New goals should shore up past health pains

The world leaders representing the 193 UN member states will adopt the Sustainable Development Goals (SDGs) to tackle global issues for the next 15 years at a special summit in New York this week.

These goals should address the glaring gaps in health needs and trends in reduced political and financial support for health.

It is important that the SDGs be rooted in the reality faced by the people and that tangible plans addressing this disparity be developed post the summit.

The 17 SDGs will replace the Millennium Development Goals (MDGs) and form the blueprint for strategic plans of national governments, international institutions, and funders in the coming years.

MARKED IMPROVEMENTS
Undoubtedly, the MDGs led to marked improvements. In Kenya, they resulted in increased vaccination coverage and access to primary health care.

Yet, the medical needs among the vulnerable population remain dire. Significant gaps in health provision continue to destroy lives and cripple communities.

Affordability is a concern in many areas of care, from the most basic to the more specialised as people with non-communicable diseases still have limited care.

Secondary health care is too expensive for most people. Spread of water-borne diseases is still difficult to control.

Response to HIV, which is seen as a clear success of MDGs, also has mixed achievements.

TREMENDOUS PROGRESS

Globally, as a result of strong political commitment, an increase in funding for HIV testing and treatment, increased awareness, innovative service delivery models, and continued decline in the prices for antiretroviral drugs and diagnostics, the target of HIV treatment for 15 million people by 2015 was achieved.

However, this progress is still fragile. In Kenya, only half of the estimated 1.6 million people living with HIV are being treated.

International donors, paying for drugs, staff salaries, and community-based services, fund 70 per cent of the country’s HIV budget.

Worryingly, donor funding is expected to reduce over the coming years, bringing expectations of a greater reliance on domestic resources.

With the government of Kenya merely allocating 4.5 per cent of its national budget on health, the test will be to see if it will prioritise the urgent medical needs of the population, especially vulnerable communities.

There is fear that the gap in health provisions may widen further, considering the recent trend of global decrease in international funding and SDGs calling for more self-reliance of countries.

JEOPARDISED FUNDING

This problem could worsen for Kenya, given its recent economic upgrade to a Lower-Middle-Income country, which means that its future eligibility for international grants may be considerably jeopardised.
To stand a better chance of achieving the SDG targets by 2030, domestic resources for health financing need to be substantially increased while policies need to be formulated based on realistic assessments of obstacles that people face in getting access to health care.

Now is the opportunity for Kenya and stakeholders to show political will and leadership by consolidating and accelerating the improvements in health over the past decade.

The government needs to swiftly act to increase financing for health and develop tangible plans based on the health needs of its most vulnerable and excluded communities.

Mr Hennequin and Mr von Rège are MSF representatives in Kenya.