2021 Progress report on the Global Action Plan for Healthy Lives and Well-being for All
Stronger collaboration for an equitable and resilient recovery towards the health-related Sustainable Development Goals
Progress on the health-related SDGs was already lagging when the Global Action Plan for Healthy Lives and Well-being for All (GAP) was launched in 2019 and is now much further off track. The COVID-19 pandemic has shone a harsh light on inequities and inequality but has also underlined the centrality of health, equity and equality as preconditions for sustainable development.
This second, annual GAP progress report illustrates how the GAP is providing an important, long-term improvement platform for collaboration among 13 agencies in the multilateral system as they support countries on the path towards an equitable and resilient recovery from the pandemic and further progress towards the health-related SDGs.
It shows the importance of clear and shared objectives in supporting countries to achieve tangible and measurable impact through a closer collaboration of the agencies and highlights that progress has been incremental rather than transformational to date and may remain so unless Boards and donors signal to the agencies that they would like to see deeper changes to the ways the agencies work together in support of countries.
From its inception, the GAP has been focused on enhancing collaboration leading to greater impact. Such collaboration can be challenging, because multilateral agencies have different mandates, strategies, funding streams and governance and accountability mechanisms, but it is also essential and requires sustained leadership from the multilateral agencies, their boards and funders and the countries that they serve.
The structure of this progress report is based on the four key commitments made by signatory agencies under the GAP: Engage, Accelerate, Align and Account. Read the full second, annual GAP progress report here.
2021 progress report on the Global Action Plan for...
Engage
| By May 2021, GAP implementation at country-level had scaled up from the five countries presented in case studies in the 2020 GAP Progress Report to 37 countries. Joint activities at country level are undertaken by the GAP signatory agencies’ country-facing teams and supported by the global-level accelerator working groups. This report presents eight case studies illustrating enhanced collaboration among the agencies on primary health care (PHC), health financing, data and other accelerator themes. |
Country case studies
This report presents eight case studies illustrating enhanced collaboration in countries where several GAP accelerators are working together to provide support for an equitable recovery from the COVID-19 pandemic. In Lao People’s Democratic Republic, Pakistan and Tajikistan, the agencies are working to strengthen sustainable financing in the context of PHC-focused reforms. In Somalia and South Sudan, innovation and strong commitment to UHC through PHC are providing a path to recovery from instability and conflict. In Malawi and Nepal, work on data and digital health aims to achieve more equitable access to PHC services. In Colombia, several agencies are using opportunities provided by the GAP to strengthen prior collaboration on determinants of health affecting access to services.
Accelerate
 | Country-level activities under the GAP are supported by the global-level accelerator and gender equality working groups. Over the last year, the working groups have created thematic communities of practice and enabled both strengthened collaboration and new interactions among GAP agencies. The accelerator working groups themselves are also collaborating more closely. Accelerator working groups have also refined their strategic approaches. This includes identification by each working group of a priority focus area (“one big action”). |
Align
 | Significant alignment among GAP agencies is happening within GAP accelerator working groups and at country level. Over the last year the GAP has also demonstrated its potential to strengthen and increase alignment in the global health ecosystem, e.g. by integrating elements of the Every Woman, Every Child. In January 2021, the International Labour Organization joined as the 13th GAP signatory agency. |
Account
 | In 2020, a joint evaluability assessment (JEA) of the GAP was undertaken by the evaluation offices of the signatory agencies. Principals of the GAP agencies reviewed the JEA recommendations and approved a management response. Implementation of the actions in the response is well underway, including development and approval of a theory of change and a monitoring framework. Increasingly, work under the GAP will focus on the key challenges and risks identified in the JEA and the review of the IHP+ discussed in this report: country ownership, institutionalization of collaboration within the agencies, and incentives from governing bodies and funders for the agencies to collaborate better.
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Collaboration is the path, impact is the destination
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Looking forward, the "North Star" of the GAP is impact at the country level in the context of equitable and more resilient PHC and a health sector that is sustainable financed through domestic and external resources. In the era of COVID-19, the GAP is well positioned to further support countries as they now strive for an equitable and resilient recovery and resumption of progress towards the health-related SDGs. |
Messages from SDG3 GAP Heads of Agencies at the Launch of the 2021 Progress Report
"The COVID-19 pandemic is exacerbating inequities in many countries. The poorest and most marginalised communities have been hardest hit. Today, in the 68 countries Gavi supports, nearly 10 million children still go without any basic, routine vaccines every year. Equitable and resilient recovery will require us to work together to reach these zero-dose children, so that no one is left behind."
- Dr Seth Berkley, CEO, Gavi, the Vaccine Alliance
“Partnership is at the heart of the GFF's country-led model. COVID-19 has made it even clearer that collaboration is critical to fight the pandemic and achieve the health-related SDGs. Working together GAP agencies have accelerated their efforts for stronger partner alignment, engagement and accountability behind country-led response and recovery efforts to reclaim the health gains and build a more inclusive and resilient recovery.”
