With 2015 looming ever closer, the process to find a set of mutually agreed global goals for development is well underway. British Prime Minister David Cameron is one of three heads of government charged to lead a high level process to agree the goals at the UN General Assembly level. Civil society around the world will feed thoughts, aspirations and priorities into a more detailed process of consultations that will feed into the high level meeting. The big question of what happens after the Millennium Development Goals should get an answer in the next 12 months.
I have previously expressed caution about the rush to find new goals, but CMF has engaged with the process, and submitted to the consultation on health goals just before the New Year. Many detailed submissions have gone in on goals relating to HIV, non-communicable diseases, maternal and child health, health systems strengthening, universal healthcare, and so forth. Rather than add to those, we wanted to give voice to the role of faith and faith based organisations in health.
We have written on both subjects before on this blog, as CMF has many members throughout the world who can speak with some authority on the subject first hand.
Firstly, faith and spirituality play a vital role in the health and well-being of communities and individuals worldwide. A recent demographic study covering more than 230 countries and territories estimated there are 5.8 billion religiously affiliated adults and children around the globe, representing 84% of the 2010 world population of 6.9 billion. While the vast majority of people in the world exercise faith in a supreme divine being, and have links with a religious community of some form (temple, mosque, church etc), every person has a ‘world-view’ and invests faith in something.
The Global Burden of Disease Study 2010, just published, is the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors. The results show that non-communicable diseases, such as cancer and heart disease, are becoming the dominant causes of death and disability worldwide. Many of these diseases have a strong lifestyle component, and lifestyle choices are in turn profoundly influenced by faith beliefs and faith communities. Anxiety, depression, substance abuse (including alcohol and tobacco), dietary habits, exercise patterns, social and personal capital, are all affected by our beliefs, values and religious practices, as individuals and societies.
Not only does faith bring positive health benefits to the individual but also to communities. Local faith communities such as churches, mosques and temples are often a focus for community action and bring the social capital that builds civil society and forms the bedrock for development and community health. DFID has stated in its paper ‘Faith Partnership Principles’:
‘Most people in developing countries engage in some form of spiritual practice and believe that their faith plays an important role in their lives. Faith groups can inspire confidence and trust. They are often seen as a true part of the local community and more committed to it than perhaps other groups. Indeed, they are often the first group to which the poor turn in times of need and crisis and to which they give in times of plenty.’
Meanwhile, faith based organisations make an enormous contribution to healthcare. This includes international organisations such as Tearfund, World Vision, Christian Aid, Islamic Relief, Jewish World Services, local institutions such as mission hospitals, and national associations such as the Christian health associations present in 17 African nations. Such organisations sometimes work alone but usually in association with local and national government health services, and international bodies such as the Global Fund. In some parts of Africa in particular, independent research shows they provide a significant proportion, or even the majority of the health services. And in other parts of the world, while they may be a smaller part of the overall health provision, they do bring other qualities, including serving more remote communities and being involved longer term. Studies show that they are often used preferentially by populations who value their faith based values and ethos.
In short, faith has an impact on health – there is no getting away from it! So unless this is recognised in the new development goals, we will fail to fully address the health and development needs of the poor.
We therefore advocated the following for any post-2015 health goals:
1) Recognition of the important role of personal faith, and therefore local faith communities, relevant to all post-2015 development targets, and especially in the area of health. This is applicable to all countries, rich and poor alike.
2) Adoption of a holistic approach to health and development, recognising that physical, emotional, social, environmental, and spiritual factors all play a part in individual and community health and well-being.
3) Recognition of the important role local faith communities in actively supporting good health through healthy spiritual practices, health education and promotion and health provision. There should be intentional engagement and consultation with local faith communities, ensuring their voices are heard and their contribution is maximised.
4) Recognition of the essential long term role of FBOs in healthcare education and provision, especially in the poorest and most marginalised sectors of society. International donors and national governments should be encouraged to support FBOs and promote their inclusion in developing national, regional and local health policies.
5) Require all FBOs to commit to impartial delivery of healthcare, based on medical need, and without discrimination based upon race, gender, sexual orientation, ethnicity, national origin, or religion.
6) Recognition that healthcare workers must be free to support individuals in their faith and also to share their own personal faith in appropriate ways without fear of persecution or disciplinary action.
7) Recognition that faith is an individual choice, freely made. National governments, and the international community, should strive to promote and protect individuals’ rights to practise their chosen faith and gather with others in faith communities, as well as the right of an individual to change faiths.
8) Commitment to an evidence-based approach in the provision of healthcare by FBOs and other organisations.
We wait to see if this argument carries any traction with the global community. It certainly seems to have already been recognised by those coordinating the post-2015 civil society consultation but we know that Christian church groups, hospitals and organisations will continue to provide healthcare to the sick as the Christian church has done since the first century. Regardless of the recognition of the world, we will continue to serve our Lord through serving the poor. But it never hurts to point out what we are doing and why to the wider world from time to time.