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ABSTRACT
In this paper we examine the Sustainable Development Goal 3 through the lens of state obligations to respect, protect and fulfil people’s human rights entitlements. We critique some of the Transforming Our World: The 2030 Agenda for Sustainable Development ‘follow-up and review’ arrangements for the health goal, SDG3. To assist in this analysis, we draw from a tripartite conceptualisation of accountability and focus particularly on monitoring and review. We use a human rights framework to explore whether the agreed SDG3 indicators for ‘follow-up and review’ promote the collection of data that could demonstrate health rights entitlements are being respected, protected and fulfilled. We find there are gaps through which breaches of human rights could fall undetected, especially around participation and quality health care. We find statistics are frequently absent in countries and communities most ‘left behind’, and suggestions that Big Data could fill these statistical gaps ignore the realities of poor information systems and the digital divide. We conclude that well resourced countries have human rights obligations to provide assistance where needed to national statistics offices to improve their capacity to contribute to human rights accountability mechanisms.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes on contributors
Carmel Williams, PhD, is a Senior Research Officer, Human Rights, Big Data and Technology Project, Human Rights Centre, University of Essex.
Paul Hunt is Professor of Law, Human Rights Centre, University of Essex.
Notes
1 UN General Assembly, Transforming Our World: The 2030 Agenda for Sustainable Development (New York: UN, 2015).
2 Ibid.
3 United Nations, Universal Declaration of Human Rights, Article 1 (UN, 1948).
4 UNGA, Transforming Our World.
5 Olivier de Schutter et al., ‘Commentary to the Maastricht Principles on Extraterritorial Obligations of States in the Area of Economic, Social and Cultural Rights’, Human Rights Quarterly 34 (2012): 1084–169; Mark Gibney, International Human Rights Law: Returning to Universal Values, 2nd ed. (Lanham, MD: Rowman & Littlefield, 2016); Paul Hunt, Judith Mesquita and Rajat Khosla, ‘The Human Rights Responsibility of International Assistance and Cooperation in Health’, in Universal Human Rights and Extraterritorial Obligations, ed. M. Gibney and S. Skogly. Pennsylvania Studies in Human Rights (Philadelphia: University of Pennsylvania Press, 2010).
6 UNGA, Transforming Our World.
7 For a discussion on human rights mainstreaming, see Paul Hunt, ‘Configuring the UN Human Rights System in the “Era of Implementation”: Mainland and Archipelago’, Human Rights Quarterly (forthcoming).
8 Committee on Economic Social and Cultural Rights (CESCR), ‘General Comment 14: The Right to the Highest Attainable Standard of Health:’, 2000, para 33. UN Doc. E/C.12/2000/4.
9 Ibid.
10 UNGA, Transforming Our World, para 73.
11 UN Economic and Social Council, Report of the Inter-Agency and Expert Group on Sustainable Development Goal Indicators (New York, 2016). UN Doc E/CN.3/2016/2, https://unstats.un.org/unsd/statcom/47th-session/documents/2016-2-IAEG-SDGs-E.pdf (accessed July 14, 2017).
12 Sakiko Fukuda-Parr, Alicia Ely Yamin and Joshua Greenstein, ‘The Power of Numbers: A Critical Review of Millennium Development Goal Targets for Human Development and Human Rights’, Journal of Human Development and Capabilities 15, nos 2–3 (2014): 105–17.
13 Ibid.
14 Paul Hunt, ‘SDG Series: SDGs and the Importance of Formal Independent Review: An Opportunity for Health to Lead the Way’, Health and Human Rights Journal, September 3, 2015, https://www.hhrjournal.org/2015/09/sdg-series-sdgs-and-the-importance-of-formal-independent-review-an-opportunity-for-health-to-lead-the-way/ (accessed July 14, 2017).
15 Ibid.
16 Julio Frenk and Suerie Moon, ‘Governance Challenges in Global Health’, New England Journal of Medicine 368, no. 10 (2013): 936–42, 939, http://www.nejm.org/doi/full/10.1056/NEJMra1109339.
17 Ilona Kickbusch and Martina Szabo, ‘A New Governance Space for Health’, Global Health Action 7 (2014), doi:10.3402/gha.v7.23507, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925805/.
