There are few, if any, keywords that receive as much airtime in global health and development as “sustainability”* (save for perhaps the dreaded I’s of “innovation” and “impact”). Fourteen letters long, it has at least as many connotations, as elusive to articulate as it is to achieve. Yet it remains the holy grail of all global development programs. It is the lighthouse that guides social entrepreneurships, the posts adjoining global health field goals, the fountain of youth empowerment. In (slightly) less figurative terms, it is the heart of the post-2015 development agenda, pumping blood into redefined interventions and targets that seek to end poverty and disease.

Two weeks ago, global health leaders gathered in Johannesburg, South Africa, for the Partners’ Forum to shape the post-2015 agenda for maternal and child health. And, naturally, sustainability reared its mystical head. On the surface, it would appear that the roughly 1,200 participants from NGOs, UN agencies, governments, companies and universities reached an important consensus: Sustainability is and will remain a chief element of all efforts to end preventable maternal and child mortality. But just below the surface lay a truth even more profound: Sustainability manifests differently for just about everyone.

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