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1. Sustainability and Sustainable Development:


Sustainability is based on a simple principle: Everything that we need for our survival and well-being depends, either directly or indirectly, on our natural environment. Sustainability creates and maintains the conditions under which humans and nature can exist in productive harmony, that permit fulfilling the social, economic and other requirements of present and future generations.


Sustainability also referred to as sustainable development can therefore be defined as Improvement in the quality of human life within the carrying capacity of supporting ecosystems that meets the needs of the present without compromising the ability of future generations‖ as stated by the Brundtland Commission.


Environmental sustainability seeks to sustain global life support systems indefinitely. Source capacities of the global ecosystem provide raw materials such as food, water, air and energy, while sink capacities assimilate outputs or waste


Economic sustainability revolves on consuming interest, rather than capital and can be defined as the amount of goods that can be consumed during a period, while remaining well off at the end of the period


Social sustainability involves human capital that invests in education, health, and nutrition of individuals and is now accepted as a part of economic development. Ultimately, there can be no social sustainability without environmental sustainability because environmental sustainability supplies the conditions for social sustainability.


It is all too easy to overlook this dependency, particularly at a time when human species is becoming increasingly and distanced from these (World Health Organization) life-support, integrated, sustainable systems. As a result of human induced impacts on these systems, the human species have now placed their lives on the line. Human health plays an integral role on human existence and development, therefore an omnipresent and undeniable link exist between human health and sustainability. this relationship has been established specially in four systematic impacts: population, food shortage, natural disasters and climate change.


The link between human health and sustainability reveals that the growing awareness that long term human population health depends on the continued flow of nature‘s goods and services and the argument for world communities to take concerted action to minimize global environmental change. It is quite obvious that acting now to sustain natural capital to reduce future risks to human health would help alleviate many of the existing local and global health problems associated with poverty, inequity, and environmental degradation.

The International Covenant on Economic, Social and Cultural Rights states that, “the enjoyment of the highest standards of health is one of the fundamental rights of every human being without distinction of race, religion, and political belief, economic or social condition”. The full enjoyment of the right to health is critical for the enjoyment of other human rights. Good health is thus an end in itself and it plays an integral role in human capabilities and well-being. Health is central to the three dimensions of sustainable development. Health is a beneficiary of and a contributor to development. It is also a key indicator of what people-centred, rights-based, inclusive, and equitable development seeks to achieve. Health is important as an end in itself and as an integral part of human well-being, which includes material, psychological, social, cultural, educational, work, environmental, political, and personal security dimensions.


2. Health :


The current WHO definition of health, formulated in 1948, describes health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” At that time this formulation was groundbreaking because of its breadth and ambition. It overcame the negative definition of health as absence of disease and included the physical, mental, and social domains. Although the definition has been criticized over the past 60 years, it has never been adapted. Criticism is now intensifying and as population’s age and the pattern of illnesses changes the definition may even be counterproductive.

Most criticism of the WHO definition concerns the absoluteness of the word “complete” in relation to wellbeing. The first problem is that it unintentionally contributes to the medicalisation of society. The requirement for complete health “would leave most of us unhealthy most of the time.

The second problem is that since 1948 the demography of populations and the nature of disease have changed considerably. Disease patterns have changed, with public health measures such as improved nutrition, hygiene, and sanitation and more powerful healthcare interventions.

Nevertheless, the limitations of the current definition are increasingly affecting health policy. For example, in prevention programmes and healthcare the definition of health determines the outcome measures: health gain in survival years may be less relevant than societal participation, and an increase in coping capacity may be more relevant and realistic than complete recovery.

The first step towards using the concept of “health, as the ability to adapt and to self manage” is to identify and characterise it for the three domains of health: physical, mental, and social. The following examples attempt to illustrate this.

Physical health: the maintenance of physiological homoeostasis through changing circumstance

Mental health: contributes to a successful capacity to cope, recover from strong psychological stress, and prevent post-traumatic stress disorders

Social health: the ability to manage their life with some degree of independence despite a medical condition, and the ability to participate in social activities including work

Measuring health: operational definitions are needed for measurement purposes, research, and evaluating interventions.


the formulation of health are the ability to adapt and self management. This could be a starting point for a similarly fresh, 21st century way of conceptualizing human health with a set of dynamic features and dimensions that can be measured. Discussion about this should continue and involve other stakeholders, including patients and lay members of the public.



Health in UN Millennium development Goal (UNMDG)


In 2000, the global community made an historic commitment: to eradicate extreme poverty and improve the health and welfare of the world’s poorest people within 15 years. The commitment was set forth in the Millennium Declaration and derived from it are eight time-bound goals, known as the Millennium Development Goals.


Health is at the heart of the MDGs - a recognition that health is central to the global agenda of reducing poverty as well as an important measure of human well-being. Health is represented in three of the eight goals, and makes an acknowledged contribution to the achievement of all the other goals, in particular those related to the eradication of extreme poverty and hunger, education, and gender equality. Importantly, the health goals also focus on problems which disproportionally affect the poor.

… Importantly, the MDGs have also helped to crystallize the challenges in health. As developed and developing countries begin to look seriously at what it would take to achieve the health MDGs, the bottlenecks to progress have become clearer. These challenges - again, we have identified five - are the subject of this report. They also represent core elements of WHO’s strategy for achieving the goals.


The first challenge is to strengthen health systems. Without more efficient and equitable health systems, countries will not be able to scale up the disease prevention and control programmes required to meet the specific health goals of reducing child and maternal mortality and rolling back HIV/AIDS, TB, and malaria.


The second challenge is to ensure that health is prioritized within overall development and economic policies. This means looking beyond the health system and addressing the broad determinants of ill-health - low levels of education, poverty, unequal gender relations, high risk behaviours, and an unhealthy environment - as well as raising the profile of health within national poverty reduction and government reform processes.

