IFMSA Delegation to the 5th OWG on Sustainable Development Goals

The IFMSA delegation to the fifth session of the open working group on sustainable development goals, 25-27th November 2013, part of the United Nation Major Group of Children Youth.

Sustainable Development Goals: Realizing the World We Want

The UN Open Working Group (OWG) on Sustainable Development Goals (SDGs) was created to allow for a global conversation around a new development agenda for post-2015. SDGs are based upon the Millennium Development Goals (MDGs) established in 2000 which has guided the development agenda for the past fifteen years. The process of developing SDGs, which started in March 2013, includes a set of eleven multi-stakeholder thematic consultations involving delegates from members’ states, United Nations Groups, and the civil society.

Health in the Development of a Sustainable Development Framework

Health is a “precondition for, an outcome of, and an indicator of all three dimensions of sustainable development”[i] : social, economy and environment. Therefore, it needs to be a crosscutting issue in the post-2015 SDGs. The protection and the promotion of health and wellbeing of all people of all ages can be part of all potential SDGs. Proposed goals and targets should include health-sensitive indicators.

The framework needs to promote action to achieve human development and promotes human health and wellbeing through the following[ii] :

  • Universal, equitable, rights-based, and human security approach
  • Inclusion of existing and future health issues : MDGs priorities, and emerging global health challenges (NCDs, mental health, infectious diseases)
  • Promotion of human rights for all, by ensuring enabling environments for the protection of human rights
  • A focus on the poorest and most vulnerable and marginalized populations: sexual minorities, older people, people with disabilities, NDCs and migrants.
  • Promotion of policies and programs supporting health and development throughout the life course, and ensuring access to services to minimize the social and economic impacts of experiencing a health condition
  • Active and meaningful engagement with nongovernmental organizations and civil society
  • Clear and strong accountability mechanisms, with adequate and sustainable financing


Fifth Session: Health as a Sustainable and Inclusive Economic Issue

“There is a sense of urgency.” “The Social Agenda has to be a strong consensus. Goals must be few, measurable, and easy to communicate.” “We must leave no one behind.” Macharia Kamau opens the fifth working group session. On Monday morning, co-chairs Körösi and Kamau lead the session on sustained and inclusive economic growth, macroeconomic policy questions (including international trade, international system and external debt sustainability), infrastructure development and industrialization.

What is sustainable and inclusive industrialization? It is national economic growth and policies that take under consideration social issues such as public health, food security, gender equity and decent employment, as well as taking environmental issues into consideration.

As a medical student, engaged citizen, and on behalf of the UN Major Group of Children and Youth, I believe that it is essential to promote health in the SDG framework on future and re-negotiated trade and investment agreements. Therefore, international trade agreements must not undermine public health, and should address tobacco control, access to medicine, and technology access. Inclusive economic growth is directly linked to poverty, inequalities, and determinants of health.

I recommend the inclusion of policies that ensure allocation of resources to support the implementation of universal health coverage (UHC) and access. I recommend targets to promote measures to decrease indoor and outdoor air pollution as the use of accessible, active and public transport. I recommend a target to increase national tax revenues and economic capacity through taxation on products that contributes to poor health outcome. Fiscal policy is a powerful tool for encouraging health-promotion behaviours.

Those recommendations were to be discussed with the delegates. One of our goals was to talk to the representatives from member states about health issues. To accomplish this, we were tracking, which means to write what each delegate was saying in short key points. After the sessions, we therefore approached them in one-on-one fashion according to our knowledge and ties to individual countries. Engaging discussion on health issues linked to energy or macroeconomics allowed for inspiring discussions with some delegates as well as for the sharing of our position.

During the sessions, the question of financial stability was repetitive. It requires transformation at an international level. Unfortunately, we did not hear concrete propositions about how the financial system can be transformed to support sustainable initiatives; therefore, fiscal policies to support countries in their sustainable efforts are necessary. Calls for donors to reaffirm their goals to allocate 0.7 % of the gross domestic product to foreign aid and to allocate funds especially for improving health outcomes according to current epidemiological trends are strongly voiced. [iii]

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Fifth Session: Health as an Energy Issue

The second half of the working group was devote to Energy issue. “Energy is the golden thread that connects economic growth, social equity, and environmental sustainability” Ban Ki-Moon, UN Secretary-General. We believe that the inclusion of indicators to measure the health equity impacts of energy policies can benefit from access to energy. We also support indicators to measure indoor and outdoor air pollution exposure, according to WHO’s assessment of ambient air pollution concentrations[iv]. Some countries talked about the interlinkages between energy and health, as well as interlinkages with many other issues like gender, economy and poverty. Energy, especially renewable energy, is a strong promoter of health.

