Module 3: Sustainability

In 1987, the United Nations Brundtland Commission convened to discuss the repercussions of environmental degradation on economic and social development. The following definition of “sustainable development” emerged as a conference outcome:

“Sustainable Development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs.”(1)

In 1992, the Declaration of Rio on Environment and Development further clarified that sustainable development was an equilibrium of three dimensions: environmental protection, economic growth, and social development.(2)

These explanations, more attuned to address ecological sustainability, are by no means comprehensive. The term “sustainability,” while frequently tossed around by development professionals and NGOs, “has neither been clearly defined nor consistently applied. Its meaning is often construed differently by various actors.”(3) In many cases, the meaning of “sustainability” has come to “favor the allocation of funding resources to organizations that are long-lived rather than effective” in the particular field in which they work.(4)

In an article entitled “’Sustainability’ in Global Health,” Yang et al. attempt to establish the definition of sustainability as it relates to health promotion by asserting:

“Our argument is that the current conceptualization of ‘sustainability’ results in the continued funding of programs that ought to end; the neglect of assets and capabilities that are most directly relevant to health outcomes; and, most importantly, shortages of essential consumables for restoring the patients in resource-poor communities … A critical distinction lies in the difference between the goal of sustaining health and the practice of sustaining an organization or the activities of an organization … Refocusing attention on sustainable health outcomes, rather than on sustaining organizations, is the lynchpin in resolving the paradox behind ineffective aid.”(5)

The authors of the article thus argue that achieving “sustainability” has much more to do with finding interventions that work, reinforcing them, and replicating them, than it does with financially fueling long-term projects that may or may not be effective. The process of identifying assets, forming partnerships, strengthening capacity-building opportunities, and utilizing resources intelligently is what should, ideally, be sustained. The best way to do this, the article contends, is to unleash “the energy and creativity” of locals to take control of health infrastructure transformation and upkeep.(6)

With this reconceptualization of sustainability in healthcare programs, “[t]he implication is that once they achieve their specific objectives, some programs should be discontinued, migrated, or reorganized. Successful programs should build cumulatively over time on the successes of discontinued prior programs as part of broader strategies for improved health. Under this approach, health providers cultivate locally relevant, specialized expertise and funders and coordinating bodies develop global strategies that unify and integrate the interventions.”(7)

In sensitizing their priorities to this article’s definition of the delicate and complicated goal of sustainability, organizations and development groups can avoid the mindset that equates extensive organizational or programmatic lifespan to sustainability. Instead, in amplifying and advocating the processes which produce widespread participation, informed investment, capacity build-up, and local enthusiasm, development workers can achieve sustainable models for growth.

Proponents of Asset-Based Community Development have found several tools to be successful at attaining this type of sustainability, which Kretzmann refers to as “competence sustainability.”(8) Creating a practical framework by which local citizens can come to realize their own potential is a process that can sustain and persist beyond the initial involvement of outside developers.

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(1) “Brundtland Definition – Three-Dimension Concept.” United Nations. Accessed on 9 June 2010.

(2) Ibid.

(3) Yang, A., Farmer, P. E., McGahan, A. M. “’Sustainability’ in Global Health.” 5.2 (Routledge, 5 January 2010): 130.

(4) Ibid.

(5) Ibid.

(6) Ibid, 134.

(7) Ibid, 131.

(8) Kretzmann, John P. Class Lecture. “The ABCD Approach & Temporary Volunteer Projects.” Northwestern University, Chicago, IL. June 2009.