Matt 2

Health Advocacy Officer, Matt Oliver, gives his opinions surrounding the release of the recent High Level Panel report on the post-2015 development agenda.

The release of the High Level Panel (HLP) report last Thursday marked the end of the beginning for the post-MDG process.  A year’s deliberation between the 27-strong panel resulted in a report that was 70 pages long, with 12 new proposed goals and 53 targets.

The report now feeds into the wider process for developing the new framework. It will be presented to the UN General Assembly in September and taken forward by the ‘Open Working Group’ which is tasked with developing the new framework.

There are many elements of the report that I’ve found encouraging. Health figures strongly. Goal 4 reads “Ensure Healthy Lives” and focuses on issues like vaccines, child and maternal deaths and diseases like TB, whilst goal 5 reads “Ensure Food Security and Good Nutrition”, touching on nutrition, stunting and sustainability.

I’m not alone in finding many positives in the report, in fact, the vast majority of feedback appears to have been positive.

But is this a cause for concern?

I appreciate that this sounds a little bizarre, if so many people appear to be happy, surely that’s a sign of a job well done by the HLP?

No. It’s a sign that the scope of the report is so wide that the vast majority of issues got name-checked. Nearly everyone is happy with the report because nearly everyone’s issues are addressed in it.

This is both understandable and problematic. It is understandable because the framework is first and foremost a communication tool. To communicate effectively the framework has to capture the imagination, and to do that it must be aspirational.

The process was designed to be inclusive. It consulted a wide range of stakeholders and drew in a wide range of opinions. Having done that, the report would have been heavily criticised by the owners any of those opinions that were left out, so few of them were.

By tending towards utopianism, though, the framework does two things I see as problematic. 1) It appeals to a certain tendency within the development community to talk about desirables rather than deliverables, and 2) it moves away from a focused set of concrete, achievable goals and targets.

Take target 4a: “End preventable infant and under-5 deaths”. No one could argue with the intentions of such a target, nor with the importance of achieving it. It is, however, so  sweeping that it is hard to imagine how it could be achieved. It draws every issue of child health under its wing and lacks clear focus.

Some would argue that this is a good thing; it leaves countries able to choose their own methods to eliminate preventable infant deaths.

Others would argue that if, for example, pneumonia and diarrhoea kill 2 million children a year, then those diseases should be a specific named target of any goal.

The breadth of focus, the desire to include everyone’s views, has resulted in a sprawling set of goals, heavy on ambition, but light on achievability.

The process is not doomed. This is just the first draft of many. Indicators are yet to be decided and will hopefully  specify certain issues as key focuses. Likewise, the lengthy process to get from the HLP report to the final framework should lead to the document being honed to a much sharper focus.

If not, I fear that the final framework will be too general  and lack the targeted approach to outcomes which will funnel development efforts onto the key issues that make the biggest differences.

So, what do I think are these key issues? It seems unfair to criticise the report for being too general and then not offer any opinions of my own.

I think the focus, for health, should focus on two key questions:

–          What kills or damages the health of the greatest number of people?

–          How do we stop it?

This will give three key focus areas:

–          Nutrition. Guaranteeing that as much of the world has access to stable, high quality food supplies.

–          Vaccines. Protecting as many people as possible against the diseases that steal their quality of life.

–          Diseases. Where there is still no vaccine, (like for HIV, TB and malaria) massively increasing the Research and Development investment needed to develop a vaccine, whilst working to mitigate their impact as much as possible.

The HLP report was a good first step. The ambition is laudable, and the consultative process also. But the hard work now must be done to tighten the focus so that it is firmly on a limited number of key issues.

Inevitably this will lead to many hard decisions, but we must make sure that the framework focuses on outcomes, on the things that will make the biggest difference to the lives of the most people. If we don’t then I worry that the post-2015 framework will have failed before it started.     

June 2013

The views and opinions expressed herein are those of the author and do not necessarily reflect the views of the Blog owner