3 Summit outcomes
The Outcome Document
17. Commentators were split between detecting a new
note of confidence at the Summit and a sense that the MDGs are
still attainable, and complaining that the gathering was heavy
on rhetoric but light on action. Most approved of the Outcome
Document, which was formally adopted at the end of the Summit.[28]
The Secretary of State was confident that the Document represented
a significant step forward, telling us that it provided "a
path for [...] renewed momentum in the global fight against poverty
and [...] an ambitious action agenda for the MDGs' final five
years."[29] Although
they had a few caveats—for example, that the Document reiterated
previous promises and was weak on clear actions for implementation[30]—NGOs
broadly agreed.[31] The
ONE Campaign praised the Document's promotion of national
'ownership' of the Goals by developing countries, and its emphasis
on accountability in the run-up to 2015.[32]
UK-supported outcomes
WOMEN AND CHILDREN'S HEALTH
18. The UK Government strongly pressed for a number
of key outcomes from the Summit, in particular the Global Strategy
for Women's and Children's Health which was launched at the Summit
to save the lives of more than 16 million mothers and children
over the next five years.[33]
This aims to boost efforts towards reaching MDGs 4 (to reduce
child mortality) and 5 (to improve maternal health)—as well
as MDG 3 (to promote gender equality).
19. While the Strategy was generally well-received,
some commentators argued that it was more a list of funding pledges
than an actual strategy and that the pledges did not all even
offer 'new money'.[34]
The NGO One World Action estimates that only around half
of this sum is 'new'.[35]
Under the Strategy, the UK pledged to double its annual support
for maternal, newborn and child health by 2012, and sustain that
level—an annual average of £740 million—to 2015.
The Strategy document calculates this to be an additional £2.1
billion of UK spending on this area.[36]
The Secretary of State assured us that this was all 'new money'.[37]
He also emphasised the UK's "very significant influence behind
the scenes and in front of the scenes" in launching the Strategy.
World Vision agreed, adding that this leadership must extend
to the delivery of the Global Strategy over the next five years
(especially as the Strategy itself does not provide a mechanism
for turning the commitments into action plans).[38]
The World Health Organisation has been given the task of developing
an accompanying "accountability framework" for the Strategy,
that is a breakdown of which organisations, governments and donors
will be responsible for particular aspects of the Strategy and
to what timescale.
20. We are impressed by the UK Government's leadership
of the launch of the Global Strategy for Women's and Children's
Health. The Strategy represents a final chance to make serious
progress on MDGs 3, 4 and 5 before 2015. We welcome the doubling
of annual UK financial support for maternal, newborn and child
health by 2012, and the maintenance of this level of funding—an
annual average of £740 million—to 2015. However, DFID
must ensure that this increase in inputs results in improved outputs.
This will necessitate sustained DFID engagement in the delivery
of the Strategy over the next five years. We recommend that, as
well as fulfilling its own pledges, DFID focus on ensuring that
pledges made by other governments under the Strategy are fulfilled
according to their allocated timescales, so that the promised
impact on child and maternal health is achieved by 2015. Central
to this will be the development of an accompanying 'accountability
framework' for the Strategy, which should clearly specify different
governments' pledges along with their timescales. We recommend
that this framework be completed by the end of January 2011 at
the latest.
MALARIA
21. A High Level Malaria Event, co-hosted by the
UK Government, was held at the Summit. The UK Government stated
that it would:
- increase funding for tackling malaria from £150
million to up to £500 million per year by 2014;
- use its resources to help halve the number of
malaria deaths in at least ten African countries with high levels
of malaria (with specific pledges for Zambia and Ghana); and
- review how malaria interventions could be included
in all DFID's programmes.[39]
22. The NGO Malaria No More told us that "increased
and sustained funding" will be "critical" to meet
the MDG 6 target of ending preventable deaths from malaria by
2015. It highlighted the scale of the challenge remaining, advocating
a multi-pronged approach that focuses on: bed-net coverage and
other preventative measures; availability and accessibility of
diagnostic tools and treatment; and ongoing research into development
of malaria vaccines.[40]
A special focus on pregnant women and young children is vital
given that 85% of malaria deaths occur in children under five
and pregnant women.[41]
DFID will publish a Malaria Evidence Paper
and Business Plan in December 2010 detailing how the £500
million per year will be spent. Three-quarters of international
malaria funding is provided by the Global Fund to Fight AIDS,
Tuberculosis, and Malaria (GFATM) and the World Bank's International
Development Association (IDA). DFID is currently carrying out
a review into its funding of these and other multilateral bodies.