18 World Health Organisation (WHO), Keeping Promises, Measuring Results (Geneva: Commission on Information and Accountability for Women’s and Children’s Health, 2011).
19 Ibid.
20 Julian Schweitzer, ‘Accountability in the 2015 Global Strategy for Women’s, Children’s and Adolescents’ Health’, British Medical Journal 351 (2015), http://www.bmj.com/content/bmj/351/bmj.h4248.full.pdf.
21 UN Secretary-General Ban Ki-moon, Global Strategy for Women’s and Children’s Health (New York: United Nations, 2010).
22 Ibid., 15.
23 WHO, Keeping Promises, Measuring Results.
24 For example, when the MDGs were established, accountability for them was primarily understood as monitoring progress: see Annex, Road Map Towards the Implementation of the United Nations Millennium Declaration, http://www.undp.org/content/dam/undp/library/MDG/english/MDG%20Country%20Reports/MDG%20Reporting%20Guidelines/MDG%20Roadmap%20from%202001.pdf (accessed July 14, 2017).
25 WHO, Keeping Promises, Measuring Results, 7.
26 Ibid., 7.
27 Ibid.
28 Ibid.
29 Ibid.
30 Julio Frenk and Suerie Moon ‘Governance Challenges in Global Health’, New England Journal of Medicine 368, no. 10 (2013): 936–42, http://www.nejm.org/doi/full/10.1056/NEJMra1109339; Ilona Kickbusch and Martina Szabo, ‘A New Governance Space for Health’, Global Health Action 7 (2014), doi:10.3402/gha.v7.23507, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925805/.
31 WHO, Keeping Promises, Measuring Results, 7.
32 Lynn P. Freedman, ‘Human Rights, Constructive Accountability and Maternal Mortality in the Dominican Republic: A Commentary’, International Journal of Gynecology and Obstetrics 82 (2003): 111–4, 111.
33 WHO, Keeping Promises, Measuring Results.
34 Ibid., 16.
35 Independent Expert Review Group on Women’s and Children’s Health, Every Woman, Every Child, Every Adolescent: Achievements and Prospects, Final Report (Geneva: World Health Organisation, 2015).
36 Every Woman Every Child, ‘The Global Strategy for Women’s Children’s and Adolescents’ Health (2016–2030) Survive Thrive Transform’, in Every Woman Every Child (UN, 2015).
37 Peter Godwin and Sujaya Misra, Report of the External Review of the Accountability Work for Women’s and Children’s Health (WHO, 2014), 50.
38 Ibid.
39 Kate Donald, ‘Breaking the Accountability Taboo in SDG Negotiations’, Center for Economic and Social Rights, http://cesr.org/breaking-accountability-taboo-sdg-negotiations (accessed March 17, 2017).
40 Godwin and Misra, Report of the External Review.
41 Independent Expert Review Group, Every Woman, Every Child, Every Adolescent.
42 Global Strategy for Women’s Children’s and Adolescent’s Health Strategy and Coordination Group, Independent Accountability Panel: Scope of Work and Terms of Reference for Panelists (WHO, 2015).
43 WHO, Keeping Promises, Measuring Results.
44 UN, Universal Declaration of Human Rights.
45 Paul Hunt, 'A Three-Step Accountability Process for the UN Secretary General's Global Strategy for Women's and Children's Health' (paper presented at the “From Pledges to Action”, A Partners' Forum on Women's and Children's Health, Ministry of Health and Family Welfare, Government of India, New Delhi, India, November 12–14, 2010), 15.
46 The Partnership for Maternal, Newborn & Child Health, A Review of Global Accountability Mechanisms for Women’s and Children’s Health (Geneva: WHO, 2011), 9, http://www.who.int/pmnch/knowledge/publications/20110222_global_accountability_final.pdf?ua=1.
47 Working Group on Accountability for Results, ‘Final Report’ (Commission on Information and Accountability for Women’s and Children’s Health, 2011).
48 Baron de Montesquieu, ‘The Spirit of the Law’ (1748).
49 Independent Accountability Panel, Old Challenges, New Hopes: Accountability for the Global Strategy for Women’s, Children’s and Adolescents’ Health (UN, 2016), 11, https://www.everywomaneverychild.org/wp-content/uploads/2017/03/IAP_Report_September2016.pdf (accessed August 2, 2017).
