Paulo  Gadelha, MD, PhD

Health as a central driver of sustainable development

An expert story by Paulo Gadelha, MD, PhD, Coordinator @ Fiocruz Strategy for 2030 Agenda

If we were to pick one word to describe 2023, ‘decisive’ would be a strong candidate. This year marks the halfway point to the deadline set for achieving the 2030 Agenda and its seventeen Sustainable Development Goals (SDGs). Unfortunately, according to the UN General Assembly SDG Progress Report, many of the SDGs are moderately to severely off track, meaning it is time to ring the alarm and press for an urgent and fundamental shift toward a better path. Although the world was already behind on its SDG endeavors before the Covid-19 outbreak, the pandemic indeed added further obstacles to this trembling process. The pandemic exacerbated pre-existing inequalities and set back progress in crucial areas, such as education, nutrition, poverty, human rights, climate change, and biodiversity protection. The last three years represent an exemplary case of how a major health catastrophe can trigger a systematic crisis that affects every single aspect of our lives, societies, and economies in all corners of the world. It is yet another reason not to overlook the role of health as a central driver of the 2030 Agenda.

The World Health Organization (WHO) has finally declared an end to Covid-19 as a global health emergency, but it is not an exaggeration to state that 2023 has the potential to be a turning point in terms of the decisions we now need to make. Our ability to learn from the response to Covid-19 and the health sector as we recover and rebuild will shape the sustainability of our planet. This will be at the core of the discussions at the next SDG Summit, the centerpiece of the High-Level Week of the UN General Assembly in September, which aims to issue a negotiated political declaration to call for an urgent recommitment the 2030 Agenda and a boost to efforts to achieve its goals.

The hard lessons from Covid-19

When it comes to the existing tools that can serve as real game-changers in pursuit of SDG acceleration, it is impossible to ignore the crucial role of Science, Technology, and Innovation (STI). However, leveraging the full potential of STI to tackle the SDGs indisputably requires solidarity. This is perhaps the most important lesson we have learned from Covid-19. The pandemic propelled remarkable STI advancements in health, with new vaccines, diagnostics, and pharmaceutical technologies developed at an unprecedented pace. However, there were millions of preventable deaths and global sustainable development was set back by years because we failed to establish adequate global supplies, ensure equitable access, and facilitate fair distribution of these technologies. Enhancing preparedness for present and future crises involves bolstering high-level collaboration among countries across institutions, sectors, and disciplines. International cooperation plays a vital role by offering advanced analytics and modeling data to aid governments and public health institutions in implementing effective policies. Moreover, fostering insight sharing strengthens decision-making processes, nurtures a trustworthy framework, and promotes solidarity in data management.

Besides highlighting the positive impact of open science, data sharing, and technology transfer on all countries, the pandemic served as a strong reminder of the importance of strengthening local innovation, production, and surveillance systems to ensure an equitable early response and recovery from health crises. Regional and local STI infrastructures can give governments greater autonomy over crucial health inputs and for responding to health emergencies. The Brazilian Health Economic-Industrial Complex (HEIC) policy is an exemplary case. HEIC offers a link between health and economic development and proposes innovative ways of meeting the most pressing needs of the Brazilian public health system through partnerships between the State and the productive sectors, science and technology organizations, enterprises, and regulatory agencies. With its robust local production system, Brazil has emerged as a global hub for Covid-19 vaccine manufacturing. To effectively address health crises and achieve universal health access, policymakers must strive for a strong and productive health industry that is committed to enhancing quality of life, meeting the demands of social inclusion strategies, and working toward reducing inequalities.

Another valuable insight from the past three years is the significance of community engagement, information integrity, trust in science, and long-term health and well-being in any successful emergency preparedness plan. Disinformation campaigns have disastrous impacts on both human and planetary health, underscoring the need to build preparedness for crises and foster trust at all levels: interpersonal trust within communities, trust in leadership, trust in public policies, and trust in science. Trust enables the effective implementation of response measures while fostering a sense of security. Increasing dialogue between scientists, governments, and civil society is key to building trust and increasing public confidence.

In addition, the pandemic reaffirmed the need to shift from business as usual into an economic development model that prioritizes the well-being of individuals and communities in accordance with environmental sustainability. Health is a central driver in this process. Health is one of the most dynamic areas of development – promoting STI and economic growth, aligning environmental and social issues into development policy, contributing to equity and social inclusion, and bridging the digital and technology access gap. At the same time, health is influenced by economic, environmental, and social factors. Thus, ensuring equal access to healthcare services and considering health in decision-making processes are essential steps toward sustainable growth, as well as a more resilient, socially cohesive, and inclusive future for all.

