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SPEAKERS
Monica Lakhanpaul, Priti Parikh, Anthony Costello, Rochelle Burgess
Monica Lakhanpaul
Hello and welcome to Unlocking the SDGs a blueprint for the future, a brand new podcast series from the UCL Sustainable Development Goals initiative. My name is Monica Lakhanpaul, and I'm a professor of Integrated Community Child Health here at Great Ormond Street Institute of Child Health UCL
Priti Parikh
And I'm Dr. Priti Parikh an associate professor at the Bartlett School for Sustainable Construction, where I head the engineering for International Development Centre. In this series, we're going to be exploring, analysing and critiquing the United Nations Sustainable Development Goals, the SDGs as we know them very well, looking at them through a whole range of lenses and angles.
Monica Lakhanpaul
And we're going to be speaking to experts from across UCL and beyond, and paying a few visits to our friends and colleagues overseas to explore the goals and the issues they aim to tackle on the ground.
Priti Parikh
In this episode, the first in the series, we're going to be exploring the impact that the pandemic has had on the Sustainable Development Goals.
Monica Lakhanpaul
In part one, we'll be speaking to two professors from the UCL Institute of Global Health, to find out more about what COVID has meant for the goals.
Priti Parikh
And in part two, we will be hearing from the University of Cape Town Vice Chancellor to discuss her experiences in South Africa.
Monica Lakhanpaul
Today, we're joined by Professor Anthony Costello. Anthony is a professor of global health and sustainable development at the Institute of Global Health at UCL. And we're also joined by Dr. Rochelle Burgess, associate professor in Global Health and Deputy Director of the UCL Centre for Global non communicable diseases, also at the Institute of Global Health. I welcome both of you here today. It's great to have you with us. Anthony, I'd like to start with you, you and I have known each other for quite a long time, and I've seen you in many, many different hats over the years. You had one key role really, which has been former director at the World Health Organisation, and you've been working on the SDGs, as we see from your title, and you've also worked on their predecessor for many, many years as well. So really, you just have this whole journey behind you that we want to tap in to. How do you think the COVID 19 pandemic has changed how we might respond to and achieve the SDGs, from your own personal perspective, but also from the perspective of how you see the World Health Organisation, and how they've actually addressed some of the SDGs through the pandemic?
Anthony Costello
Thanks, Monica, if we go back just to 2015, we'd had the Millennium Development Goals for the 15 years of this century, first 15 years. And the decision had been made some time before to replace them with the sustainable development goals. And there was a big fanfare around this and a lot of consultation over a two year period to bring about this change. There were very strong commitments, strong goals and targets. But almost from the first year or two, I think there was some fundamental problems with the SDGs. The first is that there are too many of them. In the sense that, you know, when you have five, or even eight goals, you can just about manage them. You know, with the Millennium Development Goals, there were eight goals, there were 21 targets. And there were 60 indicators to achieve those targets when you went towards the SDG, and we all agree with the idea that you know, health is in all policies, we need to address all the environmental infrastructure or energy, economic issues. But we went to 17 SDGs, giving us 169 targets. I completely understand why, you know, everybody wanted to get their goal, their targets and their indicators. But it becomes a political problem. Because getting the attention of people is very, very difficult. Even people in the business don't know what all the goals are. There has been increasingly a lack of political commitment and profile for them, and I don't think the UN has necessarily communicated communicated them well enough. Having said all with that, they are incredibly important, but the pandemic, in answer to your question, has completely sidelined them. I mean, I really cannot recall, maybe I haven't been looking in the right places, but any great messaging or talking about the SDGs apart from one or two World Bank reports, one of which came out and said that there's a massive problem with data. So everything's been about the pandemic. So that's rather a negative base. But I still believe very passionately, that these are important.
Monica Lakhanpaul
So do you think that there's a branding issue is that what you're trying to say to us, is that really we're not very good with the branding, and nobody really knows the word sustainable development goals. And I agree with you, whenever I have the conversation with people people say, don't put that in an article, if it's out for the public, nobody really understands them. And yet we have so many important issues to address. Do you have a thought about if you were going to be that person who rebranded it post COVID? What would you call them, if you were out there with the community trying to sell these to them?