Sustainable Economy on Health Outcomes
– National Taxation of tobacco or other unhealthy products
– Interdiction of non-therapeutic use of antibiotics in livestock production, as this contributes to increasing resistance in humans
– Support eradication of malaria, AIDS and tuberculosis
– Support to reduce tropical diseases and non-communicable diseases
– Support free-smoke decent job
– Policy to protect sexual and reproductive health and rights of women and adolescent girls

4 million people die per year as a result of exposure to smoke (cook stoves or open fires). 3, 3 million people die each year from exposure to outdoor air pollution. [v]

Those statistics were mentioned not only by UN major groups, but also by delegates from varied continents. Everybody agreed: energy access for all is essential to the achievement of the post-2015 agenda. However, a major question remains unanswered: how do we address energy when access for all and equity is needed as well as a transformation of energy systems to green energy alternatives?

Things we found missing in the discussions

Growth, growth, growth
Although the need for growth is understandable for development, this cannot be the single target of macroeconomic policies. Growth must most importantly be managed in a sustainable manner within planetary boundaries. How about mentioning an economist’s worst nightmare: managed economic compression in regions / economic areas that are highly unsustainable in their practices instead of only managed growth. The closest we came to hearing such bold ideas was through discussions of increased energy efficiency.

Growth is not the direct equivalence of development. Actually, these two terms refer to quite opposite concepts. Growth can be defined by the unique expansion of something such as the economy, and this is not necessarily good. Development on the other hand refers to a constant evolution toward something better.

Youth presence 
MGCY certainly had a strong delegation and there were a few UN interns present as well, but we found low youth participation. We were told by MGCY representatives that youth participation in this session was significantly lower than usual and indeed, the IFMSA delegation represented more than half of the MGCY members present at any single point in time. An important way to ensure intergenerational equity in major UN discussions is by involving youth in official member state delegation; this is something that we would like to see both in future OWG session and in other international forums.

Youth voice to promote health and equity in the post-2015 agenda is essential. Youth must be engaged in this process. Monday afternoon, Professor Jeffrey Sachs, Director of the UN Sustainable Development Solutions Network and Director of The Earth Institute, exclaims that we are running out of time and of safe space, that the work of these SDGs is essential and that it needs to inspire the world, and most important, SDGs post-post 2015 must “Empower the young people”.

Concluding Thoughts

The MDGs were without a doubt historic and monumental, but regardless, were riddled with problems and short-failings. However, the spirit at OWG5 is impressively positive and constructive in this regard. Although the group in general seems to recognize the failings of MDGs, they are regardless looking forward with bold optimism. Lessons learned from the MDGs center around sustainability, multi-dimensional targets and statistical indicators. Conversations, without a doubt, emphasize that although MDGs highlighted social needs in a unified context, these social and humanitarian goals cannot be achieved without the economic development, and consequent public capital, to spend on social avenues. Secondly, the problem of silo-ing in the MDGs occurred by the creation of single-facet goals (ie: one goal for education, one goal for health, etc.). However, this compartmentalization does not reflect reality. Issues are intertwined and networked in complex fashions, which needs to be reflected in new SDGs and their respective targets.

Although this has been discussed at the OWG5, our lobbying efforts have noticed some resilience in taking a fully integrative approach. As soon as health seems to be mentioned, economy-focussed ears and minds close up. This is the goal of our lobbying efforts this week: to try and persuade delegates that health is a multi-dimensional goal, and is necessary but not sufficient for sustainable economic development. New indicators that measure human well-being and health must be used to evaluate economic progress in the future. Although the final outcomes of our advocacy efforts will not be seen for years to come, it has been monumental to be part of these constructively critical conversations that will set a new development precedent for history.

Jennifer Walker, Mathieu Hains, Stéphanie Lanthier-Labonté, Yassen Tcholakov
IFMSA Delegation to the 5th UN OWG on SDGs

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[i] UN. The Future We Want. June 2012. http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/66/288&Lang=E. Accessed 18 November 2013.

