“Hold us to account”: IHP+ Technical Briefing at the World Health Assembly
Seven development partner behaviours identified as obstacles to better results
“This is a watershed event. We want you to hold us to account. This is what mutual accountability means,” said WHO Director-General, Dr Margaret Chan at the IHP+ Technical Briefing at the World Health Assembly on Tuesday 21 May 2013. Over 200 people attended the event, co-hosted by Dr Chan and Dr Jim Yong Kim, President of the World Bank. Speakers from developing country Ministries of Health and Finance, development partners and southern civil society presented their experiences of development effectiveness and IHP+ principles and ways of working. The aim of the meeting was to improve understanding of the continuing obstacles to better results caused by ineffective cooperation, and to reiterate the collective commitment to the IHP+ approach.
Dr Kim reiterated the need for development partners to be accountable for their actions and said, “We insist on countries being in the lead. Country partners, please hold us accountable.” In December 2012, IHP+ signatories identified critical areas where development partners need to change their behaviours (now known as the ‘seven behaviours’). If these behaviours changed positively, it would lead to visible results in the health sectors in developing countries. Gunilla Carlsson, Minister for International Development Cooperation in Sweden said, “We are not maximising our efforts today. We need to focus on health results in real people’s lives.”
Developing country governments shared their experiences of working with development effectiveness processes, speaking of both positive experiences and existing challenges. The Minister of Health in Ethiopia, Dr Kesetebirhan Admasu described the positive effects of development effectiveness processes in relation to Ethiopia’s flagship health extension programme, where access to basic healthcare services have improved significantly. He also spoke of the need for four main areas of progress. Firstly, effective planning processes with developing countries in the driving seat. Secondly, predictable and flexible financing from development partners and donors. Thirdly, using those flexible resources to scale up implementation rather than being restricted to pilot projects. And fourthly, the need for one monitoring and evaluation system.
Pe Thet Khin, Minister of Health of Myanmar, reflected how his country, having been closed from the international community for 20 years, is now re-engaging and facing the reality of the complex global aid architecture. He noted that ‘being in the driver’s seat’ does not just mean being able to say ‘yes’ or ‘no’ to partners. He called for reduced fragmentation and transaction costs, and better coordination structures which emphasize mutual accountability.
Kampeta Sayingoza, Permanent Secretary, Ministry of Finance and Economic Planning in Rwanda, raised some important challenges facing developing countries that development partners could help to overcome. She spoke about the need for development partners to allow countries to ‘dare to innovate’ for themselves and not insist on perceived international wisdom. She also raised the need to reform Public Finance Management alongside other harmonization efforts as this allows countries to track funding and measure impact. “You cannot have a reform of public health without reform in finance management,” she said. Finally, she stressed that development partners must support and fix government systems, not introduce additional layers of bureaucracy. In Rwanda, the government has rated donors according to the Paris Principles and in this way are able to hold them to account on their public commitments to aid effectiveness.
Despite the challenges, there remains much optimism. Awa Coll-Seck, Minister of Health in Senegal said, “We must have lots of hope. But we need specific action to turn dreams into reality.”
Before the Technical Briefing, three new members became signatories to the IHP+ Global Compact: Guinea Bissau, Haiti and USAID.
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