Ahead of the 77th World Health Assembly, the 13 signatory agencies of the Global Action Plan for Healthy Lives and Well-being for All (SDG3 GAP) have released their fifth progress report, Aligning for Country Impact. Past the crucial SDG midpoint, with only 15% of the 50+ health-related SDGs on track to reach their 2030 targets, the SDG3 GAP's goal remains the same: multilateral collaboration evolves in response to a rapidly changing world and, crucially, in alignment with country priorities and needs.
In 2024, the SDG3 GAP approach has been used in 69 countries. Country case studies in the report, illustrate how the commitment to stronger collaboration is being translated into reality at country level. This fifth progress report amplifies countries' voices and notes their calls for greater alignment among development partners around national plans, most recently through the second round of the SDG3 GAP monitoring framework government feedback. The analysis of this year's feedback presents successes and challenges in both coordination and collaboration and proposes corrective measures for the way forward. Using this approach, countries have been able to suggest specific improvements for collaboration and coordination at all levels. Moving forward, development partners can consider these suggestions and best practices, to enable both strong country leadership, and strong alignment with national health-sector strategies and national planning and coordination mechanisms.
The report reflects on the lessons learned so far and actions taken to implement recommendations from last year's report. This includes revisiting the accelerators (programmatic areas crucial to accelerating progress on the health-related SDGs), acknowledging that stronger leadership and enhanced cross-accelerator collaborations drive increased alignment at the country level. Successes under accelerator themes over the past year include, the work of the Primary Health Care accelerator, which has focused support to 20 priority countries to develop and deliver a comprehensive package of essential health services. The Sustainable Financing for Health accelerator, which has provided a platform for partners to provide inputs into the Future of Global Health Initiatives Process, is providing a range of pooled or co-financed operations in countries and has identified some key issues and lessons learned from their joint financing of health-systems strengthening in low- and middle-income countries.
In recognizing the importance of leveraging strengths and partnerships, the agencies support alignment with emerging agendas such as the conclusion of the Future of Global Health Initiatives Process, which captures consensus around five key shifts for the long term evolution of global health initiatives, known as the Lusaka Agenda, and new strategies such as Gavi's 6.0 Health Systems Strategy, World Bank's Evolution Roadmap and WHO's 14th Global Program of Work. Additionally, they continue to improve alliances with initiatives including UHC2030, to support countries in meeting their universal health care commitments.
"Progress towards meeting the health-related targets of the 2030 SDGs is only about one-third of what is needed," said WHO Director-General Tedros Adhanom Ghebreyesus, Chair of the SDG3 GAP Principals Group. "The SDG3 GAP is founded on the idea that stronger collaboration between multilateral agencies can help us get back on track. This report takes stock of achievements and lessons learned during these years and provides directions for how SDG3 GAP should evolve going forward in our joint efforts for better health for all."
Incentives for collaboration, including the cost of collaboration, still hold back fulfilling the immense potential for stronger collaboration and alignment both within the SDG3 GAP and across the multilateral system. Constrained financial, technical and operational resources mean that development partners' accountability mechanisms on collaboration across the broader health ecosystem are limited.
The findings of an Independent Evaluation of the SDG3 GAP are expected in September 2024. The evaluation results could prompt a rethinking of approaches taken thus far, both inside the scope of SDG3 GAP, and outside of its structures. This progress report contributes to the basis for further discussions among the signatory agencies and relevant stakeholders, on how to further improve the alignment and collaboration across the global health ecosystem to achieve progress towards the health-related SDGs.
Quotes from SDG3 GAP Principals
Dr Sania Nishtar, CEO, Gavi, the Vaccine Alliance:
"Gavi strives to make a sustainable impact on global health by ensuring our actions are in harmony with countries' efforts to improve public health and well-being. Our role in the Sustainable Financing for Health Accelerator underscores our dedication to helping countries rapidly improve the generation, allocation, and use of funds for health. By working together, we can build robust health systems that will withstand current and future global health challenges."
Juan Pablo Uribe, Global Director for Health, Nutrition and Population, World Bank and Director, Global Financing Facility for Women, Children and Adolescents:
"Ensuring better health for women, children and adolescents is the foundation of prosperous societies and resilient growth. With a clear call from countries for better alignment behind their health plans, the Global Financing Facility will continue to focus on supporting countries for stronger coordination with partners and aligned financing to accelerate health progress for women, children and adolescents, particularly in the hardest to reach communities."
