SDG Target #3.b

SDG #3 is to “To ensure healthy lives and promote well-being for all at all ages.”

Within SDG #3 are 13 targets, of which we here focus on Target 3.b:

Support the research and development of vaccines and medicines for the communicable and non‑communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.

Target 3.b has three indicators:

• Indicator 3.b.1: Proportion of the target population covered by all vaccines included in their national program.

• Indicator 3.b.2: Total net official development assistance (ODA) to medical research and basic health sectors.

• Indicator 3.b.3: Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis.

First of all, what is the Doha Declaration, as mentioned in the body of the target. This refers to an agreement made in Doha, Qatar at the Fourth Ministerial Conference of the World Trade Organization in 2001. The World Trade Organization is the world’s peak international organisation for international trade, and though it works alongside the UN, is independent of it. 

The focus of the declaration  for this target is on the TRIPS Agreement, an international treaty which stands for Agreement on Trade-Related Aspects of Intellectual Property Rights. The TRIPS Agreement is an annex of the Marrakesh Agreement establishing the World Trade Organization, signed in the Moroccan city in 1994. One of the key relationships between the World Trade Organization and the UN in relation to the TRIPS Agreement is via the World Intellectual Property Organization, one of the UN specialised agencies

This Marrakesh Agreement was the result of the so-called Uruguay Round of multilateral trade negotiations, within the framework of another international treaty, the General Agreement on Tariffs and Trade (GATT) designed to reduce or remove international trade barriers, tariffs and import quotas. 

In turn, the lengthy Uruguay Round of international trade negotiations, drawn out over 1986 to 1994, resulted in the establishment of the World Trade Organization to replace the GATT, with the Marrakesh Agreement acting as one of the WTO’s founding documents.

To turn back to the TRIPS Agreement, this WTO treaty relates to the enforcement of intellectual property rights worldwide, both for authors of creative works, and all manner of copyrights, patents and trademarks. 

The nature of the Doha Declaration is to recognise the importance of public health of developing countries, and least developed countries in particular, who are at the frontline of infectious epidemics such as HIV/AIDS, malaria and tuberculosis. 

As it applies to the TRIPS Agreement, the Doha Declaration on the TRIPS Agreement and Public Health makes it clear public health ought to take precedence over intellectual property, and though intellectual property rights is an important aspect of drug discovery, it should be balanced with the prices with which such medicines are made available in the poorest countries.

Within the definitions of our first official indicator for this target regarding vaccine coverage, we’re looking at the vaccines recommended by WHO and UNICEF, including two doses of measles, a full schedule of HPV, three doses of pertussis, and the toxoid vaccines of tetanus and diphtheria, whereby the toxins from bacteria are weakened. Also included is an immunisation for pneumococcal disease.

Looking at progress for this indicator, as of 2021, 81% of the one-year-olds worldwide have been immunised with the DPT vaccine, a 4% decrease since 2015, at the adoption of the SDGs. 71% of children worldwide had been vaccinated for measles as of 2021, up from 63% in 2015. 51% of one-year-olds had been vaccinated for pneumococcal disease in 2021, up from 38% in 2015. Worldwide, 12% of adolescent girls had been vaccinated for HPV as of 2021, up from 9% in 2015.

For the second indicator relating to ODA given to medical research and health, we can measure this via OECD data. Within the OECD is the DAC, or Development Assistance Committee, consisting of the high-income donor countries. Using this data, reported via the OECD’s Creditor Reporting System, we can see, for each donor, what amounts each year have been given of their total official development assistance flows to which sectors. In this instance, we want to see how many millions of US dollars have been given to the basic health sector and medical research.

Now is also an opportunity to look at the regions within which the World Health Organization divides its operations among its Member States, as the data for the final indicator is disaggregated into these regions to show access to essential medicines. These World Health Organization regions are:

• Africa

• PAHO (Pan American Health Organization)

• Southeast Asia

• Europe

• Eastern Mediterranean Region

• Western Pacific

These essential medicines are defined by the World Health Organization into the WHO Model Lists of Essential Medicines, including the Essential Medicines for Children, selected by the World Health Organization’s Expert Committee on Selection and Use of Essential Medicines. The intention is for sufficient quantities of essential medicines to be available at health facilities for affordable prices, per the defined dosages. Such medicines can be out of reach of the daily wages of some living below national poverty lines, earning the lowest pay for unskilled work in the labour market.