[ii] UNDESA UN, Mr. Nikhil Seth. The Health PerspectiveFifth Session of the Open Working Group on Sustainable Development Goals (OWG 5).  http://sustainabledevelopment.un.org/index.php?page=view&type=9500&menu=[%menu_nr%]&nr=1459. Accessed 21 November 2013.

[iii] UNDESA UN, Mr. Nikhil Seth. The Health PerspectiveFifth Session of the Open Working Group on Sustainable Development Goals (OWG 5).  http://sustainabledevelopment.un.org/index.php?page=view&type=9500&menu=[%menu_nr%]&nr=1459. Accessed 21 November 2013.

[iv] WHO. Health indicators for sustainable development: Energy: http://www.who.int/hia/green_economy/indicators_energy2.pdf Accessed 21 November 2013.

[v] WHO. Health in the green economy: Household energy in developing countrieshttp://www.who.int/hia/hgebrief_henergy.pdf Accessed 21 November 2013.

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Youth voices must resonate

The IFMSA delegation to the 4th open working group on sustainable development goals co-wrote a statement on behalf of youth and medicals students around the world, which you can read below.

I am a young medical student and am speaking here today on behalf of the United Nations Major Group of Children and Youth, and as a proud member of the International Federation of Medical Students’ Associations, which represents 1.3 million future physicians in over 100 countries.

I would like to address today a few comments, remarks and suggestions on the on-going meeting regarding the engagement of youth in the post-2015 process and the sustainable development goals, especially regarding the health discussions.

Where does youth fit in a post 2015 world?
Almost half of the world’s population is under the age of 25, which means there are too many of us to ignore. We, the youth, know how to communicate with each other and to make sure that our different voices are equally heard. We are the generation that grew up with social media, we are the generation of instant sharing. We are the MDGs generation, but the SDGs will help us give the future we want to the generations to come. We need clear mechanisms to participate in and contribute to sustainable development. A vibrant and politically engaged youth is necessary because after all, it is our generation that will ensure that the SDGs are achieved.

What do we, the youth, wish to see in the post-2015 world, how can we contribute?
This is a good question, and I hope to talk through some answers. We call for equal access to high-quality education that will equip us to be a part of a sustainable society. We call for decent green jobs that will give us the capacity to create our own opportunities. We call for universal social protection to support the most vulnerable amongst us, while empowering us to drive change. We call for inclusion of sexual health education in all primary school curricula. We call for education and empowerment of women and girls so they may in turn continue to strengthen their families and society.

We must stop thinking of health as medical interventions alone. The Health in all Policies approach emphasizes that all policy domains impact and are impacted by health.  Good health is both an outcome and a determinant of successful development policy. We commend many countries for their statements on health system transformation towards Universal Health Coverage and non communicable diseases. We call for health-sensitive indicators throughout the sustainable development framework. Funding, accountability and governance for health will all follow from strong indicators and targets. The post-2015 development framework must address inequality within and between countries. We need better data to meet the needs of marginalized and vulnerable children and youth. These populations must be a priority in the sustainable development goals.

I am a physician in training and by 2015, I will be a graduated doctor. I will contribute to the healthcare of the young people we are discussing. I wish for equitable health access for the people that will become my patients, and for their quality of life to allow them to be productive members of society. During my medical training I have seen obese nine year-olds with high blood pressure, women my age with young children but no home, and refugees suffering from post-traumatic stress disorder. We are the first generation with a lower life expectancy than our parents, mostly because of the burden of noncommunicable diseases, while we also clearly understand that we are likely to see a rise in infectious diseases because of globalization and climate change. We have resources unavailable to many members states, but the problems we face have universal roots in inequity. The solutions, we hope, are also universal.

Health plays a critical role in the sustainable development agenda. We ask each of you to commit to ensuring inclusion of health issues within your country’s SDG implementation.  Healthy youth are engaged youth, healthy human beings are active citizens. This is why we all need to engage today as a team for the future we want. Youth need your wisdom and expertise; you need our vibrancy, perspective and creativity. This process will be a failure if youth are not fully engaged and health. Youth voices are critical in the design of goals to promote equity and health in a post-2015 world. You will find us to be energetic, professional and full of new ideas, but we need your help to access the process.

