Will the SDGs be the last hope for lost causes?

Onchocerciasis, lymphatic filariasis, soil-transmitted helminthiases. Three diseases that affect hundreds of millions of people in developing countries, yet it’s rare to hear their names mentioned at global summits, let alone read about them in the newspapers.

These ailments along with fourteen other neglected tropical diseases (NTDs) that blind, maim, disfigure and cause horrific pain, affect more than 1.5 billion people, costing developing economies billions of dollars every year.

Despite many NTDs being straightforward to prevent or treat and progress being made to treat more people than ever before, they are still rarely prioritised in global health spending.

But the sustainable development goals (SDGs) could be an opportunity to change the NTD story, and provide an opportunity for neglected causes to gain the attention they deserve. The SDGs to be agreed in September present a once-in-a-generation chance to reframe NTDs within a more mainstream approach to health and development. This is exactly what World Health Organisation (WHO) suggests in its latest NTD report launched on yesterday.

Back in 2000 when the SDGs’ predecessor, the millennium development goals (MDGs), were agreed, despite their undeniable link to poverty and exclusion the NTDs didn’t get a look in. This year it could be a different story. As the WHO report recognises, focus has expanded from disease-specific goals to Universal Health Coverage (UHC) with the goal 3 focusing on achieving healthy lives for all.

UHC is a great goal to aspire to. Imagine everyone having access to the healthcare they need, when they need it, without facing huge financial costs. It requires a commitment to strengthening health systems – investing in health workers, supplies, medicines and infrastructure. Effective health systems drive progress on all kinds of health problems – whether it’s cancer, malaria or even onchocerciasis.

For NTDs, UHC means programmes will be much more effective as it guarantees the health facilities, workforce, infrastructure and supply chains needed to deliver treatments. UHC would mean a person with the eye infection such as trachoma could be treated at a local health centre, by a trained health worker, with readily available antibiotics – preventing the blindness that repeated, untreated cases of trachoma causes.

Supporting UHC is also about taking the long-term view. Achieving it means national governments in endemic countries will take responsibility, ownership and provide resources for treatment programmes well into the future, rather than relying on foreign aid.

What are the risks?

An attempt to position marginalised issues such as NTDs within the broader SDG agenda could work for other causes that fall below the radar of media attention or populist sentiment. Causes such as modern-day slavery, disability and financial inclusion would also benefit. But there are risks.

The draft SDG framework has 17 goals while there are only eight MDGs. There is a far broader agenda, incorporating everything from employment to the environment. With so many issues on the agenda, it risks becoming unwieldy, and unable to deliver any goals, let alone the ones on health.

A UHC approach will require that individual disease targets, to some degree, become secondary to overarching health goals. In practice, this may require that from time to time those of us who advocate for the elimination of NTDs put aside our specific asks to make way for other issues. If we do this, we may risk losing campaigning momentum and political support for our specific causes and could see NTDs fall even further into obscurity.

Another risk is that by fixing our attention on 2030, we’ll fail to achieve the existing WHO targets for 2020 (pdf). Because many NTDs require annual treatments to protect communities, failing to raise targeted funds and scale-up programmes over the next five years will result in us missing existing treatment targets, jeopardising the progress we’ve made.

The battle is not lost

These risks understandably make some advocates hesitant but we need to campaign for a twin-track approach, one that delivers treatments now while strengthening systems for the future. This means we have to make the case for sustained investment evidence-based and clear.

Engaging with the SDG process is a big investment in time and resources, felt most deeply by those organisations who might not see immediately what they stand to gain. The needs of people and planet are multiple; it is inevitable that we won’t see new funding mechanisms for each one. But the SDGs are a bold attempt to “leave no one behind” (pdf), a call I believe will see NTDs and other so-called ‘lost causes’ – and the millions of people they represent – finally brought out of the fringes of the development agenda.

Dominic Haslam is director of policy and programme strategy at Sightsavers and is speaking today [Friday 20 February] at Beyond 2020, a high-level event on neglected tropical diseases, hosted by the Bill and Melinda Gates Foundation. Follow @domhaslam123 on Twitter.

Join our community of development professionals and humanitarians. Follow@GuardianGDP on Twitter.