Sixty-ninth session of the UN General Assembly: Leave no woman, child or adolescent behind

During the 2014 Accountability Breakfast, important new data and evidence were highlighted from several new reports including the 2014 PMNCH Report on Commitments to the Global Strategy for Women and Children’s Health and the third report from iERG.

Ministers, ambassadors, senior public officials, and civil society representatives gathered on Sunday in New York at a lively breakfast meeting hosted by PMNCH, Countdown to 2015, the independent Expert Review Group (iERG) and World Health Organization (WHO). In its fourth year, the breakfast, traditionally in support of Every Woman Every Child (EWEC), is an opportunity to mobilize renewed attention and energy for improving women and children’s health and a precursor of the week to come.

Important new data and evidence were highlighted from two new reports — the 2014 PMNCH Report on Commitments to the Global Strategy for Women and Children’s Health and the third report from iERG, which focuses on a vision for women’s and children’s health in the post-2015 era. The findings of the Countdown to 2015 report, Fulfilling the Health Agenda for Women and Children, were also presented at the breakfast. Key findings and recommendations from each of these reports show both the progress that has been made and the continued and intensified effort that is still needed for women and children. With under 500 days left until the end of the Millennium Development Goals (MDGs), and with one year left to shape the sustainable development goals, these reports show that stakeholders are at critical junction for women’s and children’s health, a position laid bare during the discussions on Sunday.

A key theme throughout the event was that of sustainability and strengthening health systems. Dr Margaret Chan, Director-General, WHO, stressed that while progress has been made for women and children, the Ebola crisis in West Africa is a reminder “that even excellent progress can be so fragile.” She, along with other speakers including Julia Duncan-Cassell, the Liberian Minister of Gender and Development, emphasized the importance of building and strengthening health systems to withstand crises and ensure that results are sustainable. Minister Duncan-Cassell also noted that women make up nearly 75% of Ebola fatalities in her country, because it is often women and girls who care for the ill and wash the bodies of the deceased. In addition, the collapse of the health system has grave implications for maternal health, as women are unable or unwilling to give birth in health facilities with skilled birth attendants.

The importance of strengthening health systems, as well as of determining factors for health such as poverty reduction and female education, was reinforced by Dr. Luis Huicho, who presented preliminary findings of a Countdown to 2015 in-depth Country Case Study that he is leading in Peru. This study seeks to understand and explain Peru’s success in reducing its rates of maternal, newborn and child mortality between 2000 and 2012. Also presented at the breakfast was new Countdown analysis of financial flows for reproductive, maternal, newborn and child health (RMNCH), which showed that, while aid for RMNCH increased during 2011-2012, continued increases in both official development aid and in-country investments are needed in order to accelerate progress towards MDGs 4 and 5.

Bob Orr, Assistant-Secretary General of the UN and a key leader of the Every Woman Every Child movement, emphasized UN Secretary-General Ban Ki-Moon’s commitment to women’s and children’s health and his conviction that women and children have to be “at the front of the queue, not at the back of the MDG train.”

Top of mind for all participants was how women’s and children’s health will feature in the post-2015 development landscape and the global health architecture to support it. For the first time in a public forum, panelists and attendees discussed the current plans to develop a Global Financing Facility (GFF), hosted by the World Bank, to better coordinate and leverage financial resources for reproductive, maternal, newborn, child and adolescent health in the 2015-2030 period. Speaking on behalf of the World Bank, Dr Tim Evans briefly described the proposed facility, and expressed great optimism saying, “We have a historic opportunity to bend the curve and eliminate preventable child and maternal deaths within a generation.” While not the only solution, he suggested that the GFF would accelerate progress by pooling funding, leveraging other financial tools and mechanisms, and simplifying and streamlining the global RMNCH landscape to reduce the application and reporting burden on countries.

Agnes Binagwaho, Minister of Health of Rwanda, joined the panel on financing for greater accountability and equity to make a powerful demand from the donor community to respect country leadership in planning, to reduce the burden in reporting requirements of countries, and to work together to invest in national health systems in a more holistic manner. 'Ask us what we need and we will tell you; don't go and speculate: We have a good plan and we know our needs ... the global community must be more accountable on coordination. We are disrupted by you in our work.'

Richard Horton, Editor in Chief of the Lancet, provided an overview of the iERG’s Every Woman Every Child: Post-2015 Vision report along with a proposed new framework for a sustainable approach to improving women and children’s health. He warned that “the landscape for women’s and children’s health is about to undergo a seismic shift” calling for action not paralysis in the face of uncertainty. He told participants that “sustainability is about paying as much attention to the future as we do to the present… it is about the value we put on our lives and on the lives of our children.” Stakeholders this week in New York, will indeed pay heed to these words as they look to help shape a set of sustainable development goals, which leave no woman, child or adolescent behind.

post-2015 development agenda, maternal and child health, Millennium Development Goals (MDGs), newborn and child mortality, maternal mortality, sexual and reproductive health and rights (SRHR), UNGA