The outcome of this review—due in the first quarter of 2011—will
therefore be significant to the Department's future support to
addressing malaria. DFID's provision of funding will be particularly
important in view of the "funding shortfall" announced
by GFATM in October.[42]
23. We commend the UK Government's role in promoting
anti-malaria strategies at the Summit. Reliable, expanded funding
will be crucial to meeting the MDG 6 target of halting the spread
of malaria by 2015. We trust DFID's Malaria Evidence Paper and
Business Plan will provide detailed information as to the mixture
of interventions needed to reach the target. We recommend that
these interventions be co-ordinated closely with DFID's increasing
support for maternal and infant health, given that children under
five and pregnant women account for 85% of malaria deaths. We
recommend that the Multilateral Aid Review, due to be published
early in 2011, ensure that DFID continues to provide adequate
funding and technical assistance to the Global Fund to Fight AIDS,
Tuberculosis, and Malaria.
What was missing?
24. Several interlocutors argued that the Summit
focused too narrowly on the health MDGs and that the UK should
have helped include other MDG priorities such as sanitation and
agricultural development.[43]
There was particular concern at the lack of priority accorded
to the issue of hunger at the Summit.[44]
ActionAid said that, while the UK did publicly support
the Scaling Up Nutrition '1000 days' campaign, it "could
and should have placed a greater priority on hunger" at the
Summit, including "the importance of supporting smallholder-based
agriculture as a key route to tackling poverty, hunger, food insecurity
and malnutrition".[45]
When we raised this with the Secretary of State, he defended his
use of a "sheep dog approach" to chasing up the most
offtrack goals such as maternal mortality.[46]
However, he accepted that DFID "can" and "must"
do more on nutrition, an issue which he said was "at the
heart of MDG 1". He said that DFID would fund nutrition research
over the next few years and had offered to sit on the leaders'
group on nutrition.[47]
Our predecessor Committee highlighted the need for DFID to develop
a nutrition strategy in its 2008 report on The World Food Programme
and Global Food Security.[48]
The Department published a strategy in March 2010.[49]
25. We welcome the UK Government's decision to
prioritise the health-related MDGs at the Summit. It is right
to focus on those Goals that are most off-track. However, other
Goals, such as MDG 1, seeking to eradicate hunger, are also off-track.
The proportion of under-nourished people in the world is growing
rather than contracting, and one in four children under-5 are
underweight. We find the extent of hunger and malnutrition deeply
worrying and urge the UK to continue its work to support efforts
to reach MDG 1. We welcome the Secretary of State's support for
nutrition initiatives and recommend that DFID widely disseminate
its research into nutrition. In addition, DFID should continue
to examine ways of supporting smallholder-based agriculture.
Developing country commitments
26. During our inquiry, we were told of the impressive
commitments made by a number of developing country governments
at the Summit. DFID was favourably struck with the level of participation:
Various ministerial participants remarked on
the quality and seriousness of the policy debate between developed
and developing countries, especially on health, education and
nutrition. Also notable was the degree to which a growing
number of developing country ministers were well-informed by economic
analysis and independent evaluation of what works and what doesn't.[50]
27. The Department was also impressed by the fact
that, "unlike previous summits", there were "significant
new commitments" made by developing countries.[51]
For example, Nigeria agreed to spend a share of oil revenues on
healthcare. Liberia pledged to implement universal coverage of
anti-malarial bednets.[52]
Many more commitments were made under the Global Strategy for
Women's and Children's Health, described earlier in this chapter.
