The BusinessGreen Guide to the SDGs: SDG3 - Good Health and Well-being

James Murray
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The BusinessGreen Guide to the SDGs: SDG3 - Good Health and Well-being

The BusinessGreen SDG Hub takes the microscope to the world's health-related development goals

The targets

3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.

3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-five mortality to at least as low as 25 per 1,000 live births.

3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.

3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents.

3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.

3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.

3.A Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.

3.B Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.

3.C Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States.

3.D Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

Progress to date

Health is one of the areas where the most impressive progress has been made in recent decades.

The UN Development Programme says that since 1990 there has been an over 50 per cent decline in preventable deaths globally. There has also been a 45 per cent reduction in maternal mortality, driven in large part by a sharp increase in the proportion of live births undertaken with the assistance of a health professional - between 2000 and 2005 only 62 per cent of mothers gave birth with professional support, by 2012-2017 the share had risen to almost 80 per cent. At the same time the mortality rate for children under five has almost halved.

Life expectancies have continued to rise, health risks from environmental factors have been curbed, especially in industrialised countries, and progress has been made on once intractable health crises. For example, new HIV/AIDS infections fell 30 per cent between 2000 and 2013, while 6.2 million lives were saved from malaria.

Other medical interventions are having similarly impressive results. For example, the widespread use of hepatitis B vaccine in infants has considerably reduced the incidence of new chronic hepatitis B virus infections - as reflected by the decline in hepatitis B prevalence among children under-five from 4.7 per cent in the pre-vaccine era to 1.3 per cent in 2015.

And yet huge challenges remain, with the starkest health risks still borne by the poorest communities.

The latest UN progress report confirmed that in 2015 an estimated 303,000 women around the world died due to complications of pregnancy and childbirth, with two thirds of these deaths occurring in Sub-Saharan Africa. Progress in tackling HIV has also been slowest in Sub-Saharan Africa with HIV incidence rates at 1.28 per 1,000 uninfected population. Meanwhile, the UN warns "the world is not on a trajectory towards ending malaria by 2030 - in fact, the trends are worrisome" with reported cases rising from 210 million in 2013 to 216 million in 2016.

Progress on tackling unsafe drinking water, unsafe sanitation and lack of hygiene has also been too slow, with around 870,000 deaths in 2016 attributed to dirty water. Environmental, infrastructure, and social issues are also blamed for sluggish progress on tackling uncommunicable disease and mental health.

Globally, 32 million people died in 2016 due to cardiovascular disease, cancer, diabetes or chronic respiratory disease, while suicide rates remain static with nearly 800,000 people taking their own lives each year. Efforts to tackle the health impacts of alcohol and tobacco remain mixed with only 14 countries of the 181 that ratified the WHO Framework Convention on Tobacco Control having improved their national monitoring of tobacco use in accordance with Article 20 of the Convention.

Air pollution is now blamed for some seven million deaths worldwide, while a further 1.25 million people worldwide were killed and 50 million more were injured in traffic accidents in 2013.

Finally, healthcare coverage remains highly variable. Globally, almost 12 per cent of the world's population spent at least 10 per cent of their household budgets to pay for health services in 2010, up from 9.7 per cent in 2000. Available data from 2005 to 2016 indicates that close to 45 per cent of all countries and 90 per cent of LDCs have less than one physician per 1,000 people, and over 60 per cent have fewer than three nurses or midwives per 1,000 people.

Business implications

Health has both direct and indirect implications for the business community. While many countries deliver health services through the public sector many others rely on private companies and insurance-based systems to provide healthcare. At the same time businesses dominate the pharmaceutical sector. As such it will be impossible to meet the SDG3 targets without close co-operation between governments and the business community.

More broadly, businesses are easily blamed for many of the environmental factors that increase health risks. From tobacco, alcohol, and poor diets to air pollution, road traffic accidents, and sedentary lifestyles, businesses will inevitably be impacted by any policy measures designed to tackle escalating health risks.

At the same time businesses stand to benefit from improvements in health and well-being, as well as underlying infrastructure, which are all likely to boost employee productivity and reduce costs for commercial organisations.

Business risks

The risks faced by businesses from SDG3 fall into two categories: risks associated with a failure to meet the targets and risks associated with the policies required to meet the targets.

Beyond the human tragedies that result, a failure to improve healthcare and health outcomes, especially in developing economies, will undermine economic growth and act as a continued drag on productivity. Air pollution, dirty water, road traffic accidents, and the fallout from mental health crises and alcohol abuse all impose costs on businesses, alongside the inevitable health impacts on communities.

However, while the long term benefits of improved health care are obvious some businesses will be concerned about the short term impact of health-related policies. The target to 'achieve universal health coverage' promises to open up new markets for health insurance, but it also implies higher tax rates in many countries.

As evidenced by intense and controversial lobbying campaigns in industrialised nations, the pledge to tackle health impacts from tobacco and alcohol, and "substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination", is likely to have a direct impact on the profitability of businesses that fail to adapt to new regulations and 'sin' taxes.

From automotive to tobacco and food to chemicals whole sectors and their investors face escalating risks as health-related regulations are tightened.

Business opportunities

The flip side to these risks are provided by both the net economic benefits on offer from a healthier population and the specific commercial opportunities presented by expanding healthcare sectors and the creation of new markets arising from the focus on preventative health interventions and well-being.

More effective healthcare will drive growth in emerging markets and improve productivity across all economies, while preventative interventions should serve to slash costs for businesses and provide a boost to the multi-billion dollar fitness and well-being industries.

The deployment of healthier infrastructure, whether it is safe drinking water in emerging economies, or safer roads and better cycle lanes in cities, will benefit all businesses. The extension of healthcare services will create huge new markets for healthcare companies and insurance firms.

More broadly, crackdowns on tobacco, air pollution, bad diets, and hazardous chemicals may curtail certain markets, but will also create massive new markets for cleaner and greener technologies. Electric vehicles, safer chemicals, plant-based food innovations, and many other clean tech companies have a clear role to play in supporting SDG3 and stand to directly benefit from the mission to deliver on its ambitions.

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