50 Aristotle, Politics.
51 Godwin and Misra, Report of the External Review, 37.
52 Ibid., 30.
53 Ibid., 15.
54 Alicia Ely Yamin and Rebecca Cantor, ‘Between Insurrectional Discourse and Operational Guidance: Challenges and Dilemmas in Implementing Human Rights-Based Approaches to Health’, Journal of Human Rights Practice 6, no. 3 (2014): 451–85, 458.
55 Schweitzer, ‘Accountability’.
56 WHO, Keeping Promises, Measuring Results.
57 Every Woman Every Child, ‘Global Strategy for Women's Children's and Adolescent's Health Strategy and Coordination Group’ (Independent Accountability Panel - Scope of Work and Terms of Reference for Panelists, November 12, 2015), http://www.who.int/pmnch/media/news/2015/iap_tors.pdf (accessed August 2, 2017).
58 Independent Accountability Panel, Old Challenges, New Hopes, chs 2, 5.
59 UNGA, Transforming Our World, paras 72–91.
60 UN Economic and Social Council, Ministerial Declaration of the High-Level Segment of the 2016 Session of the Economic and Social Council on the Annual Theme ‘Implementing the Post-2015 Development Agenda: Moving from Commitments to Results’ (UN ESC, 2016), Annex paras 7–8, https://www.un.org/ecosoc/en/events/2016/ecosoc-high-level-segment-implementing-post-2015-development-agenda-moving-commitments (accessed August 2, 2017).
61 Ibid.
62 Danish Institute for Human Rights, ‘Human Rights in Follow-up and Review of the 2030 Agenda for Sustainable Development’ (Copenhagen, 2016).
63 Schweitzer, ‘Accountability’.
64 UN Economic and Social Council, doc no E/HLS/2016/1, Annex, High Level Panel on Water ‘Action Plan’ September 21, 2016, https://sustainabledevelopment.un.org/HLPWater (accessed August 2, 2017).
65 UN Special Rapporteur on the Right to Health Dainius Puras, Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health (Geneva: UN General Assembly, 2016).
66 Ibid.
67 Ibid., para 76.
68 CESCR, ‘General Comment 14’.
69 Paul Hunt et al., ‘The Right to the Highest Attainable Standard of Health’, in Oxford Textbook of Global Public Health, ed. Roger Detels et al. (Oxford: Oxford University Press, 2015), vol. 6, ch. 4.1.
70 UN Statistics, ‘Metadata on SDGs’, http://unstats.un.org/sdgs/files/metadata-compilation/Metadata-Goal-3.pdf (accessed November 29, 2016).
71 Ibid.
72 Gunilla Backman et al., ‘Health Systems and the Right to Health: An Assessment of 194 Countries’, The Lancet 372, no. 9655 (2008): 2047–85; UN Special Rapporteur Puras, Right of Everyone to the Enjoyment of the Highest Attainable Standard.
73 UN Special Rapporteur Puras, Right of Everyone to the Enjoyment of the Highest Attainable Standard.
74 Audrey R. Chapman, ‘Editorial: The Contributions of Human Rights to Universal Health Coverage’, Health and Human Rights Journal 18, no. 2 (2016): 1–5.
75 WHO, Tier 3 Discussion for 3.8/UHC (IAEG meeting, Mexico City, 2016).
76 Ibid.
77 WHO, World Health Statistics 2016: Monitoring Health for the SDGs WHO, http://www.who.int/gho/publications/world_health_statistics/2016/en/ (accessed November 29, 2016).
78 Ibid.
79 WHO, Tier 3 Discussion for 3.8/UHC (IAEG meeting, Mexico City, 2016).
80 A report to the Secretary-General of the United Nations by the Leadership Council of the Sustainable Development Solutions Network, 7, http://unsdsn.org/wp-content/uploads/2015/05/150612-FINAL-SDSN-Indicator-Report1.pdf (accessed July 14, 2017).
81 Casey Dunning and Jared Kalow, ‘What Sdgs Can We Track Now?’, in Views from the Center 2016 (Centre for Global Development, UK, 2016).
