14172.pdf
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Countries, Agencies and Global initiatives that so far have
committed to one or several actions in the Global Campaign:
Afghanistan
Bonin
Bill & Melinda Gates Foundation
Brazil
Burundi
Cambodia
Canada
Chile
Ethiopia
France
Germany
Ghana
Global Alliance for Vaccines and Immunization (GAVI)
Global Fund for AIDS. Tuberculosis and Malaria (GFATM)
Indonesia
Kenya
Liberia
Mali
Mozambique
Nepal
The Netherlands
Norway
Pakistan
Partnership for Maternal. Newborn and Child Health (PMNCH)
United Republic of Tanzania
UNAIDS-Joint United Nations Programme on Hiv/AIDS
United Kingdom
United Nations Children’s Fund (UNICEF)
United Nations Population Fund (UNFPA)
United States of America
World Bank (WB)
World Health Organisation (WHO)
Zambia
SOCHARA
Community Health
Library and information Centre (CLIC
Centre for Public Health and Equity
No. 27,1st Floor, 6th Cross, 1st Main,
1st Block, Koramangala, Bengaluru - 34
Tel: 080 - 41280009
email: clicasochara.org/cphe0sochara.fl
wwwsochara.org
Building momentum
- the beginning of the Campaign
Achieving the Millennium Development Goals (MDGs) on health
by 2015 will be difficult. Although progress has been made, many
countries are off track. There is a real danger that the appalling
mortality figures for children and pregnant women will continue
- unless countries, agencies, NGOs and partners renew their efforts.
The Health Millennium Development Goals:
V.DC 4 Reduce child mortality
Reduce by two thirds the mortality rate
among children under five.
This is why the Global Campaign for the Health Millennium Develop
ment Goals is being launched. It is a growing campaign encompassing
several interrelated initiatives. All of them aim to accelerate progress
on the health MDGs, and they have many features in common. But
each also has its own approach, and focuses on a different aspect of the
problem: even though some progress has been noted, why do mortality
figures remain unacceptably high in most developing countries?
MDG 5 Improve maternal heath
Reduce by three quarters the maternal
mortality ratio.
MDG 6 Combat HIV/AIDS, malaria
and other diseases
Halt and begin to reverse the spread
of HIV/AIDS. Halt and begin to reverse
the incidence of malaria and other
major diseases.
The Campaign is unfolding rapidly and builds on the work of the Highlevel Panel on UN System-wide Coherence.1 On 5 September 2007, in
London, Prime Ministers Gordon Brown of the United Kingdom and
Jens Stoltenberg of Norway launched the International Health Partner
ship (IHP).2 This aims to improve the co-ordination of support for
national health plans, and brings together international health organi
sations and major donor countries, as well as developing countries.
On 26 September 2007, in New York, Jens Stoltenberg with other
global leaders launched the Campaign with a special emphasis on
women and children, in accordance with MDGs 4 and 5. The Campaign
signals a commitment to finding better ways of achieving value for
money and ensuring that the most vulnerable groups have access
to essential services. The Providing for Health initiative, supported
by Germany and France, will play an important role in this.
The day after the New York launch, some of the largest development
assistance donors met in Berlin to commit new finances for MDG 6 at
the High-level Meeting of the second replenishment conference of the
Global Fund to Fight AIDS, Tuberculosis and Malaria.3 And in October,
the Women Deliver global conference focused on the health of women,
mothers and newborn babies.4
This is just the beginning, and new actions and new commitments
will follow in the days and months ahead. A good start has been made,
a lot remains to be done.
BUILDING MOMENTUM - THE BEGINNING OF THE CAMPAIGN
1
]^>While we are
half way to 2015,
we are much less
than halfway
to achieving most
of the MDGs
The Millennium Development Goals
- renewing the 2015 pledge
In the year 2000, at the beginning of a new millennium, the countries
of the world made eight promises. These were the Millennium Develop
ment Goals (MDGs),6 and they committed us to working together to
reduce the number of people waking up each day to grinding poverty.
Three of those goals relate directly to health. They pledge us to re
ducing child mortality (MDG 4), improving women’s health (MDG 5),
and combating HIV/AIDS, malaria and other diseases (MDG 6).
