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14 October 2014
Cecilia Kihara recalls the advice she received during marathon season at school, and how it applies to the new development goals.
I went to an all girls’ high school run by Irish nuns. I now seem to spend a lot of my time talking about sexual and reproductive health and rights. Oxymoron? Maybe, maybe not – but more on this later.
I totally enjoyed my time at school but what I disliked was the marathon season in the middle of July, often the coldest month in Kenya. Apart from having to run through the neighbouring boys’ school, the sessions were timed and Sister Ann (not her real name) would wait for the latecomers with a look on her face that would escort you with shame for a month. Every week, Sister Ann’s message was the same. Time is of the essence, pace yourself, breathe and watch the clock, she would say. Keep time. I think we all need to hear that same message as we get closer and closer to the deadline to meet the Millennium Development Goals (MDGs).
As of 18 August this year, we had exactly 500 days until the target date to reach the MDGs. A lot of work has been done on MDGs 4, 5 and 6 on child mortality, maternal health, and HIV/AIDS, malaria and other diseases. The latest UNAIDS data shows that the number of people newly infected with HIV continues to decline and that more people are on treatment. However, there are still 2.3 million new HIV infections every year, 800 maternal deaths a day and 3 out of every 5 people living with HIV cannot access treatment. There’s a clear need to build up the momentum, to pick up the pace.
At the same time, over the past months, consultations have been ongoing concerning the post-2015 development framework and what comes next. There is consensus that it should build on the current MDGs to ensure that gains made to date are not lost. It looks likely that the three existing health goals will be replaced with one overarching health goal. From the perspective of the organisation I work for, the International HIV/AIDS Alliance, integrating HIV into health and broader development efforts is key to finally ending AIDS.
Earlier this month, the UN General Assembly decided that the outcome document from the Open Working Group on Sustainable Development Goals would be the main basis for integrating the sustainable development goals into the future development agenda. HIV and health are covered in five goals in total and include ensuring healthy lives and promoting well being; achieving gender equality and empowering all women and girls; reducing inequality within and among countries and promoting peaceful and inclusive societies for sustainable development, and strengthening the means of implementation.
However there are still many contentious issues around these goals. Language is important - words left out can include or exclude critical pillars of an approach. For example we need to include marginalised groups as part of the health goal; we need to include rights in the sexual and reproductive target; and, as an alliance of organisations working at the community level, we feel that community–delivered care is critical and should be discussed in the next intergovernmental engagement.
The above omissions need to be addressed because, without them, we are making too many assumptions. We assume that rights are cross-cutting, we assume that marginalised groups will be defined at ‘some stage’, we assume that health systems can successfully operate separate to community systems. We are also in danger of ignoring young people and in particular young marginalised populations, a huge cohort that should be at the centre of the HIV response.
Negotiations between UN member states kick off this September after the UN General Assembly meeting and the post-2015 Development Framework will be adopted in September 2015. It’s critical that we engage at the national level to ensure that the final framework speaks to the needs in country. That young people are not left behind; that references to sexual and reproductive rights are protected and that the importance of community systems is recognized.
As Sister Ann used to say to me: “keep up the momentum, don’t tire”. This is like a marathon, we cannot tire mid-way. Pick up the pace, breathe and above all keep time because people are dying as we plan and re-plan.
P.S: I finally ran and finished a half marathon in Nairobi in 2010. It will likely be my last. Until the next attempt…..