Transforming Our World, the 2030 Agenda for Sustainable Development, which is likely to be adopted next week by UN Member States, contains astonishingly bold and ambitious aspirations for transforming global health.1 The Agenda includes a series of “zero targets” to be achieved by 2030, including to “end preventable deaths of newborns and children under 5 years of age” and to “end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases.”2
But such targets are simply unattainable unless there’s a massive scale-up in research and development (R&D) for conditions that disproportionately affect poor communities in low- and middle-income countries (LMICs). Unfortunately, the SDGs as currently written say way too little on the essential role of scientific innovation in achieving SDG 3 (the health goal) and they say nothing at all about the crucial importance of monitoring progress in global health R&D.
A compelling new report by Policy Cures, an independent research group, published last month made the case that the SDG 3 targets “will not be achieved without R&D to develop new health technologies—such as new and improved drugs, vaccines, diagnostics, and other critical innovations—and to improve our understanding of how to best target the tools we already have.”3
The Lancet Commission on Investing in Health, a group of 25 economists and health experts chaired by former US Treasury Secretary Lawrence Summers, has helped to quantify the R&D need (I was one of the 25 Commissioners).4 The Commission modeled what it would take to achieve a “grand convergence” in global health by 2035—that is, a reduction in avertable infectious, maternal and child deaths down to universally low levels. The group found that even with very aggressive scale-up of existing medicines, vaccines, and other health tools to coverage levels of around 95%, low-income countries would only reach about two thirds of the way to convergence by 2035. New health tools will be needed to fully close the gap.
As I’ve previously noted in the Health and Human Rights Journal, both the Universal Declaration of Human Rights (UDHR) and the International Covenant on Economic, Social, and Cultural Rights (ICESCR) place access to science firmly within a human rights framework.5 The UDHR states that everyone has the right “to share in scientific advancement and its benefits” (Article 27, section 1) and the ICESCR recognizes the right of everyone to “enjoy the benefits of scientific progress and its applications” (Article 15, section 1). With only 1-2% of spending on biomedical R&D currently directed at diseases that disproportionately affect lower-middle income countries, the world’s poor are surely being denied their right to achieve better health through scientific innovations.6
The Lancet Commission urged the international community to quickly double its annual spending on global health R&D from $3 billion to $6 billion.7 Such a rise in funding is entirely feasible through the collective efforts of donor-, middle-, and low-income country governments, philanthropy, and the private sector. And an R&D monitoring framework must be adopted to track commitments and hold investors to account.
Transforming Our World, the 2030 Agenda for Sustainable Development certainly pushes and challenges us to aim high. But its health targets are a fairytale without a renewed global commitment to meet the R&D needs—and rights—of the world’s poor.
1. Transforming Our World: the 2030 Agenda for Sustainable Development. At https://sustainabledevelopment.un.org/content/documents/7891Transforming%20Our%20World.pdf
3. Policy Cures. Measuring Global Health R&D for the Post-2015 Development Agenda. August 2015. At http://www.ghtcoalition.org/files/GlobalhealthRandDinpost2015_web.pdf
4. Summers LH, Jamison DT, Alleyne G, Arrow KJ, Berkley S, et al. Global health 2035: a world converging within a generation. Lancet 2013;382: 1898-955. At http://www.globalhealth2035.org/sites/default/files/report/global-health-2035.pdf
5. Yamey G. “Excluding the poor from the biomedical literature: a rights violation that impedes global health” Health Hum Rights. 2008; 10(1):21-42. Available at http://www.hhrjournal.org/2013/09/11/excluding-the-poor-from-accessing-biomedical-literature-a-rights-violation-that-impedes-global-health/
6. See note 4
7. See note 4 Gavin Yamey is Professor of the Practice of Global Health & Public Policy, Duke Global Health Institute, Duke University, NC, USA. Previous papers published by Gavin Yamey in the Health and Human Rights journal Excluding the poor from the biomedical literature: a rights violation that impedes global health (2008) Building the “Knowledge Commons” (2009)
Gavin Yamey is Professor of the Practice of Global Health & Public Policy, Duke Global Health Institute, Duke University, NC, USA.
Previous papers published by Gavin Yamey in the Health and Human Rights journal