for Women’s, Children’s and Adolescents’ Health
for Women’s, Children’s and Adolescents’ Health
In line with the mandate from the UN Secretary-General, every year the IAP issues a report that provides an independent snapshot of progress on delivering promises to the world’s women, children and adolescents for their health and well-being. Recommendations are included on ways to help fast-track action to achieve the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016–2030 and the Sustainable Development Goals - from the specific lens of accountability, of who is responsible for delivering on promises, to whom, and how.
The theme of the IAP’s 2018 report is accountability of the private sector. The 2030 Agenda for Sustainable Development will not be achieved without the active and meaningful involvement of the private sector. Can the private sector be held accountable for protecting women’s, children’s and adolescents’ health? And if so, who is responsible for holding them to account, and what are the mechanisms for doing so? This report looks at three key areas of private sector engagement:
Recommendations are addressed to the range of stakeholders dedicated to fulfilling the Global Strategy and SDGs aspirations - Member States, United Nations agencies, development cooperation partners, the UHC2030 partnership and EWEC partners as well as the private sector.
Access to services and the right to healthLearn More
The pharmaceutical industry and equitable access to medicinesLearn More
The food industry, obesity and NCDsLearn More
The UN Global Compact and the EWEC partnersLearn More
Donors and business engagement in the SDGsLearn More
In response to the IAP’s Call for Evidence to inform the contents of this report, we received contributions from a range of stakeholders, including case studies on national policy and programme developments, emerging data, and promising examples of accountability at work from local to global levels. Some individuals and organizations also responded generously to our targeted requests for information.
The IAP approach captures the full cycle of accountability—monitor, review, act and remedy—building on the approaches of the Commission on Information and Accountability for Women's and Children's Health, and of the Independent Expert Review Group. This year, we have adapted our accountability framework to focus on the private sector.
This report draws on the IAP’s public call for evidence, intensive research, and consultations with private sector leaders and the range of stakeholders involved in the Every Woman, Every Child (EWEC) initiative. These were extraordinary learning opportunities for gathering the insights that have made this report possible.
Chapter 2 offers a snapshot of progress in advancing the Global Strategy across the three dimensions of rights, results and resources, with a focus on equity gaps and on whether we are measuring who and what really matters. The IAP offers observations on current global monitoring efforts and also highlight promising developments since our last report, in 2017. Particular attention is given this year to commitments made by private sector actors to the EWEC initiative, which showcase companies’ leadership in support of women’s, children’s and adolescents’ health. The IAP examines how the contributions of these initiatives are tracked and their performance is measured, and we look at the monitoring and accountability gaps that still need to be filled. The IAP also reviews the due diligence and accountability standards that Global Strategy partners have in place for their engagement of the private sector, as well as those of the UN Global Compact.
In Chapter 3, the IAP takes a more in-depth look at private sector engagement and accountability in women’s, children’s and adolescents’ health across our three focus areas: health service delivery in the context of achieving universal health coverage; the role of pharmaceutical companies and access to essential medicines; and food-industry impacts on rising obesity and NCDs. The questions asked: What do we know? What works for accountability? What are the gaps? Throughout, the IAP reviews the obligations of states and the international human rights standards that govern the private sector, which should be used by executive and legislative branches of government and the range of stakeholders as guideposts to strengthen accountability. Furthermore, the IAP identifies how parliaments and judicial systems can help to build stronger checks and balances for women’s, children’s and adolescents’ health by providing effective oversight; and we look at the role of citizen-led and independent accountability.
In Chapter the IAP presents its recommendations, addressed to the range of stakeholders: UN Member States, the UN system, private sector actors, development cooperation partners, the EWEC global partners, the UN Global Compact, as well as civil society, including adolescents and youth
The stakes are highest for the younger generations. What world will they be inheriting in 2030—will it be business as usual, or the transformative change they have been promised?
To achieve universal access to services and protect the health and related rights of women, children and adolescents, governments should regulate private as well as public sector providers. Parliaments should strengthen legislation and ensure oversight for its enforcement. The UHC2030 partnership should drive political leadership at the highest level to address private sector transparency and accountability.
Ministries of health should integrate for-profit providers into national health governance systems by developing private sector stewardship and accountability strategies.
Parliaments should enact and strengthen legislation governing the parameters for private sector engagement in health, and ensure meaningful oversight and enforcement.
The UHC2030 partnership should help drive action to ensure comprehensive national policies and transnational collaboration for addressing private sector accountability. It should position women, children and adolescents—and accountability for their health and rights—at the forefront of the global UHC agenda. A comprehensive approach is warranted, including but going beyond the roles of ministries of health, to involve a range of sectors in holding industries to account for their impacts on nutrition, environmental and other social and economic determinants of health.