Anthony Costello
Well I'd get them down to...I'd have a three, just three over lord goals. So I would say, yeah, we're talking about the Sustainable Development Goals., and they relate to three things; the environment, infrastructure, and human development.
Monica Lakhanpaul
So there we have it, we have Anthony's Sustainable Development Goals for our future. Thank you, Anthony. And moving to Rochelle, Rochelle, just picking up on some of those items that Anthony has really talked about, mental health, obviously, it's one of the ones that we wouldn't want to lose and mental health is something that's been key through the pandemic globally for children, adults alike. So I was just wondering if you could tell us a little bit about how important you've seen mental health linking to the SDGs, through this pandemic?
Rochelle Burgess
Yeah, I guess there's a few things that sort of jumped in to my mind while Anthony was speaking, one thing that came to mind was about how some of my work on mental health and child marriage has been funded by UCL grand challenges in global health. And one of the things that they sort of asked us to do is sort of say, we want to highlight your work, linking to one of the goals. And I was like, Oh, what, okay, one goal, which one, it's actually the intersection of four goals. If you want to talk about the mental health consequences of child marriage, you have to talk about gender and mental health and poverty and inequality and climate change. And so I guess the thing for me and thinking about the goals and trying to, I suppose hold mental health at the centre of that and to hold communities at the centre of that is to try and say how do these goals and perspectives and ways of defining things pull us away from the realities that people are living through, and ultimately, they don't live through these dynamics, or these these factors as independent of each other, they're very much intertwined with each other. And so it's the intersection of all of these challenges that really make things difficult in terms of thinking about how we promote good mental health and prevent the development of mental ill health. And when I think about what the pandemic has enabled us to do in the context of mental health is to really crystallise for people that mental ill health and the experience of mental health conditions is inseparable from these wider structural socio political realities. There's sort of this long standing acknowledgment that yes, things like poverty are really important. And yes, things like racial inequality are important to mental health or experiences of good quality of care and these types of things. But for me, the pandemic has really made it so we cannot talk about mental health, without talking about the ability for us to develop mental health enabling environments. And I found that that kind of structure has been really helpful in trying to talk to I suppose policymakers, and then try to get them to see how mental health becomes everyone's responsibility and sort of to move it out of this domain where it has largely been held by the health sector. And because of that, because of that location, so strongly within the health sector, it sort of means that the non medicalized dimensions of mental health are overlooked. And we sort of have this revolving door, it's something I started talking about many moons ago in my PhD, where actually, you're just sort of moving people through mental health systems, sending them back into environments where the environment hasn't changed at all. And we think the most important thing about promoting good mental health is about getting people access to treatment and building quality mental health systems, and that is a huge part of it. But it becomes insufficient in the context of wider social and structural failings. I think that's hugely important when we think about the mental health of young people and thinking along sort of developmental trajectories, how important it is not just to think about okay, increasing mental health services for young people or supports within schools, but thinking about the whole society where young people are embedded, where they live their lives, where they have aspirations, where they try to have hope, and what hope is possible and available for them is very much determined, independently of the health sector. And for me, what's powerful about the Sustainable Development Goals is it could be a chance for us to think more intersectionally, but what happens with funding and strategies is that we can't, because there's so many of them, we sort of think everybody sort of picks a goal, oh, this is my goal, I'm going to do this. And this is my goal, I'm going to do that. When in reality, if you go back to the way communities and everyday citizens talk about living their lives, there is no separation. And so I've been really excited to see an acceptance of that truth rise to the surface during the pandemic.
Priti Parikh
This is a question for both of you, Anthony and Rochelle, because you have rightly highlighted that health and mental health are vital, and in a way, the pandemic has brought those issues to the forefront. But then as a result of that, do you feel that this hampers progress on some of the other important SDG targets and goals?
