Global Health Checkup: Polio eradication may take longer after funding cuts, but it can still happen – Healthbeat

Global Health Report: Progress and Setbacks in Achieving Sustainable Development Goals

Polio Eradication and its Alignment with SDG 3

Financial Challenges and Strategic Readjustments

The global effort to eradicate polio faces significant financial constraints that directly impact the timeline for achieving targets related to SDG 3 (Good Health and Well-being). A major funding shortfall is necessitating a strategic realignment of the program.

• The Global Polio Eradication Initiative’s budget will be reduced by 30% starting in 2025.
• This represents a total shortfall of $1.7 billion through 2029.
• The target for stopping the last wild strain of the virus (in Afghanistan and Pakistan) has been moved from 2026 to 2027.
• The target for eliminating the vaccine-derived strain, primarily in Africa, is now set for 2029.

Maintaining Momentum Towards SDG 3.3

Despite budget cuts, program officials assert that the goal of eradication, a key component of SDG 3.3 (End the epidemics of… communicable diseases), remains achievable. New strategies are being implemented to maximize efficiency and impact, reflecting a commitment to SDG 17 (Partnerships for the Goals).

1. Operational Efficiencies: Streamlining bureaucratic processes to do more with less.
2. Vaccine Optimization: Stretching supplies by utilizing smaller, effective doses.
3. Program Integration: Merging vaccination drives with other health initiatives, such as Gavi, the Vaccine Alliance.
4. Targeted Focus: Concentrating resources on the few remaining regions where the virus persists.

A significant operational challenge remains in Afghanistan, where a ban on house-to-house vaccination campaigns complicates efforts to reach every child.

Avian Influenza Outbreaks: A Threat to Multiple SDGs

Global Spread and Escalation

Widespread outbreaks of Avian Influenza (H5N1) across Europe and the United States pose a multi-faceted threat to global health, food security, and biodiversity, impacting several Sustainable Development Goals.

• Outbreaks have been confirmed in 10 European Union countries and Great Britain since August.
• In Germany, the virus has been detected in wild birds across nearly all states, leading to the culling of over 200,000 poultry.
• In the United States, the virus has affected over 180 million farmed birds since 2022, with recent outbreaks identified in dairy cows in three states.

Implications for Sustainable Development

The increasing frequency and species-jump capability of H5N1 present significant risks to the achievement of the SDGs.

• SDG 3 (Good Health and Well-being): The potential for the virus to evolve and spread between humans represents a major global pandemic risk, threatening health security.
• SDG 2 (Zero Hunger): Mass culling of poultry disrupts food supply chains and threatens the livelihoods of farmers, impacting food security.
• SDG 15 (Life on Land): The spread of the virus via migratory birds and its jump to mammal populations highlights complex challenges in managing diseases at the intersection of wildlife, livestock, and human health.

Fiji’s Elimination of Trachoma: A Public Health Victory for SDG 3 and SDG 6

Milestone Achievement

The World Health Organization has officially verified that Fiji has eliminated trachoma, the world’s leading infectious cause of blindness. This achievement is a significant step towards fulfilling the targets of SDG 3 (Good Health and Well-being).

A Model for SDG Implementation

Fiji’s success demonstrates the effectiveness of sustained, collaborative efforts in achieving public health goals.

• SDG 3.3: This victory directly contributes to the target of ending neglected tropical diseases.
• SDG 6 (Clean Water and Sanitation): As trachoma spreads in areas with poor sanitation and water access, its elimination underscores the interconnectedness of health and environmental goals.
• SDG 17 (Partnerships for the Goals): The success was the result of decades of collaboration between local NGOs, international health organizations, and government agencies, proving that strong partnerships are essential for achieving the SDGs.

Senegal’s Rift Valley Fever Response and Regional Health Security

Coordinated National Campaign

Senegal has launched a comprehensive, nationwide campaign to combat its worst outbreak of Rift Valley Fever in decades. This response serves as a critical test of national and regional health systems’ capacity to uphold SDG 3 amidst global funding constraints.

A Multi-Sectoral Approach Aligned with the SDGs

The campaign exemplifies the integrated approach required to achieve the Sustainable Development Goals.

• SDG 17 (Partnerships for the Goals): The response involves a coordinated effort between the ministries of health, agriculture, environment, and water resources.
• SDG 3 (Good Health and Well-being): Key activities include disease surveillance, mosquito control, livestock vaccination, and public health communication in over 30 local languages and dialects.

The outbreak’s presence in a livestock corridor shared with Mauritania and Mali highlights the need for cross-border cooperation to ensure regional health security and prevent setbacks to SDG progress.

Impact of Funding Shortfalls on Malaria and SDG 3

Projected Consequences of Aid Reductions

A new analysis quantifies the severe impact that funding cuts to The Global Fund to Fight AIDS, Tuberculosis and Malaria would have on progress against malaria, directly threatening the achievement of SDG 3.3 and broader economic development under SDG 8 (Decent Work and Economic Growth).

Modeling the Human and Economic Toll

Researchers from the African Leaders Malaria Alliance and Malaria No More modeled the effects of potential funding cuts. A 20% reduction in funding for The Global Fund by 2030 could result in:

1. An additional 33 million malaria cases.
2. An additional 82,000 malaria deaths.
3. Approximately $5 billion in lost GDP across sub-Saharan Africa.

