We recently attended the “2014 Partners’ Forum” in Johannesburg, South Africa, together with about a thousand other colleagues from the public and private sectors who are working on maternal and child health, nutrition, education, gender and development. Our agenda was to discuss progress towards the Millennium Development Goals (MDGs) and generally take stock of progress and commit to accelerating action for women’s and children’s health. The outcomes are neatly summarised in this infographic.
The post-2015 agenda is already on many people’s lips. The global public health community is thinking about the next big target. But we are not yet over the line with the MDGs. The MDGs are eight goals that all 191 UN Member States agreed to try to achieve by the year 2015. As with most targets, Nigeria was an enthusiastic signatory and has claimed that it is pursuing them vigorously. But what has been achieved since signing the agreement? The MDGs we will focus on in this post are goals 4 and 5.
Goal 4: Reduce child mortality.
Target 4A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate.
Goal 5: Improve maternal health.
Target 5A: Reduce by three quarters, between 1990-2015, the maternal mortality ratio.
Target 5B: Achieve, by 2015, universal access to reproductive health.
Progress to both goals has been slow in Nigeria, and it is now unlikely that we will meet these goals. You can find a status report for 2014 here, which shows that Nigeria is still a long way off. Another recent report on progress towards the MDGs by the UN showed us in a few un-enviable positions. The large number of Nigerians that live in extreme poverty particularly highlights how much still needs to be done. Nigeria is among the five countries with the largest share of the global extreme poor. Nine percent of the global extreme poor are our fellow citizens. From a Nigerian perspective, there is really not a lot to celebrate.
One of our personal highlights of the forum was Dr Aminu Magashi’s participation in a panel together with Joy Phumaphi, Co-chair, Independent Expert Review Group, and Stephen Kebwe, the Minister of Health and Social Welfare of Tanzania, to discuss an accountability model for post-2015. Aminu was representing Africa Health Budget Network, a group of African and global organisations and individuals using budget advocacy as a tool to improve health service delivery in Africa. Aminu said during the session:
“We note that our governments are shy about sharing public expenditure on health in our country. We want to know more. This matters to the women and children of my country, Nigeria”
We agree. Getting data on anything in Nigeria, talkless of expenditure data on the health sectors is almost impossible. Aminu works for Mama Ye, a multi-year programme which aims to improve maternal and newborn survival in sub-Saharan Africa initiated by Evidence for Action.
While the sessions focused mostly on global issues, it was hard to ignore the number of prominent Nigerians at the event. Amina J. Mohammed was until recently the Senior Special Assistant to the President of Nigeria on the Millennium Development Goals. She is now the UN Secretary-General’s Special Adviser on Post-2015 Development Planning. Watch her talk at TedxEuston about what motivates her public service here.
Dr. Osotimehin, who also attended, was Nigeria’s Minister of Health from 2008 to 2010. Prior to that, he was Director-General of Nigeria’s National Agency for the Control of AIDS. Today, he is the Executive Director of UNFPA, the United Nations Population Fund. We loved this quote from him: “Young people need to be able to ask questions, and we need to listen to them.”
Mrs Toyin Saraki, Founder of the Wellbeing Foundation, was also in attendance, as usual fighting the corner of midwives saying; ”Midwives are at the frontline and therefore have a key role to play in advocating for and protecting mothers and newborns”. She highlighted the benefits of a hand-held Personal Health Record introduced by the Wellbeing Foundation, which captures medical information for mother and child until the age of five, ensuring that healthcare providers have the crucial medical history of their patients, and mothers are able to receive the right care.”
And the Minister of Health himself, Professor Onyebuchi Chukwu, gave a speech.
With all these big guns from Nigeria, you would have thought that there would be an in-depth discussion on why Africa’s most populous country and largest economy is unlikely to meet the MDGs. But, no … all Nigerian participants took an internationalist stand point and conveniently “forgot” to mention Nigeria. Other attendees must have been left wondering how this can happen in a country with so many obviously talented professionals. But like the South African Health Minster Aaron Motsoaledi reminded us throughout the conference: It is not yet 2015. There is still time left to progress towards the MDGs.
Despite the disappointment from the Nigerian contribution, the conference left a positive impression with us. An enduring memory from the meeting was a deeply moving personal statement from Graca Machel dressed all in white on her first appearance since ending the mourning period following Madiba’s passing:
“Every day counts, every action counts, every life counts”
All pictures courtesy of Ann Pettifor, Director. Advocacy International Ltd.