A great deal has been achieved. Many developing countries have
been making impressive efforts to improve the health services for
their populations. The amount of money given in aid for improving
the health of the world’s poor has more than doubled to $14 billion.
The number of children who die of measles each year has halved since
1999.6 Polio, which paralysed over 350,000 children in 1988, is on
the verge of being eradicated.7 The resources flowing through the
Global Alliance for Vaccines and Immunization8 have prevented the
deaths of over 2.3 million people and with the long-term predictable
support for the International Finance Facility for Immunization,9
can save an additional 10 million lives by 2015.10 The resources
invested through The Global Fund to Fight AIDS, Tuberculosis and
Malaria so far have already averted 2 million deaths and is saving
110,000 lives every month.11
Yet, while we are half way to 2015, we are much less than half way
to achieving most of the MDGs.1'2
In particular, the health MDGs are behind schedule. At the current
pace, the child mortality goal will not be achieved until 2045;13 our
promise on maternal health will not be fulfilled and in some regions
maternal mortality rates will be worse.14 There are positive signs that
malaria and tuberculosis can be controlled by 2015, and while
we are rapidly increasing the number of people on AIDS treatment,
new HIV infections are still growing fast.11
Unless we take action, millions of children and their mothers will suffer
and die. Countries’growth and prosperity will continue to be drained
by diseases. And we will break our promises to the poorest 2 billion
among us. In addition to continue investing in areas such as education
THE MILLENNIUM DEVELOPMENT GOALS - RENEWING THE 2015 PLEDGE
3
The Campaign is a move
ment for all - showing
that we are taking action
to get back on track.
and clean water, there is now an urgent need to focus more on the
performance of health systems and the key bottle necks relating
to lack of human resources, infrastructure and sustainable financing,
as declared also recently by the G8 summit in Heiligendamm.
The Global Campaign for the Health MDGs
Everyone agrees that action is needed. Countries and international
partners have mobilised to develop an effective response to the MDGs.
What is missing is a focus for political action at the highest level.
That is what the Global Campaign for the Health MDGs is - a call
to renew our commitment to achieving the Millennium Development
Goals on health by 2015.
«■ U5MR based on current trend
• USMR if MDG4 target is to be met by 2015
This figure shows projections of under-5 mortality
The Campaign is a movement for all - which donors, international
agencies and stakeholders can join — showing that we are taking
action to get back on track by the end of 2010 and achieve the health
MDGs by 2015.
up to 2015 based on current trend (green line).
and the reductions required to meet the MDG4
target (red line). Source Murrayeta!.. The lancet in pten
So, what are the principles of this Campaign?
• Countries set their own priorities
Countries decide their own health priorities, and create national
health plans to achieve them. Aid agencies should co-ordinate their
work to fit and support these plans.
• Agencies give aid without adding to countries’ administrative burdens
Aid agencies shouldn’t add to the amount of reporting, information
collecting and administration that governments and health workers
have to do. In fact, this burden should be lightened. We should avoid
creating new institutions that make the way aid is given (the “aid
architecture”) more complex.
• Everyone ensures that money is well spent
More attention should be given to results, so that the money spent
is linked to the results achieved - in work on women’s and children’s
health, HIV/AIDS, tuberculosis, and malaria. This will ensure that
neglected issues and groups get the attention they need.
4
THE MILLENNIUM DEVELOPMENT GOALS - RENEWING THE 2016 PLEDGE
• Agencies help to develop the country’s whole health system
Aid agencies should work in ways that strengthen the country’s health
system as a whole. That means increasing the flexibility of funding
so countries can build up local facilities, increase the number of health
professionals and ensure that enough health workers and medicines
are in place where they are needed. It also means making and keeping
long-term commitments.
• All partners work in a transparent and accountable way
Openness benefits everyone: the voters whose taxes are spent on
development work, the contributors to charities, and the people in the
countries being helped. They all have a vested interest in knowing that
money is being spent — and healthcare provided — in a fair, open,
honest and effective way. Independent evaluation processes will be
critical to this principle and ensure effective use of resources.
In short, we must be more effective, better coordinated, invest more
and ensure that we reach the poorest and weakest.
