From the Special Envoy: Our 2015 Balancing Act

Two-Thousand-Fifteen.  We’ve known all along that it would eventually arrive.  But seeing that iconic MDG target year on the MDG Countdown Clock in our office was still a bit of a shock.

We have an important balancing act ahead of us in 2015: It is imperative that we do everything that we can to address the major causes of preventable deaths for women and children in our sprint to the MDG finish line on December 31^st of this year. At the same time, we must support the development of a robust post-2015 development agenda that protects our hard-won gains while embracing an even more encompassing and ambitious set of goals. I am looking forward to working with the UN Secretary-General Ban Ki-moon as well as our many partners in global health to manage this exciting year of transition.

As we buckle down for the hard work ahead, I am reminded of a quote from former U.S. National Security Advisor General Jim Jones who reflected that “The work being done in the global health world … is crucial for promoting global stability and eliminating the circumstances that foster hate and radicalism.” I could not agree more. Fighting preventable deaths and diseases by fostering global collaboration, identifying requisite financing and adhering to clear action plans is the most potent of efforts towards a more peaceful world. Much more so than weapons of war.

Here are the four areas where our office will focus in the coming year, working in close collaboration with so many valued partners.

First, on malaria, we have seen a nearly 60% decrease in the mortality rate in malaria-related child deaths in Africa since 2000. Last year, a record 211 million insecticide treated bed nets were delivered globally, which should provide protection to more than 385 million people over the next three years.  Since we began working with net manufacturers over ten years ago, the world has produced and delivered over 1 billion bed nets worldwide with the support of the global donor community – this is an historic accomplishment of which we should all be proud.

With these 2014 gains, along with expected additional progress in coverage of diagnostics, treatment, and prevention for malaria in 2015, our path is clear to reaching the target of fewer than 100,000 child deaths from malaria – what we define as “near-zero” deaths.  As we move towards this success, we can begin to turn our attention to an even more audacious goal – the eradication of malaria once and for all.   Working with Bill Gates and his team, Margaret Chan and hers, along with others, planning is underway to develop a roadmap that would lay out a potential pathway for reaching this visionary goal. We look forward to sharing progress on this plan throughout the year.

Second, on financing of the health-related MDGs, we have seen continued increases in the resources available for financing maternal and child health.  In September we had the announcement of a Global Financing Facility (GFF) for Reproductive Maternal Newborn Child and Adolescent Health, with an initial capitalization of nearly US $4 billion supported by the World Bank and the Governments of Norway, Canada and the United States.  Detailed consultations are under way for all aspects of the GFF, from governance to focus areas for funds distribution.  At the same time, the RMNCH Trust Fund recently mobilized an additional US$120 million from the government of the United Kingdom, and we continue to work closely with our colleagues in Canada to advise them on MDG-related funding opportunities this year.   We see a massive potential to roll out several large-scale health bonds over the course of this year, building on the incredible momentum building in the social impact investing space.   I have seen few moments this promising throughout my financial and philanthropic career.

On financing for global health in the future, the world is entering an important transition period that presents great opportunity, and great risk if not managed carefully. According to an analysis conducted at the Bill and Melinda Gates Foundation, between 2014 and 2030 approximately 41 countries are expected graduate from the World Bank’s fund for the poorest, the International Development Association (IDA).  Additionally, 15 countries are expected to graduate from the African Development Bank’s Africa Development Fund; 15 countries are expected graduate from the Asian Development Bank’s Asian Development Fund; and as many as 38 countries are expected to graduate from the Global Alliance on Vaccines and Immunization (GAVI). Such graduations should be welcomed, but also managed carefully. We need to dramatically increase our focus on innovative financing approaches such as social and development impact bonds, pooled procurement schemes, impact investing and others, in order to support countries on the path to increased domestic investment in health and to ensure that we reach the most vulnerable populations of women and children around the world. On that last point, we know that over half of all maternal and child deaths are in fragile state/conflict settings, and we must work to improve financing for health and education for these most vulnerable populations.

Third, on Ebola, we must to everything we can to support the speediest possible end to the outbreak, ensuring that funding, resources and management are all supported as needed. But the real test of victory in this fight will be our ability to capture lessons learned from the outbreak and then develop the plans and actions needed to prevent the next one.  Clearly, all roads lead to the development of much more robust health delivery systems, and I would suggest that a natural point of entry is around Community Health Workers.   We need to follow Ethiopia’s lead, and deploy armies of these workers, who could be used not only to fight and trace the “next Ebola”, but would be essential to ending malaria, and ending preventable maternal and child deaths.

Fourth and finally, on nutrition and newborn survival, 2015 is the year for donors and countries to accelerate funding against commitments they made for Nutrition for Growth (N4G) and the Every Newborn Action Plan (ENAP) in 2013 and 2014, respectively. My team will continue to work with partners to channel funding in 2015 towards high-impact nutrition and newborn survival interventions such as early initiation of breastfeeding for newborns and improved care and treatment of mothers and newborns in facilities, especially during the first 48 hours of a child’s life.

The reality that only 331 days remain between today and the MDG deadline is humbling. I believe we have enough time remaining to make a significant impact and achieve even greater results, allowing us to enter the post-2015 era in the strongest position ever to achieve the next set of goals.  Through securing sufficient resources for health, we have been and will continue to strengthen international relationships and improve human lives on a massive scale.

Here is to a successful sprint through the home stretch of this phase of the race.