A total collapse in funding would have a catastrophic generational impact, leading to an estimated 525 million more cases and 990,000 more deaths, with approximately 750,000 of those deaths occurring in children under five.

Analysis of the Article in Relation to Sustainable Development Goals

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • This is the most prominent SDG in the article. The text is entirely focused on global public health issues, including the fight to eradicate polio, the elimination of trachoma in Fiji, outbreaks of bird flu and Rift Valley Fever, and the impact of funding cuts on malaria control. All these topics directly relate to ensuring healthy lives and promoting well-being for all at all ages.
2. SDG 17: Partnerships for the Goals
   • The article repeatedly emphasizes the importance of collaboration and funding. It mentions numerous partnerships, such as the Global Polio Eradication Initiative (involving UNICEF and WHO), Gavi, Project Heaven, USAID, The Global Fund, the African Leaders Malaria Alliance, and Malaria No More. The discussions on budget shortfalls and international financing for health programs are central to this goal.
3. SDG 2: Zero Hunger
   • The sections on bird flu and Rift Valley Fever connect directly to this goal. These diseases affect livestock and poultry, which are critical for food security and agricultural economies. The article mentions the culling of “more than 200,000 chickens, geese, ducks, and turkeys” in Germany and outbreaks in dairy cows in the US, highlighting the threat to food production systems.
4. SDG 8: Decent Work and Economic Growth
   • The article explicitly links public health to economic outcomes. The analysis on malaria funding shortfalls quantifies the potential economic damage, stating that a 20% cut could result in “$5 billion in lost GDP across sub-Saharan Africa by 2030.” This demonstrates the connection between disease burden and a country’s economic productivity.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Under SDG 3 (Good Health and Well-being):
   • Target 3.3: “By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.” The article directly addresses this target through its discussion of efforts to eradicate polio, eliminate trachoma (a neglected tropical disease), control malaria, and respond to outbreaks of Rift Valley Fever and bird flu.
   • Target 3.b: “Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries…” The entire global polio eradication effort, which relies on vaccines, and the mention of livestock vaccination for Rift Valley Fever align with this target.
   • Target 3.d: “Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.” Senegal’s coordinated, multi-ministry response to the Rift Valley Fever outbreak is a direct example of managing a national health risk. The global concern over bird flu evolving into a pandemic also highlights the importance of this target.
2. Under SDG 17 (Partnerships for the Goals):
   • Target 17.2: “Developed countries to implement fully their official development assistance commitments…” The article’s focus on the shrinking budget of the Global Polio Eradication Initiative and the potential 20% funding cut to The Global Fund by donors like the UK directly relates to the fulfillment of international financial commitments for global health.
   • Target 17.16: “Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships…” The article provides numerous examples of such partnerships, including The Global Fund, the Global Polio Eradication Initiative, and the collaboration between local NGOs and international bodies like USAID to eliminate trachoma in Fiji.
3. Under SDG 2 (Zero Hunger):
   • Target 2.4: “By 2030, ensure sustainable food production systems and implement resilient agricultural practices…” The threat that zoonotic diseases like bird flu and Rift Valley Fever pose to poultry and livestock farming is a direct challenge to this target. The culling of birds and outbreaks in dairy cows illustrate the vulnerability of food production systems to disease.
4. Under SDG 8 (Decent Work and Economic Growth):
   • Target 8.1: “Sustain per capita economic growth in accordance with national circumstances…” The article provides a clear example of how disease impacts economic growth by citing the analysis that funding cuts for malaria could lead to “$5 billion in lost GDP” and a total funding collapse could cost “$83 billion in lost GDP.”

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions several quantitative and qualitative indicators that can be used to measure progress:

• Disease Incidence and Mortality Rates: The article provides specific numbers that serve as indicators for Target 3.3.
  • Potential increase in malaria cases (“33 million extra malaria cases”).
  • Potential increase in malaria deaths (“82,000 malaria deaths,” “990,000 more deaths”).
  • Mortality rate for a specific demographic (750,000 deaths of children under 5 from malaria).
• Disease Eradication/Elimination Status: This is a key indicator for Target 3.3.
  • The official declaration of Fiji as “free of trachoma.”
  • The revised target dates for polio eradication (“stopped by 2027” for the wild strain and a “new 2029 target” for the vaccine-derived strain).
• Financial Resource Flows: These are direct indicators for Target 17.2.
  • The budget shortfall for the Global Polio Eradication Initiative (“$1.7 billion shortfall through 2029”).
  • The percentage of funding cuts to health initiatives (“shrinking by 30%,” “a 20% funding cut to the Global Fund”).
• Impact on Agriculture and Food Supply: These numbers serve as indicators for Target 2.4.
  • The number of animals culled to contain a disease (“more than 200,000 chickens, geese, ducks, and turkeys have been culled”).
  • The number of animals affected by an outbreak (“more than 180 million farmed birds” affected in the US since 2022).
• Economic Impact of Disease: This is a direct indicator for Target 8.1.
  • The monetary value of lost Gross Domestic Product (GDP) due to disease (“$5 billion in lost GDP,” “$83 billion in lost GDP”).

4. Table of SDGs, Targets, and Indicators

Source: healthbeat.org