If we can all sign up to these principles - as many have already done
in signing up to the Paris Declaration on Aid Effectiveness (2005) and
the International Health Partnership Global Compact2 — we will have
a real chance of meeting the health MDGs. And that will mean we have
helped to create a fairer world for everyone.
THE MILLENNIUM DEVELOPMENT GOALS - RENEWING THE 2015 PLEDGE
5
If we can al] sign up to
the principles of the
Campaign, we will have
a real chance of meeting
the health MDGs.
A new way
of doing business
to achieve
better results
What will be done?
A lot of good work is already going on. The countries receiving aid are
at the core of this work, supported by partners and partnerships that
provide technical and funding assistance. The Campaign will help
to find ways of making that work more effective, giving a better chance
of achieving the health MDGs by 2015.
Action will focus on three areas:
1.
We will respect country leadership: Ongoing international health initia
tives will cooperate better, simplify procedures to respond to country
partners and agree on priorities squarely based on each developing
country’s national health development plans and budgets. Everyone,
development partners, international agencies, civil society and country
governments will work together to support their development. While
disease-focused activities are achieving impact on the ground, health
systems as a whole will be supported and strengthened, so that improve
ments become sustainable and reach across all parts of its population.
2.
We will do more for mothers and their children: In addition to sustaining
and accelerating efforts on AIDS, TB and malaria, we must simply
do more for women and children. Maternal, newborn and child health
does not yet get the priority it needs, neither by those who provide
assistance nor by those who fund the health services in developing
countries. It is unacceptable that almost 10 million children die each
year largely from preventable causes and that each year more than
500,000 women die from treatable or preventable complications of
pregnancy and childbirth. Improving newborn health will be essential
to meet MDG 4 and will contribute substantially to meeting MDG 5.14
3.
We will invest more resources: For all these efforts to succeed, more resour
ces will be raised, including innovative sources of financing, and invested
in a more effective way to produce results. While both international as
sistance and many developing countries have increased their investments
in health, we remain far short of what is needed to achieve our goals.15
Health systems need longer-term and more predictable financing.
Success will be measured through a reduction in mortality, and funding
will be provided based on performance. More work is also needed to de
velop sustainable financing mechanisms that give access to the poorest,
including sound risk-pooling approaches relevant to the country context.
WHAT WILL BE DONE?
7
Success will be measured
through a reduction
in mortality, and funding
will be provided based
on performance.
The IHP global compact
represents a commit
ment to a new ami
better irar of working.
So far, five actions are being taken that support the Campaign’s
principles. The Campaign is being joined by governments, agencies
and donors that are ready to throw their support behind its goals.
1 - Providing a framework for co-ordinating aid, and reducing
the burdens that go with it
The International Health Partnership (IHP)2
There are many different organisations involved in providing aid, but
they often fail to take account of one another. One result of this lack of
co-ordination is the reporting demands and requirements on how each
entity’s money is being spent, and the effect it is having.
Because agencies and initiatives ask for different information in differ
ent forms, collecting and delivering it takes up a great deal of time for
health workers, civil servants and other valuable people - and this loss
of time means that aid is less effective than it could be. For example,
doctors spend time on reporting rather than treating patients.
How the IHP will work — a global compact
The IHP aims to support governments to achieve health results by
helping aid agencies work together more effectively, reducing wasteful
duplication and ensuring that the money achieves more. The IHP
global compact, signed in London on 5 September by leaders, donors,
agencies and countries, represents a commitment to a new and better
way of working - co-ordinating their work to support countries’
national health plans.
The compact will involve commitments from those who receive aid
as well as those who provide it. It is important that governments listen
to their own citizens in preparing their plans, and that they take
account of citizens’ views about its performance. The providers of aid
need to know that their efforts are supporting a well designed national
health plan that will genuinely improve people’s health. They need
to know that the plans support their efforts - whether on AIDS
or maternal health - before they support it. Governments will be
accountable for achieving results.
8
WHAT WILL BE DONE?
Country agreements
Work will begin with a first wave of countries to decide how to put
the commitments into practice, and to agree on measurable targets
- drawn from current plans and national priorities, so avoiding creating
more administration. These targets will be set down between govern
ments and partners in a memorandum of understanding, a code of
conduct or a separate country compact.
