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THE EFFECTIVENESS OF SDGS IN

REDUCING NR-NCDS
Matshidiso Moqhae u21609072
ABSTRACT
The Millenium Development Goals (MDG; 2000-2015) was proposed to focus primarily on
poverty reduction, hunger, and infectious diseases, then later in 2012 the Sustainable
Development Goals (SDGs) was proposed, and it targets and pays more attention to
nutrition and non-communicable diseases (WHO.,2018). The 2030 Agenda for Sustainable
Development Goal 3, adopted by the United Nations in 2015 recognizes noncommunicable
diseases as a major health challenge and it includes a target of reducing the probability of
the death from any of the four main NCDs between the ages of 30 and 70 years by one third
by 2030 (Jarnail Singh Thakur.,2019). Other proposed targets include reducing premature
deaths from NCDs by one third and end malnutrition in forms. Nutrition related NCDs are
standing at the intersection between malnutrition and NCDs. Driven in a large part by
remarkable transformations of food systems, they are rapidly increasing in most low- and
middle-income countries (LMICs)(Popkin BM et al.,2012). The transformation to modern
food system began in the period following World War II with policies designed to meet a
vastly different set of nutritional and food needs and continued with globalization in the
1990s onwards. Another type of food systems transformations needed is to shift from
western diet to a healthier and more sustainable diet- as it will be meeting many of the other
SGDs (C Hawkes.,2015).

Keywords

Sustainable development goals, millennium development goals, infectious diseases,

noncommunicable disease (NCDs), NCD Countdown 2030, nutrition transition, food
systems, ultra processed foods (UPFs).

Introduction

Non-communicable diseases (NCDs) are the leading causes of ill health in the world and
account for seven of ten worldwide deaths. NCD mortality is higher in low-income and
middle-income countries, and, at least in high-income countries, in people with lower
socioeconomic status, making NCDs an important obstacle to reducing global and national
health inequalities (WHO.,2023). NCDs are also included in Sustainable Development Goal
(SDG) target 3.4, to “by 2030 reduce by one third premature mortality from non-
communicable diseases through prevention and treatment and promote mental health
and well-being”. The indicator used to measure progress in reducing premature NCD
mortality is the same as the 25 × 25 target, and suicide mortality is used as a tracer indicator
for mental health. The NCD Countdown 2030 is an independent collaboration to inform
policies that aim to reduce the worldwide burden of NCDs and ensures accountability
towards this aim. The NCD Countdown 2030 will monitor and report on a more
comprehensive indicator that includes outcomes and age groups that go beyond SDG target
3.4, in the spirit of leaving no one behind. Over time, NCD Countdown 2030 will also analyse
and report on important NCD risk factors, relevant health system interventions and multi-
sectoral policies, and financial commitments by governments and donors. (Lancet.,2020)

At present, all high-income and many low- and middle-income countries are in a stage of the
transition where nutrition-related noncommunicable diseases including obesity, type 2
diabetes, and hypertension are dominating adult morbidity and mortality and are extremely
high or growing rapidly in prevalence (BM Popkin.,2018). Some countries still have key
subpopulations facing hunger and undernutrition defined by stunting or extreme thinness
among adults. We call these double burden of malnutrition countries. All low- and middle-
income countries face rapid growth in consumption of ultra-processed food and beverages,
but it is not inevitable that these countries will reach the same elevated levels of
consumption seen in high-income countries, with all the negative impacts of this diet on
health. With great political and civil society commitment to adoption of policies shown in
other countries to have improved dietary choices and social norms around foods, we can
arrest and even reverse the rapid shift to diets dominated by a stage of high ultra-processed
food intake and increasing prevalence of nutrition-related noncommunicable diseases (BM
Popkin.,2022).

The nutrition transitions.

Globalization has led a major shift in dietary patterns around the world. With the increase in
international trade and travel, people are now exposed to the variety of food choices than
ever before. This has led to the adoption of Western- style diets (foods high in sugar,
sodium, saturated fats, and a use of substantial proportion of highly refined grain). At the
same time urbanisation has led to the loss of traditional food knowledge and practices and
increased the use of convenience foods (A Azzam.,2021). These changes have led to a
negative impact on health, leading to higher rates of obesity, diabetes, and other chronic
diseases. With the increasing adoption of Western-style diets, there has been a decrease in
the consumption of traditional whole foods like fruits, vegetables, and whole grains. This has
resulted in a decrease in the intake of important nutrients like fiber, vitamins, and minerals,
leading to micronutrient deficiency that results in the triple burden of malnutrition (Clemente-
Suárez VJ et al.,2023).

