, there is an ongoing debate about getting other donor countries to play a more substantive part because there is a mismatch at the moment around the world. We need to galvanise political will in the emerging economies to really drive economic delivery.”
The SDGs will replace the Millennium Development Goals, which were implemented in 2001 and are due to expire at the end of this year.
For Mr Nelson the advancements made under the MDGs are something to celebrate and build on, and he is keen to keep the momentum going.
A new WHO and UNICEF report, published last week, has underlined this progress further, revealing that the malaria mortality has fallen by 60 percent during the MDG era.
“It is a huge achievement that the malaria mortality rate has fallen by 60 percent in fifteen years. Over six million lives have been saved, and now we have countries declaring that they are on the route to eliminating malaria. All of that is great, but we are at a point where we have to keep that going.
“Controlling malaria where it is highly endemic takes three things: hard work, diligent compliance and a consistent flow of commodities. I think we have got to keep that in mind and not just get lost on an the eradication agenda.
“In building off the past, there is a lot we can learn, but we are facing significant challenges going forward. There is the very real danger of parasites becoming resistant to our current tools, which is a real challenge in South East Asia right now and would be horrendous if it was to get to Africa, or develop in Africa.
“We are right at a turning point when it comes to drug resistance. If Plan A, in terms of drugs, were the Quinine derivatives, when resistance developed to these, we had a plan B – Artemisinin Combination Therapies (ACTs). Currently, there is no drug-based plan C. So if we get beaten soon with our current drugs then we don’t yet have a fall-back position. There are some hopeful looking options a little way down the path but drugs take a long time to bring to market. We need to be aware that if slow down now, because we are coming to the end of the MDGs, it will be a great shame.
“I personally believe many hundreds of thousands or millions will die as a consequence if we don’t just keep going, because we can beat malaria.”
In continuing to drive progress, Malaria Consortium sees part of its role as building the evidence base to inform the disease control programmes of endemic countries.
According to Mr Nelson: “One of the primary things that we feel is our role is to develop evidence of what works and how interventions can achieve the most impact.
“We are coming from a background of disease control, but also as part of what we do in the evidence gathering is look at the wider impact in the immediate community, on the local economy and on the wider economy, because it is good to demonstrate to the finance ministers around the world that their investment is valuable.
“Part of our history and our heart is about being a specialist organisation that develops evidence to provide evidence-based solutions. We are also spending time working with endemic countries’ Governments to help them decide what their health system should look like in the future.
“We want to help governments develop that road map of what they should do next.”
The UK government should, according to Mr Nelson, focus on specific areas where the UK has expertise and a competitive advantage.
“I think given the UK’s history, picking a few notable goals where we already have expertise, and focussing on them, would be good,” he says.
“We are not going to be able to support everything, and health is clearly one of the UK’s areas of expertise. DFID has great experience in that and we have great resources in the NHS which can be brought to bear on the task of building strong health systems around the world.
“Making sure that we share the learnings of what works in recipient countries, and helping the countries decide what they want their system to look like at the end, is vital. There is a still a danger that we could end up encouraging change without being clear what we want to change to.
“Simply saying ‘you will save billions in improved macro-economics if you beat infectious diseases’ is almost meaningless. We must make the transition to speaking in more practical terms.”
This is something Mr Nelson understands from personal experience of working to improve health outcomes all over the world.
Adding his personal insight he concludes: “When I first joined the sector, I quickly realised I had in some ways confused vulnerability with a notion of weakness. Actually the people I have had the privilege to meet who are the most vulnerable are probably some of the strongest people in the world. They are incredibly resilient. And I would say that when strong people ask for help they probably need it.”
If the strength of the global community’s commitment can match the strength of those they seek to help, the success of the SDGs may well be achievable.
Keywords: Advocacy and policy