Health is prominently featured in the Sustainable Development Goals — and rightly so. It affects us all. From developing strategies that address the Ebola crisis to ensuring healthcare systems meet the needs of all people, health is a human right and central to positive economic, social and environmental outcomes.
Goal 3: Ensure healthy lives and promote well-being for all at all ages includes a cross-cutting set of targets on maternal mortality, HIV/AIDS, sexual and reproductive health, and environmental impacts. Health is also integrated as a target across a number of goals, including those related to gender, the environment, poverty and consumption — implicitly recognizing the inter linkages necessary to health. Such an approach signals a shift from how development was conceived in the Millennium Development Goals (MDGs) (three separate goals), toward the new integrated development framework of the SDGs, which aspires to be grounded in a human rights-based approach.
One area where such a shift is clear in the SDGs is around sexual and reproductive health.
The ways in which the MDGs considered sexual and reproductive health created siloes between development responses. Maternal mortality was viewed as separate from gender equality, despite there being clear evidence to demonstrate the linkages between the advancement of women’s rights and decreases in maternal mortality. The SDGs however include sexual and reproductive health across goals — recognizing that positive outcomes depend as much on a strong health system, as addressing social determinants of health in education, as well as efforts to advance gender equality and trade.
Still, challenges remain.
The negotiation of the SDGs made clear the positions of governments against integrating sexual and reproductive health and rights across the SDGs. And theagenda failed to explicitly reference access to safe and legal abortion and comprehensive sexuality education, both of which are central to health.
The same goes for implementation. In order for health — specifically sexual and reproductive health — to be meaningfully addressed, linkages need to be made across sectors. This will require Ministries of Health to work directly with Ministries of Education, Labour, Immigration, and Justice. Some donor governments, likeSwitzerland, have already begun this process; but working in such a way will require significant political will and financial resources.
Finalizing indicators is another piece. While remaining apolitical, Canada as a member of the Inter-Agency and Expert Group on Sustainable Development Goal Indicators, can play a significant role in ensuring that indicators are rights-based and both quantitative and qualitative. A strong set of balanced indicators provides the necessary scope to assess the availability, accessibility, acceptability and quality of sexual and reproductive healthcare and services. To do this, guidance can be drawn from resources like the UN Office of the High Commission for Human Rights’ ‘Human Rights Indicators: a guide to measurement and implementation.‘
Finally, governments will be entrusted with developing strategies for implementing the new development agenda domestically and internationally. These strategies will need to include human rights standards, operationalize human rights principles, clearly delineate responsibilities among levels of government and departments, and include support for monitoring mechanisms involving government sectors, parliamentarians, academic experts, development partners and donors, Indigenous organizations and civil society — especially women’s, youth and other organizations representative of especially excluded groups and diverse constituencies. All of this must be undertaken not only to operationalize the SDGs, but also to meet existing obligations governments have through the ratification of international human rights treaties.
So what can Canada do? Two things.
One: it must create a global policy on sexual and reproductive rights to guide action on sexual and reproductive health, gender equality and human rights, in line with the SDGs.
And two: this must be part of a larger commitment to establish a national strategy for the implementation of the SDGs, in Canada and abroad. And this must be built onrespect for human rights, diversity, the advancement of gender equality and women’s empowerment, transformational change, and universality.
In concrete terms, and as a starting point, Canada can do so by deepening its commitment to maternal, newborn and child health by providing a comprehensive package of sexual and reproductive health services, which includes abortion.
The universal nature of the agenda should encourage the federal government to carefully examine the extent to which the public healthcare system truly meets the needs of all people, ensuring migrants and refugees have equitable access to healthcare (including sexual and reproductive healthcare), addresses healthcare discrepancies across provinces (including access to abortion services), and gives access to affordable care, including providing HIV medications, for example, through a national drug plan.
For the SDGs to truly be transformational, political will and financial resources will be required.
Governments need to address the sexual and reproductive health needs of all people through a concerted commitment to overcoming existing health challenges, holistically. Implementing the SDGs is step one.
Sarah Kennell is the Public Affairs Officer with Action Canada for Sexual Health and Rights, a progressive, pro-choice charitable organization committed to advancing and upholding sexual and reproductive health and rights in Canada and globally.