Each government and their partners will consult and work together
to determine how the global compact will work locally. This will help
identify the sorts of changes needed in the way agencies and partners
work to more effectively support national health plans.
Because national plans will be strengthened and monitored, the results
they produce will be validated. This information can be presented in
a way that all aid agencies will accept, which will reduce the burden
of reporting currently borne by valuable workers in developing coun
tries. The information countries provide can then be aggregated for
global and regional uses.
The IHP has broad support from bilateral partners including the UK
(lead promoter), Norway, the Netherlands, Germany, Canada and
France, as well as multilateral agencies including the WHO, UNAIDS,
UNICEF, UNFPA, the World Bank, the Global Fund for AIDS, TB and
Malaria and the GAVI Alliance.
Countries that will participate in the first wave of implementation
include Ethiopia, Kenya, Zambia, Mozambique, Burundi, Nepal,
Cambodia and Mali. And this group will grow as new countries join.
2
- Making sure women and children receive priority
Women and children continue to get the worst deal in health. They
benefit least from health services, even though they are often most
in need of them.16
In addition, women and children often lack a voice - a means of
expressing their opinions - which means that there is little pressure
on governments to provide services for them. They need to be given
a strong and concerted voice - a combination of others advocating
WHAT WILL BE DONE?
9
Each government and
their partners will
consult and work
together to determine
how the global compact
will work locally.
Deaths (millions)
action on their behalf, and enabling them to raise their own voices
- in order to call for the services they need and hold governments
to account.17
Because of this the number of women who die from pregnancyrelated causes each year is still over 500,000 - the same number
as 20 years ago. And for every woman who dies giving birth, another
30 suffer debilitating injuries.18 The same lack of local services is
one of the main reasons for the fact that, of the ten million children
who die before their fifth birthday, and almost half are less than
one month old.19
• Sub-Saharan Africa
♦ Americas
• Asia
& North Africa 8* Middle East
• Europe
This figure shows the number of under-5 deaths
by region since 1970 and projected to 2015.
Over this 35 year period, the number of children
dying each year in the world will decrease from
over 16 million to below 10 million. Yet based
on current trends, the number of children dying
in sub-Saharan Africa is actually increasing.
Sourer Murray et a1. The lancet in preu.
U deliver
now
¥
gW0MeN +
°CHILDReN
Vertical, disease specific initiatives can deliver impressive results,
but do not necessarily contribute to comprehensive health and nutri
tion services for women and children.14 Despite the overall increase
in aid funding for health, a large portion of that increase has gone
to specific diseases, while funding for maternal, neonatal and child
health has not increased significantly, and is not sufficient to achieve
MDG 4 and 5.15
A network of heads of state
Political commitment is needed at the highest level. Only this will
make it a government priority to protect and promote the health and
wellbeing of all women and children, pushing through the necessary
changes, and allocating resources appropriately. Heads of state and
government from a number of countries have joined in a “Network of
Global Leaders” to provide the necessary leadership and momentum.
Currently, these countries include Norway, Brazil, Chile, Indonesia,
Mozambique, Pakistan, Tanzania and the UK. In order to keep up
the momentum they will be regularly briefed on progress relating
to Women and Children’s health. The briefs will be informed by
independent reviews.
A consistent long-term advocacy drive
To keep momentum both in the North and the South a dedicated
advocacy and communications drive is being developed: “Deliver Now
for Women & Children”. Coordinated by the Partnership for Maternal,
Newborn & Child Health20 - a global network of more than 180 organi
zations - the advocacy drive will strengthen civic activism to increase
10
WHAT WILL BE DONE?
demand for maternal and child health services, hold political leaders
accountable and committed to deliver in investment and expansion
of maternal and child health services, strengthen the capacity of the
media, and enable scaling up of health services to reduce maternal,
newborn and child mortality. The drive will promote solutions in line
with the principles of the Global Campaign.
Delivering maternal, newborn and child health services
There are good estimates of what it costs to help women and children.21
This action will identify where the gaps22 are between what is needed
and what is being done. Work can then be co-ordinated, as a result
of the other actions detailed here, to close these gaps. One such
framework is the African Union’s strategy for child survival, which
has widespread support including from UNICEF, WHO and the
World Bank, among others.