Youth voices must resonate within the United Nations walls.

Claudel P-Desrosiers, Kimberly Williams, Neil de Laplante, Mike Kalmus-Eliasz, Anneleen Boel, Rispah Walumbe and Gerald Makuka.

Contributed to by AMSA-USA: Laura Bertani and Aliye Runyan, M.D.

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4th open working group on sustainable development goals to kick off in New York on Monday!

It is our pleasure to introduce you the IFMSA delegation to the 4th open working group (OWG) on sustainable development goals (SDGs), to kick off at the United-Nations Headquarters in New York, on June 17th 2013. As we draw closer to the meeting, the IFMSA delegation makes final preparations to make sure our participation is valuable and meaningful as well as a good representation for IFMSA and youth everywhere.

Who we are
We are a bunch of enthusiastic IFMSA members from all over the world, with various backgrounds, ready to advocate for health and youth issues, and to ensure that the voice of medical students worldwide is well-heard by stakeholders.

Why a meeting on sustainable development goals
Last June, Rio de Janeiro welcomed the United Nations Conference on Sustainable Development, also known as Rio+20. In the outcome document The Future We Want, The present member states agreed on launching a process to develop a set of sustainable development goals (SDGs), while being pretty vague and only stating that those goals should be “limited in number, aspirational and easy to communicate”. Above all, those goals should balanced the three dimensions of sustainable development: society, environment and economy. On paper, sustainable development is pretty cool: it aims to meet the needs of the present, such as poverty reduction and economic growth, without compromising the ability of future generations to meet their own needs, for example environmental protection and intergenerational equity (Brundtland, 1987). But it gets a bit more challenging when we try to put policies in place. To learn more on sustainable development, we suggest you to take a look at the UN Division for Sustainable Development (DSD) at : http://www.un.org/esa/dsd/.

So after this huge meeting in Rio where IFMSA sent a delegation, an open working group was mandated by the General Assembly to prepare a proposal on the SDGs that would be sensitive of the UN development agenda beyond 2015. After being officially established on January 22nd 2013, the open working group decided of its own innovative modalities to ensure the full involvement of relevant stakeholders and civil society, including the Major Group of Children and Youth (MGCY), with which IFMSA has collaborated many times in the past. So far, the group has met thrice and will meet for a fourth time between June 17th-19th to focus especially on health and population dynamics, social protection, youth, and education.

Why is this meeting important
The general idea of this meeting is that the contributions made in this forum will play a pivotal role in shaping the SDGs and what goes into them for the High Level Panel of Eminent Persons to review. The SDGs will be what we strive towards, tackling various issues in health, climate change, social protection, education, and youth among many others. We want to make sure that important issues we cherish are not missed within these broad topics. A lot has been brought up of concern with other groups also participating in the MGCY. With UNFPA and UNICEF amongst others sending big and strong delegations, this 4th OWG meeting is likely to be the biggest so far.

What we will do
Our group will be representing IFMSA at this meeting, where we are hoping to contribute on interventions regarding health and youth issues. We have also been working on drafting specific statements on different agenda items. We will be using IFMSA various policy statements including the last we adopted in March 2013 on future development goals. We will advocate for what we know best: universal health care, health in all policies, sexual and reproductive rights, non-communicable diseases including mental health, climate change and health co-benefits of sustainable development. Furthermore, we will also participate in MGCY Mini Youth Blast happening today (June 16th) where we will facilitate sessions, contribute to others, strategize for the meeting ahead, as well as in numerous side-events.

Overall, we hope that we will be able to trigger discussions, both within and outside of IFMSA, to play an active role in work on health beyond 2015 and to help shape the future we want. As Richard Horton from the Lancet recently wrote, we have about 30 months to get this right.

We will be sending regular updates on twitter, using the hashtag #IFMSASDG. And we want you to engage with us! Send us a tweet, comment on our IFMSA blog entries, and most of all make sure you get involved in the discussions on the future we want!

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Delegation Meeting in Bryant Park on Saturday June 15th

Until next time,

Claudel P-Desrosiers and Rispah Walumbe
On behalf of the delegation: Mike Kalmus-Eliasz, Anneleen Boel, Neil De La Plante, Gerald Makuka, and Kimberly Golding Williams.

For more on the meeting: http://sustainabledevelopment.un.org