2016 begins with two historic global agreements shaping sustainable development as never before. Despite the challenges we face, this pairing provides a reason for optimism and a path for the global community to take. It's up to us to hold to that path and realize enormous benefits for the health of populations everywhere.
The first of these agreements is the 2030 Agenda for Sustainable Development, adopted by the United Nations General Assembly in September. The 17 Sustainable Development Goals — and their 169 targets — aim, in the words of UNDP, "to end poverty, hunger and inequality, take action on climate change and the environment, improve access to health and education, build strong institutions and partnerships, and more."
The second of the two international roadmaps is the Paris Agreement to curb global warming, adopted at the COP21 meetings in December. "The most ambitious climate change agreement in history," according to the White House, which added, "For the first time, all countries commit to putting forward successive and ambitious, nationally determined climate targets and reporting on their progress towards them using a rigorous, standardized process of review."
Neither is viewed primarily as prescription for public health, but both of these global accords, at their core, are precisely that. The challenge of public health in the 21st century is to maximize population health, and the SDGs and the Paris Agreement offer a roadmap to health and security for all nations. Both agreements perfectly match the definition of public health from the US National Academy of Medicine: the science-based "actions we must take collectively to protect our health."
The Sustainable Development Goals are designed to fulfill a vision — one fundamentally of public health. That vision is defined by the United Nations as follows:
In these Goals and targets, we are setting out a supremely ambitious and transformational vision. We envisage a world free of poverty, hunger, disease and want, where all life can thrive. We envisage a world free of fear and violence. A world with universal literacy. A world with equitable and universal access to quality education at all levels, to health care and social protection, where physical, mental and social well-being are assured. A world where we reaffirm our commitments regarding the human right to safe drinking water and sanitation and where there is improved hygiene; and where food is sufficient, safe, affordable and nutritious. A world where human habitats are safe, resilient and sustainable and where there is universal access to affordable, reliable and sustainable energy.
The Paris Agreement recognizes two fundamental principles in its preamble: (1) "that climate change represents an urgent and potentially irreversible threat to human societies and the planet and thus requires the widest possible cooperation by all countries"; and (2) "that deep reductions in global emissions will be required in order to achieve the ultimate objective of the Convention and emphasizing the need for urgency in addressing climate change." The entire Agreement, a response to "an urgent and potentially irreversible threat" to public health, is predicated on growing awareness of the damaging effects of extreme heat, historic storms, threats to water and food, novel infectious elements, and air pollutants and increased pollen counts on human health.
What makes these agreements all the more remarkable is the extent of the global community's engagement in developing them. That buy-in is crucial to their implementation and ultimately their impact, and can teach us much about the value of engaging all sectors and building consensus to address the many conditions that affect public health.
More than 150 countries have signed on to the Sustainable Development Goals, which, as Liz Ford wrote in The Guardian, "were presented to the UNGA last year by an open working group of 70 countries that had been charged with producing a set of targets to replace the millennium development goals...Their final draft goals incorporated the views of UN agencies, the private sector, civil society, consultations in 130 countries and the 7 million people who took part in the UN's My World survey."
As the White House noted about the Paris Agreement, which was adopted by 196 nations, "The deal builds on the unprecedented participation of 187 countries that submitted post-2020 climate action targets in advance of the meeting...The Agreement moves beyond dividing the world into outdated categories of developed and developing countries and instead directs all parties to prepare, communicate and maintain successive and ambitious nationally determined climate targets."
That latter distinction is an important one as well. Agreement often requires parties to abandon preconceived notions and create a framework that recognizes the legitimate interests of all involved. The test now is in the implementation of these agreements and fulfillment of their extraordinary potential — it's crucial that the global community's engagement in the adoption process translates to an ongoing commitment to achieve them.
These two global agreements underscore the magnitude of the challenge of maximizing and protecting population health. That's a challenge that the field of public health recognizes well — and one that requires the commitment of the entire world.