Peter A. Singer

Peter Singer has dedicated the last decade to bringing innovation to tackling the health challenges of the world’s poorest people. He is well known around the world for his creative solutions to some of the most pressing global health challenges. Dr. Singer is Chief Executive Officer of Grand Challenges Canada. He is also Director at the Sandra Rotman Centre at University Health Network and Professor of Medicine at University of Toronto.

On May 30, 2013, the High-Level Panel on the Post-2015 Development Agenda released its report on post-2015 development goals. Overall, the Panel should be commended for moving the ball forward on a very challenging field.

My initial reaction to the report was that it was a smorgasbord. I meant this as positive (there are a lot of people in Scandinavia who love a good smorgasbord). With 12 illustrative goals and 54 targets, the report provides something for (almost) everyone. GAVI likes the immunization target. Girls Not Brides likes the target to end child marriage. GAIN likes the nutrition target. Save the Children likes the child survival target. I think you get the idea. To be fair, these targets are good, and some – like the stand-alone goal on gender (along with its associated targets) – are visionary. The report also expands the scope of development goals to include governance and economics, which is a needed corrective.

This strength of the report is also probably its main flaw. By providing something for everyone, it’s difficult to find the fundament of the report. Its writers would probably say the fundamental of the report is to tackle inequality. This was one of five transformational shifts meant to signal priorities but only loosely connected to the goals everyone will care about and focus upon. There is a very important section that points out that a goal is met only if no one is left behind. The report has also been criticized for the lack of an inequality target and measure, but I do not share this critique as I have seen a policy focus on the poorest quintile achieve strong social change in countries like Brazil.

My greatest disappointment in the report was the absence of any real narrative or theory of change for how the goals would work together – how the whole can be more than the sum of the parts. For an example of such a narrative, please see this video I released in early March.

In addition, for a report focused on inequality, it missed the mark by not explicitly calling out the fundamental force that perpetuates inequality across generations: early child development. There is increasing evidence that the first 1,000 days of a child’s brain development strongly influences whether that child will reach her/his full potential. Early brain development has been associated with educational attainment and poverty. Despite its importance, the report makes no explicit mention and puts no explicit focus on this critical issue.

The report does tackle a number of the risks to early brain development and, as such, its focus on stunting from malnutrition and early education are commendable. But it missed the mark – and a significant opportunity – in not calling out early child development and the overarching opportunity for saving brains.

There are some other omissions that should be easy to fix. For example the report mentions non-communicable diseases but does not explicitly mention global mental health, which represents 13% of the global burden of disease.

As attention shifts from the ‘what’ to the ‘how’ of the post-2015 development goals, the envisioned global partnerships mentioned in the report will gain increasing importance. Here, the concepts of Anne Marie Slaughter of “networked governance” and “government as platform” will be very useful. The Grand Challenges approach is an instantiation of these concepts in global health and development.  In other recent blogs, I describe how the Grand Challenges approach can be applied to help the world solve its biggest problems and how a solved Grand Challenge can be seen as equivalent to a post-2015 goal reached. The Grand Challenges approach emphasizes innovation with impact – a needed addition to the High-Level Panel report which, like the original MDGs, gives short shrift to the power of innovation and social entrepreneurship in making the world a better place.

What’s next? Ultimately the UN General Assembly will need to approve a set of post-2015 development goals. Over the coming two years, I hope that the fundamentals of these goals become clearer, with an enhanced focus on child brain development in the first 1,000 days, since this is a key force perpetuating inequality. In addition, some omissions (such as global mental health) could be added to round out the challenges. Finally, if we are interested in execution, we will need to focus on global partnerships that are up and running and achieving results, such as the Grand Challenges approach.

So thank you to the High-Level Panel. Their task was challenging and they advanced the discussion. But more work needs to be done to cross the finish line on setting the post-2015 development goals, which of course is also the starting line for actually achieving them!