The 2030 agenda is even more complex than its predecessor, the Millennium Development Goals (MDGs) which, despite efforts and spending by the government, my country failed to meet. Out of 41 indicators adopted by Pakistan, only four were achieved, while progress on 24 of them was off track. From my own experience in the health sector, some of the reasons for this failure to achieve the MDGs include the lack of adequate planning for goals and related actions, the absence of a multi-sectoral approach, and the sparsity of data for monitoring and planning purposes.
Turning to the SDGs, the task facing the country is even greater, given that the 17 goals are interrelated in nature and therefore cannot be achieved by working in silos. Poverty is one of the major causes of ill health, and in turn catastrophic health expenditures are pushing people further into poverty. Similarly, education, climate change, waste management, and occupational hazards all are interlinked with health and other targets. Meeting the SDGs will require adopting a multi-sectoral approach and involving a diverse set of stakeholders to develop and implement the right policies.
Stakeholder mapping around the health- related SDGs
While carrying out a mapping study of stakeholders to promote the health-related SDGs in Pakistan, I found the country’s efforts towards achieving the goals to still be in their infancy. And while numerous stakeholders are working towards the 2030 agenda, the type of coordinated efforts we desperately need among all actors – NGOS, think thanks, academia, the media, and government – appear to be lacking. The SDGs require not only a multi-sectoral approach, but also a multi-stakeholder approach to be adopted in true spirit.
Yet, there is an opportunity in Pakistan to engage all these various stakeholders through SDG units being set-up to provide overall strategic coordination and oversight of the agenda. These units are being established both at the Federal level within the Ministry of Planning, Development and Reforms, as well as at provincial levels within planning and development departments. At both levels, core committees have been created to facilitate representation from all stakeholders. In addition to this, a SDGs Secretariat and a task force consisting of parliamentarians are working at federal and provincial levels. When it comes to health, SDG units are also being established within the federal ministry of health and within departments of health at provincial levels. The linkages of these various units and task forces, however, remain somewhat unclear.
Unfortunately, the involvement of these units with think tanks, academia, or NGOs has so far been limited to consultative meetings and discussions, with little ensuing action. Furthermore, most of these discussions have excluded stakeholders and organizations working outside of federal or provincial capitals – organizations who are often the ones closer to the issues at hand and have the most to contribute.
Recognizing that the national level SDGs discussions have only slowly been gaining momentum, there is still great hope going forward. The existing SDG units can play a pivotal role in enhancing meaningful coordination among stakeholders, including between different ministries and departments, leading to the development of a detailed roadmap for implementation of the SDGs in Pakistan.
As a first step towards the development of this actionable roadmap, the federal unit could organize a national forum that would bring together all relevant actors to discuss their current roles, analyze their strengths and weaknesses, agree on responsibilities, and identify ways to track progress and convert it into an actionable roadmap as a collective national vision, instead of working on silos. Such a roadmap, which could include clear roles and responsibilities with attached targets and performance indicators, is indispensable to providing a voice to all stakeholders and ensuring government accountability for their actions, and thus ultimately achieving the SDGs.
This kind of arrangement will require the government to take on a leadership role while at the same time creating space for deeper consultation and involvement of various stakeholders, both outside and inside of government. Only by having an integrated and inclusive approach will the country stand a chance of achieving the SDGs.