• Childhood (1-5 years)
o Post-neonatal (1-12 months)
The majority of maternal and newborn deaths could be prevented
if women had access to cost-effective interventions and health care
during pregnancy, childbirth and after delivery as well as access
to family planning services.23
• Neonatal (first month of life)
This figure shows that over the period 1970 to
2005 and projected to 2015 progress on reducing
post-neonatal mortality is much greater than for
reducing neonatal mortality. Progress on neo
Today, only half of the world’s women have the care of a skilled pro
fessional when giving birth,14 and only one in ten of HIV-positive
pregnant women in low- and middle-income countries receive anti
retroviral prophylaxis to prevent HIV transmission to their child.24
The greatest risk of death is at the very beginning of life: three
million newborns die each year within one week of birth, and up
to two million babies die on their first day of life.19
natal mortality may be slower because it requires
more complex health system support for birth
and post-natal care and because less priority
has been given to newborn and maternal health.
Source Murray et al. The lancet >n prm
To achieve progress, investments in health systems and human
resources will need to focus on women, newborns and children in
order to provide sustainable services, increase demand and address
behavioural factors such as promotion of breastfeeding.
Agencies and civil society need to have a shared agenda in order
to better support countries to deliver an essential package of inter
ventions for women, newborns and children.
WHAT WILL BE DONE?
II
Simple mid a ffordable
solutions exist for
many of the most
common causes of child
and maternal deaths.
3 - Extending essential services to reach more people, with a focus
on outreach at the community level
The problem
In many of the poorest countries a majority of children and women
with life-threatening disease are not able to get lifesaving medical
services. Simple and affordable solutions exist for many of the most
common causes of child and maternal deaths. Without strengthening
and extending health services to deliver these solutions to those that
need them most little progress will be made.
A common results-based approach
Canada in partnership with Norway, UNICEF, WHO, the World Bank,
the Bill and Melinda Gates Foundation and USA are working together
to develop an innovative approach - to be launched shortly - to
strengthen health systems in order to achieve sustainable results, and
ensure women and children receive essential health services. Critical
to this approach are both capacity building and support to the health
system to tackle weaknesses in health services (such as shortages
of skilled workers, medicines or other resources) at the front line.
In addressing these weaknesses there is a need for assistance that builds
increased and sustained access to proven cost-effective and high impact
services for those who need it most. Depending on the country services
to be scaled up interventions may include: community based delivery
of vitamin A supplements, and long -lasting insecticide-treated bednets
for mothers and children, treatment for malaria, pneumonia and
diarrheal disease, breastfeeding counselling, immunizations for mothers
and children, and prevention of mother to child transmission of HIV.
4
- Finding the most effective ways of spending money
Current funding mechanisms do not always help governments
achieve health results because of restrictions, for example, that funds
be used only within defined disease control programs or for specified
activities or by specified groups. When the disease goal requires
broader systems fixes or when the health provider doesn’t perform,
the government does not always have the flexibility or motivation
to change how funds are used.
12
WHAT WILL BE DONE?
The objective of Innovative Results-based financing is to test out and
evaluate new ways of financing to better achieve our health goals.
The aim is to get the greatest value for money spent. By linking
funding to measurable results, governments and communities have
increased motivation and capacity to achieve results - or fix what
ever problems are impeding them. In results-based financing, money
depends on real improvements for the health of poor people.
How successes have been achieved
with resufts-based financing
Births are more likely to go well if there
is professional care, advice and equipment
on-hand. In India, a government scheme
directed at mothers living under the poverty
line in the poorest states motivated 80%
of them to choose to give birth in health
Responding to incentives
The evidence suggests that small financial incentives targeted at
the right level, such as those described above, are enough to change
behaviour significantly and achieve results. Attention to results means
those with the power to make change quickly become aware of pro
blems and have the motivation to take action, for example by moving
funds to wherever they can be used more effectively. Of course, coun
tries still need predictable, long-term funding. Through results-based
financing they can be assured of funding— what changes is how it is
spent- unless results are good.
facilities - up from just 20% the year before
the scheme began?' This happened because
the scheme subsidised the cost of transport
to and from the clinic for mothers, as well
as providing incentives for the health
workers involved.
