Leaving no one behind by 2030

As part of a wider discourse to ‘leave no one behind’ in the 2030 agenda for Sustainable Development Goals (SDGs), Dr Fortunate Machingura talks about how she is developing tools to assist policymakers, development practitioners and donors to understand inequality among marginalised social groups in Zimbabwe living with HIV/AIDS.

The aphorism that no population or person should be ‘left behind’ continues to consume the development world. Announced in 2015, the 17 Sustainable Development Goals (SDGs) have galvanised thinking about how to achieve this aim, and are based on optimism as to the world’s capacity to cooperate and govern for sustainability, with an ultimate aim of ending poverty, deprivation and inequality for all.

History demonstrates that there is often a disconnect between the priorities of those involved in development policymaking and those at the receiving end of interventions. Closing these gaps has the potential to improve the legitimacy and effectiveness of development work. 

Two significant opportunities

This optimistic outlook informs my work as part of the Economic and Social Research Council’s (ESRC) Global Challenges Research Fund, which I believe presents two significant opportunities.

Firstly, the international network created through my research should help to leverage and build impact opportunities, and to debate the practical and contextually relevant mechanisms for bringing political and policy attention back to some of the cross-cutting issues that are critical to building responsive health systems, but which are not well understood – such as how to tackle health inequality and preventable mortality. 

For many households in low-resource contexts, health is the difference between whether you live above or below the poverty line; whether your children can attend primary and/or secondary education; or whether you have access to potable water and decent sanitation.

Yet there is a common failure on the part of governments to provide basic services, water and sanitation, which can erode trust and promote instability. Unless health inequality – and other broader social determinants of health – are tackled, those vulnerable to poverty, disease and deprivation will continue to constitute an ever-growing marginalised group.

Community symposium on the SDGs in Mwanza Communal Lands

Community symposium on the SDGs in Mwanza Communal Lands, attended by Dr Fortunate Machingura

Secondly, the project is already translating my PhD findings into useful policy tools – bridging that research-practice gap. These tools might have a lasting impact on the advancement of well-being and quality of life of low-income communities, particularly those living with HIV/AIDS.

“Leaving no one behind also means moving towards a culture of inclusion and human security, to strengthen solidarity.”

The work aims to identify the priorities of marginalised groups, especially low-income people living with HIV/AIDS, by digitising and weighting their priorities through community-level data traces.

Big data

These will be linked with big data through well-being weighting economic techniques and transformed into an HIV outcome measure (CHOM) to strengthen understanding on what matters for the most vulnerable – and how data uptake by them could improve patient choice.

This approach is particularly significant when local-level data traces are the condition required to access free health care, and a pathway to addressing inequality at the community level – where the need is greatest.

Understanding who vulnerable populations are, where they live, and what kinds of inequalities they experience, is critical. Effective participation for groups that are ‘left behind’ would mean that their voices are heard from the outset. Leaving no one behind also means moving towards a culture of inclusion and human security, to strengthen solidarity. This is what my research aims to do.