Anthony Costello
Yeah I mean having said that, the Sustainable Development Goals have a very low profile or media profile. Having said that, if you're talking about mental health, as Rochelle was, or I'm talking about child health, or if we're, you know, talking about climate change, all of those require a multi-sectoral approach. I think that's what Rochelle was saying that, you know, mental health is as much about your environment, your housing, your economy, etc. And so we're all talking about, if you like, the causes of the causes. So if you've got poor child health, then okay, you could think of it in terms of symptoms, like diarrhoea or COVID, or malaria or whatever. But we've seen from the pandemic, the underlying problem that in this country, for example, the socio-economically deprived have been much, much more affected, black and minority ethnic groups have been worse affected. All of these things touch upon the need to address health broader than the from the narrow kind of doctor and nurse approach, or the narrow health sector approach. When the SDGs were first talked about, there was some papers coming out about the importance of health in all policies, because three of the eight MDGs were specifically on health factors on child survival, maternal survival, and a whole range of things like HIV, TB, malaria. And then suddenly, we were gone from three from eight goals to one from 17. And people said, no, no, no, that's the wrong way to think about it, because actually, health is in all policies. And I completely agree with that. And the reason I'm involved in this thing called children in all policies is because looking at climate change and child health, we did this report for the Lancet, which is freely downloadable, which anyone can read came out two years ago, called a future for our children question mark, which was a WHO UNICEF Lancet commission. And that came to the conclusion that when you think about children, you've got to think about them across all the range of sectors, you know, because, you know, the commonest cause of death over after the age of five is road traffic accidents. So you need a transport policy, we need to think about food policies and subsidies and agriculture for child nutrition, social services, education, housing, I mean, you know, unless you address some of these issues, you're never going to get to the root of why more children die, or more children do less well, in terms of child development and the like. So we have to think in these terms. The question then is how to do it, multisectoraly. I think the way to do it is not by trying to get ministries to work together because ministries are competitive. I think you either have to go above it to get the agenda onto the cabinet. The other way is to go below ministries down to district level into communities, because they think much more cooperatively. You know, if you're a poor subsistence rural dweller somewhere, you're concerned about the health of your crops, the health of your animals, the health of your children, and family. And it's all integrated. And so getting down to that level and getting to districts where people, education and health will meet one another more socially and talk more is how you're going to get some of these things involved.
Rochelle Burgess
I ultimately would like to see a discourse on sustainable development that is arguing for funding, specifically for those co-produced bottom up strategies that enables people to do that work,
Priti Parikh
Rochelle, in a way we talk a lot about COVID hampering the goals. But do you think the pandemic is an opportunity for us to do better, and if so, what could we do better?
Rochelle Burgess
I think for me, the thing that we could do better is this opportunity to sort of take this as a blank slate almost. I think what COVID sort of shows us is that what we're doing isn't really working in so many ways for so many people all over the world, I think if we sort of used this an opportunity to sort of radically imagine sort of new ways of running economies and devolving power to communities, and then actually putting the bits of money we do have where our mouth is, I think that could work. I think, this whole narrative of building back better, or fairer, or whatever we call it, I think takes for granted that, you know, what we're building on was already broken. Like it's pretty broken. And I think a lot of the ways that we're seeing sort of people try and reimagine life post pandemic, to me aren't radical enough. And it might not be that we need anything new, it might be that we just need to look at communities and what they did to survive and funding that. There was a paper that we wrote about making sort of community lead approaches to vaccine uptake. One of the things we talked about in that paper was actually this plan for how we could do that bottom up. But I think it was general enough that we could use a plan like that to sort of imagine any kind of new system, from the bottom up, working in communities with people that are already trusted with people that are already doing work to enable survival, asking them what is needed, and putting resources there to build that way. And I think that what happens is you sort of get very local infrastructure, as Anthony was saying, sort of going hyper local, where people are engaging with the downstream consequences of the causes of the causes every day, and they build solutions that will make sense to that location, and then you sort of think about scale from there.
Monica Lakhanpaul
I've got three last questions, really, for both of you, Rochelle, and Anthony. And we've got only about four minutes left. So we're going to do this in a slightly different way. It's a little bit of a quick response, quick question, if that's okay. So the first one's over to Anthony, how has COVID revealed gaps in priority areas not covered by the goals?