In Rwanda, the use of bed nets for children
increased from 4% to 70% over three years,
producing a dramatic reduction in malaria
rates and emptying beds in paediatric wards.
This happened because the amount of
money the government gives municipalities
to spend on health depends on how many
There are many ways of implementing results-based financing, and
countries will be able to design what suits their circumstances best.
Different options will be tested and expanded as governments and
partners learn what works. Learning by doing is an essential
component of this effort.
children sleep under mosquito nets.
GAVI pays a country US$20 for each addi
tional child immunised. An independent
review in the Lancet, one of the world’s most
respected medical journals, found that the
Importantly, results-based financing would still allow special
interest groups to donate to achieve specific outcomes - such as
fighting a specific disease - but without having to separately track
their money. Funds from different partners can also be pooled to
support the national health plan, with an eye on how well it delivers
results. In this way, Innovative Result-Based Financing will con
tribute to the work of the International Health Partnership. It will
also have a special emphasis on outcomes for women and children.
A number of countries have expressed interest developing this ap
proach, including Norway (the lead promoter), Canada and the UK,
as well as global funds: GFATM, GAVI, and the Bill and Melinda Gates
Foundation. The World Bank will coordinate this work. This innova
tive financing approach may be linked to the Bank’s core development
WHAT WILL BE DONE?
13
scheme led to many more children being
vaccinated in the countries that had pre
viously performed least well •ZJ0
Iii residls-based fiiianciny, money depends on
rciil improv-emems for
die health of poor people.
financing through IDA.26 We are exploring interest among partner
countries in participating in a first wave, testing and developing
these approaches.
5
- Providing for Health Initiative
Promoted by Germany and France this initiative has been supported
by the G827 under the German Presidency. Its main objective is
to improve sustainable and equitable financing structures of health
systems to enhance access to health services of adequate quality
in developing countries and to protect people from the adverse finan
cial consequences of high out-of-pocket payment.
Overall, if health care systems in poor countries are not reinforced,
notably through establishing social health protection systems, all
of efforts to fight contagious and non-contagious diseases in these
countries may prove to be in vain.
In sub-Saharan Africa, spending on health is US $30 per person per
year, nearly 100 times less than in the OECD countries.28 This amount
is insufficient to cover the most essential needs in this field. Moreover,
more than half of health spending is borne by households in the
form of direct payment at the point of consumption. Because of this
payment method, disease and the spending it generates cause
100 million people to fall below the poverty line every year as a result
of one member of the household experiencing dramatic expenditures
due to a serious health event.
Out of pocket spending for health financing through direct payment
generates profound inequities in the health systems of the over
whelming majority of developing countries. Moreover, access to health
services is always lower for women, young people and households
living below the poverty line.14 The poorest segments of the population
are devoting a proportion of their income to health spending signifi
cantly larger than those in the higher income groups.
Tb date, the policies carried out with the support of the international
organisations to improve social health protection coverage in develop
ing countries have failed to achieve the expected results. Free services
in the public health sector have had to contend with the need for sound
14
WHAT WILL BE DONE?
management of public finance and have failed, in many countries,
to prevent continued or even exacerbated inequality in health and
access to health services, to the detriment of the poor. Similarly,
policies relating to health cost recovery, launched 1987 in the Bamako
Initiative,30 which promotes direct participation of users in the financing
of health services, have not made it possible, despite some successes
at local level, to provide long-term financing of primary health centres
or to reduce inequalities in access to services.
Macro-economic studies have confirmed
that better health is correlated with
stronger economic growth. Investing in
health promotes pro-poor growth.
Thus, if the recommendations of the WHO
Commission on Macroeconomics and
Health were implemented, life expectancy
in developing countries would be raised
from 59 years at present to 68 years, which,
they claim, would increase growth in these
countries by 0.5% per year.2’
The way forward
A growing international consensus, reflected in the conclusions
of the Berlin (2005) and Paris Conferences (2007), is now emerging
in favour of developing ways to improve the financing and effective
ness of social health protection coverage in developing countries.31
This aims at seeking the best combination of public intervention
on the one hand and the establishment of mechanisms for social
protection in health (e.g. through social or mutual insurance schemes
or taxed-based mechanisms etc). A number of countries have intro
duced policies aimed at building a universal social health insurance
system. Others have experimented with a variety of mutual health
insurance schemes, ranging from community-based insurance
to private non-profit insurance and the private voluntary insurance
market. These experiments will be fully assessed before pursued
for scale up in other countries.
