When member states of the United Nations agreed on the historic Millennium Development Goals 15 years ago, we aimed to end poverty, hunger and disease. To that end, we set milestones for maternal, newborn and child mortality reduction that were unprecedented in human history.
At the time, I was minister of health in Botswana, and HIV and AIDS were ravaging our families and communities with relentless precision.
“This is a crisis of the first magnitude,” then-President Festus Mogae said. “People are dying in chillingly high numbers. We are threatened with extinction.”
Within a year, Botswana became the first country in Africa to launch a national public sector antiretroviral program. But at the time, the expensive, lifesaving drugs were beyond the reach of the public sector’s health budgets, so innovative solutions had to be found to enable access.
The indomitable nature of the human spirit guided us all as international, regional and national stakeholders from every sector took ownership of the challenge and became part of the solution. Partnerships were formed to finance the response, to research the solutions and to implement the programs. And people living with the virus guided our every step. Within only five years, we made treatment available to 95 percent of HIV-positive people in Botswana.
This massive collaboration is just one example of what has been done to meet the MDGs. In Botswana, maternal deaths have been halved in recent years, and the availability of HIV treatment has surpassed anything I would have imagined at the time of the MDGs’ creation.
What made this possible? Strong political will in both partner and donor countries, coupled with active national and international citizen engagement, and sustained support from multilaterals, foundations, academia and research Institutions, as well as private sector participation.
Globally I have seen time and time again how improving reproductive, maternal, newborn, child and adolescent health can transform people’s health and prosperity. Ensuring that women are well nourished and safe in childbirth, that adolescents are empowered to delay sex and avoid pregnancy, and that couples are able to choose if or when to have children is key to making sure children are well nourished, vaccinated, healthy and able to learn. This is critical to sustainable development and ending poverty.
We should be proud of how much our global community has built together. In 2008, women’s and children’s health was on the G-8 agenda for the first time. Only two years later, U.N. Secretary-General Ban Ki-moon took up the challenge with his Global Strategy for Women’s and Children’s Health. Many governments, businesses and organizations joined the collective effort, and women and children are getting better access to preventive health care services and treatment than at any other time in human history.
Now, as we approach another major crossroad in global development, we have the responsibility to engage all those people whose lives will be affected by the decisions we make. Robust universal political commitment and universal citizen engagement are central to achieving sustainable development.
Member states are engaged in the intergovernmental negotiations on the post-2015 development framework. These global decision-makers will continue to shape the sustainable development goals, which will be finalized in September and take effect through 2030. This global manifesto for change must be based on a democratic agenda set by all citizens of our world and must build accountability into the operational framework.
Alongside these efforts, the U.N. secretary-general has begun to revisit his 2010 global strategy and explore means to incorporate it into this post-2015 agenda. An updated Global Strategy for Women’s, Children’s and Adolescent’s Health could bring together one single framework for accountability, and also will need to embrace citizen participation and leadership.
As global policymakers, we have a duty to form a bridge between political leaders at the United Nations and the citizen advocates, local councilors and leaders of all political parties at the national level. Good governance relies on engaged communities and civil society that can hold governments to account for their commitments. When political leaders and citizens work together, results are assured, progress made and sustainable development achieved.
I am encouraged by the Citizens’ Hearings taking place across Africa, Asia and South America. Citizen advocates are sitting down with government representatives and political leaders to inform and shape the decisions that will impact the lives of every citizen. Following these national-level dialogues, citizens will voice their priorities for women’s and children’s health in the Global Citizens’ Hearing at the World Health Assembly in Geneva in May. As we set the development agenda for the next 15 years, let us be bold, and let us do it together. Sustainability in development and poverty elimination can only be built when everyone is given the space to play their role effectively.
The world is a global village, and we have the capacity to finally eradicate — once and for all — poverty, disease and suffering. History will judge us harshly if we let this opportunity pass.
Have you participated in similar widespread consultations in the past? How were they able to help ensure accountability? Share your experience by leaving a comment below.
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