The sustainable development goals as a vehicle for achieving global health objectives: an ethical critique

Abstract

This is an ethical critique of the Sustainable Development Goals (SDGs); and specifically, their potential for achieving healthy lives and well-being for all human beings. Drawing from globalization as the context in which various interactions take place across the globe between persons, corporations, institutions, and states, an argument is made that the dominant narratives of globalization have focused on its macro environmental impact, but have under-explored globalization’s effects on individual health and well-being. The case is made that the negative effects of globalization which individuals experience emanate from exclusion, powerlessness, and physiological risks to health. A further claim is made that Agenda 2030 and the SDGs represent a global consensus that seeks to focus on individual health and well-being. Using a broader conception of health and well-being that is grounded in diverse philosophical approaches, a link between the determinants of health and individual health and well-being is made, with Agenda 2030 and the SDGs as a central component of this undertaking. An ethical critique of reason, motive, and intention is also carried out; justified by an argument that they are crucial to the sustainability of actions under Agenda 2030. A detailed epidemiological and ethical analysis of SDG3 is also carried out, and the links between SDG3 and other goals explored. Challenges identified by various authors as being impediments to progress towards the SDGs are analysed, and solutions proposed. A contribution to knowledge is made by proposing Herbert Simon’s related concepts of satisficing and bounded rationality as being relevant to guiding the decisions that states will make towards progress in Agenda 2030. The conclusion is reached that while the SDGs are unlikely to be achieved by 2030, they are congruent with several philosophical approaches and represent a robust impetus for action to improve health and well-being for all.