Realising the potential of the post-2015 development agenda for Indigenous health

To the Editor: The United Nations Millennium Development Goals (MDGs) of 2000 included three health-related goals: reduce child mortality (goal 4), improve maternal health (goal 5) and combat HIV/AIDS, malaria and other diseases (goal 6). Like many other high-income nations, Australia did not consider its national health priorities subject to the MDG framework. In 2005, the then Aboriginal and Torres Strait Islander Social Justice Commissioner Tom Calma observed that the Australian Government had committed to eradicate poverty through the MDGs “in third world countries by 2015, but has no similar plans to do so in relation to the extreme marginalisation experienced by Aboriginal and Torres Strait Islander Australians”.1 In response to the Close the Gap campaign launched in 2007, the government has addressed the health inequalities experienced by Indigenous Australians (with mixed progress reported), and introduced the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.2

Global debate around the new post-2015 development goals, which will replace the MDGs when they expire in December 2015, is presently underway, with the intergovernmental Open Working Group on Sustainable Development Goals providing its initial report on the potential goal framework in July 2014 (http://sustainabledevelopment.un.org/focussdgs.html). Although the new goals are not yet finalised, under proposed goal 3 (to ensure healthy lives and promote wellbeing for all at all ages), 13 subgoals are currently being negotiated. The expectation is that the new goals will be universal and applicable to all countries — including high-income nations like Australia — with differentiated targets to redress inequities both between and within countries. Although it is unlikely that there will be any international legal obligation to comply, Australia, as a “good global citizen”, may face significant normative pressures to implement domestic policy changes to reflect post-2015 targets. This raises the question of the likely implications for Australian domestic health policy — and for Indigenous health in particular — in light of the new health and development goals. Through post-2015 commitment to overcome domestic and global health and related inequities, the Australian Government will be more accountable on the world stage not only for its Indigenous peoples but also for all people.