Clean drinking water runs freely from a communal water faucet in Ndombil, Senegal. One of the aims of the U.N. Millennium Development Goals (MDGs) is that, by 2015, approximately 1.2 billion people will have access to safe drinking water. UN Photo/Evan Schneider.

The theme of the conference is “Advance Global Health: Achieve the MDGs,” and when conference attendees return home on 1 September, Norton wants them to do so with tangible plans for doing just that—improving world health by taking a comprehensive approach to the MDGs. If her wish is fulfilled, U.N. Secretary-General Ban Ki-moon will be a happy man because he, too, is calling for “less talk, more action” in achieving them.

Mary Norton

What are the MDGs?
Anyone familiar with the United Nation’s World Health Organization or otherwise involved in improving world health is also familiar with the Millennium Development Goals, or MDGs. Established in 2000, these eight ambitious objectives include measurable, deadline-based targets (bottom of page). For most of the targets, the deadline is 2015, and that’s not far away. Ban Ki-moon is calling on world leaders to “keep the promise” of the MDGs and accelerate progress toward achieving them by attending a summit in New York from 20-22 September, this year.

“Our world possesses the knowledge and the resources to achieve the MDGs” the secretary-general stated in his pre-summit report, “Keeping the Promise.” In that report, published in February, he states, “Our challenge today is to agree on an action agenda to achieve the Millennium Development Goals. ... We must not fail the billions who look to the international community to fulfill the promise of the Millennium Declaration for a better world. Let us meet in September to keep the promise.” With the 63rd Annual Conference in Australia coming as it does just 2 1/2 weeks before the summit of world leaders in New York, what is accomplished in the first meeting will no doubt inform the latter.

Not all of the goals focus directly on health. In fact, of the eight MDGs, only Goals 4, 5 and 6 appear to be health related, until you consider that virtually every one of the goals directly affects the health of the world’s people, a point Norton is quick to emphasize: “The themes of the last four DPI/NGO conferences—human rights, climate change, human security and dignity, and disarmament—also relate to the Millennium Development Goals and to global health,” she says. “If you look at the Millennium Development Goals, most people interested in improving world health would focus on maternal child health and things that look specifically like health issues, but when you look at the social determinants of education and gender issues and partnerships, everything relates to health. That’s really one of my goals, to raise people’s consciousness to the fact that social determinants link all the goals to each other and to global health, and to not look at these goals in isolation.”

More than disease management
To illustrate her point, Norton directs attention to the visual-identity graphic developed for the conference. In the center of the circular graphic is the theme, “Advance Global Health: Achieve the MDGs” and, on the circumference, the words: prevention, education, human rights, economics, infrastructure, political will, partnerships and sanitation.

View image detail.

It’s an approach that Bill Gates has recently adopted in his role as a full-time philanthropist. After giving $700 million to defeat polio, a centerpiece of his foundation’s charitable giving, Gates, informed that the disease was making a comeback, especially in Africa, asked, “So, what do we do next?”

“That question,” writes Robert Guth in the Wall Street Journal, “goes to the heart of one of the most controversial debates in global health: Is humanity better served by waging wars on individual disease, like polio? Or is it better to pursue a broader set of health goals simultaneously—improving hygiene, expanding immunizations, providing clean drinking water—that don’t eliminate any one disease, but might improve the overall health of people in developing countries.”

Gates and his advisors opted for the latter approach, “an acknowledgement ... that disease-specific wars can succeed only if they also strengthen the overall health system in poor countries.” One result? Gates has begun to work more directly with religious leaders in Nigeria,“Ground Zero” for polio’s reemergence, to gain their support for immunizations.

“That’s been my experience, too,” says Norton. “We did a lot of work in Iran immunizing children, and the people that we worked with in a particular village were religious and civil leaders. If you had their backing—particularly the religious leader—he would get up and say, ‘This is a really good thing. You should do it,’ and people would respond. So it’s all encompassing. You can’t just take one aspect of health or wellness and say, ‘I’m just going to work on this. It has to be multidisciplinary and multisectoral.”

