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Editorial Commentary

Millennium Development Goals (MDGs)

to Sustainable Development Goals (SDGs):
Addressing Unfinished Agenda and Strengthening
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Sustainable Development and Partnership

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Introduction pregnancy or from childbirth-related complications.

Progress tends to bypass women and those who are
International development agenda has been actively led
lowest on the economic ladder or are disadvantaged
by the United Nations (UN) and its technical agencies
because of their age, disability, or ethnicity. Disparities
and funds from their inception in the late 1940s. Till 1990s,
between rural and urban areas remain pronounced.(2)
the approach was fragmented and disjointed initiated
by its specialized agencies or funds at various World
India has made a substantial improvement in MDGs
Summits and Conferences to address three dimensions of
but the progress is mixed. The under-five mortality rate
development — economic, social, and environmental. The
(U5MR) has come down from 126 (1990) to estimated
Millennium Declaration and Millennium Development
48 not reaching the target of 42 by 2015. However,
Goals (MDGs) saw the convergence of development agenda
the estimated child deaths have come down from
of United Nations Development Programme (UNDP);
3.36 million (1990) to 1.2 million (2015) that translates to
United Nations Environment Programme (UNEP); World
3,300 child lives saved every day! U5MR in India is still
health organization (WHO); United Nations Children’s
above the world average (43), and is higher compared to
Fund (UNICEF); United Nations Educational, Scientific and
Sri Lanka (10), Nepal (36), and Bangladesh (38). Infant
Cultural Organization (UNESCO); and other development
mortality and neonatal mortality rates have come down
agencies.(1) Recently adopted Sustainable Development
to 38 (target 27) and 28 from 88 and 57, respectively.(3)
Goals (SDGs) reflect further strengthening convergence of
India achieved a maternal mortality rate (MMR) of 167
the development agenda. The SDGs also strengthen equity,
(2011-2013) and expected to reach 140 in 2015 down
human rights, and nondiscrimination.
from 437 in 1990, which is well above the target of
109.(4) If we go by the latest UN estimates of MMR of
Progress in MDGs and Build Up to SDGs 560 in 1990,(5) the target should be 140 and India is on
The MDGs generated new and innovative partnerships, track to achieve this target. The target of safe drinking
galvanized public opinion, and showed the immense water has been achieved in rural areas and is likely to
value of setting ambitious goals. By putting people be achieved in the urban areas as well. The target of
and their immediate needs at the forefront, the MDGs sanitation is likely to be achieved in urban areas and
reshaped decision-making in the developed and missed in rural areas.(5)
developing countries alike. It helped to lift more than one
billion people out of extreme poverty, to make inroads The SDGs and Targets
against hunger, to enable more girls than ever before to
attend school, and to protect our planet. Yet inequalities To create a new, people-centered, development agenda,
persist and the progress has been uneven. The world’s a series of global consultations were conducted both
poor remain overwhelmingly concentrated in some parts online and offline. Civil society organizations, citizens,
of the world. Several women continue to die during This is an open access article distributed under the terms of the
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Access this article online License, which allows others to remix, tweak, and build upon the
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How to cite this article: Kumar S, Kumar N, Vivekadhish S. Millennium

DOI: development goals (MDGS) to sustainable development goals (SDGS):
Addressing unfinished agenda and strengthening sustainable development
10.4103/0970-0218.170955 and partnership. Indian J Community Med 2016;41:1-4.

