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What evidence is there for an intersectoral approach to the SDGs?

@SDGoals @PHE_uk @UN @SustDev @polygeia #publichealth #globalhealth #SDGs #PHE

Summary: This year, the NCD team is evaluating the literature to look for examples of an intersectoral approach to addressing the Sustainable Development Goals (SDGs). Starting with areas of personal interest, we have explored obesity, disability and well-being so far.

United Nations Member States first adopted the Sustainable Development Goals (SDGs) in 2015 as a blueprint for a global partnership for the future of our planet. Although ambitious, the goals are far from simple, and span thematic issues including water, energy, climate, oceans, urbanisation, transport, science and technology. As such, it has been proposed that a collaborative, intersectoral approach will be required to address the Goals adequately. This year, the Polygeia Non-Communicable Diseases group will be exploring examples of intersectoral approaches to complex problems so to evaluate whether an evidence-based methodology can be adopted to work together on the SDGs.Every layout comes with the latest social features built in. Readers can easily share posts on social networks like Facebook and Twitter and view how many people have liked a post, made comments and more.

The team has started the project by considering the potential benefits of, and opportunities presented by, intersectoral collaboration. Additionally, we have begun to explore whether there are any examples of effective intersectoral collaboration to achieve policy goals and any case studies that illustrate such approaches. To date, we have investigated these questions through topics related to the SDGs that are of personal interest to team members; specifically, obesity, well-being and disability.

For example, the tenth SDG is to reduce inequalities and targets the successful empowerment and promotion of social, economic and political inclusion of all, irrespective of demographic factors by 2030. One group identified as being at risk of discriminatory laws, policies and practices is those living with a disability. The World Health Organisation’s World Report on Disability estimates that up to 15% of the world’s population lives with a disability. The WHO identifies a range of different disadvantages experienced by persons with disabilities, including poorer health outcomes, lower educational achievements, and increased dependency. Clearly, these disadvantages extend beyond only healthcare, and therefore any measures enacted to address them must target factors such as a reduction in poverty, provision of education, and clean water and sanitation; thereby necessitating an intersectoral approach.

Fortunately, there is evidence that an intersectoral approach can be practical. For example, in the early 2000s, Ireland implemented a series of laws designed to tackle problematic alcohol consumption. These laws included measures such as reducing the hours of the day during which alcohol could be sold and banning the advertisement of alcoholic products on public transport. Following that campaign, alcohol consumption in Ireland has fallen significantly, from 14 litres of pure spirit per capita in 2002 to 11.5 litres in 2016. Although not entirely analogous, obesity shares many disease characteristics with excess alcohol consumption, and so the Irish model may serve as an example as to how to address problematic, complex, and multifaceted NCDs.

In a different, albeit no less intersectoral way, it is also possible to see how such an approach has been used to address SDG 3 – Good health and well-being. In Uganda, treatment for malaria and other life-threatening diseases is often free, but compliance is a real issue. To counter this, an SMS programme has been set up to remind patients to take their medicine. Health service delivery can be challenging, but mobile phone penetration is approximately 70%, so uptake has been excellent. In conjunction with the SMS programme, Uganda has also adopted a village health team (VHT) system which promotes the appointment of community members as health advocates to help bridge the gap between service providers and patients. These approaches demonstrate the complex interplay that is required between government, service providers and members of the community to optimise health and well-being.

Our preliminary research has indicated that there is both a readily identifiable need for and track record of success using, an intersectoral approach to SDGs. We look forward to continuing to evaluate the literature to develop a policy paper that outlines the best practice of an intersectoral approach.

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