Looking Back, Moving Forward

Over the last 15 years, the Millennium Development Goals (MDGs) have driven unimaginable progress in global development, lifting over one billion people out of extreme poverty, reducing child and maternal deaths dramatically, and giving more children than ever a chance to attend school. In September, a new set of global goals –the Sustainable Development Goals (SDGs) – were adopted to continue the legacy of the MDGs by providing a bold vision to give all people the chance to enjoy prosperous and fulfilling lives by 2030.

When setting goals, it is important to take a moment to reflect on the lessons learned from previous ventures to inform the path forward. This is true for personal goal setting, and it is true for the new SDGs. Based on the lessons I learned from the MDG era, I believe there are three important approaches that must be in place for us to achieve the SDGs.

1.      Create implementation roadmaps and financial plans

No business can get started without a roadmap or plan in place. A solid business plan gives leaders and investors the confidence to believe that the vision of the business can be achieved – and the global goals are far more ambitious, visionary and complex than any business plan I’ve seen.

But their complexity and scale does not excuse the need for clear roadmaps and implementation plans; rather, it makes it all the more necessary. With the vision of the SDGs in hand, we need to see a clear roadmap and financial plan for goal achievement, especially in the first 1-2 years of execution – which will set the trajectory for success or failure. While these plans must be country-led, owned and informed by leaders who understand what is possible in the national context, I believe there is also value in developing plans at a more macro level – perhaps region by region.

Thankfully, some of this work has already begun. This September, building on the success achieved in the last ten years through strategic plans and working backward from clear deadlines, together with Bill Gates, we laid out an ambitious yet achievable vision of eradicating malaria by 2040 in an in-depth report titled From Aspiration to Action: What Will It Take to End Malaria? The report works back from 2040, draws on lessons from previous eradication efforts and applies innovative new strategies, tools, and financing. It has a particularly strong focus on the first 2-3 years of the effort, which will be our pace setter for the rest of the plan, and during which period, much more is known.  Similarly, the UN Secretary-General’s Every Woman Every Child movement has launched a new Global Strategy for Women’s, Children’s and Adolescents’ Health, which has the buy-in of many public and private stakeholders, as well as a financing platform in the Global Financing Facility hosted by the World Bank, alongside key funders such as the Global Fund and Gavi.  An operational framework is currently being drafted to ensure our collective trajectory will reach the intended destination, and it is important that this plan serve as a clear and quantitative guide for the critical country-by-country planning process.

My first-hand experience with malaria during the MDG era showed what could be done when roadmaps and plans were created and shared.  Countries with well-crafted, quarter-by-quarter plans shaped with regional input were far more successful at securing funding, driving complex operations and holding leaders accountable in the quest to save more lives.

Plans will inevitably be refined and adjusted the day after they are written, but getting a first version written and agreed upon to set the course is an important first step.

2.      Develop strong accountability frameworks informed by reliable data

With solid plans in place, we must develop an accountability framework for sharing progress with all partners, as well as the people for whom the goals were created. Accountability mechanisms provide a way to keep all stakeholders motivated and engaged. A successful example of this from the MDG period that is now carrying over to the SDGs is the Scorecard created by the African Leaders Malaria Alliance (ALMA), an alliance of 49 African Heads of State who meet regularly to compare progress on malaria prevention and control and share information among the community. I know that the Partnership for Maternal, Newborn, and Child Health has been giving serious consideration to accountability as well, and I applaud those efforts.

The successes of the MDG period, however, belie deep inequities.  Well over half of maternal and child mortality, for instance, remains focused in fragile or hard-to-reach areas – many in conflict or post-conflict –  where the low quality or absence of data leads to low quality or absence of services. The data that inform service delivery is often incomplete and biased towards those most easily accessed. These girls and women, boys and men, fall between the cracks of humanitarian assistance and development.

Equitable improvement in health and human development in coming decades will require tools aimed at including the world’s most marginalized populations. This challenge necessitates the timely creation of a crucial public good, an “atlas” might ensure that those who are least likely to be counted, are counted, and their needs registered to allow us to collectively target our response. To this end, I welcome the continued leadership of the Canadian government in their quest to improve Civil Registration and Vital Statistics, working alongside partners such as Massachusetts Institute of Technology’s Media Lab, Twitter, the Arnhold Global Health Institute, Intellectual Ventures, the Institute for Health Metrics and Evaluation, and Google Earth, among others, who are leading an innovative collaboration between the technology and development sectors to address this critical need.

3.      Create incentives to bring in new financial investments and business know-how

The well-being of people and planet is the motivation behind the SDGs. But it is financial investment – along with smart management – that will enable us to achieve them. Fortunately, the economic case for achieving the SDGs is extraordinarily strong. Over 34 million children’s lives have been saved during the MDGs, which has driven an estimated $3.8 trillion return to the economies of the countries in which these lives were saved. The return on investment of the SDGs also merits this potential.

With the cost of achieving the SDGs estimated in the trillions, the task of raising the needed funds is a big one. We simply must source it in new and more innovative ways, and given the economic benefits of the achievement of the global goals, assist implementing countries to find ways to frontload their efforts while their economies grow and they begin to reap the benefits of goal achievement. In addition, while it will not make up the majority of what’s needed, there is substantial private money seeking investment opportunities if social returns are generated alongside financial ones, and if we can create the requisite structures and mechanisms to incentivize these investors.

In recent years, Nigeria and India have structured highly effective collaborations bringing together private investors and philanthropists with their governments, at national and state levels, to drive change and improve maternal, newborn and child health. The ground-breaking public-private Indian Alliance for Saving Mothers and Newborns (ASMAN) is about to launch – thanks to the leadership of the Indian Government, alongside the Gates Foundation, Merck, the Reliance Foundation, the Tata Trust, and USAID.  I would especially like to call out the leadership of Dr. Naveen Rao, director of Merck for Mothers and one of our leaders in the MDG Health Alliance, who with this team has worked so hard to support this effort. An alliance is also emerging in Kenya to fit unique national opportunities and objectives. These collaborations have resulted in improved returns on philanthropic investments in areas ranging from impact investments to specific healthcare program implementation.

Finally, global financing institutions like the World Bank, Inter-American Development Bank, Islamic Development Bank, the Global Fund, Gavi, and others are developing funding mechanisms that leverage their available capital to incentivize additional funding from governments and the private sector. The newly launched Global Financing Facility-IBRD window is an excellent example. By providing countries access to additional funding through IBRD bond issuances, and combining it with the GFF trust fund’s ability to create very attractive financing terms through results-based buy-downs, billions of additional dollars will be brought into the health financing space. Similar collaborations are underway with the Global Fund, and we’ll all need to rally together to support its successful replenishment to continue the tremendous progress that has been made through Global Fund investments.

As we acknowledge our successes of the past years, as we embrace a new and more ambitious set of goals, and as we celebrate 70 years since the founding of the United Nations, I hope that all of us can find ways to engage with achieving our shared vision for the future. There’s no better time to get started than now.