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What, Really, Does 'Sustainable' Mean?

Leif Parsons for NPR

Sustainable, sustainable, sustainable.

Sustainable. Sustainable.

SUSTAINABLE!

Oh, excuse me. I was just counting the number of times the word "sustainable" (and its close cousin, sustainability) appear in the 17 Sustainable Development Goals that the U.N. will endorse this coming weekend.

I got 75. And I probably missed a few.

The SDGs, as they're called, aim to improve life on earth, especially in poor countries — no more extreme poverty, the eradication of "a wide range of diseases," education and equal rights for all, taking care of the planet.

And, clearly, the designers of the goals want them to be, well, sustainable.

But the more I thought about that word, the more I wondered: What exactly does the word "sustainable" mean when it comes to development goals?

"You really hit upon the million dollar question," says Casey Dunning, a senior policy analyst at the Center for Global Development. "Ask any given analyst and you would get a different definition on any given day."

So, I asked a few analysts. Their collective response follows.

It means that there are no endless handouts.

"I would say a sustainable goal is one that has, explicit in its outcome, the notion that aid is not necessary in perpetuity," says Dunning. Consider PEPFAR, the United States President's Emergency Plan for AIDS Relief. "There's a transition period, Dunning says, in which local governments begin to kick in financing and set up ways to deliver medicines. The idea, she says, is that the country that benefits from the initial round of aid will eventually do "all the unsexy stuff it takes to carry off these activities." And then it's a sustainable effort.

It signals that we really care about the earth.

Before the SDGs there were the MDGs — the Millennium Development Goals.

Manish Bapna, executive vice president of the World Resources Institute, points out: "When the MDGs were constructed in the late '90s, they focused quite a bit around social development issues but didn't give as much attention to some of the planetary-related environmental issues."

So the word "sustainable" is a signal that "tackling poverty and protecting the planet are inextricably linked," he says. And, thus, we have goals like: "Ensure ... sustainable management of water" and "Conserve and sustainably use the oceans..." and "Protect ... sustainable use of terrestrial ecosystems..."

It indicates that a quick fix is not as good as a long-term solution.

"One thing the Ebola crisis exposed is that you'll get caught flat-footed if you don't have a strong health care system in place," says Dr. Gavin Yamey, a professor at the Duke Global Health Institute.

"You need a strong health work force, quality clinics, medicines in place, systems to finance quality improvement," he says.

And you need built-in resilience: a system designed "to bend but not break, bounce back from those big shocks in an increasingly unstable world," says Sara Bennett, associate director of the Health Systems Program at the Johns Hopkins Bloomberg School of Public Health.

It's vague (which is good and bad).

The drafters of the goals wanted to be "comprehensive and far-reaching and all-encompassing," says Yamey. That's a way to rally the troops, perhaps. But he would like to see more specificity. For example, one goal calls for "Good health and well-being."

"How do you even define well-being, let alone measure it?" he asks.

It's a reminder that you've got to spend money to change the world.

To create solid health care systems, says Yamey, "a government must set aside a portion of the GDP to finance health." But maybe not as much as you'd think. In a report on "A Grand Convergence in Global Health," the forecast was that one to three percent of GDP is enough for "a universal reduction in infection" and a drop in maternal and child death rates to "universally low levels."

It should make governments think about the consequences of their actions.

Douglas Beal, managing director of the Boston Consulting group, gave a Ted talk about sustainability, so I asked for his two cents.

Before sustainable became an eco-buzzword, he says, it was a business term. And it simply meant "longevity — something that can continue."

And, so, the word sustainable puts governments on notice: "You see people being harmed because [their leaders] ignored good governance, they ignored the environment, they ignored civil society," he argues.

It adds an optimistic spirit to the goals, but...

The word "sustainable" is "trendy and has a positive connotation," Beal says. "It's a nice word! You feel better about buying a product or doing an activity if the word 'sustainable' is in front of it."

But 70-some "sustaintables" in one set of goals? Is that a bit much?

"Imagine if Moses called them the sustainable commandments," Beal says. "They were the ten commandments, not the ten sustainable commandments." And they were pithy.

"If only the SDGs could be so concise," he says with a sigh.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Marc Silver
Marc Silver, who edits NPR's global health blog, has been a reporter and editor for the Baltimore Jewish Times, U.S. News & World Report and National Geographic. He is the author of Breast Cancer Husband: How to Help Your Wife (and Yourself) During Diagnosis, Treatment and Beyond and co-author, with his daughter, Maya Silver, of My Parent Has Cancer and It Really Sucks: Real-Life Advice From Real-Life Teens. The NPR story he co-wrote with Rebecca Davis and Viola Kosome -- 'No Sex For Fish' — won a Sigma Delta Chi award for online reporting from the Society of Professional Journalists.