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SINGAPORE: Moving from a limited focus on the environment to recognising the importance of health, well-being and prosperity of people and the planet, the concept of sustainable development has transformed over the years. Gaining some insight into this development may widen the understanding of what sustainability can mean for health professionals today.
In 1972, the first environment summit was held in Stockholm in Sweden, and the phrase “environmentally sound development” was born. By the following year, the phrase was changed to “eco-development”.1 Fifty years of processes, change and research cannot easily be summarised, and it is good to remember that progress is challenging. It is a continuous change of mindset, and what is “true” today might not be “true” tomorrow. A 1960s example from Scandinavia is public information on how to keep the seashore clean. People were encouraged to place their trash in a box, weigh it down with rocks and then sink it in the ocean. Fortunately, a great deal has happened since then.2
What does sustainability mean?
Most of us are familiar with the word “sustainable”. It is commonly associated with terms like “climate change”, “environment” and “recycling”. Although we strive towards a common goal, these expressions are sometimes used to convince, shame or pressure people and organisations. “Not sustainable”, “not biodegradable” and “bad for the environment” not only mislead and generalise the subject, but also miss the essence of sustainability. Companies describe themselves and their products as sustainable using phrases like “bio-based”, “plant-based” and “green”, but sustainability goes beyond this; it includes complex interactions and sometimes unexpected causes and effects.3
An early definition of “sustainability” is “development that meets the needs of the present without compromising the ability of future generations to meet their own needs”. This modern-time description of sustainability was published in the report Our Common Future by the Brundtland Commission in 1987. Although the environment seems to be in focus, it refers to economic growth while protecting the environment and people, also known as sustainable development; implying the physical and mental benefit of treating each other and the environment with respect.4
Sustainable development is sometimes described as “green economic growth”, economic growth with minimal impact on the environment and people. One example is production with decreased carbon dioxide emissions, fair working conditions and an efficient supply chain. Sustainable development is more popularly described according to its three pillars—environmental, economic and social—which have gradually developed from the Brundtland report (1987) and the world summits in Rio de Janeiro in Brazil (Agenda 21, 1992) and Johannesburg in South Africa (2002). However, there is no clear framework and no in-depth explanation of the three pillars, and the model has therefore been adapted by different professional fields.1
The three pillars are commonly described as follows:1
- Environmental (planet): Protect the planet. Consumption at a rate at which resources can renew themselves.
- Economic (profit): To have and generate access to resources to meet our needs.
- Social (people): Fair leadership, human rights, equality between sexes, access to education and healthcare, for example.
Health is to the highest degree involved in all three pillars. The individual needs access to care, but also to be able to generate sufficient means to afford it and to have the option of environmentally friendly care without being put at risk owing to compromise—it is all integrated.
“Think globally and act locally”—Agenda 21
To implement sustainable development globally, nationally and locally, Agenda 21, a dynamic programme with the slogan “Think globally and act locally”, was presented at the world summit in Rio in 1992. Though endorsement was voluntary for the member states, it still delivered a framework with vital steps towards health and well-being, not only for mankind but for all life on earth—people, plants and wildlife.5 Agenda 21 has since played a central part in the UN’s sustainability work, and the implementation and progress have been reviewed several times; at the world summits in 1997, 2002 and 2012, where the member countries were once again invited to endorse their commitment to sustainable development in the paper The Future We Want.6
The Millennium Development Goals
In 2000, eight Millennium Development Goals (MDGs) were set to reduce extreme poverty and its immediate effects, reduce the spread of HIV and provide education. Compared with Agenda 21, which consisted of 351 pages, the MDGs included only eight goals, 18 targets and 48 indicators to be met by 2015. Commitment from the member states was still voluntary, and the goals were mainly aimed at developing countries, support being provided by developed countries.7, 8
“Spare no effort to free our fellow men, women and children from the abject and dehumanising conditions of extreme poverty”7—The Millennium Development Goals Report
The MDGs are to date the most effective movement for pursuing health and well-being on a global level and have helped more than a billion people out of extreme poverty and resulted in record-high school attendance by girls.7, 8 While the programme was successful, it highlighted other areas necessary to achieving sustainability on a global level. The MDGs therefore resulted in the next step of sustainable development, Transforming Our World: The 2030 Agenda for Sustainable Development, referred to as Agenda 2030.9
Agenda 2030 and the Sustainable Development Goals
In 2015, the UN General Assembly approved Agenda 2030 for sustainable development. It is a commitment by the UN member states to work towards achieving a socially, environmentally and economically sustainable world by 2030. It consists of 17 Sustainable Development Goals (SDGs) and 169 sub-goals to fulfil by 2030. They are independent, but still connected to one another and are an extension of previous work that aims at providing a better world for future generations. More equally framed, the programme is aimed towards developed and developing countries alike.10, 11
When the SDGs were introduced in 2018, it became clear that even the most sustainable countries in the world were behind on fulfilling the 17 goals by 2030.12 Nevertheless, the goals help to pinpoint actions that need to be taken, and today, many organisations use them for mapping out a way forward, often focusing on goals where they can make a true difference.
For dental care and healthcare, the third SDG—ensure healthy lives and promote well-being for all at all ages—lies closest to our hearts, but most SDGs—if not all—have either a direct or an indirect impact on people’s physical and mental health. Therefore, improvement regarding any SDG is beneficial for health and well-being. After five decades of progress, the motto “Primum non nocere”—first do no harm—runs deep within sustainable development.
About the author and editorial note: Dr Sanjay Haryana is an education and odontology specialist at TePe Oral Hygiene Products. A list of references can be obtained from the publisher.
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