Anthony Costello
Oh, well the goals cover virtually everything, except perhaps political philosophy, and knowing how to disrupt the medical industrial complex. I'd say one thing is, if you're going to set up a pandemic advisory group of experts, you don't have two thirds men, four doctors from independent schools leading it, not a single black and ethnic minority person on it, and you know, not a social scientist on it, and not a single public health person on it. I mean, that is not the way to advise about a pandemic, and of course the critical early months were the ones that led to the disaster. So that's one thing that you know, how you structure scientific advice, and health advice is something that we really need to look at.
Monica Lakhanpaul
Thank you. And, Rochelle, I'll ask you the next question. So building on that, do you think there are ways in which the goals themselves are no longer fit for a COVID-19 world? Sounds like we're being very negative here, don't we?
Rochelle Burgess
Yes, we are being negative, but we're also being helpful. We're trying to be helpful, too. I think that's okay. Can I be very cheeky and just borrow Anthony's answer from right at the beginning?
Monica Lakhanpaul
We're always cheeky with Anthony aren't we?
Rochelle Burgess
But I do think, you know, we don't need 11 goals, all of those things that we are interested in can be brought together under three or four. And I think that if we were to sort of restructure them, I would do that because you know, that challenges and forces us to think intersectionally and to think about partnerships, and the current structure of the goals allows us to think independently of each other, which is what we don't want.
Monica Lakhanpaul
Thank you. And to round up, I'd like to ask you both this question; how realistic is the 2030 deadline? Anthony, go for it.
Anthony Costello
Well any deadline, we will miss things that always happens, the UN sets them as a way of trying to be multilateral get countries together to really focus on things and that's a good thing to do. Inevitably, we will miss things in the same way that we're going to miss our climate targets for 2030, the chances of us keeping to you know, 1 - 1.5 degrees, I think are slim to zero. And, you know, as we saw with COP 26, the gaps between the science and the political commitments is still a long way. But you know, I think the SDGs are going to be a very valuable way of checking on progress, whether you call it across 17 goals or across three things like the environment, human development, and you know, the social and economic infrastructure. I mean, the biggest crisis of all, which is one element of SDGs is the climate crisis, because that is going to affect us hugely and our children in the next 10 to 15 years. I mean, it's affecting us already all over the world, every region is being affected by climate change at a level that 10 years ago, we didn't really expect so soon. So we've got to get to grips with that in the longer term, and the SDGs will be one way of helping to check on what we've been doing on the broader aspects of tackling climate change.
Monica Lakhanpaul
Thank you, Rochelle, a final word from yourself?
Rochelle Burgess
Yeah, I think if we didn't have a deadline, we wouldn't do anything. So even if we think we might not make it, you need to have something to look towards. So I'm looking forward to 2030 when as Anthony says, we see how far we've come. We probably repackage them again, hopefully in Anthony's very clear, three trifecta package to anyone out there who's listening and set another goal. And we just keep going. Because what other alternative is there?
Monica Lakhanpaul
Thank you very much. On behalf of Priti and myself, we'd like to thank both of you for joining us today. We've learned a great deal and the conversation has been fascinating. We've learned about intersectionality, partnerships, sharing knowledge, and the role of the community and the importance of the community, but also how people see the SDGs and if they are actually achievable, not when you have so many to deal with. But we all love deadlines in higher education. And so we have a deadline of 2030 for our SDGs. let's hope we get some way along that journey. You've been listening to Unlocking the SDGs, a blueprint for the future. This episode was presented by me, Professor Monica Lakhanpaul
Priti Parikh
And me, Dr. Priti Parikh,
Monica Lakhanpaul
And produced by the UCL SDGs initiative, with support from UCL Global Engagement. Our guests today were Professor Antony Costello and Dr. Rochelle Burgess, from the UCL Institute for Global Health. If you'd like to hear more podcasts from UCL, please do subscribe to UCL Minds wherever you download your podcasts.
Priti Parikh
Join us next time we'll be back soon.