Five things you need to know about the SDGs – and how the pandemic has shifted the goalposts

1. The SDGs were devised as a roadmap for humanity

The 17 global goals were created in 2015 to meet the 2030 Sustainable Development Agenda. The goals were ambitious and included every marker of human development, including good health and wellbeing, no poverty or hunger, better education and renewable energy.

COVID-19 has drawn focus away from almost every other health issue going in the past two years, but while the pandemic may have thrown the world off course, the SDGs offer a compelling approach to guide global recovery and build resilience.

Taken together, the SDGs were intended to offer a “blueprint for peace and prosperity” by recognising and addressing the interconnectedness and interdependence of people, planet and prosperity.

This holistic approach marked a shift away from siloed approaches to different problems affecting health and development, underpinned by the knowledge that no single solution could improve our wellbeing, and progress in one SDG can also bring cross-cutting benefits to others.

2. Vaccines are a key ingredient in meeting the goals

SDG3 is about ensuring health and wellbeing for all, at every stage of life. One target within it is to 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. Another is to end the preventable deaths of newborns and children under five years of age – for which vaccines are critical. But the role of immunisation goes far beyond this goal, and has a part to play in achieving  many of the 17 goals.

For instance, vaccines protect child health, support cognitive development and improve a child’s ability to attend school (meeting SDG4 on quality education). Routine immunisation is also an enabler to breaking the cycle of undernutrition and many of the preventable diseases at its root. 

By protecting the health of communities, vaccines reduce the proportion of people forced into poverty (contributing to SDG1 on eliminating poverty) and ensure that even marginalised, vulnerable children have a chance at a productive, healthy future (SDG10 on reducing inequalities).

3. Impressive gains had been made pre-pandemic

Although the world had seen many crises in the past few decades, year on year, gains were still made in health and development.

Infant and maternal mortality has been falling: the under-five mortality rate and the number of under-five deaths had fallen by more than half since 1990. Malaria deaths have been halved and deaths from HIV/AIDS have been steadily falling too.

The number of people living in extreme poverty had also been waning, as had the proportion of people who are undernourished.

4.  COVID-19 is threatening to derail progress

The pandemic has turned back decades of progress in global development, including health and health-related SDGs, through a disruption of health services and routine immunisation programmes, a rise in hunger, malnutrition and out-of-pocket expenditure on healthcare.

COVID-19 has also exacerbated existing inequity among vulnerable groups such as women, refugees and migrants, among other marginalised groups, which has led to a rise in the number of so-called “zero-dose” children who never receive a single vaccine. 

The work of Gavi and partners to reduce the number of zero-dose children by 1.7 million over the previous four years was impacted by pandemic, and in 2020 the number of zero-dose children has increased by 3.1 million in lower-income countries compared to 2019.

In many low and lower middle-income countries, they are facing economic disruption and the backsliding of much progress made in both infectious and non-communicable diseases, as well as facing a pandemic where only a small proportion of their population have been vaccinated against COVID-19.

5. The pandemic has shown that we need to double down on meeting the SDGs

COVID-19 has drawn focus away from almost every other health issue going in the past two years, but while the pandemic may have thrown the world off course, the SDGs offer a compelling approach to guide global recovery and build resilience. Equity has been a core principle of the SDGs – the concept of leaving no one behind that is also at the heart of Gavi’s mission to reach zero-dose children.

Routine immunisation reaches more children than any other health interventions and can be leveraged to integrate other interventions such as WASH (water, sanitation and hygiene), nutrition and maternal care. Reaching zero-dose children is particularly important because vaccines are often the first contact these families and communities have with basic health services, and thus immunisation acts as an important gateway to healthcare as well as other services.

Both emergency preparedness and “everyday resilience” need to be built in at all levels and growing evidence shows that health services, in order to be equitable, need to be delivered in community settings rather than only at fixed facilities. This is because local communities are better positioned to address the underlying social determinants of health – such as clean water and housing – especially those affecting the health outcomes of the most vulnerable and marginalised in their community.