82 Ibid.
83 Ibid.
84 Susan Munabi-Babigumira et al., ‘Factors That Influence the Provision of Intrapartum and Postnatal Care by Skilled Birth Attendants in Low- and Middle-Income Countries: A Qualitative Evidence Synthesis’, Cochrane Database of Systematic Reviews, no. 2 (2015): 2, doi:10.1002/14651858.CD011558.
85 Sustainable Development Solutions Network, Indicators and a Monitoring Framework for the Sustainable Development Goals.
86 Ibid.
87 Ibid., 4.
88 Independent Accountability Panel, Old Challenges, New Hopes.
89 Data-Pop Alliance, ‘Opportunities and Requirements for Leveraging Big Data for Official Statistics and the Sustainable Development Goals in Latin America’ (White Paper, Harvard Humanitarian Initiative, MIT Media Lab, and Overseas Development Institute, 2016), 15.
90 Independent Expert Advisory Group on a Data Revolution for Sustainable Development, ‘A World That Counts: Mobilising the Data Revolution for Sustainable Development: Report for the UN Secretary General’, ed. Data Revolution Group (November 2014).
91 Abdullahi Abdulkadri, Alecia Evans and Tanisha Ash, ‘An Assessment of Big Data for Official Statistics in the Caribbean: Challenges and Opportunities’, in A Studies and Perspective Series (UN ECLAC Subregional Headquarters for the Caribbean, 2016).
92 Data-Pop Alliance, ‘Opportunities and Requirements’, 11.
93 See for example, Australia Ministry of Foreign Affairs, ‘Medical Supply Reform Impact Evaluation Papua New Guinea’, Ministry of Foreign Affairs, http://dfat.gov.au/about-us/publications/Pages/medical-supply-reform-impact-evaluation-papua-new-guinea.aspx (accessed November 29, 2016); Dhirendra Pratap Singh, ‘Inclusive Growth Is New Mantra’, eHealth, May 2, 2012, http://ehealth.eletsonline.com/2012/05/inclusive-growth-is-new-mantra/ (accessed July 14, 2017).
94 David Bollier, The Promise and Peril of Big Data (Washington, DC: The Aspen Institute, 2010).
95 Simon Ross, ‘Virtual Health Information Network – Big Health Data for Epidemiology: Opportunities and Challenges’ (paper presented at Big Health Data for Epidemiology Opportunities and Challenges using the SNZ IDI and other sources of ‘big data’ for epidemiological research in New Zealand, Wellington, January 26, 2016).
96 Dimiter V. Dimitrov, ‘Medical Internet of Things and Big Data in Healthcare’, Healthcare Informatics Research 22, no. 3 (2016): 156–63; Maged N. Kamel Boulos et al., ‘How Smartphones are Changing the Face of Mobile and Participatory Healthcare: An Overview, with Example from Ecaalyx’, BioMedical Engineering OnLine 10, no. 24 (2011); Timothy W. Kenealy et al., ‘Telecare for Diabetes, Chf or Copd: Effect on Quality of Life, Hospital Use and Costs. A Randomised Controlled Trial and Qualitative Evaluation’, PLOS One (2015).
97 Data-Pop Alliance, ‘Opportunities and Requirements’.
98 World Bank, World Development Report 2016 ‘Digital Dividends Overview’ (Washington, DC: World Bank, 2016).
99 Data-Pop Alliance, ‘Opportunities and Requirements’.
100 Zendesk, ‘Internet Live Stats’, http://www.internetlivestats.com/internet-users-by-country/ (accessed December 12, 2016).
101 See for example, Cathy O’Neil, Weapons of Math Destruction (New York: Crown, 2016).
102 Abdulkadri, Evans and Ash, ‘An Assessment of Big Data for Official Statistics in the Caribbean’.
103 Independent Accountability Panel, Old Challenges, New Hopes.
104 Big Data UN Global Working Group, ‘Big Data Project Inventory’ (UN Dept of Economic and Social Affairs, Statistics Division), http://unstats.un.org/bigdata/inventory/?selectID=201435 (accessed November 29, 2016).
105 Ibid.
106 Zendesk, ‘Internet Live Stats’.
107 WHO, Keeping Promises, Measuring Results.