To ensure equitable, affordable access to quality essential medicines and related health products for all women, children and adolescents, governments and parliaments should strengthen policies and regulation governing the pharmaceutical industry.
Strengthening the accountability of the pharmaceutical industry as a whole to align it with public health should involve a mix of effective self-regulation by pharmaceutical companies in compliance with policies, laws and robust internal codes of conduct and strictly enforced government and legal regulations, alongside policies that offer incentives for companies.
Ministries of health and public regulatory and procurement agencies should strengthen the policies and regulations governing the pharmaceutical industry and other actors involved in delivering medicines, in collaboration with ministries of finance and trade, among others.
Parliamentarians should strengthen legislation and oversight to ensure that public and private actors involved in the provision of essential medicines are aligned with rights-to-health and fairpricing principles.
To tackle rising obesity and NCDs among women, children and adolescents, governments and parliaments should regulate the food and beverage industry, and adopt a binding global convention. Ministries of education and health should educate students and the public at large about diet and exercise, and set standards in school-based programmes. Related commitments should be included in the next G20 Summit agenda.
UN Member States should develop a binding global convention to promote healthy diets and restrict marketing of unhealthy commodities by the food and beverage industry, with particular attention to women, children and adolescents.
The convention, to be negotiated after broad public consultation, should:
National governments, parliaments and the judiciary should enact and enforce regulations and legislation to curb the food and beverage industry’s production and marketing of unhealthy products, with particular attention to women, children and adolescents.
Governments and companies should ensure that socially responsible commitments to women’s, children’s and adolescents’ health are included in the agenda of the next G20 Summit, with a focus on tackling obesity and NCDs.
They should ensure clear targets and independent monitoring mechanisms to track implementation of the commitments. Minimum do-no-harm standards on public health should be established for companies joining the B20 (representing the G20 business community); these should extend across the borders of corporate operations, including through extraterritorial enforcement mechanisms.
The UN Global Compact and the EWEC partners should strengthen their monitoring and accountability standards for engagement of the business sector, with an emphasis on women’s, children’s and adolescents’ health. They should advocate for accountability of the for-profit sector to be put on the global agenda for achieving UHC and the SDGs, including at the 2019 High-Level Political Forum on Sustainable Development and the Health Summit. The UN H6 Partnership entities and the GFF should raise accountability standards in the country programmes they support.
In the context of the UN Secretary-General’s proposals for system-wide reform of partnerships with the private sector, our recommendations reflect standards that are common practice among development and UN agencies—but are not necessarily expected of, nor applied, when it comes to the for-profit sector.
The UN Global Compact Board and Office should strengthen accountability standards to protect the right to health among women, children and adolescents.
The UN Global Compact and the UN H6 Partnership Heads of Agency should ensure that the issue of business engagement and accountability for women’s, children’s and adolescents’ health and rights is made an explicit work stream of the UN system’s inter-agency platforms addressing private sector engagement, at both the principals and working levels. They should also involve civil society in processes to determine due diligence and accountability standards for qualifying corporations as partner-ready for engagement with the UN.
The EWEC global partners should ensure systematic application of robust monitoring and accountability standards with relation to engagement of the business sector, including to the support they provide governments for implementing the Global Strategy. The EWEC global community is well-positioned to play a leadership role in innovating and modelling private sector accountability for women’s, children’s and adolescents’ health. The strategic positioning of the PMNCH Private Sector Constituency and the for-profit EWEC commitment-makers, as EWEC champions, should be leveraged to this end.
The EOSG should enable the PMNCH Secretariat to assume full responsibility for coordinating and managing improvements across the full cycle of EWEC commitments, including those of governments and corporations. The PMNCH should build in accountability standards from the start of private sector EWEC commitments. It should facilitate the establishment of exclusionary criteria, as well as a due diligence process, governing EWEC private sector commitments.
The EWEC High-Level Steering Group should help put accountability of the for-profit sector on the global agenda for achieving UHC and the SDGs, including at the 2019 High-Level Political Forum on Sustainable Development and the Health Summit during next year’s UN General Assembly. It should also place private sector accountability for women’s, children’s and adolescents’ health on its own agenda.
The UN H6 Partnership entities and the GFF should apply due diligence and accountability standards to the technical advice and country programmes they support involving the private sector.
Development cooperation partners should ensure that transparency and accountability standards aligned with public health are applied throughout their engagement with the for-profit sector. They should invest in national regulatory and oversight capacities, and also regulate private sector actors headquartered in their countries.
Development cooperation partners—including bilateral donors, the development banks, global health foundations such as the Bill & Melinda Gates Foundation, and the UN system—should ensure that their engagements with the for-profit sector are guided by the same standards that they regularly apply to recipients of their technical and financial support.