Leave no one behind? Not if you’re over 70

This post, written by Peter Lloyd-Sherlock, Professor of Social Policy and International Development, UEA, is the seventh in our blog series which aims to explore how the Sustainable Development Goals can be drafted to include all social and economic groups. 

On 24 September 2015, all United Nations member states will ratify the Sustainable Development Goals Treaty. These Goals will frame national and international policy priorities for the next 15 years.

There are many positive aspects to these goals, such as their ambitious call to eradicate hunger and extreme poverty, as well as for universal primary and secondary education. In terms of health, there is also much to welcome, including a call to end preventable deaths among the under 5s. The inclusion of a target specifically related to non-communicable diseases is to be applauded.

Despite this, the current formulation of this non-communicable disease target (SDG Target 3.4) is highly problematic, since it is explicitly discriminatory and ageist. Target 3.4 calls on all member states to:

“By 2030 reduce by one-third pre-mature mortality from non-communicable diseases (NCDs) through prevention and treatment, and promote mental health and wellbeing”.

The UN define “premature mortality” as deaths among people up to the age of 70. Consequently, people aged 70 or more would be excluded from this target. Achieving Target 3.4 would represent a major challenge for all countries. To do so would require the diversion of a substantial part of health expenditure away from people aged 70 and over. Furthermore, the concept of “premature mortality” is inherently ageist, indicating that mortality among the over 70s should not be a major public policy concern.

Globally, there are now 1.2 billion people aged 55 and over, the great majority all of whom will reach 70 during the 15 year lifetime of the SDGs and therefore face potential UN-sanctioned discrimination. Target 3.4 directly contravenes the over-arching objectives of the SDGs, as set out by the UN Open Working Group, which include: “…to strive for a world that is just, equitable and inclusive…without any distinction of any kind such as age, sex, disability, culture, race, ethnicity, origin, migratory status, religion, economic or other status”. [1]. More fundamentally, it undermines the key principle of health as a right for all.

In 2014 the United Nations Secretary General said: “Older persons make wide-ranging contributions to economic and social development. However, discrimination and social exclusion persist. We must overcome this bias in order to ensure a socially and economically active, secure and healthy ageing population.”

Surely, ratification of a target that so obviously discriminates against a large proportion of the voting population would be highly embarrassing to national governments. In many countries it would also contravene key national legislation such as the UK’s 2010 Discrimination Act.

It’s therefore of paramount importance that we call on all member states to insist upon a change to the wording of SDG Target 3.4, replacing “premature mortality” with “preventable mortality”. This would be an effective and non-discriminatory target, which would support the wider ambition of the SDGs to “leave no-one behind”.

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