IAPAC and FTCI Statement on the UN Summit of the Future:

Envisioning a Sustainable World for 2040 and 2050

20 September 2024 ▪ Washington, DC

As the world moves closer to the 2030 deadline for achieving the Sustainable Development Goals (SDGs), it is crucial to adopt a dual focus: one that emphasizes immediate acceleration to meet the SDG targets while also preparing for the future – the decades beyond 2030, including 2040 and 2050. This vision for the future must be underpinned by multilateralism, the engagement of subnational and urban actors, and the transformation of governance and finance systems to be nimble, responsive, and person-centered. At the core of this future must be a commitment to the well-being of people, especially youth, and a Pact for the Future that sets the foundation for the next phase of global development aligned with human and planetary health. The statement reflects the input provided by the International Association of Providers of AIDS Care (IAPAC) and Fast-Track Cities Institute (FTCI) in the months leading up to the UN Summit of the Future to advocate a person-centered, health-focused development agenda that helps accelerate progress toward the SDGs and establishes a foundation for equitable, sustainable development beyond 2030.

ACHIEVING THE SDGs BY 2030: A RENEWED COMMITMENT TO HEALTH, WELL-BEING, AND MULTILATERALISM

The SDGs represent an integrated approach to global development, one where health and well-being are not only critical goals but are also foundational to achieving the broader SDG agenda. While SDG 3 specifically focuses on health, health outcomes are inextricably linked to many other goals, from poverty reduction (SDG 1) to gender equality (SDG 5), and from sustainable urban development (SDG 11) to climate action (SDG 13). Health and well-being, therefore, are cross-cutting themes that are vital to achieving sustainable development. For instance, access to quality education (SDG 4) equips individuals with the knowledge needed to live healthier lives. Access to clean water and adequate sanitation (SDG 6) is essential for preventing the spread of diseases, but so, too, is economic opportunity (SDG 8) and reduced inequality (SDG 10); all factors that directly impact the health and well-being of all people, but notably those who are socially disenfranchised, denying them the security needed for a healthy life.

As the global community works to meet the 2030 SDGs and looks to the future, it is essential that health be understood not just as a sectoral priority but as a fundamental aspect of human dignity and equity that intersects with all other areas of development. At the core of these efforts is the recognition of the right to health for all individuals, which demands universal access to affordable, quality health care and the elimination of barriers that prevent marginalized communities from realizing the right to health.

• One Health Approach to Global Well-Being: In recent years, the interconnectedness of human, animal, and environmental health has become increasingly apparent, especially in the context of global crises such as pandemics, antimicrobial resistance, and climate change. This recognition has given rise to the “One Health” concept, a collaborative, multisectoral, transdisciplinary approach emphasizing the interdependence of these three domains. By integrating expertise from a wide range of disciplines, One Health seeks to develop sustainable solutions that protect and promote the well-being of all life forms on Earth. One Health represents a holistic, forward-thinking approach to safeguarding global health. By recognizing the interdependence of human, animal, and environmental health, the Summit of the Future must map a path forward toward solutions that address the root causes of many modern health challenges. Moving forward, the adoption and expansion of One Health principles will be crucial to achieving a sustainable, healthy world for 2030, 2040, 2050, and beyond.
• Strengthened Multilateralism for Health and Well-Being: The global nature of health challenges such as pandemics, antimicrobial resistance, and non-communicable diseases (NCDs) necessitates a strong multilateral response. As nations converge at this Summit of the Future, there is a clear opportunity to reinvigorate international cooperation, not just to address health crises but to enhance health systems resilience globally. Investments in universal health coverage (UHC) and health equity must be prioritized, with specific attention to marginalized communities, refugees, and populations affected by climate-related displacement. Moreover, these investments must also address the persistent burden of communicable diseases such as HIV, tuberculosis (TB), viral hepatitis and malaria, which continue to disproportionately affect vulnerable populations globally.
• Urban Leadership in Promoting Health Equity: Cities and local governments are at the frontline of delivering health services and promoting health equity. Their unique capacity to understand and respond to the health needs of their populations makes them essential actors in the quest to achieve the SDGs. As urbanization continues to increase at a rapid pace, cities must be empowered to address the health impacts of pollution, climate change, and growing inequalities, while also serving as engines of innovation in healthcare delivery. Cities must also remain vigilant in addressing communicable diseases such as HIV and viral hepatitis, which require ongoing efforts to expand testing, treatment, and prevention services, particularly in densely populations urban centers. In many respects, cities and communities have already demonstrated leadership in the public health space and that leadership should be strengthened as the world strives to achieve the SDGs by 2030 and plans to meet the challenges it will face through 2040 and 2050.