- Dr Muhammad Pate, Director, Global Financing Facility for Women, Children and Adolescents
"Today’s global health challenges call for an integrated approach and intensive collaboration between all partners. We are committed to working together to deliver more effective and efficient support to countries, build the path towards an equitable and resilient recovery from the COVID-19 pandemic and accelerate progress towards achieving Sustainable Development Goal 3: health and well-being for all."
- Peter Sands, Executive Director, Global Fund
“The ILO welcomes the progress for 2020 and as a new member looks forward to engaging with all SDG3-GAP partners in 2021 and beyond. The COVID-19 crisis has clearly demonstrated the interaction between health, social factors and decent work. It has highlighted the critical need for investments in all three areas. This will foster recovery and lead to a more sustainable, equitable development path. Equally, investments in the health of workers and of care workforce are vital to make progress towards universal health coverage. If we are to achieve SDG3, increased cooperation is needed. By joining this partnership the ILO reaffirms its commitment to support countries during this pandemic and beyond, through a multilateral and coherent approach.”
- Guy Ryder, Director-General, International Labour Organization
“We have seen with HIV and now with COVID-19 the critical role communities play in connecting key and vulnerable populations to essential health and social services, in ensuring gender equality, inclusion and rights-based approaches to health and
social care, and in reducing inequalities. Resilient health systems rely on communities, this is why they feature prominently as a key pillar in the Global Action Plan and why they must be fully engaged, supported and funded."
- Winnie Byanyima, Executive Director, UNAIDS
"The COVID-19 pandemic affects everyone everywhere, but it is having a disproportionate impact on the world’s most vulnerable. By 2030, eight out of ten people pushed into poverty, as a result of COVID-19, will live in low and medium human development countries. Greater cooperation is the only way to defeat COVID-19 and restore and accelerate progress on the SDGs and on the pledge to leave no one behind. The SDG 3 Global Action Plan (GAP) is enhancing collaboration to support countries with their COVID-19 response and to lay the foundation for an equitable and sustainable recovery.”
- Achim Steiner, Administrator, United Nations Development Programme
“As the world rethinks health and other systems in the wake of the pandemic, we have a chance to address the inequalities, discrimination and exclusion COVID-19 has laid bare. Let us seize this opportunity to aim for universal coverage that upholds the fundamental rights, well-being and dignity of all. With quality disaggregated data to understand who is being left behind and why, and with women and girls at the centre of our rebuilding efforts, we can identify the best investments for strong, equitable health systems and resilient communities.”
- Dr Natalia Kanem, Executive Director, UNFPA
"Investing in primary health care is critical to keeping children, women and families safe during and beyond the pandemic. These investments will help countries prevent and fight future epidemics and pandemics, while achieving better health outcomes overall. UNICEF is proud to stand with our GAP partners as we help governments around the world design and deliver scaled-up primary health care services that can reach every child in every community.”
- Henrietta H Fore, Executive Director, UNICEF
"If the past year has shown us anything, it's that global solidarity is imperative to address the critical health challenges that confront us all, but particularly the world's most vulnerable populations. Alongside work to defeat the pandemic, we must not let progress against TB, malaria, HIV, other infectious diseases and women and children's health slip backwards, but rather double down on the goal of achieving the health-related SDGs. Equitable access to innovation has a vital role to play in getting lifesaving health products to everyone, no matter where they live."
- Dr Philippe Duneton, Executive Director, Unitaid
"The negative pressures exerted on our societies and economies by the COVID-19 pandemic both demonstrated and exacerbated gender inequalities and their intimate relationship with globally pervasive issues like men’s violence against women and the burden of unpaid caregiving work carried by women and girls. Resolution of these complex problems underpins the achievement of the SDGs. It demands responses grounded in partnerships, such as the collaboration under the Global Action Plan, that rebalance power, realize women’s rights to health, and recognize their leadership roles as active agents of change in their households, workplaces, and communities."
- Phumzile Mlambo Ngcuka, Executive Director, UN Women
“The Covid-19 pandemic has exposed weaknesses in health systems worldwide and set back progress towards SDG3. The World Bank is taking fast, comprehensive action to save lives and protect poor and vulnerable people, including with $12bn for vaccines, drugs and therapeutics. Partnerships and close coordination across all agencies is essential to help countries fight the pandemic effectively. We remain fully committed to working with all partners to strengthen countries’ health systems, including for better pandemic preparedness, and ensuring that no one is left behind.”
- Dr Mamta Murthi, Vice President, Human Development, World Bank
"The COVID-19 pandemic taught us to adapt, innovate and collaborate to save lives. We need to build on these lessons and step our game up even further. Working together even more effectively is critical so we can we meet increasing needs and build back better for a healthier, more well-nourished future".
- David Beasley, Executive Director, World Food Program
“The GAP partners have shown their unwavering commitment to countries during the pandemic. Collaboration is now more relevant than ever. The GAP provides the platform to improve collaboration in the multilateral system to support countries to recover from the pandemic and drive progress towards the health-related SDGs, with a focus on equity and enabled by stronger primary health care.”
- Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization
Repositioning primary health care during the pandemic to save lives and protect the customs and traditions of the Wayúu people. Nazareth hospital, Alta Guajira, Colombia. July 28, 2020.