Situating Health Within the 2030 Agenda-A Practical Application of the Sustainable Development Goals Synergies Approach.

Background: The Sustainable Development Goals (SDGs) are integrated, indivisible and interdependent and interact and affect each other directly and indirectly. However, the 2030 Agenda does not attempt to identify or characterise these interactions. Evidence: The SDG Synergies approach was developed to enable the investigation of the strength and nature of interactions between SDGs based on the perception of a multistakeholder group. Two examples are given to concretely demonstrate how this approach overcomes present challenges and can be applied to situate health within the 2030 Agenda. Policy Options and Recommendations: There are clear benefits to situate desired health policy outcomes within the 2030 Agenda, and the SDG Synergies approach can be used as lever for including health aspects in traditional non-health sectors. Although focusing on specific health policies cannot be substituted with multisectoral policies alone, utilizing tools and methods such as the SDG Synergies approach can help policy makers put health at the centre of the SDGs. Conclusion: SDG Synergies is an impactful approach for policy makers to gain a systemic understanding of how broader sustainable development shape the health and well-being of people and vice versa.

A stakeholder group assessment of interactions between child health and the sustainable development goals in Cambodia.

Background: With the implementation of the Sustainable Development Goals, a systematic assessment of how the goals influence child health and vice versa has been lacking. We aimed to contribute to such an assessment by investigating the interactions between child health and the Sustainable Development Goals in Cambodia. Methods: Based on the SDG Synergies approach, 272 interactions between 16 Cambodian Sustainable Development Goals and child health were evaluated by an interdisciplinary Cambodian stakeholder group. From this a cross-impact matrix was derived and network analysis applied to determine first and second-order effects of the interactions with a focus on child health. Results: We show that with the exception of Cambodian Sustainable Development Goal 15 (life on land) the interactions are perceived to be synergistic between the child health and the Cambodian Sustainable Development Goals, and progress on Cambodian Sustainable Development Goal 16 (peace, justice and strong institutions) could have the largest potential to contribute to the achievement of the Cambodian Sustainable Development Goals, both when it comes to first and second-order interactions. Conclusions: In this stakeholder assessment, our findings provide novel insights on how complex relationships play out at the country level and highlight important synergies and trade-offs, vital for accelerating the work toward the betterment of child health and achieving the Sustainable Development Goals.

Tipping toward sustainability: emerging pathways of transformation.

This article explores the links between agency, institutions, and innovation in navigating shifts and large-scale transformations toward global sustainability. Our central question is whether social and technical innovations can reverse the trends that are challenging critical thresholds and creating tipping points in the earth system, and if not, what conditions are necessary to escape the current lock-in. Large-scale transformations in information technology, nano- and biotechnology, and new energy systems have the potential to significantly improve our lives; but if, in framing them, our globalized society fails to consider the capacity of the biosphere, there is a risk that unsustainable development pathways may be reinforced. Current institutional arrangements, including the lack of incentives for the private sector to innovate for sustainability, and the lags inherent in the path dependent nature of innovation, contribute to lock-in, as does our incapacity to easily grasp the interactions implicit in complex problems, referred to here as the ingenuity gap. Nonetheless, promising social and technical innovations with potential to change unsustainable trajectories need to be nurtured and connected to broad institutional resources and responses. In parallel, institutional entrepreneurs can work to reduce the resilience of dominant institutional systems and position viable shadow alternatives and niche regimes.

Reconnecting to the biosphere.

Humanity has emerged as a major force in the operation of the biosphere, with a significant imprint on the Earth System, challenging social-ecological resilience. This new situation calls for a fundamental shift in perspectives, world views, and institutions. Human development and progress must be reconnected to the capacity of the biosphere and essential ecosystem services to be sustained. Governance challenges include a highly interconnected and faster world, cascading social-ecological interactions and planetary boundaries that create vulnerabilities but also opportunities for social-ecological change and transformation. Tipping points and thresholds highlight the importance of understanding and managing resilience. New modes of flexible governance are emerging. A central challenge is to reconnect these efforts to the changing preconditions for societal development as active stewards of the Earth System. We suggest that the Millennium Development Goals need to be reframed in such a planetary stewardship context combined with a call for a new social contract on global sustainability. The ongoing mind shift in human relations with Earth and its boundaries provides exciting opportunities for societal development in collaboration with the biosphere--a global sustainability agenda for humanity.

Towards systemic and contextual priority setting for implementing the 2030 Agenda.

How the sustainable development goals (SDGs) interact with each other has emerged as a key question in the implementation of the 2030 Agenda, as it has potentially strong implications for prioritization of actions and their effectiveness. So far, analysis of interactions has been very basic, typically starting from one SDG, counting the number of interactions, and discussing synergies and trade-offs from the perspective of that issue area. This paper pushes the frontier of how interactions amongst SDG targets can be understood and taken into account in policy and planning. It presents an approach to assessing systemic and contextual interactions of SDG targets, using a typology for scoring interactions in a cross-impact matrix and using network analysis techniques to explore the data. By considering how a target interacts with another target and how that target in turn interacts with other targets, results provide a more robust basis for priority setting of SDG efforts. The analysis identifies which targets have the most and least positive influence on the network and thus guides, where efforts may be directed (and not); where strong positive and negative links sit, raising warning flags to areas requiring extra attention; and how targets that reinforce each others' progress cluster, suggesting where important cross-sectoral collaboration between actors is merited. How interactions play out is context specific and the approach is tested on the case of Sweden to illustrate how priority setting, with the objective to enhance progress across all 17 SDGs, might change if systemic impacts are taken into consideration.

[Thyroid storm and diabetic ketoacidosis (DKA) in a previously healthy male - a significant differential diagnostic challenge]. / Tyreotoxisk kris maskerades av ketoacidos.

Thyroid storm is a potentially lethal condition sometimes seen in cases of untreated thyrotoxicosis. Hypermetabolism, fever, and tachycardia are typical symptoms of the increased thyroid hormone activity. Thyroid storm is often triggered by infection, trauma or recent surgery and rarely by other causes. We present a case of thyroid storm and diabetic ketoacidosis (DKA) in a previously healthy male. After extensive lab testing, the patient was found to have both an undiagnosed type 1 diabetes and Graves disease. This combination of underlying conditions and the combined presentation of thyroid storm and DKA pose a significant differential diagnostic challenge, and this case report reminds us to think broadly when presented with an atypical case.

Mapping interactions between the sustainable development goals: lessons learned and ways forward.

Pursuing integrated research and decision-making to advance action on the sustainable development goals (SDGs) fundamentally depends on understanding interactions between the SDGs, both negative ones ("trade-offs") and positive ones ("co-benefits"). This quest, triggered by the 2030 Agenda, has however pointed to a gap in current research and policy analysis regarding how to think systematically about interactions across the SDGs. This paper synthesizes experiences and insights from the application of a new conceptual framework for mapping and assessing SDG interactions using a defined typology and characterization approach. Drawing on results from a major international research study applied to the SDGs on health, energy and the ocean, it analyses how interactions depend on key factors such as geographical context, resource endowments, time horizon and governance. The paper discusses the future potential, barriers and opportunities for applying the approach in scientific research, in policy making and in bridging the two through a global SDG Interactions Knowledge Platform as a key mechanism for assembling, systematizing and aggregating knowledge on interactions.