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UN Commission on Information and Accountability for Women’s and Children’s Health
 
Ban Ki-moon
photo credit: ITU/V. Martin
“The world’s women and children need more than pledges. Commitments are wonderful and generous, but by themselves they cannot build health clinics or immunize children. That is why we have made accountability a hallmark of the Global Strategy. We are determined to hold ourselves and everyone else involved accountable.”

Ban Ki-moon
United Nations Secretary-General
image
Photo credit: ITU/V. Martin
From left to right (front row): Dr Hamadoun I. Touré, ITU Secretary-General and co-Vice Chair of the Commission; Beverly Oda, Canada’s Minister of International Cooperation and Alternate co-Chair; Stephen Harper, Canada’s Prime Minister and co-Chair; Jakaya Kikwete, Tanzania’s President and co-Chair; and Dr Margaret Chan, Director-General of WHO and co-Vice Chair of the Commission

As reported in the December 2010 issue of ITU News, the World Health Organization (WHO) has established a Commission on Information and Accountability for Women’s and Children’s Health at the request of United Nations Secretary-General Ban Ki-moon. The Commission, which held its first meeting in Geneva on 26 January 2011, will develop an accountability framework that will link resources destined for women’s and children’s health to actual results. In particular, the framework will help monitor global financial commitments for maternal, newborn and child health, and ensure that resources save as many lives as possible.

The Accountability Commission is co-chaired by Tanzania’s President Jakaya Kikwete, and Canada’s Prime Minister Stephen Harper. The Secretary-General of ITU, Dr Hamadoun I. Touré, and the Director-General of WHO, Dr Margaret Chan, are co-Vice Chairs of the Commission.

      At the United Nations Summit on the Millennium Development Goals, held in September 2010, countries and their donor organizations pledged USD 40 billion to the Global Strategy for Women’s and Children’s Health over five years, insisting on accountability to ensure that these resources achieve the expected results
The new Commission will create a framework to monitor global financial commitments for maternal, newborn and child health, and ensure that resources save as many lives as possible

Speaking at the meeting, Dr Touré underlined the enormous benefits that digital technologies can bring to the collection, dissemination and sharing of health information. “At the beginning of 2011, there were more than 5 billion mobile subscriptions and more than 2 billion Internet users. Certainly, we still have far to go in delivering the affordable broadband access which is vital for really meaningful progress in digital health initiatives and programmes. But these figures show that technologies already at our disposal, such as ordinary mobile telephones, can play an increasingly vital role in health care, as vehicles both for data collection and analysis, and for delivery of basic health services to communities.” Dr Touré added that some of the members of the Commission are already well-advanced in implementing exactly these types of ICT-based strategies, and their experiences will be invaluable over the coming months as they work towards the Commission’s final recommendations.

The commissioners have been chosen from a wide range of stakeholder groups in high-income and developing countries, including governments, international organizations, civil society, the private sector, foundations and academia. At their first meeting, the commissioners agreed to work towards recommending an accountability framework, with an action plan to strengthen countries’ ability to collect essential data. The framework will be designed to track results and resource flows at global and country levels. The commissioners will identify a core set of indicators and measurements of women’s and children’s health, propose steps to improve health information and registration of vital events — births and deaths — in low-income countries, and explore how information technology can improve data collection and access to reliable information on investments and outcomes. The Commission will finalize its report in May 2011, in time to be submitted to the World Health Assembly.

Why a Commission?

The idea for the Commission arose from the United Nations Summit on the Millennium Development Goals (MDGs) held in September 2010. UN Secretary-General Ban Ki-moon launched the Global Strategy for Women’s and Children’s Health — an ambitious agenda for collective action to improve the health of women and children, and accelerate progress on the health-related MDGs. The Global Strategy aims to save the lives of 16 million women and children under five years of age by 2015, prevent 33 million unwanted pregnancies, protect 120 million children from pneumonia and 88 million children from stunting, advance the control of malaria and HIV/AIDS, and ensure access for women and children to good quality facilities and skilled health workers in the world’s 49 poorest countries.

At the summit, countries and their donor organizations pledged USD 40 billion to the Global Strategy over five years, insisting on accountability to ensure that these resources achieve the expected results. This accountability will be achieved by integrating service delivery and funding platforms, involving a wide range of stakeholders, emphasizing research and innovation, and tracking progress through an accountability framework.

      image
photo credit: AFP

The Commission’s working groups

Two working groups of technical experts are guiding the work of the Commission. One addresses how to improve accountability for results — the outcome of programmes — and is chaired by Richard Horton, chair of the Health Metrics Network and editor of The Lancet. The other addresses the best ways to ensure accountability for financial resources, and is chaired by Anne Mills, professor of health economics and policy at the London School of Hygiene and Tropical Medicine.

Three characteristics of the Commission’s work

First, with only five years to the target date of 2015 for achieving the Millennium Development Goals, the Commission will work rapidly and complete its report by May 2011.

Second, the Commission is action-oriented with its clear aim to propose an accountability framework, along with a plan to improve monitoring of progress and tracking of resources.

Third, the work of the Commission is inclusive. The Commission will build on existing global and country-level processes in order to increase coordination and reduce the difficulty of meeting the demands for health information. It will draw on the wealth of experience in many countries and many sectors through the use of Internet-based information technologies and social media.

      “ If we are going to be able to deliver health care for all in this new century of connectivity, it will be through cooperation and partnership between the technology and healthcare sectors. ”

Dr Hamadoun I. Touré

What the leaders say

Speaking on the occasion of the first meeting of the Commission in Geneva, UN Secretary-General Ban Ki-moon said: “The world’s women and children need more than pledges. Commitments are wonderful and generous, but by themselves they cannot build health clinics or immunize children. That is why we have made accountability a hallmark of the Global Strategy. We are determined to hold ourselves and everyone else involved accountable. We will track how many promises are kept; we will monitor what we are doing with the funds that do come in; we will ensure that progress is made across the spectrum; and where we fall short, we will be open about that too.”

Noting that the Commission brings together medical professionals, finance officers, policy-makers, statisticians and human rights experts, Mr Ban said: “We cast a wide net because the health of the world’s women and children is everyone’s responsibility. Our aim is simple: to turn our Global Strategy into global action for women’s and children’s health. This Commission will help us make health systems work better for all people.”

President Jakaya Kikwete sketched the scope of the challenge ahead, emphasizing that Africa has just 12 per cent of the global population but accounts for half of all maternal deaths and half of all deaths of children under five years of age.

Canada’s Prime Minister Stephen Harper stressed that accountability is essential “to ensure the respect of commitments made, that the resources are spent accordingly and that the desired results are achieved.”

WHO’s Director-General Margaret Chan commented that more than 100 countries currently do not have welldeveloped civil registration systems. “This means that many births and many deaths globally are invisible. For true accountability, we must be able to count every birth and every death. Countries need to know how many people are born and die each year — and why they are dying,” she said.

Dr Touré stressed that “if we are going to be able to deliver health care for all in this new century of connectivity, it will be through cooperation and partnership between the technology and healthcare sectors.”

ITU and WHO have joined forces in facilitating national e-health planning, bringing together the health, ICT and finance sectors to collaborate in developing a toolkit to guide national decision-makers. Dr Touré also co-chairs — together with Professor Klaus Leisinger from Novartis Foundation — the Advisory Board of the Digital Health Initiative (DHI). “The DHI is a perfect example of a public–private partnership which aims to harness the full potential of ICT and digital user devices to accelerate the achievement of the MDGs for health — goals which I am sure you will agree are perfectly in line with the ambitions of this Commission,” Dr Touré said.

 

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