Private sector. Who is accountable? for women’s, children’s and adolescents’ health?

Posted by Maria Codina on November 8, 2018 at 11:21 am

At this point in the roadmap to 2030, it is essential to get it right regarding the private sector’s accountability for women’s, children’s and adolescents’ well-being, and for public health.

The 2030 Agenda for Sustainable Development (2030 Agenda) will not be achieved without the active and meaningful involvement of the private sector. In a context of instability, uncertainties and budget constraints in many parts of the world, governments, bilateral donors and the United Nations (UN) system increasingly look to the private sector to help meet global challenges and fund the Sustainable Development Goals (SDGs), with their price tag of US$ 5 7 trillion. The health SDG alone will require nearly three times the current level of investment in low- and middleincome countries—as much as US$ 371 billion annually by 2030.

The current proliferation of public-private partnerships (PPPs) is expected to accelerate under the SDGs. The Joint Fund for the 2030 Agenda was launched in 2018 by the UN Deputy- Secretary-General to facilitate scaling up SDG implementation through PPPs. Increasingly, corporations feature prominently in international policy circles and CEOs mingle regularly with the world’s decision makers in Davos and at UN headquarters. Yet at the same time, tax avoidance by multinationals—estimated at US$ 500 billion annually—undermines policy coherence and drains money from the countries most in need.

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 explores this theme, asking the key questions: Who is checking to see if businesses are aligned with people’s rights to
health? Are adequate standards and oversight systems in place under the 2030 Agenda and the Addis Ababa Action Agenda? Just how much socalled corporate blue washing is going on?

The UN Secretary-General’s Independent Accountability Panel for Every Woman, Every Child, Every Adolescent (IAP) has set out to answer these questions in fulfilment of our mandate: provide a snapshot of progress on the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016 2030, using the specific lens of accountability: Who is accountable to whom, for what, and how?

Getting accountability right

The IAP is well aware that this report ventures into hotly contested terrain, riddled with misconceptions and mistrust. We hope that it will mitigate some unnecessary polarization and facilitate meaningful dialogue, transparency and accountability. It comes at an important moment, a year away from the first review of the 2030 Agenda by heads of state and government. It is especially relevant given the private sector’s role in universal health coverage (UHC), them growing privatization of health services, and the steady growth of business engagement in health. The powerful influence that corporate interests wield in setting public policy agendas and in democratic elections, through political lobbying on the domestic front or through trade negotiations and involvement in the G20 and World Trade Organization processes, makes it increasingly important to address the questions set forth in this report.

At this point in the roadmap to 2030, it is essential to get it right regarding the private sector’s accountability for women’s, children’s and adolescents’ well-being, and for public health more broadly. Private sector engagement in health cannot be treated as largesse or charity. Accountability, beyond answering to shareholders and investors, must include the public: the individuals and families that rely upon equitable, quality and efficient health systems; the workers that make up the backbone of health systems; and the people deeply affected by private sector operations within and across borders—including the environmental and gender impacts of these
operations. The private sector’s role in health is not new.

Its members—who have saved and improved countless lives—include family doctors; creators of vaccines, medicines and medical breakthroughs; advertising firms behind public health campaigns (to combat, for example, HIV/AIDS or violence against women); and developers of information and communications technologies (for instance, m-health and telemedicine for remote communities), to name but a few. The challenges of harnessing the innovations and potential contributions of such an important sector are both ethical and practical. The private sector’s bottom line is primarily financial profitability, which does not necessarily mean putting people’s well-being first. This inevitably poses serious dilemmas and possible conflicts when attempting to put in place a global agenda founded on principles of human rights, dignity, equity and leaving nobody behind. Concerns around the privatization of development and the abdication of responsibilities by states and global institutions are central to the thinking of the IAP and are shared by many.


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