Health and accountability in post 2015: statement from the iERG
iERG comment on the Draft Report of the Global Thematic Consultation on Health
19 February 2013
The Global Thematic Consultation on Health is off to a very good start with this excellent report which presents a thoughtful synthesis of the many contributions offered by a wide variety of stakeholders from around the world. The iERG strongly endorses the recognition that the present health MDGs should still be priorities after 2015, and the recommendation that accountability and transparency be guiding principles of the new development framework.
Created in 2011, following the recommendation of the UN Commission on Information and Accountability for Women’s and Children’s Health, the iERG has published its first report on September of 2012, where the need for additional sustained efforts on MDG 4 and 5 are amply documented. Drawing from a wide variety of sources, the report paints a very worrisome situation where, not only progress has not been fast enough to reach the global targets, but it also has been quite uneven, with very few countries poised to meet the targets of reduction of child and especially maternal mortality by 2015.
Furthermore, the first annual report of the iERG (three more are planned for the upcoming years) has made abundantly clear the difficulty of documenting precisely the progress made on the commitments pledged towards the Global Strategy on Women’s and Children’s Heath. We would strongly recommend that the difficulties pointed out in the report, and the experience of the iERG more generally, be incorporated in the Draft Report of the Global Thematic consultation. This would substantiate the recommendation of the Draft report that accountability and transparency be guiding principles of the new framework, and would further advance the definition of the nature of accountability mechanisms, and the role they should play in translating aspirational goals into the reality on the ground.
As we can see in numerous submissions to the thematic discussion, there is a widespread desire for greater accountability. Past experience with promises of resources that are not materialized, or with inefficient use of resources, and disappointing results, have led to the acknowledgement that accountability mechanisms are sorely needed. The moment has arrived for solid incorporation of accountability as an integral part of the new development framework. Accountability discussions, however, are presently very nascent. There is no consensus yet, on the nature and role of the mechanisms needed for effective accountability. Furthermore, given the limited experience with this relatively new idea, the obstacles to effective accountability are still not well understood.
We don’t think that accountability can be addressed at a later moment, once the framework has been decided. In fact, the definition of targets themselves, must take into consideration the indicators for measuring achievement, but this does not mean we have to limit our thinking to currently available data because new creative and practical ways can be devised. The iERG, in its next report, will be forging new paths with linkages with accountability tools for the respect, protection and fulfillment of human rights.
Another reason why accountability should be a major consideration from the very beginning is that the post 2015 is an excellent opportunity to build a strong global governance framework that brings together the various initiatives to avoid fragmentation, duplication and inefficiency, one of the recommendations of our first report. The need for harmonization among the data standards of the multiple agencies was strongly felt in our efforts to meet our mandate.
The iERG mandate is principally linked to the 2015 targets and accountability process. Some have suggested that had the iERG come into existence in 2005 instead of 2011, perhaps there would have been greater impetus for change. In any case, we would like to suggest that our experience be used to devise an improved process for the post 2015.
The Members of the iERG
Richard Horton (Co-Chair)
Joy Phumaphi (Co-Chair)