A new framework for future crises preparedness and health for all

In recognition of the high complexity of the multiple planetary crises we currently face, the World Health Organization (WHO) is leading a comprehensive approach to preparing the world against future crises. This framework underscores the need for reinforcing mission-oriented innovation, evidence-based policies, open science, genomics, and data sharing. In addition, it highlights the need for common platforms for research and development, along with regulatory, procurement, governance, and deployment enhancements.

STI plays a crucial role in promoting universal health coverage, and the WHO has developed a comprehensive long-term scientific roadmap for health. The roadmap outlines key objectives, including pandemic prevention and preparedness mechanisms, improved vaccine distribution, AI-driven antibiotic discovery, disease screening applications, biobank coordination, and addressing information gaps. In the coming years, the WHO aims to advance point-of-care diagnostics, AI-assisted clinical reasoning systems, drug development, phage therapy, genetic engineering, and digital health. Looking further ahead, the focus will shift toward telemedicine, microbiome-based therapies, and addressing the healthcare needs of immigrants.

The holistic nature of these approaches needs to be aligned with the principles of human rights, sustainability, and equity that are enshrined in the 2030 Agenda as it acknowledges that the world’s challenges cannot be addressed in isolation. We sincerely hope that these values will prevail as we embark on the next steps of this journey at this year’s SDG Summit and at the 2024 United Nations’ Future Summit.

This expert story was written in collaboration with Cibele Reschke, journalist and international relations advisor, Danielly Magalhães, scientific advisor, and Guto Galvão, senior researcher.

Contribution to the sustainable development goals post-2030

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Check the author's bio

Paulo  Gadelha, MD, PhD

Paulo Gadelha, MD, PhD

Fiocruz Strategy for 2030 Agenda

Coordinator

As coordinator of the FIOCRUZ Strategy for the 2030 Agenda, Dr. Paulo Gadelha is in charge of promoting FIOCRUZ’s strategic engagement with the Agenda’s aspirational principles and goals. His background in technology includes studies of the application of technology in public health, healthcare models, and the history of STI. He is also a former member of the 10-Member Group appointed by the UN Secretary-General to support the Technology Facilitation Mechanism with the Inter-agency Task Team on STI for the SDGs. Dr. Gadelha served as president of Fiocruz from 2009 to 2016, leading scientific achievements in biomedical sciences, the generation of scientific and technological knowledge, and health and social development promotion. Previously, he founded and directed “Casa de Oswaldo Cruz”, a Fiocruz Institute dedicated to the sociology and history of science and health. Dr. Gadelha served as a member of the National Health Council’s Science and Technology Intersectoral Commission. As President of the Brazilian Association of Collective Health, he chaired the 11th World Congress on Public Health. In 2017, with UN/DESA, he chaired FIOCRUZ’s efforts in organizing the 1st Consultation on Health and STI in the 2030 Agenda’s implementation.

Check the author's bio

Paulo  Gadelha, MD, PhD

Paulo Gadelha, MD, PhD

Fiocruz Strategy for 2030 Agenda

Coordinator

As coordinator of the FIOCRUZ Strategy for the 2030 Agenda, Dr. Paulo Gadelha is in charge of promoting FIOCRUZ’s strategic engagement with the Agenda’s aspirational principles and goals. His background in technology includes studies of the application of technology in public health, healthcare models, and the history of STI. He is also a former member of the 10-Member Group appointed by the UN Secretary-General to support the Technology Facilitation Mechanism with the Inter-agency Task Team on STI for the SDGs. Dr. Gadelha served as president of Fiocruz from 2009 to 2016, leading scientific achievements in biomedical sciences, the generation of scientific and technological knowledge, and health and social development promotion. Previously, he founded and directed “Casa de Oswaldo Cruz”, a Fiocruz Institute dedicated to the sociology and history of science and health. Dr. Gadelha served as a member of the National Health Council’s Science and Technology Intersectoral Commission. As President of the Brazilian Association of Collective Health, he chaired the 11th World Congress on Public Health. In 2017, with UN/DESA, he chaired FIOCRUZ’s efforts in organizing the 1st Consultation on Health and STI in the 2030 Agenda’s implementation.