Global goals vs local realities

The UN general assembly meeting in September every year is not just about the heads of state giving speeches. There are dozens of meetings on the sidelines on a whole host of issues including health, education and other aspects of global development. For the last several years, many of these conversations have centred around the Sustainable Development Goals (SDGs). SDGs are list of 17 goals, with a large number of sub-targets, adopted in 2015 with the aim of well-being of all people. The idea, in and of itself, is praiseworthy. Everyone around the world should have an opportunity to live a meaningful, safe, secure and healthy life. When the SDGs were first adopted, and a few years afterwards, there was a lot of excitement around them. Most meetings in the international development circles would link individual activities with a particular SDG. In the last couple of years, however, the momentum seems to have slowed down considerably. This year, a number of observers noted that not only globally we are not on track to achieve the goals by the target date (2030), but also there seemed to be a genuine fatigue among countries and development experts. While some have suggested the pandemic being the sole reason, I am not sure it is simply the pandemic. I think there are much bigger issues at play here.

I have gotten to know a bit about SDG on health (SDG 3), both as it relates to my own work and from my interactions with development professionals. Over the years, I have seen that while there is excitement at the higher level, there is little interest at the ground level. Let me explain what I mean by that. Every year, I do a mini experiment in my class in Boston (which has plenty of students who are interested in global health). I ask them what are their views on SDGs. Most of them — to my surprise — have never heard of it. This happens every year with a new cohort of students. Now, one can dismiss this mini experiment by saying that many US students are disconnected from the world and live in their own universe. That may be true. But I have done a similar experiment with students I have interacted with in Pakistan, Nigeria and Lebanon. The answer is pretty much the same: zero awareness. The only students who know (and care) are often in affluent European countries where achieving these targets is not going to be an issue. Similarly, in my interactions with colleagues in the ministries of health in several countries, the only people who know of SDGs are senior bureaucrats (if that) but those who are actually doing the work on the ground are neither aware, nor interested. For the ministry colleagues I have worked with, these goals seem distant, arbitrary and often contextually irrelevant.

Then there is issue of financing. In countries like Pakistan, healthcare spending is woefully small. Financial crises, like the one we are facing right now, change development priorities. In this climate of anxiety, SDGs are going to be the last thing on anyone’s mind.

Beyond the local, there are also other global realities. Increasing nativism, along with new regional realities have eroded have impacted the local impact of UN and its agencies. Goals set by the UN, even if signed on by countries, are not what political leaders are thinking about.

Finally there is the issue of what “global goals” and “everyone” really means. When war hits Yemen and destroys the local health infrastructure, and there is more interest in the west in selling weapons than providing support to the vulnerable, can we say that we care about all countries reaching the said targets? When over a million refugees are given thirty days to return to a war-torn country in the midst of a devastating humanitarian crisis, can we expect that there would be quality healthcare for all in the next seven years? Until we set our own goals, and own those goals locally with empathy and care for everyone, any set of goals will remain a distant and an arbitrary dream.

Published in The Express Tribune, October 10^th, 2023.

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