Gilbert F. Houngbo, Director-General, International Labour Organization:
"The ILO is committed to promoting a social justice approach to investments in health and care as a contribution to achieving the SDG 3 targets. This includes investments in social protection, occupational safety and health, and decent work for health and care workers."
Peter Sands, Executive Director, The Global Fund:
"The world is beset by interlocking and intersecting crises. These crises, and those looming on the horizon, are exposing the fragility of advances in human health and development. The Global Fund's partnership model is the foundation for successful implementation of the SDGs. Restoring advancement toward the SDGs and future-proofing progress requires agile, collaborative, well-resourced and resilient systems for health that leave no one behind when crises inevitably strike."
Winnie Byanyima, Executive Director, UNAIDS:
"Too many countries are struggling to meet the health needs of their people. The good news is that we know what needs to be done. World leaders need to urgently boost public financing for health, and fix the global debt crisis that is draining vital resources needed to save lives. Leaders need to support communities to lead, so that health systems can meet people's needs. And leaders need protect everyone's human rights, so that all people can access all services without fear or stigma. With courage, commitment, and collaboration, health for all can be secured."
Achim Steiner, Administrator, United Nations Development Programme:
"The continued, slow recovery from the COVID-19 pandemic and the crushing weight of debt servicing in many developing countries is curtailing critical investments in healthcare and health systems. At the same time, conflicts, crises, and a changing climate are inflicting an increasing toll on societal health and wellbeing. In this context, the latest SDG 3 GAP progress report pinpoints the interventions needed to realize the health-related Sustainable Development Goals and a revitalized global health ecosystem aligned with country priorities that safeguards the health of both people and planet – an attainable ambition that the United Nations Development Programme will continue to support with our partners across the globe."
Dr Natalia Kanem, Executive Director, UNFPA:
"Thirty years since the adoption of the International Conference on Population and Development Programme of Action, the evidence is clear: resilient health systems are essential for ensuring universal access to sexual and reproductive health and rights – a cornerstone for achieving our 2030 targets. In a turbulent world, UNFPA and our partners in the SDG 3 Global Action Plan remain steadfast in our commitment to supporting country-led action to uphold the health, rights and choices of every woman and girl."
Catherine Russell, UNICEF Executive Director:
"UNICEF is committed to realizing the Child Survival goals by 2030, with Primary Health Care as a critical investment to end preventable deaths and save the lives of women and children. These efforts must go hand-in-hand with interventions that protect girls, such as keeping them in school, while avoiding child marriages and early pregnancies. UNICEF supports the alignment of fully funded health plans under the leadership of national governments. Community Health Workers, who are trained and paid, and who have access to well-resourced primary health care facilities, are key to accelerating progress on child survival and development."
Dr Philippe Duneton, Executive Director, Unitaid:
"A coordinated global health response is critical to achieving the Sustainable Development Goals. We rely on mechanisms like the Global Action Plan to monitor our progress and help us refine our approach so we can reach more people with vital care and improve global health for all."
Sima Bahous, Executive Director, UN Women:
"Unlocking the full potential of the 2030 Agenda lies upon achieving gender equality and championing the rights of all women and girls everywhere. SDG3, aiming at achieving good heath and well-being for all, is no exception. UN Women encourages all stakeholders to double their actions, to dedicate resources at the grassroots level and to dismantle discriminatory norms. Together, we can pave the way for a future where every woman and girl thrives, where their health and well-being prospers without barriers."
Dr Mamta Murthi, Vice President for Human Development, World Bank Group:
"Investing in people's health and nutrition creates human capital and is a key driver for ending poverty on a livable planet. With governments around the world under increasing financial constraints, we need to make sure that health investments remain a priority. By working together in support of country-led plans to strengthen health systems, partners can help countries crowd-in resources and use them effectively to improve health outcomes and make progress towards the health-related SDGs."
Cindy McCain, Executive Director, World Food Programme:
"Robust health and balanced nutrition are two sides of the same coin so it's vital that we all work together to address the causes of hunger, malnutrition and illness. The SDG3 Global Action Plan provides a valuable route map to help us collaborate even more effectively, paving the way to a healthier, hunger-free future for all."