LOOKING TO 2040 AND 2050: HEALTH AND WELL-BEING AS CORNERSTONES OF SUSTAINABLE DEVELOPMENT

Health and well-being will remain central to global sustainability efforts beyond 2030, and the Pact for the Future must enshrine health as a cornerstone of the post-2030 development agenda. The world of 2040 and 2050 will face challenges related to climate change, global migration, rapid urbanization, and emerging health threats, all of which require stronger, more agile health systems and policies.

• Global Architecture for Health Resilience: Health systems need to evolve to meet the challenges of future pandemics and the ongoing burden of NCDs, which are predicted to become the leading cause of mortality in most regions of the world. In addition, the response to communicable diseases such as HIV, TB, and other infectious diseases must remain a priority, integrated into global health security efforts. The Pact for the Future should include commitments to global health security, focusing on pandemic preparedness, stronger disease surveillance systems, and a global response network that can quickly mobilize resources and expertise. Upholding the right to health should be central to these commitments, ensuring that health security measures prioritize the most vulnerable and those disproportionately affected by global health threats.
• Innovative Financing for Health: To sustain progress, the global community must move toward innovative financing mechanisms for health and well-being. This includes expanding access to country funding sources and multi-lateral donors like the Global Fund to Fight AIDS, Tuberculosis, and Malaria, while also incentivizing domestic and international private sector investments in health, particularly in low- and middle-income countries. Blended finance, social impact bonds, and health taxes can be mechanisms to generate funding for health programs. Such financing should also support efforts to combat communicable diseases such as HIV and TB, particularly in low- and middle-income countries. Moreover, international financial institutions should reorient their investments to prioritize health infrastructure, particularly in underserved regions where resources are often limited.

THE PACT FOR THE FUTURE: SHAPING BOLDER, MORE EQUITABLE SUCCESSOR GOALS TO THE SDGs

As we approach the midpoint to the 2030 deadline for the SDGs, the world must start thinking about what comes next. The successor framework and goals to the SDGs should be built upon the foundations laid by the Pact for the Future. This forward-looking pact should not only address current global challenges but also anticipate future ones, providing a blueprint for the next wave of global development goals that will be implemented post-2030.

• Health as a Cross-Cutting Theme: The Pact for the Future must reaffirm the understanding that health intersects all other areas of development, maintaining health and well-being as interconnected components of a framework guided by the right to health. For example, future goals related to sustainable cities must include access to health services, while goals related to employment with a living wage should incorporate occupational health and safety standards. Similarly, access to services for the prevention and treatment of communicable diseases must be integrated into urban health strategies to ensure these diseases do not exacerbate existing inequities.
• Leveraging Multilateral Health Partnerships: The Pact for the Future offers a platform to strengthen partnerships that will carry forward into the successor to the SDGs. These partnerships must include traditional development actors as well as private sector, civil society, and academic stakeholders to innovate in health technology, digital health, and public health policies. The integration of digital health tools and artificial intelligence into health systems can transform healthcare delivery, making it more efficient and accessible, especially in remote areas.
• Youth as Leaders in Health Innovation: The world’s youth will be pivotal in shaping the health systems of the future. The Pact for the Future should enshrine mechanisms that support youth-led health innovation, from creating startups that provide telemedicine solutions to leading advocacy efforts around mental health and reproductive rights. Programs that engage young people in community health work and health literacy campaigns will be critical in ensuring that the next generation is both healthier and more empowered to make decisions about their own well-being.
• Involvement of Affected Communities: Effective policymaking for the future requires the active involvement of all sectors of society, particularly those most directly affected by the challenges the Pact for the Future aims to address. A whole-of-society approach, bringing together governments, civil society, private sector actors, and individuals, will ensure that solutions are inclusive and sustainable. Central to this approach is the value of lived experiences from people directly affected by health inequities, environmental challenges, and economic vulnerabilities. The insights gained from these communities are critical for shaping sustainability frameworks and policies that are responsive to realities on the ground as we envision a sustainable world for 2040 and 2050.