Nutrition transition can be broken in 3 stages:

1. Traditional diets: Most of the food is obtained from locally grown crops and livestock.
This stage is characterized by a high intake of whole grains, fruits, vegetables, and
legumes with little or no processed foods.
 2. The transition to a modern diet: There is an increased intake of sugar, refined grains,
oils, and animal fats. This stage is marked by a gradual shift from traditional to more
energy dense foods, and it is usually associated with increasing rates of overweight
and obesity.
3. Nutrition paradox: There is a coexistence of undernutrition and overnutrition. In this
stage, there is an increasing number of people who are either overweight or obese,
while undernutrition remains a problem. This stage is often associated with rapid
economic development, urbanization, and globalization.

Figure 1 below provides a clearer explanation of what Nutrition transition entails.

Figure 1 The nutrition transition. Adapted from information in studies by Popkin et al. (7) and
Vorster et al 30 June 2018

Sustainable Development Goals and Nutrition-related NCDs

The 2030 Agenda for SDGs represents a common framework of international cooperation to
promote sustainable development. It encourages all countries (low, middle, and high income)
to reach the 17 goals. The SDG2 (End hunger, achieve food security and improved nutrition
and promote sustainable agriculture) is the only goal that mentions the concept of nutrition. It
is noteworthy that achieving several SDGs is crucial for achieving the nutrition goal, as it is
the essential component for achieving many of the other SDGs (G Grosso.,2020). Poor
nutrition is influenced by several socio-economic factors, including food insecurity,
attributable poverty, and war (SDG 1). About 800 million individuals in the world are
suffering from hunger caused by poverty, with about 43 million in the European Union being
unable to afford regular quality meals every second day. Education, decent work, and
economic growth (SDG 4 and SDG 8) are also associated with better diet quality and
improved food security. When people in the community get proper education, they become
at an advantage to get a proper paying job that will enable them to have a broader food
choice and can buy more nutritious foods unlike people from poorer environments. People
from poorer environments do not have much of a choice but to consume low-quality food
(energy-dense food and nutrient poor) because they are more affordable and within their
reach. With a high-quality education, they also get the nutrition education they need to make
better food choices that will help increase their life span as they will be a minimal risk of
noncommunicable diseases, reducing the prevalence of obesity and being overweight.

SDG 6 (Clean water and sanitation) is also crucial for food security. Access to clean water
and sanitation is essential for growing and preparing food. SDG 7 (Affordable and clean
energy) is important for ensuring that food can be transported and stored properly. SDG 8
(Decent work and economic growth) is key for ensuring that people have the income they
need to buy safe and nutritious food. SDG 10 (Reduced inequalities) is important for
ensuring that everyone has access to food, no matter their income, socioeconomic status.
SDG 12 (Responsible consumption and production patterns) aims to promote sustainable
consumption and production patterns, which are vital for reducing food waste and improving
sustainability of the food system. SDG 15 (Life on land) focuses on protecting ecosystems
and biodiversity, which are essential for sustainable food production. Finally, SDG17
(Partnerships for the goals) is important for ensuring that all the SDGs are implemented
effectively, and that progress is monitored and evaluated (G Grosso.,2020).
2030 Agenda for Sustainable Development Goals

The 2030 Agenda Sustainable Development Goals is a global framework adopted by the
United Nations in 2015. The agenda outlines 17 SDGs and 169 targets that address issues
such as poverty, inequality, climate change and more. The SDG aims to achieve a more
sustainable world by 2030, and they are a blueprint for a better future for all. They also call
to action for countries, organizations, and individuals to work to make a better world
(UN.,2020).

