The position of health in sustainable development negotiations: a survey of negotiators and review of post-Rio+20 processes

BackgroundSustainable development is central to the post-2015 development agenda after the establishment of the UN Open Working Group on Sustainable Development Goals at the Rio+20 conference. Negotiations about sustainable development, including the Working Group, are typically undertaken by foreign or environmental ministries and traditionally involve little input from health ministries. We reviewed the negotiations to assess the role of health.MethodsWe assessed changes to the Rio+20 negotiation text. We surveyed negotiators at the 4th session of the Working Group and reviewed their discussions. We reviewed and analysed the position of health in Multilateral Environmental Agreements (MEAs) and the methods of the new High Level Political Forum for sustainable development.FindingsThe initial draft of the Rio+20 outcome document mentioned health twice; however, the final document included a section on health and population dynamics and committed countries to achievement of universal health coverage and use of health indicators for sustainable development. Most governments discussed the links between health and sustained development. The delegates surveyed agreed that health should be integrated into other areas of sustainable development—eg, energy, education, and employment. The objective of the most recent MEA—the Minimata Convention on Mercury—was to protect human health; which was also the aim of many other MEAs. The High Level Political Forum does not explicitly refer to health in its methods but includes a review of environmental, economic, and social aspects of sustainable development commitments similar to the Universal Periodic Review of the UN Human Rights Council.InterpretationHealth is central to sustainable development and governments recognise its cross-cutting nature. The inclusion of health to date is the result of active engagement by the health community, which must be sustained to keep health at the centre of the post-2015 development agenda. Improved health data, collected more often, could improve accountability in the periodic review process of the High Level Political Forum and for the non-health sustainable development goals.FundingInternational Federation of Medical Students Associations.