This was the message from Action for Global Health’s annual policy conference this week in London, UK.
Delegates from government, civil society in Europe, the UK and Africa, and agencies like the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Bill and Melinda Gates Foundation discussed what could be done to get governments to meet their pledges to achieve the health Millennium development Goals (MDGs), which are hugely off track.
Ten years ago the world’s governments committed to reduce child mortality, improve maternal health and combat HIV/AIDS, TB and malaria. Yet a child born in a developing country is still over 13 times more likely to die within their first five years; between 8-10 women die in childbirth every 10 minutes and for every two people who start on HIV treatment, five others become newly infected with HIV.
The conference has come at an important moment, as in September governments will gather to assess the progress they have made in all the MDGs at the UN MDG Review Summit in New York.
Integration, integration, integration
Leonard Okello, Programme Director of Alliance Uganda, spoke about the need to end the ‘projectisation’ of health and development and emphasised that health isn’t a three year project that can be put into separate boxes. Integrating our response to health is much more effective and it’s unlikely the MDGs will be achieved if the issues remain individually packaged. Now is the time to look at more effective integration.
This issue was also raised by the distinguished delegates from Nigeria, Ethiopia and Uganda, including His Excellency Ambassador Berhanu Kebede, Ethiopian Ambassador to the UK and Hon Saudatu Sani, MP who is Chair of the Network of African Parliamentarians on MDGs. They also spoke of the struggle they experience due to the lack of healthcare workers. Retaining and training staff remains deeply problematic.
Dr Isabelle de Zoysa from the World Health Organisation (WHO) called for a continuum of care particularly for maternal health. She reiterated the need for one national plan, one funding mechanism and one monitoring and evaluation process as being a more effective way to achieve results.
Abolish user fees
Chief Executive of Interact and Plan UK, Marie Staunton, who opened the conference called for user fees to be abolished by governments but emphasised that they must be supported in that process. She highlighted that the role of communities to provide solutions to health challenges is of significant importance in order to help meet the health MDGs. Increasing the awareness and demand for communities to access services and hold governments to account is critical.
Making the money work
Jenny Amery from DFID set out the UK government’s key priorities of transparency, being results focused, innovation in the way partners and donors work and obtaining value for money. The need for efficiency was echoed by Joe Cerrell from the Gates Foundation.
Sufficient funding regularly comes up in health discussions but at a time of economic austerity it becomes even more challenging to find funds. Richard Manning who is Vice Chair of Replenishment from the Global Fund, highlighted that the funding shortfalls for the Global Fund will have devastating consequences and that innovative financing may be one way of raising the money. This was echoed by Alvaro Bermejo, the Alliance’s Executive Director who called for more pressure on governments to introduce taxes on the financial sector so they pay their fair share for the financial mess they caused, which is resulting in less money being available to meet the health MDG’s. Options include a Financial Transaction Tax, whilst the IMF have recently recommended a new Financial Activities Tax .
Listen to communities
The conference ended with a powerful request from Alvaro to respect citizenship, to listen to what patients from the community want in developing country contexts and to respect that desire for better healthcare.
Ultimately, the ability to achieve the MDGs should come from communities themselves and we should be more accountable to them.
Health isn't a three year project that can be put into boxes