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Health in post-2015: Forging consensus in Botswana

Today and tomorrow, a high level meeting has been convened in Botswana to conclude the post-2015 health consultation.

The 40 participants include representatives from governments, the Health 8, the UN Secretary General’s High-Level Panel of eminent persons on the Post-2015 Development Agenda, academia, civil society, the private sector, youth, global leaders, and the Botswana, Sweden, UNICEF, and WHO Task Team that has led the consultation.

Save the Children facilitated a consultation in Bolivia, so we are lucky to have a colleague there to feed into the discussion and report back. Watch this space…

To influence what?

A  report from this health consultation will be submitted to the High Level Panel to influence the their cross-sectoral report to the UN Secretary General. This will inform a Summit at the United Nations General Assembly this September, facilitating negotiations between Member States on what follows the Millennium Development Goals (MDGs).

Why does it matter?

While a report to influence another report to influence a Summit might seem far off exciting, it is nonetheless an important step to securing a strong and integrated health goal in the sustainable development agenda.

What are we calling for?

As we have outlined in Ending Poverty in Our Generation and our health briefing, Save the Children is calling for recognition of health as a driver and an objective of sustainable development. Health is a human right and a public good. Better and more equitable health outcomes also increase productivity and resilience, reduce poverty and promote social stability. The importance of health was recognised in the MDGs and must not be lost in the framework that follows.

Getting to zero

The future development framework must build on the strengths and learn from the weaknesses of the MDGs, maintaining momentum on unfinished business and increasing ambition to accelerate progress. Such ambition must be matched with commensurate political and financial resources, acknowledging global shared responsibility to realise the right to health for all.

Save the Children is calling for the future health goal to:

  • Bring an end to preventable maternal and child mortality with a zero target on preventable deaths;
  • Lay the foundations for sustainable progress on health outcomes through Universal Health Coverage (UHC);
  • Drive reductions in inequalities through goals and targets that are applied explicitly to all sections of society, notably the bottom two wealth quintiles, and not just national averages.

An opportunity for consensus?

As reflected in the draft consultation report, the health community remains fragmented with competing proposals for goals that deliver to particular interest groups. I fear that this will undermine our ability to secure sufficient focus on health in the post-2015 agenda.

But I do believe that consensus can be forged, and the current debates on measurement of UHC could be more inclusive to demonstrate this.

An inclusive health goal can capture the unfinished business of the MDGs, maintaining a focus on mortality and coverage of key interventions. This list should be expanded to reflect the burden of ill-health and chronic diseases, as well as key interventions to address the social determinants of health.

There must be a health systems component that includes financial risk protection and other proxies across the pillars of the health system such as access to appropriately trained health workers.

We feel that it could also include indicators on political commitment to health by tracking public expenditure on health and the institutionalisation of legal frameworks on the right to health. All of these targets and indicators should guide and track reductions in inequalities.

Rather than being territorial and exclusive, we must now be inclusive and collaborative to align behind a strong recommendation to the HLP. We call on the participants on the meeting in Botswana to rise to this challenge.

 

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