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2023 Goalkeepers Report: A Reason for Hope

By Atul Tandon

Last week, the Bill and Melinda Gates Foundation released its annual Goalkeepers Report—an inside look at pressing humanitarian challenges, the Foundation’s current priorities, and exciting interventions that are improving lives around the world. This year, the report focused on child and maternal health and highlighted a handful of innovative solutions that could collectively save millions of lives.

As I read the report, I was struck first by just how essential these life-saving efforts are—all of our work to improve education and build sustainable livelihoods is for naught if children are not surviving past their fifth birthday and mothers are dying in childbirth. I began reflecting on the broader themes that all of us in the humanitarian sector can learn from the Gates’ insights—lessons that extend beyond health, into countless initiatives designed to move the needle on the UN’s Sustainable Development Goals.

With Opportunity International representatives participating in the 2023 SDG Action Summit at the United Nations this past week, this progress is what I continued to run through my mind—and this is what gives us hope and a plan for action.

A call for celebration

As the Report noted, we are at a crossroads. Despite the immense progress we have made on nearly every global metric—from poverty to health to education to good governance—over the past 30 years, we are not on pace to achieve the goals we have set for 2030. Here, at the halfway point to the SDG finish line, we risk missing the mark.

Yet here is what else is true: We have made absolutely remarkable progress in the last 30 years. Since 1990, over 1 billion people have been lifted out of poverty. 200 million fewer people are hungry. The global primary school completion rate was 70% in 2000—by 2018, it was 84%. The extreme poverty rate has dropped from over 30% in 1990 to about 8.4% today.

In the Gates’ efforts, they noted, “For the first time in human history, basic lifesaving health care was made available to hundreds of millions of people: AIDS medication, contraceptives, childhood vaccines, bed nets to prevent malaria.”

While it’s easy to see current trends and get discouraged, we must remember just how far we have come—and just how much we have learned in the process. As Hans Rosling famously said, Step-by-step, year-by-year, the world is improving. Not on every single measure every single year, but as a rule. Though the world faces huge challenges, we have made tremendous progress. This is the fact-based worldview.”

A call for commitment

In the last few years, our progress has stalled. Global conflict, increased climate emergencies, and the ongoing reverberations of the COVID-19 pandemic have caused an abrupt shift in our rapid progress.

90 million more people have been pushed back into extreme poverty, almost all students  experienced losses in education, and we’re facing hunger levels we haven’t seen since 2005.

Yet in the midst of these setbacks, we have not stopped learning. Practitioners the world over have continued to develop and test new ways to solve old problems. We’ve discovered lots of things that don’t work—that’s valuable, in and of itself. And when we’re lucky, we discover something that does work.

Take, for example, our Community Health program and women like Phool in India. As a Community Health Worker, Phool builds her livelihood by supporting her community’s health. She received training from Opportunity International, and now delivers life-saving education on hygiene, sanitation, nutrition, maternal health, and child health to her neighbors. She sells basic health goods like menstrual products, cleaning supplies, and basic medicines. And because of her work—and the work of thousands more like her—we have seen incredible results.

  • The number of women giving birth in a hospital increased from 33% to 79%
  • The number of women breastfeeding on the first day of their baby’s life went from 27% to 72%
  • Child immunization increased from 42% to 89%
  • Family use of mosquito nets went from 50% to 85%

Because of a simple solution—women trained to train others—thousands of mothers and babies are living healthier lives. This is what we’ve learned—and these are the kinds of results that give us hope.

A call to continue

Our course forward is simple: we keep going.

In addition to continued innovation, we must shift our attention to access and delivery of the tools that already work. How do we get proven solutions like the Community Health Worker model into more communities? How do we ensure that more mothers and babies have access to the tools and treatments the Goalkeepers Report outlines? How do we take what we know and get it to the people who need it most?

The answers are practical, but not easy: We leverage local players who can develop and implement solutions from the ground up. At Opportunity, that looks like building an ecosystem of banks and nonprofit organizations; training farmers to become Farmer Support Agents who can turn around and train their peers; gathering educators into clusters who can learn from and support one another; and equipping microenterprise owners to build thriving businesses that create opportunities for their neighbors. Helping those facing extreme poverty save, and training entrepreneurs to build jobs, farms, businesses, and income in their communities.

The people most in need are often those who are the hardest to reach, which means that the path to zero­—zero hunger, zero poverty, zero maternal deaths—will be a long, difficult one. But it’s a path we stay on because every year we keep going is a year where more babies make it to their fifth birthday, more mothers survive childbirth, more children go to school, more people go to bed with full bellies, and more families break the cycle of poverty for good.

It's also a path that is paved by relationships, partnerships, and persistent, unwavering progress, even when that progress is slower than we hoped.

This is the vision the Sustainable Development Goals set, and this is what our collective efforts have in mind. We’ve done good work and we’ve learned a tremendous amount. Today, we face enormous obstacles, but we know what we need to do. Why in the world would we stop now?



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