1 © 2016 Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow

 Kumar, et al.: MDGs to SDGs

scientists, academics, and the private sectors from Health targets

around the world were all actively engaged in the The health goal has nine targets and four subpoints.(6) The
process. The SDGs include 17 goals and 169 targets.(6) first three targets are continuation of MDGs, the next three
Indicators are expected to come out in March 2016. The are on no communicable disease (NCD), and the last three are
17 goals in abridged form are as follows: mixed. Nine health targets and four sub-points are as follows:
1. No poverty; 1. Reduce the global maternal mortality ratio to below
2. Zero hunger; 70/100,000.
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3. Good health and well-being; 2. Reduce neonatal mortality to below 12/1,000 and
4. Quality education; U5MR to below 25/1,000.
5. Gender equality; 3. End the epidemics of AIDS, tuberculosis, malaria,
6. Clean water and sanitation; and neglected tropical diseases and combat hepatitis,
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7. Affordable and clean energy; water-borne diseases, and other communicable

8. Decent work and economic growth; diseases.
9. Industry, innovation, and infrastructure; 4. Reduce by one-third premature mortality from
10. Reduce inequality; noncommunicable diseases.
11. Sustainable cities and communities; 5. Strengthen the prevention and treatment of substance
12. Responsible consumption and production; abuse.
13. Climate action; 6. Halve the number of global deaths and injuries from
14. Life under water; road traffic accidents (by 2020).
15. Life on land; 7. Ensure universal access to sexual and reproductive
16. Peace, justice, and strong institutions; and health-care services.
17. Partnership for the goals. 8. Achieve universal health coverage.
9. Reduce the number of deaths and illnesses from
Detailed goals and indicators are at https:// hazardous chemicals and air, water, and soil pollution
sustainabledevelopment.un.org/?menu=1300. The and contamination.
targets are aspirational and global and that each
government will set its own national targets taking into Four subpoints are:
account the national circumstances. a. Strengthen the implementation of the WHO
Framework Convention on Tobacco Control.
The SDGs can be broadly divided into three categories: b. Support the research and development of vaccines
First, an extension of MDGs that includes the first and medicines.
seven SDGs; second group is inclusiveness (jobs, c. Substantially increase health financing and the
infrastructure, industrialization, and distribution). recruitment, development, training, and retention of
It includes goals 8, 9, and 10; and the third group is the health workforce.
on sustainability and urbanization that covers the d. Strengthen early warning, risk reduction, and
last seven goals: sustainable cities and communities, management of health risks.
life below water “consumption and production;
climate action; resources and environment; peace and
Difference Between SDGs and MDGs
justice; and the means of implementation and global
partnership for it”. SDGs benefit from the valuable lessons learned from
MDGs. These also carry forward the unfinished agenda
Health goal of MDGs for continuity and sustain the momentum
The third SDG — “ensure healthy lives and promote generated while addressing the additional challenges
well-being for all at all ages” — is wider-ranging of inclusiveness, equity, and urbanization and further
compared to the health goals in MDGs that were limited strengthening global partnership by including CSOs and
to child and maternal mortality and communicable private sector. They reflect continuity and consolidation
diseases. The social determinants of health though of MDGs while making these more sustainable by
not spelled as such but are addressed through Goals strengthening environmental goals.
1 (poverty), 2 (hunger), 4 (education), 5 (gender
equality), 6 (clean water and sanitation), 7 (affordable There are seven major differences in MDGs and SDGs;
and clean energy), 8 (decent work and economic 1. MDGs were drawn up by a group of experts in the
growth), 9 (industry innovation and infrastructure), ‘basement of UN headquarters’ whereas SDGs have
10 (reduced inequalities), 11 (sustainable cities and evolved after a long and extensive consultative
communities), 12 (responsible consumption and process including 70 Open Working Groups, Civil
production), 13 (climate action), and 16 (peace, justice Society Organizations, thematic consultations,
and strong Institutions). country consultations, participation of general public

