The coronavirus disaster has badly hit the Sustainable Development Agenda 2030. One of the major impacts of the pandemic on the SDGs’ structure is through its differential effect on communities. Marginal groups are more vulnerable now than ever. This includes women, migrants, informal workers, refugees and indigenous tribes.

This is in direct conflict with the SDGs’ social-inclusivity sermon of “leaving no one behind” in its inception document: the Sustainable Development Goals Report of 2016. Once the Covid-19 emergency is under control, and the world economy is back on track, the status and fate of the 2030 Agenda, also known as Sustainable Development Goals (SDGs), will need reassessment.

The 2020s had been declared the decade of action. With just 10 years left to progress, strategic plans were made to undertake “ambitious global efforts” to deliver the 2030 promise by mobilising more governments, civil society organizations and businesses, and calling on all people to make the global goals their own.

Before the worldwide lockdowns began in March 2020, various stakeholders of the SDG movement were planning to undertake a full-scale five-year evaluation. Fifty-one countries had signed up for voluntary national reviews (VNR) by May 2020.

The process came to a halt with the pandemic crisis. The pandemic is among other things a reminder for collective investments in resilient systems that go beyond health care. The SDGs provide both the aspiration and a unifying framework for these investments.

When the first cycle of SDGs progress evaluation drew to a close last year, evaluation panels noted bright spots, such as advances in child health and education. However, technical experts agreed that gaps in measurement, investment, and shared commitment hindered progress.

There is a consensus that the pandemic will further slow the progress on SDGs, combining the economic shock of a depression with rising mortalities in countries at various stages of development.

Many of the primacies of SDG3 (good health and well-being) are relevant to the surge response and recovery from Covid-19. This is why the United Nations has called the pandemic “an opportunity for the human family to act in solidarity” to achieve the SDGs. The SDGs actually provide the agenda for a sustainable global response to Covid-19, sustainable in that the response to this emergency should not lead to a neglect of the critical elements for equitable, affordable health care for all.

The premise of health insurance is protection against uncertainty. Nearly half of the world’s population has sufficient finances to access essential health services. The health-poverty trap ensures that any health care event can wreak catastrophic devastation on uninsured people, with the cost of care pushing around 100 million people into extreme poverty, each year.

The SDG3 recognises that we will never be able to protect against pandemics, if populations cannot access or afford basic resources to weather the natural storms in human life. Universal health coverage (UHC) is a common destination with many paths. Pakistan’s Sehat Sahulat Programme is a milestone towards social welfare reform; ensuring that the identified under-privileged citizens across the country get access to entitled medical health care in a swift and dignified manner without any financial obligations.

Although each country is unique, decades of evidence highlight the importance of revenue raising, pooling mechanisms, data governance, and institutional accountability. Efforts to fill the knowledge gap in resource-constrained settings will be crucial to provision of universal health care. Policymakers should renew their focus on UHC as a starting point to improve the health and well-being of populations around the world. After all, the best way to prevent infections is to first inoculate against poverty. That starts with ‘standardised’ primary health care, so that households are not pushed into insolvency by preventable illnesses.

Drugs require sustained investments for years before they bear fruit in the form of disease prevention and treatment. Yet funding for health innovations like vaccines is inversely related to their public health value. The emergence of public financing mechanisms (e.g., the Global Fund for AIDS, TB and Malaria) and international non-profits (e.g., Coalition for Epidemic Preparedness Innovation) have filled holes in the research and development pipeline for global health products. Despite these efforts, the funding gap has persisted.

It is unrealistic to expect countries with large gaps in health coverage, shortages in health professionals, and barriers ranging from poor transport to counterfeit medicines to implement extreme measures.

We have already learned from the aftermath of Ebola, that it is likely that funding infusions for global health research and development will follow Covid-19 pandemic. History shows that such investments are as transient as our memories of the impact of outbreaks.

We must find ways to ensure that the response to Covid-19 is one of sustainable financing. Policymakers have many tools for financing a “global commons for health,” from international taxation mechanisms to pooled funding and strategic purchasing. The key will be securing long-term commitments insulated from politically motivated funding cuts.

But it’s about more than just funding; a sustainable response requires ‘out-of-the-box’ thinking about both financial capital and intellectual capital. For example, patent protections have long been a barrier to access to innovation in low-resource settings.

The fact that many of the proposed therapies for Covid-19 are repurposed medications has reignited conversations about the importance of flexibilities granted under the Agreement on Trade Related Aspects of Intellectual Property Rights. When the world reconvenes for a pandemic postmortem, countries need to go beyond calendar-year commitments and begin to make grants for generations.

Warmer climates can be the breeding grounds for vectors of communicable diseases that, as Covid-19 has shown, can quickly spread across the world. Recognising the interdependencies between the two will be crucial to improving the health of communities and achieving the SDGs mission. First, we need to develop a better understanding of how climate change amplifies the effects of known exposures affecting population health.

Consider how intimately related the public health goals of SDG3, reductions in air, water, and soil pollution, are to the climate crisis. Climate change can, for example, increase the prevalence of waterborne diseases, which kill half a million children a year. Likewise, runaway carbon emissions increase the incidence of respiratory illnesses.

Second, the infrastructure required for health systems strengthening and climate adaptation are two sides of the same coin. For example, basic public health interventions like hand washing are impossible in environments with high levels of water contamination.

Additionally, protecting people against the effects of climate change e.g., natural disasters requires investing in safety nets for vulnerable populations. While each crisis has its unique challenges, policymakers can use the natural synergies between health care needs and climate change’s effects to make investments at the population level.

It is unrealistic to expect countries with large gaps in health coverage, shortages in health professionals, and barriers ranging from poor transport to counterfeit medicines to implement measures like mass testing and building field hospitals to meet the demands created by health emergencies. How then, should policymakers set public health priorities?

A promising way is to build “compounding capacity”: foundational investments that communities can build on over time to create resilient systems. For example, SDG3 calls for improving workforce training and recruitment. The field force of community health workers have an evidence-based value-addition for health care delivery and provide an additional channel for epidemic response in both low-income and high-income countries.

Likewise, developing digital capacity can improve access to care in rural regions e.g., via telemedicine while also creating an analytical foundation for disease surveillance. Underpinning all of these service delivery innovations are health financing reforms to enable frontline providers, whether treating lung failure from Covid-19 or managing a person with diabetes, cancer or kidney failure, to provide timely and convenient care.

Gaps in the global response to Covid-19 should renew a sense of urgency to achieve the SDGs among policymakers worldwide. Addressing global challenges goes beyond any one country’s ability to, say, contain, trace and treat a virus. Although the Covid-19 disaster will delay the timeline for achieving the global goals, the SDGs have to stand the test of time to see how global partnerships in the future can make Agenda 2030 successful.

While readjusting to the changing world orders after the pandemic, it is important for nations to strive toward the SDGs, capitalising on the fact that this huge challenge in the present is an immense learning opportunity for the entire human race in the future.

The writer is a senior public health leader from Pakistan with international experience of design and management of health systems strengthening initiatives