Food security is an important part of the 2030 Agenda of SDGs. SDG 2, which is Zero
Hunger, aims to end hunger, achieve food security, and improve nutrition by 2030. To
achieve this goal, the SDGs are focusing on several targets including increasing agricultural
productivity, improving access to food, reducing food waste and more (UN.,2020). The 2030
Agenda is taking a few steps in ensuring that by 2030 every person will have access to safe,
nutritious, and sufficient food all year round. These steps include:

1. Increasing investments in agriculture and small-scale farmers. This includes investing

in agricultural research and innovation, providing better access to credit and markets,
and improving agricultural infrastructure.
2. Improving access to nutritious food, especially for the most vulnerable people. This
includes improving access to social safety nets like food assistance programs and
nutrition education.
3. Reduce food loss and waste by improving storage and transportation systems and
promoting sustainable consumption and production.

The progress towards achieving Sustainable Development Goals is very uneven with some
areas making more progress than others, for example, the goal of reducing stunting by 40%
by 2025 is not on track, and progress has been slow in areas such as ensuring access to
clean water and sanitation, there are other successes such as the reduction in the number of
people living in poverty. Overall, the 2030 Agenda is an ambitious, long-term goal and the
progress will not always be linear.
Recommendations and limitations

There are several things that can be done on an individual, community and policy level to
improve food security and help reduce the prevalence of nutrition related NCDs. At individual
level, some recommendations include making healthy food choices, limiting the intake of
salt, sugar and saturated fats and being physically active. For people in vulnerable
communities or countries, it is exceedingly difficult to make healthy food choices because
they do not have broad choices to choose from as there is lack of affordable and
accessibility to good nutrition and enough income to buy them. What can be done is the
implementation of interventions that are needed to address the root causes of food insecurity
and malnutrition. This could also include improving access to food through programs like
food-subsidies or creating food markets in low-income areas. It could involve local farmers in
producing and selling more nutritious foods.

Increasing awareness about the importance of good nutrition and how to make healthy food
choices is important. It does not really change the situation if nutrition education is provided
in communities but often not possible to put that knowledge into practice because there are
no means of achieving the desired outcomes. In high income countries or communities,
nutrition education is quite effective because people have greater access to safe and
nutritious food and to health care facilities. In these settings, people may be more likely to
have the resources to make healthy choices such as buying more nutritious food, accessing
quality health care services, and exercising regularly. However, even in high-income
countries, there are often disparities in access to healthy food and healthcare. For example,
people living in low-income neighbourhoods may not have access to grocery stores that sell
healthy food or may not even be able to afford them.
Access to healthcare facilities is a big issue because poor quality water and sanitation can
lead to infectious diseases that weakens the immune system making them prone to other
deadly diseases. Because the healthcare facilities are far from the residential areas in low-
income areas, even when people are sick, they do not go because of the long distance they
are about to travel, so they instead go when their immune system has weakened, and their
micronutrient stores have diminished. What the government can do is introduce the use of
mobile clinics that will come to the communities at least 2 times a month and in that way,
they are provided basic healthcare such as vaccinations, check-ups, and treatment for
common illnesses. In addition to mobile clinics, community health works can also play a vital
role in bringing healthcare services to those who need them. They provide basic care,
educate people on health issues, and refer patients to more specialised healthcare services
when needed. These interventions can help ensure that everyone has access to quality
healthcare, regardless of their location and social status.
Conclusion

One of the most important aspects of the Sustainable Development Goals is their focus on
sustainability. The goals should be achieved in a way that is environmentally, economically,
and socially sustainable. The economic development should be done in a way that will not
damage the environment, and that it benefits all people not just a small group of elites. It
also means that the development should be done in a way that will not create a debt for the
future generation.

In line with the 2030 Agenda for SDGs, policies and interventions should be designed to
ensure that all people regardless of their income level or location have the equal opportunity
to lead healthy lives. This requires addressing the underlying social, economic, and
environmental factors that contribute to health inequalities. The ultimate goal is to create a
world which all people have access to the resources and opportunities they need to live
healthy, fulfilling lives.

To conclude, addressing the nutrition related NCDs burden in vulnerable communities

requires a comprehensive, multi-sectoral approach. Policies and interventions should aim to
create healthy environments, increase access to healthcare facilities and services, and
promote nutrition education. However, the effectiveness of these resources available in the
community and tailoring the interventions to the specific context of each community to
ensure the effectiveness.

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