PACT FOR THE FUTURE: A BLUEPRINT FOR PERSON-CENTERED, HEALTH-DRIVEN DEVELOPMENT

The most ideal and fit-for-purpose Pact for the Future must be one that prioritizes people over institutions, ensuring that all policies and actions are directed toward enhancing the dignity, equity, and well-being of individuals and communities. By putting health and well-being at the center of the Pact for the Future, the international community can build a future that is not only sustainable but also just and equitable.

• Inclusive Governance for Health: Governance systems must be reimagined to include the voices of the most vulnerable populations, particularly those who have been traditionally excluded from decision-making processes. An inclusive governance model places a premium on co-designing health policies with affected communities, ensuring that their voices are heard and that solutions are shaped by lived experiences. The Pact for the Future must embrace this participatory approach to enhancing equity by considering the unique needs of historically underrepresented groups, including women, sexual minorities, Indigenous peoples, migrants, and people living with disabilities. Moreover, inclusive governance should be viewed as a feedback loop to continuously evaluate and refine policies based on the real-time experiences of communities.
• Global Health as a Public Good: The Pact for the Future should recognize global health as a public good that transcends national borders. Investments in global health should be seen as investments in global security, economic stability, and social equity. Equitable financing mechanisms must ensure that resources are allocated based on need, with particular attention to low- and middle-income countries, marginalized communities, and regions that are disproportionately affected by global health challenges so that no one is left behind in the pursuit of well-being. Moreover, equitable intellectual property management, including the open sharing of scientific research and innovation, is essential for ensuring that breakthroughs in health technologies, including vaccines, all forms of prophylaxis, and treatments, are accessible to all people.

FROM 2030 TO 2050: BUILDING A HEALTHIER, MORE SUSTAINABLE WORLD FOR ALL PEOPLE

The 2030 deadline to achieve the 17 SGDs adopted by UN member-states in 2015 is fast approaching, but the work does not end there. The world must use the Summit of the Future to lay the groundwork for decades to come, with health and well-being as cornerstones of future global development goals. The path from 2030 to 2050 will require more than incremental changes; it will demand transformative shifts in how we approach health and sustainability. Climate change, urbanization, technological advances, and socioeconomic inequalities will all play defining roles in shaping the global health landscape.

The Pact for the Future, and the successor to the SDGs, must be people-centered, equity-driven, and health-focused, with an emphasis on multilateralism, innovative and inclusive governance, and financial systems that prioritize the well-being of all people. To build a healthier world, it must also promote intersectoral collaboration with health embedded into policies on education, housing, employment, and the environment. Technological advancements, such as digital health solutions and artificial intelligence, will offer new opportunities to enhance health systems, but they must be equitably deployed to avoid exacerbating existing disparities. At the same time, long-term investments in sustainable development, green technologies, and resilient infrastructures will be key to protecting future generations from the growing impacts of environmental degradation and public health crises.

The Pact for the Future must serve as both a roadmap and a call to action, ensuring that global commitments are translated into tangible, equitable health and social outcomes. By prioritizing equity and resilience in health and development, the international community can create a sustainable future where health and well-being are a reality for all people, offering an opportunity for everyone on the planet to live a life of dignity, peace, and prosperity.

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