This Strategy's format—a series of individual country pledges—puts
the onus on governments to commit to a specific set of actions.
Pledges were made by Afghanistan and Yemen to increase access
to family planning and safe births. Zimbabwe, Liberia, Malawi,
Nepal, Niger and Haiti all announced their intention to provide
(or extend) free healthcare for women and children.[53]
28. We are impressed by the commitments made by
a number of developing country governments at the Summit. However,
the fact that a large number of countries is seriously off-track
for a number of Goals demonstrates inter alia that much
greater commitment is needed from many countries. We welcome
the principle of country ownership embodied within the Global
Strategy for Women's and Children's Health. We strongly encourage
DFID to support with both technical and financial assistance those
developing countries which have made pledges under the Strategy,
especially those seeking to introduce or expand free healthcare
to women and children.
29. When we asked the Secretary of State how to assist
developing country governments to fulfil their MDG responsibilities,
he emphasised the importance of boosting civil society's capacity
to hold their governments to account.[54]
He also highlighted the difficulty in "holding to account
leaders in developing countries [...] if members of the G8 do
not stand by their promises". He proposed that the UN should
name each year those countries which had not stood by their commitments.[55]
He said that the US Agency for International Development (USAID)
had accepted a proposal of his that the UK and US should publish
an annual audit of best practice worldwide for each MDG.[56]
We agree with the Secretary of State that supporting civil
society in developing countries to hold their governments to account
over MDG pledges will help ensure that leaders fulfil their commitments.
We also believe that DFID should continue to work with partner
donors to encourage better and more effective governance and promote
civil liberties. Parliaments have a vital role to play in holding
governments to account and DFID must continue to support programmes
which seek to strengthen them. Similarly, donors such as the Italian
Government should be held to account on their promises. We agree
that a useful step towards this would be for the UN to 'name and
shame' donors or governments which have reneged on promises.
28 For instance, Ev w28-29. Summit Outcome Document,
'Keeping the Promise - United to achieve the Millennium Development
Goals' (September 2010) Back
29
Rt Hon Andrew Mitchell MP, Secretary of State for International
Development, letter to Parliamentarians, 5 October 2010 Back
30
Ev w28-29 Back
31
For example, Ev w140 Back
32
Ev w98-99 Back
33
Ev w28-29 and UN, 'Every Woman, Every Child: Summary of Commitments
for Women's and Children's Health' (22 September, 2010). Back
34
For example, see Owen Barder, 'UN Summit roundup: three development
narratives', 28 September 2010 www.owen.org/blog and Ev w158 Back
35
Ev w106 Back
36
UN, 'Every Woman, Every Child: Summary of Commitments for Women's
and Children's Health' (22 September, 2010), p.11 Back
37
Q 20 Back
38
Ev w160 Back
39
Ev w50 and DFID Business Plan 2011-2015 (November 2010) Back
40
Ev w92 Back
41
Ev w93 Back
42
Ev w94 Back
43
Ev w133 and Ev w8 Back
44
Ev w8 Back
45
Ev w8. Scaling Up Nutrition was launched at a side event co-hosted
by Hilary Clinton. It attempts to tackle malnutrition amongst
mothers and infants in the first 1000 days of an infant's life.
Back
46
Q 16, 21 October 2010 Back
47
Qq 34-35 Back
48
International Development Committee, Tenth Report of Session 2007-08,
The World Food Programme and Global Food Security, HC 493-1 Back
49
DFID, 'The neglected crisis of under-nutrition: DFID's strategy'
(March 2010) Back
50
Ev w49 Back
51
Ev w52 Back
52
Ev w52 Back
53
Ev w160 Back
54
Q 42 Back
55
Q 41 Back
56
Q 11 Back
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