September 26, 2015
Written by Christine Sow, President and Executive Director, Global Health Council, Lola Dare, President and Chief Executive, CHESTRAD & Nejla Liias, Founder and President, Global Health Visions
During this week of the UN General Assembly, New York’s streets are buzzing with global health and development leaders moving from one event or meeting to the next, discussing a host of important issues, and fighting for the chance that “their issue” might break through the noise. But, as we embark upon a new set of global Sustainable Development Goals (SDGs) to improve the lives of people and our planet, there is one theme which is relevant across all of the issue areas, and critically important to the achievement of the SDGs: accountability. Without accountability for goals and commitments, there is little point in making them.
As global health advocates, we share a passion for accountability because it means that decision makers will follow through on their promises to improve the health and well-being of all people, especially the most vulnerable. And, beyond that, we share an even greater passion for ensuring that advocates, government representatives, parliamentarians, health professionals, and other stakeholders understand how to put accountability into practice, calling for action to reward, mitigate unintended negative effects or implement sanctions as each matter might require: What’s working? Who’s making it work? What’s not working?
We are not alone in this quest: partners at all levels are more interested than ever in getting the accountability piece right. While we all bask in the excitement of the UN’s adoption of the post-2015 development agenda, as advocates we ultimately have one thought on our minds: what are the means of effective implementation and accountability?
Specifically, how are we going to hold duty-bearers accountable? How will we hold governments—and yes, we’ll say it— development partners, to their commitments to improve the health of women, children, and communities? How can we translate press releases into policies, policies into practice, and practice into healthy lives?
Yesterday’s event on accountability at the Rockefeller Foundation, organized by Global Health Council, together with CHESTRAD International, Global Health Visions, Action for Global Health, and International AIDS Alliance, revolved around precisely these questions. Global Health Visions shared the results of a provocative new report Engendering Accountability: Upholding Commitments to Maternal and Newborn Health, which profiles accountability processes at the regional, national, and sub-national levels, outlining what’s working, what’s not, and what changes we need to make to help country accountability efforts flourish. It contains in-depth landscape analyses of India, Nigeria, and Uganda, as well as detailed findings and recommendations that apply to accountability efforts across the board.
Additionally, CHESTRAD’s new report Amplifying Whispers and Enabling Action: Global Accountability in the Sustainable Development Goals, released in collaboration with Global Health Council,is a critical contribution to the field of accountability, examining lessons learned from the MDGs on accountability, improving the technical and supply sides including goals, indicators, measurement, data availability and quality. The report explores the role of stakeholders (including civil society) and calls for increased investment in demand-side functions on accountability to reduce fragmentation and promote alignment. It identifies an urgent need to incentivize political will for behavior change among development partners, technical agencies and global programs. It further calls for greater motivation to enable the watchdog role of civil society at the country level, to hold to account within the multi-layered, multi-sector accountability framework for global health in the Sustainable Development Goals.
With so many key players in accountability in one place, Thursday’s event served as an important touch point for the week, and the years ahead, to remind stakeholders that accountability must be a critical part of the conversation, to discuss how to make accountability work effectively, and to ensure that civil society plays a central role. As we move towards key milestones in accountability – including immediate ones like the PMNCH “Accountability Breakfast” and the launch of the new Global Strategy for Women’s, Children’s and Adolescents’ Health, and longer term ones, such the High Level Political Forum’s 4-yearly Summits to review progress on the SDGs – we want to take this opportunity to raise our voices in support of accountability practices that make targets, indicators and partner behaviors matter.
The takeaways from yesterday’s event are clear:
We need to empower civil society to do this important work – they must be at the center of local, national, regional, and global accountability efforts, within an inclusive, supportive accountability framework. But they can’t do it alone. Many need resources, support and technical assistance, and capacity building. And first things first – let’s do a better job making sure they have a meaningful seat at the table.
Top-down approaches need to go the way of the dinosaur – start local. We need to shift our strategic focus towards national and sub-national partners. The disconnect between commitments at the global level and awareness of commitments among stakeholders at the country level is holding us back.
To that end, we need to monitor fragmentation and improve partner behavior. Alignment and coordination at the country level matter more than ever before to achieve the 17 goals and 169 targets of the Sustainable Development Goals. Political will for improved processes and behavior change are critical, shifting incentive systems from attribution to contribution and through meaningful, resourced and enabled civil society engagement in accountability frameworks across programs and at all operational levels.
We all know data is important – but it is just not enough. There are many efforts focused on the collection and perfection of data. We need to work to connect data to action to achieve the change we want. Even “imperfect” data can be a part of the solution, especially when it is local, user-centric, and accessible in real time. At the same time, scaled investments in measurement, performance, data quality and dialogue are required to balance demand and incentivize political will for behavior change and action.
Collaboration is key. There are sucessful accountability efforts out there, and what they tend to share is robust cooperation between stakeholders—government, civil society, lawmakers, healthworkers. Let’s start to share these successes and work to scale them up.
When it comes to creating rich, constructive accountability mechanisms that give voice to the most vulnerable and ensure that people everywhere can live healthy lives, we have our work cut out for us. The good news is that today we have a lot more evidence and information on which to base our path forward.