Rio+20: Not Quite the ‘Future We Want’ on Health

Rio+20: Not Quite the ‘Future We Want’ on Health

{Photo credit: MSH.}Photo credit: MSH.

Over 100 conference delegates came together at the United Nations Conference on Sustainable Development last week in Rio de Janeiro, Brazil, to strategize smart solutions to global development and poverty reduction while promoting environmental concerns such as clean energy, sustainability, and equitable use of resources.  Popularly known as “Rio+20” --- for occurring twenty years after the 1992 Earth Summit  --- the three days of high-level meetings attended by heads of state and government and high level representatives resulted in “The Future We Want,” a 53-page document that outlines and renews global commitments to sustainable, earth-friendly development.

Recognizing Right to Health, Universal Health Coverage, Health Systems Strengthening and Chronic NCDs

Management Sciences for Health (MSH) congratulates the delegates for their commitment to environmentally-sound global development, including “the full realization of the right to the enjoyment of the highest attainable standard of physical and mental health” [article 138 of "The Future We Want"]. We applaud them for “recognizing the importance of universal health coverage to enhancing health, social cohesion, and sustainable human and economic development” and our encouraged by their “pledge to strengthen health systems towards the provision of equitable universal coverage” [article 139].

We also welcome their commitment to “redouble efforts to achieve universal access to HIV prevention, treatment, care, and support and to eliminate mother to child transmission of HIV as well as renewing and strengthening the fight against malaria, TB and neglected tropical diseases” [article 140].

For forty years, MSH has worked to strengthen national health systems, so we are encouraged by the delegates’ call, “for further collaboration and cooperation at the national and international levels to strengthen health systems, through increased health financing, recruitment, development, training, and retention of the health work force, improved distribution and access to safe, affordable, effective and quality medicines, vaccines and medical technologies, and through improved health infrastructure” [article 143].

We especially applaud the delegates for recognizing chronic non-communicable diseases (NCDs) as an integral issue for sustainable development. MSH encourages global leaders to continue the recent focus on chronic NCDs such as at the 2011 United Nations High Level Meeting on Non-Communicable Diseases and the World Health Assembly meeting last month.

We appreciate the multiple references that the document makes to chronic NCDs, including in articles 138 & 141:

  • We understand the goals of sustainable development can only be achieved in the absence of a high prevalence of debilitating communicable and non-communicable diseases...
  • We acknowledge that the global burden and threat of non-communicable diseases constitutes one of the major challenges for sustainable development in the twenty-first century.
  • We commit to strengthen health systems towards the provision of equitable, universal coverage and promote affordable access to prevention, treatment, care and support related to non-communicable diseases...
  • We also commit to establish or strengthen multi-sectoral national policies for the prevention and control of non-communicable diseases.

Not Going Far Enough on Chronic NCDs and Family Planning/Reproductive Health

MSH, along with leading implementers and advocates such as the NCD Alliance, laments the document’s lack of strong wording and commitments to chronic NCDs. We believe that the outcome document did not go far enough in making countries accountable for progress. Instead it merely proposed a set of voluntary sustainable development goals.

MSH also agrees with the delegates in their initiative to include language on women’s empowerment, family planning, reproductive and sexual health, and gender. Delegates said in articles 145, 146, and 241:

  • We call for the full and effective implementation of the Beijing Platform for Action and the Programme of Action of the International Conference on Population and Development, and the outcomes of their review conferences, including the commitments leading to sexual and reproductive health and the promotion and protection of all human rights in this context.
  • We emphasize the need for the provision of universal access to reproductive health, including family planning and sexual health, and the integration of reproductive health in national strategies and programmes.
  • We reaffirm our commitment to gender equality and to protect the rights of women, men and youth to have control over and decide freely and responsibly on matters related to their sexuality, including access to sexual and reproductive health, free from coercion, discrimination and violence...
  • We will work actively to ensure that health systems provide the necessary information and health services addressing the sexual and reproductive health of women, including working towards universal access to safe, effective, affordable and acceptable modern methods of family planning, as this is essential for women’s health and advancing gender equality.
  • We are committed to promote the equal access of women and girls to education, basic services, economic opportunities and health-care services, including addressing women’s sexual and reproductive health, and ensuring universal access to safe, effective, affordable and acceptable modern methods of family planning.

MSH regrets, however, that these issues critically important and central to sustainable global development are not mainstreamed throughout the entire outcome document. Instead they are mentioned briefly in only three of the document’s 283 paragraphs.

These essential topics appear to be afterthoughts rather than issues of vital importance.

Jill Sheffield, president of the global advocacy organization Women Deliver, said, “We simply cannot achieve sustainable development without the inclusion of women, who deliver enormous social and economic benefits for their families, communities and nations every day.”

We couldn’t agree more.

Barbara Ayotte, MSH’s director of strategic communications, contributed to this post.

Sara A. Holtz, DrPH, MPH, is senior technical officer at Management Sciences for Health.