Children from Tsimahavaobe primary school, Menabe region, Madagascar race against each other. One year into the UN Global Goals, the race to 2030 is a complex challenge. Photo: WaterAid/ Ernest Randriarimalala
With the Olympic Games just wrapped up in Rio, I have been mulling over games of yore.
Remember the Rubik's Cube, that multi-coloured brain teaser puzzle that was all the rage in the '80s?
Here's a reminder - the aim was to get all 6 sides of the Rubik Cube aligned with the same colour, which required getting the 9 segments of each of the 6 sides to match.
One year on from the adoption of the UN's new Sustainable Development Goals, they look something akin to a Rubik's Cube. The 17 Goals, and 169 targets within those, applicable to 193 countries, are a colourful and immensely challenging combination puzzle. One cannot be solved without the others; they are inter-dependent.
UN Goals a challenge of Rubik's complexity
The UN High Level Political Forum last month in New York was the first global gathering since the goals were agreed. I was left with two major take-aways. Governments are struggling, first, with the central challenge to leave no one behind, and second, with the imperative to break through traditional policy boundaries and ensure sectors work together to deliver on the enormity of the Goals' ambition -- all in the space of 14 years.
These twin concepts - integration and leaving no one behind -- are not buzzwords. They are key to unlocking the Goals and achieving the eradication of extreme poverty by 2030, including Goal 6, universal access to water, sanitation and hygiene (WASH).
Let's apply the Rubik's Cube approach to the progressive 'Every Woman Every Child' movement sponsored by the UN Secretary-General's office, of which WaterAid is a proud member. Take 3 policy areas (health/nutrition/education), 3 priority groups (women/children/adolescents) and 3 outcomes (survive/thrive/transform) as an illustration.
1. Every woman needs health to survive.
2. Every child needs nutrition to thrive.
3. Every adolescent needs education to transform.
Each of these goals needs water, sanitation and hygiene to underpin successful, sustainable outcomes. They're catchy and easy to tweet, but far less easy to deliver.
If we explore each of these three propositions, we can see that this Rubik's Cube analogy and approach will ensure that each of the 17 Global Goals cross the proverbial 'winning line' by 2030. No one said it would be easy. Indeed, a profound change of mindset amongst governments, policy makers, funders and partnerships is now required.
Catchy to tweet, harder to deliver
We know that every woman needs good health, and healthcare, to survive but last year the World Health Organisation found that 38% of health care facilities in developing countries do not have an improved water source. Imagine giving birth where there is no safe water? Water, sanitation and hygiene are critical in helping to end preventable newborn deaths from infection and sepsis.
Integrating WASH and health policies effectively will require more than infrastructure. Achieving behaviour change, good hygiene including hand washing, and creating trust are also pivotal.
For example during the recent Ebola virus pandemic in Sierra Leone and Liberia, healthcare facilities struggled with poor water supply, poor sanitation and the inability to maintain good hygiene. As a result of this crisis, the health workforce was decimated and patient trust eroded. National and local health systems couldn't hold up under the pressure. WaterAid is still working with local authorities to improve WASH services in hospitals, and with women's groups to help re-establish trust in services.
Integration: not just a buzzword
Who could possibly dispute the second proposition, every child needs nutrition to thrive? But if there is unanimity about this, why has it not been translated into funding and policies on the ground? Nutrition is not just about ending hunger with sufficient food. WHO estimates that 50% of all undernutrition is associated with infections and intestinal worms caused by poor WASH, and is a major factor in child stunting, as well as many of the annual 860,000 preventable deaths of children under five.
Effective integration of programmes for nutrition and WASH is possible. In Nepal, WaterAid is working with the Ministry of Health on an immunisation and hygiene integration programme, which trains travelling community health workers to deliver water, sanitation, hygiene and nutrition advice to mothers alongside their babies' regular immunisations.
And finally, of course, every adolescent needs education to transform. Among the reasons for girls dropping out of school once they reach puberty is the lack of separate toilets and menstrual hygiene facilities. Education in the Agenda 2030 era is, critically, about quality of education and retention of students, not just enrolment. WaterAid works closely alongside schools, girls' groups and WASH authorities to join these policy dots, which helps girls to finish their education and puts them in a far stronger position for later life choices.
So, if we focus on women, girls and adolescents, and we work together across traditional policy sectors to integrate WASH, health, education and nutrition, our Global Goals Rubik's Cube puzzle stands a good chance of being solved.
This is not a game
And of course this is where any analogy with the Rubik's Cube ends. This is not a game. The opportunity, and responsibility, to align and integrate sustainable development agendas is huge. By doing so we will deliver on the vision of the Global Goals, and transform the daily lived reality of the most marginalised and poorest women and girls in the world.
Now that is a race worth winning.