UN Member States and partners held accountable for avoiding millions of unnecessary deaths of adolescents
Launch of the UN Secretary-General’s Independent Accountability Panel Report: Transformative Accountability for Adolescents
The Independent Accountability Panel (IAP) for Every Woman, Every Child, Every Adolescent launched its 2017 Report, Transformative Accountability for Adolescents, at the United Nations Headquarters, issuing an urgent appeal for strategic investments in 10 to 19 year olds to achieve the 2030 Agenda.
Adolescents, who number 1.2 billion, or 1 in 6 of the global population, are the key for progress on the Sustainable Development Goals (SDGs). “But today, the health and rights of millions of adolescents are at risk of being eroded”, and “they face a host of threats.”
“Adolescents’ health and rights continue to be neglected, with grave repercussions for them and the world’s future... Smart policies and smart investments are needed now. Accountability for them is urgent.”
Dr Carmen Barroso
Every year, 1.2 million adolescents die, often from preventable causes—such as violence, suicide, pregnancy-related complications among girls, HIV/AIDS, road injuries and drowning, as well as diseases and respiratory infections. As the report states, however, high impact, cost effective solutions to improve adolescent health can yield huge benefits and billions in savings that can place them on better tracks for life, reaping demographic dividends.
The IAP, a fully independent body, is mandated by the UN Secretary-General to assess progress on the 2016-2030 Global Strategy on Women’s, Children’s and Adolescents’ Health in the context of the SDGs from the specific lens of who is accountable to whom, and for what.
Co-hosted by the Governments of Denmark and South Africa, and organized by the IAP in collaboration with the Partnership for Maternal, Newborn & Child Health (PMNCH), the IAP’s 2017 recommendations were unveiled by the IAP Co-Chairs, Dr Carmen Barroso and Kul Chandra Gautam, at a high-level event. The forum engaged government delegates to the General Assembly and leaders of the UN System, civil society, youth groups, public health experts, the private sector and donors in a dynamic exchange of reactions to the IAP’s recommendations for strengthening accountability on the roadmap to 2030.
Co-Chair Gautam noted that while “relatively good progress was made in women’s and children’s health under the MDGs era, in terms of public policy priorities, adolescents are largely invisible…The adolescent age group has fallen between the cracks.” Adolescents are only mentioned once in the entire 2030 Agenda, even though they are at stage when “life-long habits are formed, and life-long damage can be inflicted”. In addition, “adolescence is an age where attention to prevention is also most cost-effective”.
“The political and institutional context is key for accountability”, stated Dr Barroso, but “what should be the ‘new normal’ of a UN culture of accountability is instead met with restrictions on rights to information and freedom of expression, underfunding and shrinking civil society space”.
The IAP’s six recommendations are to:
- Leverage Accountability to Achieve the Global Strategy and the SDGs, which is essential to achieve women’s, children’s and adolescents’ health.
- Make adolescents visible and measure what matters, by ensuring governments and UN agencies consistently report on their health and rights, and by improving data disaggregation. The IAP also proposes an Adolescent Health and Well-being Index, similar to other human development indices.
- Foster whole-of-government accountability to adolescents, with all ministries that affect adolescent health on board, alongside strengthened oversight institutions. This includes the role of parliaments in protecting their rights and lifting harmful legal restrictions.
- Make universal health coverage work for adolescents, by ensuring Ministries of Health and Finance are held accountable for providing them with access to a package of essential services that are free at the point-of-service delivery.
- Boost accountability for investments, including for adolescent health and well-being, by increasing national and donor resources, adopting adolescent-responsive budgeting, and improving the UN Development System’s effectiveness.
- Unleash the power of young people, by meaningfully engaging them in decision-making, and empowering them to seize the full potential of the digital age.
Reactions to the recommendations
A message from the UN Secretary-General, delivered by Nana Kuo of Every Woman, Every Child, encourages “all actors to consider [the report’s] proposals”. It affirms that “Accountability lies at the core of the 2030 Agenda for Sustainable Development”, underscoring that women’s, children’s and adolescents’ health is “critical for realizing our vision of empowered individuals, inclusive communities, vibrant economies and peaceful societies.”
In their reactions to the recommendations, the distinguished panellists and various stakeholders welcomed the IAP report.