Indian Journal of Community Medicine/Vol 41/Issue 1/January 2016 2

 Kumar, et al.: MDGs to SDGs

through face-to-face meetings and online mechanisms will not be enough funds to meet the aspirational
and door to door survey; nature of the goals. It included a recommitment to
2. While MDGs were focused with only 8 goals, the UN target on aid spending 0.7% of gross national
21 targets and 63 indicators, SDGs include 17 goals income (GNI) set more than 40 years ago. Multilateral
with 169 targets. An expert analyses by noble banks committed $400 bn;(9)
laureates at Copenhagen consensus, suggest that if 2. Maintaining peace is essential for development.
the UN concentrates on 19 top targets, it can get $20 to A threat to international peace and stability by
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$40 in social benefits per dollar spent, while allocating nonstate actors is emerging as a major factor for both
it evenly across all 169 targets would reduce the figure developed and developing countries. The recent crisis
to less than $10. Being smart about spending could be in Syria has forced 12 million people to leave their
better than doubling or quadrupling the aid budget;(7) homes and made them refuges.
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3. MDGs had a focus on developing countries with 3. Measuring progress: A number of targets in the SDGs
funding came from rich countries. All countries, are not quantified. The indicators for measuring
developed or developing, are expected to work progress have not yet been identified. Even if they limit
towards achieving SDGs; to two indicators per target there will be 338 indicators
4. The pillars of human development, human rights and to monitor and report. “Having 169 targets is like having
equity are deeply rooted in SDGs and several targets no targets at all.”(10) Measurability will depend on the
seven explicitly refer to people with disabilities, six availability of data and capacity to measure them.
to people in vulnerable situations, and two to non- 4. Accountability: There was a lack of accountability for
discrimination. These were not even mentioned in the inputs into MDGs at all levels. This challenge needs
MDGs; (iv) MDGs had 3 direct health goals, 4 targets to be addressed in SDGs.
and 15 indicators with emphasis on child, maternal
mortality and communicable diseases. SDGs have At the international level, most of the developed countries
one comprehensive goal emphasizing well-being and have not met the target of allocating 0.7% of GNI to
healthy living including NCDs; international aid in the last 40 years. The lack of priority
5. MDGs had a time span of 25 years though adopted in funds allocation within country budget has also been
in 2002 baseline data for the year 1990 was used and a problem during MDGs. Similar lack of accountability
some of the baselines were revised subsequently exists at ministry, state, and local administration level.
which shifted ‘the goal post’. For the SDGs, the If we take SDGs seriously the accountability needs to be
baseline is from 2015 estimates. It may be revised as strengthened at all levels.
more recent data becomes available;
6. SDGs include a vision of building vibrant and India and SDGs
systematic partnerships with private sector to achieve
sustainable development. It builds on, UN Compact The momentum created by MDGs in India needs to be
which was launched in year 2000 and IMPACT 2030; sustained with focus on completing the unfinished task of
7. MDGs had no concrete role for the Civil Society MDGs. India-specific goals, targets, and indicators along
Organizations (CSOs), whereas SDGs have paid with the roadmap to achieve these should be drawn up
attention to this right from the framing stage itself by the concerned ministry and states and union territories
with significant engagement of civil society actors. (UTs). One major challenge will be to fund these goals.
It is also important to estimate the budget required
The CSOs can play an important role to hold governments and to find out from where these funds will come. The
accountable at the local level. preliminary estimates from global meetings suggest
mobilizing required resources is going to be a major
Challenges challenge. The need to establish a system of collecting
relevant data to monitor the progress is vital to achieve
The four major challenges that need to be addressed for these goals, targets, and indicators that are much larger in
achieving the SDGs are as follows: numbers compared to MDGs. The reliance on data from
1. Some of the SDGs that have been costed show that surveys needs to be minimized. The health goal will need
the cost of the SDGs is huge. The rough calculations a major effort in addressing noncommunicable diseases
have put the cost of providing a social safety net to and accidents and injuries while sustaining efforts to
eradicate extreme poverty at about $66 bn a year,(8) address maternal and child health and nutrition.
while annual investments in improving infrastructure
(water, agriculture, transport, and power) could be
up to a total of $7 tn globally. A major conference on
Conclusion
financing for the SDGs, held in the Ethiopian capital MDGs helped in mobilizing international community,
Addis Ababa in July, failed to ease concerns that there leaders, politicians, civil society and sectoral ministries,

3 Indian Journal of Community Medicine/Vol 41/Issue 1/January 2016

 Kumar, et al.: MDGs to SDGs

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