“If we achieve clean water and sanitation, people will be healthier to work, girls will attend school instead of fetching water and infant mortality statistics due to diarrhea will improve.”

Much of Norton’s work has been in developing nations, and her experiences affect how she is approaching the upcoming conference.

Doing something
“You learn a lot working in developing nations,” she says. “In the last four or five years [of DPI/NGO conferences], we have tried to formulate a declaration of recommendations for presentation to the U.N. General Assembly, but this year, in addition, I would really like to have a project come out of this, so we can say we are actually going to do something as a civil society.

“My favorite theme is sanitation and clean water, which are fundamental to health, and sustainability of achieved health progress. Immunizations are essential, but if people don’t have fundamental sanitation and clean water, they are only going to become ill again. There is a staggering statistic that 6,000 people die every day from impure water!”

“If we achieve clean water and sanitation, people will be healthier to work, girls will attend school instead of fetching water and infant mortality statistics due to diarrhea will improve. It seems like such a simple thing but, when you’re talking on a global scale, it’s not. I would really like to refocus, so that civil society would be able to say, ‘This is what we’re going to do,’ in other words, not just talk about the issue, but actually do something about it.

“If we can agree on a project, we will also need to mobilize political will,” says Norton. “Some countries are on target to achieve the MDGs and some are not. So that should really be the focus. Why are they not on target?”

Political will is key
When it comes to achieving the Millennium Development Goals, political will is a currency in even shorter supply than money, thus, its inclusion with the elements shown on the conference’s visual-identity graphic.

“Political will,” says Norton. “That’s what we’re trying to foster to bring about sustainable change.”

If anyone can foster political will, Norton can. Like a roving U.N. ambassador, she’s been around. A five-time recipient of the Fulbright Award, as well as several USAID grants, her teaching, research and field work have taken her to Tehran, Iran (during the revolution that saw the Shah’s overthrow); Karachi, Pakistan; Cambodian refugee camps; Beijing, China (during the Tiananmen Square uprising); the Kingdom of Bahrain; Amman, Jordan (courtesy of four Fulbright Awards); Helsinki, Finland (courtesy of the other Fulbright Award); Doha, Qatar; Geneva, Switzerland; Merida, Mexico; and Muscat, Oman.

She’s developed a number of “first” baccalaureate, masters and PhD programs and has taught nursing in all of the countries mentioned above, while working with the Catholic Medical Mission Board; the U.N. High Commission for Refugees; the International Rescue Committee; Cornell Medical School; Project Hope; the World Health Organization (WHO) and the National Institutes of Health. With her U.N. background, it’s no surprise that Norton is an NGO representative for both Felician College in New Jersey, where she serves as professor/associate dean for global initiatives, and for the International Council of Nurses. Felician College is one of only 18 colleges in the world to have achieved NGO status and, yes, you can credit Norton for spearheading that effort.

Source of her motivation
“Well, I grew up in a very small community and my mother and father were both very active. They always instilled in us to give back," says Norton. "We were so fortunate to have the things we had. Not that we were rich or anything like that but, whatever you had, you could share with someone. Of course, that was reinforced in the Catholic educational system I attended and the lessons stuck! It’s very enriching, really. The more you give, the more you get back.”

And what would she like members of the Honor Society of Nursing, Sigma Theta Tau International to be most aware of with regard to the upcoming DPI/NGO conference?

“We are going to focus on all the social determinants of health—not the management of disease—trying to educate people that everything we do has a health implication to it.  In addition, we will focus on the impact of political will in advancing global health," says Norton. "Sanitation and clean water, essential to promoting health, are issues that recently captured the attention of the United Nations General Assembly. On July 28, 2010, they voted to declare that access to clean water and sanitation is a human right.” RNL