Minister in the Presidency of South Africa Jeff Radebe stated that the “IAP is on point by addressing the issue of accountability…as a human rights imperative”. In Africa, “Fixing the broken promises of the ‘196 million challenge’ [of adolescents] … is a matter of exceeding and exceptional urgency”. He recalled the African Union pledge to harness demographic dividends to ensure that adolescents’ futures are secured and free of the demons and nightmares of starvation, corruption, unemployment, inequality and poverty.”
Minister for Equal Opportunities and Nordic Cooperation of Denmark Karen Ellemann welcomed the IAP report as “incredibly important”, since “ensuring adolescents’ health – and ensuring women’s and children’s health- is not a choice, or something we can choose to ignore…it is our obligation, our duty, to uphold that right. The report is a tool … that helps us translate the goals into actions. The failure to deliver these services … is not only a failure of the duty bearer to deliver. It is also a missed opportunity.”
New Director-General of the World Health Organization Dr Tedros Adhanom Ghebreyesus underscored this “never-before moment for adolescent health”, lamenting the 3,000 adolescents who die every day, most of them in low- and middle-income countries, including from conflict and mental health problems. In response to the IAP’s challenge on Universal Health Coverage for adolescents, he affirmed that in collaboration with UN partner agencies, “we will act on that call. I promise.”
Dr Denis Mukwege, Member of the High-Level Working Group for the Health and Human Rights of Women, Children and Adolescents exhorted world leaders to take every measure to “ensure adolescents can fully enjoy their human rights… However, in my day-to-day work as a Doctor, I have found that this right, for many, only exists on paper….Even when resources are limited, leadership can make all the difference in the lives of adolescents.”
Graҫa Machel, Chair, PMNCH Board, and Member of the High-Level Steering Group for Every Woman, Every Child affirmed that “Accountability is the best innovation for how the global community can commit and deliver,…a tool for fast-tracking progress…and to help us meet our promises”. Independent accountability can be “a model for the world for all the SDGs”. She encouraged the IAP “to be bold” and “stand for the truth, for the facts.”
Gogontlejang (GG) Phaladi on behalf of PMNCH’s Adolescents and Youth Constituency committed to take the IAP recommendations forward. She called for “breaking down barriers and doing business unusual” to enhance adolescents’ access to services and their enjoyment of human rights. “We must also stop making adolescents’ health rights an opportunity cost…Most importantly, we need actions.”
Minister of the Status of Women of Costa Rica Alejandra Mora welcomed the IAP’s focus on the inter-linkages of gender equality, adolescence, violence, and discrimination against marginalized groups—important elements of her country’s public policy priorities and recent legislation adopted to protect adolescent girls from abusive relationships.
White Ribbon Executive Director Betsy McCallon, representing civil society, called on “all partners within the Every Woman, Every Child architecture to stand with civil society and make stronger links between health and transparency, democracy and governance, and human rights…There are political issues that must be addressed, not only technical ones, if we are to achieve the goals of EWEC.” In agreeing “whole-heartedly” with the IAP’s call for strengthening citizen-led accountability, she emphasized the reality “that structures are non-existent or incredibly weak in most settings.”
Luiz Loures, Deputy Executive Director of UNAIDS on behalf of the H6 Partnership (UNFPA, UNICEF, UN Women, WHO, World Bank) agreed with the IAP that, while a recent evaluation of their work was positive, “We should still do much better…When human rights are the central challenge, business as usual does not work and inclusiveness is key.”
Other stakeholders, including PMNCH constituencies, also committed to follow-up on the recommendations and reaffirmed the report’s findings. The Global Financing Facility (Mariam Claeson), on behalf of the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI, endorsed several recommendations, especially on strengthening accountability at country levels. Guttmacher Institute (Ann Starrs), BD (Gary Cohen of Becton, Dickinson &Co.), and the Lancet Commission on Adolescent Health and Well-being (George Patton) addressed data issues. Others welcoming the report included the Government of Canada; the Office of the High Commissioner for Human Rights (Craig Mokhiber), appreciative of the IAP’s ‘hard form of accountability” grounded in law and social justice, including for sexual and reproductive health and rights; and the Organization for Economic Cooperation and Development (Marcos Bonturi), which invited the IAP for further dialogue; as well as the YWCA (Malayah Harper) and IPPF/WHR (Maria Antonieta Alcalde), among others.
Jordanian Minister for Social Affairs Halal Talouf also expressed her appreciation for the report, viewing accountability as “a fresh new approach that is integrated and can finally make a difference in the lives of people”.