Commentary: new development goals must focus on social determinants of health

BMJ 2013; 346 doi: (Published 28 March 2013) Cite this as: BMJ 2013;346:f1893
  1. David Legge, scholar emeritus1,
  2. David Sanders, emeritus professor 2
  1. 1La Trobe University, Melbourne VIC 3086, Australia
  2. 2School of Public Health, University of the Western Cape, Belville, South Africa
  1. Correspondence to: D Legge dglegge01{at}

Although the millennium development goals (MDGs) addressed some of the starkest manifestations of the contemporary global health crisis, they failed to confront the underlying structures that maintain the crisis, including globalisation. In reflecting on the post-2015 development agenda,1 we need to challenge some key assumptions about the genesis and effect of the current goals.

Much of the discourse around the MDGs since 2000 has suggested that attainment would be secured by creating a global partnership for development (goal 8) and would require “more of the same,” including increased development assistance. An alternative interpretation is that both the goals and the increased development assistance since 2000 were motivated, at least in part, by the need to shore up the legitimacy of what was …

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