The third challenge is to develop health strategies that respond to the diverse and evolving needs of countries. This means designing cost-effective strategies which address those diseases and conditions which account for the greatest share of the burden of disease, now and in the future.

 The fourth challenge is to mobilize more resources for health in poor countries. Currently, low-income countries cannot ‘afford’ to achieve the MDGs, and aid is not filling the gap.

The fifth challenge is that we need to improve the quality of health data. Measuring country progress towards the MDGs is a key responsibility of national governments, and global monitoring is one of the most important functions performed by the United Nations system.






Health in Millennium Development Goals





This year, the millennium development goals – launched in 2000 to make global progress on poverty, education, health, hunger and the environment – expire. UN member states are finalizing the sustainable development goals that will replace them.



4. Health in Sustainable Development Goals


The sustainable development goals (SDGs) are a new, universal set of goals, targets and indicators that UN member states will be expected to use to frame their agendas and political policies over the next 15 years.

The SDGs follow, and expand on, the millennium development goals (MDGs), which were agreed by governments in 2000, and are due to expire at the end of this year.

There is broad agreement that while the MDGs provided a focal point for governments on which to hinge their policies and overseas aid programmes to end poverty and improve the lives of poor people – as well as provide a rallying point for NGOs to hold them to account – they have been criticised for being too narrow.

The eight MDGs – reduce poverty and hunger; achieve universal education; promote gender equality; reduce child and maternal deaths; combat HIV, malaria and other diseases; ensure environmental sustainability; develop global partnerships – failed to consider the root causes of poverty, or gender inequality, or the holistic nature of development. The goals made no mention of human rights, nor specifically addressed economic development. While the MDGs, in theory, applied to all countries, in reality, they were considered targets for poor countries to achieve, with finance from wealthy states. Every country will be expected to work towards achieving the SDGs.

As the MDG deadline approaches, around 1 billion people still live on less then $1.25 a day - the World Bank measure on poverty - and more than 800 million people do not have enough food to eat. Women are still fighting hard for their rights, and millions of women still die in childbirth.

17 SDGs goals

1) End poverty in all its forms everywhere

2) End hunger, achieve food security and improved nutrition, and promote sustainable agriculture

3) Ensure healthy lives and promote wellbeing for all at all ages

4) Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all

5) Achieve gender equality and empower all women and girls

6) Ensure availability and sustainable management of water and sanitation for all

7) Ensure access to affordable, reliable, sustainable and modern energy for all

8) Promote sustained, inclusive and sustainable economic growth, full and productive employment, and decent work for all

9) Build resilient infrastructure, promote inclusive and sustainable industrialisation, and foster innovation

10) Reduce inequality within and among countries

11) Make cities and human settlements inclusive, safe, resilient and sustainable

12) Ensure sustainable consumption and production patterns

13) Take urgent action to combat climate change and its impacts

14) Conserve and sustainably use the oceans, seas and marine resources for sustainable development

15) Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification and halt and reverse land degradation, and halt biodiversity loss

16) Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels

17) Strengthen the means of implementation and revitalise the global partnership for sustainable development

Within the goals are a proposed 169 targets, to put a bit of meat on the bones. Proposed targets under goal one, for example, includes reducing by at least half the number of people living in poverty by 2030, and eradicating extreme poverty (people living on less than $1.25 a day). Under goal five, there’s a proposed target on eliminating violence against women. Under goal 16 sits a target to promote the rule of law and equal access to justice




Health in UN Post-2015 Development Agenda



The Millennium Development Goals (MDGs) have proven to be a powerful force in maintaining political support for development. The simplicity of the framework, readily understandable objectives, and focus on quantitative monitoring have proved durably engaging. The debate about how the next generation of global goals post-2015 raises important questions about how progress in improving human health should be reflected in any future set of goals.


The UN is in a process of determining its future development framework as the targets of the Millennium Development Goals expire in 2015. Defining a post-2015 development agenda is Member State-led with broad participation from different stakeholder groups, including businesses and investors. This is an opportune moment for business and the UN Global Compact to help shape the future priorities of the UN and to prepare for supporting the implementation of the results of the post-2015 process, which is anticipated to include Sustainable Development Goals (SDGs).

The development agenda post-2015 is being debated at a time when sustainable development is in the political foreground. While the first draft of the Rio + 20 outcome document was disappointing, health is relatively well reflected in the final version of “The Future We Want”. In addition to the fact that healthy people have stronger cognitive and physical capabilities and, in consequence, make more productive contributions to society, health policy contributes to poverty reduction through the financial protection inherent in universal health coverage. Changes in population growth rates, age structures and distribution of people are also closely linked to national and global development challenges. In addition, health is also a potential beneficiary of policies in a wide range of other sectors such as transport, energy and urban planning. And health metrics can measure progress across the economic, social and environmental pillars of sustainable development.

Health outcomes can be defined precisely and are measurable, and health concerns are immediate, personal and local. Measuring the impact of sustainable development on health can generate public and political interest in a way that builds popular support for policies that have more diffuse or deferred outcomes (such as reducing CO2 emissions)1 . Similarly, health is an important component of other “holistic” approaches to development that seek to replace or supplement GDP as the main indicator of economic progress.

the potential for using Universal Health Coverage in the post-2015 agenda as a way of accommodating the wide range of health concerns discussed above. As a starting point, it is important to be clear as to what is meant by UHC; how UHC can accommodate and accelerate the achievement of and not compete with other more specific programmatic health goals; and how progress in UHC can be measured.

Universal Health Coverage offers a way of sustaining gains and protecting investments in the current set of health-related MDGs – providing a vehicle for sustained technical and financial support after 2015.