Rabies control in the SDG era
In September 2015, the 193 countries of the United Nations formally adopted the 2030 Agenda for Sustainable Development, which lays out aspirations for what the world should look like in 2030. Building on the Millennium Development Goals (MDGs) which focussed primarily on decreasing poverty and improving health in the developing world, the new Sustainable Development Goals (SDGs) reach far wider, encompassing economic development, education, justice, peace and environmental sustainability. The scope is ambitious: the goals address more problems, there are goals to end (not just reduce) poverty and hunger, and the emphasis on equality makes the goals relevant to developed and developing countries alike. A strong emphasis on monitoring, evaluation and accountability is also built into the SDGs, which with 17 goals and 169 targets will be a huge task.
Most relevant for rabies control is SDG 3, “ensure healthy lives and promote well-being for all at all ages”, and within it SDG Target 3.3, “By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, waterborne diseases and other communicable diseases”.
However, consistent with the interconnections captured by the SDGs, progress towards several other goals (e.g., those related to poverty, inequality, education, and infrastructure) could indirectly benefit rabies control.
In December 2015, The World Health Organization, outlined its contribution to the SDGs, in its publication Health in 2015: from MDGs to SDGs. Rabies is addressed alongside other NTDs, for which the WHO sees the key strategic priority as high quality universal health coverage (defined as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship). NTD indicators are being developed to allow assessment of how well health care is reaching neglected populations.
At the recently concluded WHO Executive Board meeting, a number of participating member states created a draft resolution on Health in the 2030 Agenda for Sustainable Development (EB138/CONF./8) in which they also stress the need for Universal Health Coverage, and call for all member states inter alia to "strengthen the linkages between veterinary, medical and environmental communities with a special attention to emerging and re-emerging diseases, along with the emergence of antimicrobial resistant pathogens in a way that enables strengthened and improved surveillance, research, preventive measures and training to ensure or to build capacities to address these threats."
The draft resolution emphasises co-ordinated intersectoral action, using existing mechanisms to the greatest extent possible, toward the achievement of the SDGS. For rabies, the WHO/FAO/OIE Tripartite partnership with GARC is just such a mechanism, and the strategic framework agreed at recent the Global Meeting on the Elimination of Dog Mediated Human Rabies provides the details for achieving the vision of an end to human deaths by 2030.
Other existing mechanisms are relevant to a coordinated effort towards rabies control. One is the Global Health Security Agenda (GHSA), a global partnership that lends support to countries to improve their capacity to prevent, detect and respond to infectious disease threats. In a number of countries the GHSA is being used to strengthen both human and veterinary laboratory and field surveillance for rabies, and capacity building in the use of surveillance software such as DHIS2 would benefit the control of many diseases.
A key goal for achieving the new SDGs is SDG17: “Strengthen the means of implementation and revitalize the global partnership for sustainable development”. Many partners have a role to play in promoting universal health care and realising the benefits of rabies-contol and other disease control efforts for all neglected populations.
It is unlikely that the global community will have additional new monies for meeting the SDGs in 2016. But if member states at the WHA agree to better direct existing resources, including through increased global coherence and collaboration in policies for rabies, which would be almost as good. We will keep you posted on the developments.
Contributed by Spring Gombe, a policy consultant at GARC, and Louise Taylor of GARC. The United Nations’ Sustainable Development Knowledge Platform provides accessible information on all the goals and targets, together with the report Transforming our World: The 2030 Agenda for Sustainable Development. There was also a commentary on NTDs in the SDGs published last month in the Lancet. More information on the GHSA is available here.