The SDGs present a new, comprehensive and more integrated model of development. This should prompt an evaluation of how fit for purpose the global architecture is to deliver upon its targets, including those of the Global Strategy. The UN system agencies working on health will work together to implement the Global Strategy and support the application of this Operational Framework, as the H6 partnership, building on the progress during the MDG era of the H4+ partnership. But there is also a need to go beyond the UN to coordinate the efforts and impacts of the broad range of global and regional actors, including bilateral development partners, international NGOs and faith-based organizations, development banks and regional entities (such as the African Union, ASEAN, ECOWAS, SADC, MERCOSUR and SAARC).

Operationalizing the Global Strategy is critical to achieving the SDGs. In the process of aligning and coordinating global and regional support for the Global Strategy, there is an opportunity to recommit to the principles of the Paris Declaration, the Accra Accord and the IHP+ on aid effectiveness. Key principles that require greater adherence include:

  • respecting country leadership in all activities both through national political leadership and the active engagement of civil society, the private sector and individual citizens
  • reducing fragmentation and duplication of activities
  • providing global and regional support in accordance with national planning timelines rather than external timelines
  • prioritizing national use of data, and national accountability frameworks, for decision-making
  • supporting rather than supplanting nationally-led efforts in systems strengthening.

In operationalizing the Global Strategy, global and regional actors can undertake a number of functions:

Technical assistance – across all ingredients for action, in particular in supporting, upon request, the convening of a country platform and the development of prioritized, costed plans. It is particularly important here that the above principles are adhered to. The GFF process will provide support for this work in “frontrunner” countries, but support is required in all countries, including funding for the process, support of consultation, evidence generation, modelling and costing, setting of numerical targets, and prioritizing interventions. The H6 should coordinate this support, potentially setting a timeline for plan development linked to countries’ national planning cycles, and incorporation of SDG targets. New thinking will also be required to support the new areas of the Global Strategy, for example, in taking a multisectoral approach to health.

Financing including continued provision of direct funding (aligning delivery of global sources of funding including the Global Fund, GAVI and bilateral development partners) and other forms of complementary financing (including loans), supporting financial management systems, providing technical assistance to support domestic financing and lending stewardship of private sector investment and impacts at the global level, including by transnational corporations.

Capacity building and sharing of experiences – in particular, supporting the development of institutions and expertise within countries to build capacity including management capacity and quality assurance. There is also a need to support in-country and inter-country exchange visits between key actors to facilitate learning and scale-up. The website for this Operational Framework will provide a place to document and share countries’ experiences in implementing the Global Strategy.

Advocacy – there is a need for dissemination and advocacy for use of the Global Strategy (and this Operational Framework) itself, as part of SDG advocacy and support efforts. Its use by a large network of actors and country leaders needs to be encouraged, building awareness across the Every Woman Every Child movement. This is another task for the H6. More generally, global and regional advocacy networks can play a powerful role alongside country efforts in mobilizing resources and supporting national efforts, particularly those in high-burden countries where civil society advocates may be less visible, more likely to be marginalized or peripheral to the RMNCAH landscape.

Accountability global actors have a specific role with respect to accountability for the Global Strategy in supporting the function of the Independent Accountability Panel (IAP). The Partnership for Maternal, Newborn and Child Health will house the secretarial for the IAP. Global and regional partners should also promote accountability and transparency through regional and global reporting, to enable progress to be compared across countries and regions. Further, global and regional partners can improve methods for global maternal and child mortality estimation and tracking, while technically supporting countries in their own national accountability processes and mechanisms. Regional bodies could play a greater role in accountability, for example through peer dashboards and scorecards or regional targets/milestones.

Multisectorality – global and regional actors can support a multi-sectoral approach by supporting joint global and national monitoring of interventions and targets across sectors (driven by the United Nations Secretary-General’s office as part of SDG monitoring) and mobilizing financing (existing and new) in addition to incentivizing multisectoral collaboration and action through existing and new partnerships. Within countries, there is a need for support of governance, financing and monitoring capacity for cross-sectoral work.

Global public goods and market shaping – to this end, global partners can identify new high-impact commodities and the appropriate market shaping interventions; secure price reductions and pooled-procurement agreements beyond the initial set of commodities; develop product standards; and better capture the contribution of all sectors to commodity procurement.

To fulfil these functions, global and regional actors can:

Consider neglected areas or gaps that merit new Commissions – under the original Global Strategy, two UN Commissions were convened (one on commodities, a second on information and accountability). These commissions catalysed new financing, organization and collective action across agencies. Consideration should be given to new commissions in areas of particular challenge, for example, implementing the SDG agenda for health across countries at different income levels, or multisectorality.

Identify the differential support needs of countries at SDG baseline – For the Global Strategy targets, countries are starting at widely differing levels. For example, early modelling suggests that at current rates of progress, many countries have already achieved the maternal, neonatal and child mortality targets implicit in SDG 3.1 and 3.2, a further group of countries are likely to achieve these targets by 2030 at current trajectories, but over 40 countries will miss the under-5 target, and over 60 countries will miss the maternal and neonatal targets. This type of analysis could provide an informed basis for prioritization of support to countries. Similar analysis could inform allocation of resources and support within countries for high burden sub-national areas.

Reconceptualize the delivery of support within countries including better alignment of initiatives and coordination of activities – there is an urgent need for improved alignment of global, regional and national initiatives by different actors. This proliferation of initiatives is particularly marked for RMNCAH. A core aim of operationalizing the Global Strategy is addressing this. It is essential to improve alignment and communication among UN system agencies and other global actors at global, regional and country levels, enhancing efficiency by simplifying processes and reducing transaction costs.

Operationalizing the Global Strategy needs to bring together key initiatives launched during the MDG era to accelerate progress, including the Every Newborn Action Plan, the Global Vaccine Action Plan, A Promise Renewed, Family Planning 2020, Ending Preventable Maternal Mortality, and the Global Action Plan on Pneumonia and Diarrhoea. Countries who have engaged with these initiatives can sustain this momentum towards achievements of the SDGs under the umbrella of the Global Strategy, without needing to start again.

At the outset of the SDGs, countries should be supported to map the activities of partners and encourage rationalization. It is especially important that the activities related to the GFF are seen as core to implementation of the Global Strategy and aligned with existing global and national initiatives rather than becoming a parallel exercise. The H6 has a major role in ensuring this.

National consultations and workshops within countries are required to coordinate all actors on the SDGs and Global Strategy, and integrate existing global efforts with new initiatives like the GFF. The process of convening the country platform can be central to this coordination. Finally, the H6 should coordinate and facilitate coherent delivery of health assistance at country level under the leadership of government counterparts and the UN Resident Coordinator, also taking advantage of the UN Development Assistance Framework.