13.5 Monitoring of the achievement of the health-related Millennium Development Goals

Posted Mon, 2012-04-02 08:24

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Documents

The issues before the Assembly

The document (A65/14) provides the annual report on the progress in achieving the MDGs and shows that substantial progress has been made even though large gaps persist between and within countries. The Assembly is invited to consider global health goals after 2015,  

Document A65/15 reports on the finalisation of the Commission on Information and Accountability for Women's and Children's Health (focusing on MDGs 4 & 5) and the implementation of the recommended monitoring mechanisms for which WHO has some responsibility.

PHM pre debate comment

The failures in the achievement of the health MDGs has its roots in the failure to invest in sustainable functioning health systems and in the construction of disease-focused interventions without adequate connections with the wider issue of sustainable and inclusive socio-economic development.

There are high cost barriers to accessing medicines in many low and middle income countries, particularly in public sector health facilities (para. 16) with consequent impoverishment from out-of-pocket expenditure. 

The document includes also some comments on global health goals after 2015 presenting interesting ideas regarding new challenges to health and new approaches to development, and stating that setting new goals need to be clearly linked with the process of WHO reform.

In our view the next round of global health goals should focus not only on vertical targets but on building integrated functioning health systems and on processes and determinants that need to be addressed in order to achieve these goals.

Report of WHA65 Discussion

The discussion focused on two reports from the WHO Secretariat: one progress report on the health related MDGs which included also a section on global health goals after 2015 and a document on the implementation of the recommendations of the Commission on Information and Accountability for Women’s and Children’s Health. Resolution EB130.R3 was also considered.

All countries emphasized the importance of this agenda item and recognized that even if substantial progress has been made, large gaps still persist between and within countries. Many countries were particularly concerned about the lack of progress in reducing maternal and infant mortality.

Iran pointed out that the main obstacles in achieving the MDGs are an insufficient political commitment and huge inequities in the allocation of health resources.

Mauritius, on behalf on AFRO, stressed the importance of health systems strengthening, access to effective medicines and alignment of external resources with national priorities.

The importance of health system strengthening was also reiterated by Switzerland and Canada.

The need for increased efforts to address the social determinants of health was stressed by several countries.

Mexico and Ethiopia recalled the importance of monitoring and ensuring quality of data by strengthening health information systems.

Concerning the goals after 2015 , many countries appreciated the Secretariat's strategic thinking about global health goals after 2015. Norway recalled the new challenges the world will face in the following years (such as climate change, NCDs, food security, geopolitical changes). These challenges should be taken into account in setting the new goals. Other countries stated that the new framework should focus on sustainable development. Brazil and Japan affirmed that, even if they support the discussion on the goals after 2015, they think that WHO and Member States should firstly concentrate on the achievement of the past MDGs and asked WHO to continue its efforts in this area.

The Assembly adopted the resolution proposed by the EB on the monitoring of the MDG health related goals.  See Third draft report of Committee A

PHM post debate comment

Some people working in public health are worrying that ‘health will lose out’ in a new post 2015 set of global goals, mooted to be adopted at Rio+20 in June 2012.  

It is anticipated that a new set of goals based on the idea of inclusive and sustainable development will be adopted.  This could be a significant improvement on the MDGs. While the huge increases in foreign assistance for health since 2000 have saved lives they have not directly addressed social, economic and institutional development.

With a new focus on inclusive and sustainable development there will be opportunities to progress the issues of health system strengthening and action on the social determinants of health.

The recommendations of the Commission on Information and Accountability and the accountability mechanism being put in place provide an interesting case study in the mutual accountability of nation states.