WHAT WILL BE DONE?
15
The day
of our birth
is the most
critical day
How will it all work?
Because the Campaign’s principles place so much emphasis on working
with countries to meet their national health plan goals and on
co-ordinating efforts from different sources, the different actions
described above will work differently in each country - in a planned
and complementary way, but specific to the circumstances of the
country. These actions will be tailored to each country and included
within its national health plan. Partners will be committed to coordi
nated action around the national health plan and to engage in “one
conversation” with governments.
Development partners will closely coordinate their work with all
stakeholders facilitated by the newly established Heads of Health
Agencies (the “Health 8” - WHO, the World Bank, UNICEF, UNFPA,
UNAIDS, GAVI, GFTAM, and the Bill and Melinda Gates Foundation).
The annual review of progress nationally and globally at the highest
level as outlined by IHP will be used across the different actions
in the Campaign for mutual accountability, monitoring progress
towards the health MDGs, and addressing gaps. Intermediate goals
will be aggregated based on individual country plans.
Reporting of
validated results
Financing for results
First wave countries for the five actions will be distinct, but with over
laps. In the scale-up phase, they are foreseen to be implemented jointly.
To maintain political momentum and hold all partners to account
on performance and progress:
Illustration of the relationship between the differ
ent actions in the context of national inclusive
Annual political reviews of progress on health MDGs will be
organised by the International Health Partnership
ownership. Action 1 (IHP) primarily operates at
central level around the one country health plan
(upper part of the figure); action 3 focuses on
processes that need to happen at local level (lower
A “Status Now” conference focusing on women and children will
be organized in late 2010 to take stock and renew the Campaign
if catch-up has not been achieved.
HOW WILL IT ALL WORK?
part of the figure); actions 4 and 5 promote effec
tive spending and health delivery - and action 2
provides an additional focus and mobilization for
women and children.
17
The phases of the work for current Campaign actions
Each of the actions — and their timing — will work differently, but
it is anticipated that each will follow a common sequence of phases.
Phasing will depend on agreement and progress at country level,
with the intention of moving as quickly as possible.
The preparation and design phase will involve first-wave countries working
with agencies to develop plans for the actions. Indicators of progress will also
be selected and developed during this phase.
The implementation phase for first-wave countries will be well underway
by early 2008, with clear plans in place and agreed arrangements - embodied in
country-level compacts - for co-ordinating the activities of the various partners.
Monitoring and review will examine the results of actions in first-wave
countries and identify lessons for scale-up by 2009.
Scale-up and expansion will, depending on progress and lessons learned in first| wave countries, involve actions being rolled out more widely between 2010-2015.
The figure illustrates how distinct but over
lapping actions in the start-up phase will evolve
into integrated solutions in the scale-up phase.
Success depends on countries taking the
leadership role around their national health plan.
18
HOW WILL IT ALL WORK?
References and websites
1 Delivering as one. Report of the Secretary-
11 Global Fund publications can be accessed:
General's High-level Panel on UN System-
http://www.theglobalfund.org/en/media_
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^brochures
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2 The International Health Partnership - IHP:
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uk/output/Pagel3063.asp
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http://www.polioeradication.org/
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neonatal survival
• The GAVI Alliance:
http://www.gavialliance.org/
’ The International Finance Facility
for Immunisation website:
http://www.womendeliver.org/pdf/
Maternal_Lancet_series.pdf
http://www.thelancet.com/collections/
series/srh
http://www.iff-immunisation.org/
The Millennium Development Coals for
x0 Effect of the Clobal Alliancefor Vaccines
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Health - Rising to the Challenges 2004:
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sowc07_table_l.xls
Kashif Khan, Christopher JL Murray.
The Lancet, Vol. 368, Issue 9541,
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September 2006, Pages 1088-1095:
http://www.thelancet.com/
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