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Our lessons on accountability and transparency can help to move us forward not only to accelerate progress on maternal, newborn, and child health, but also on the Millennium Development Goals. They will help us build a stronger, more effective partnership beyond 2015.

Since their launch in 2000, the global community has made important progress on the Millennium Development Goals (MDGs) and improved the lives of many. Millions of girls and boys have had the opportunity to attend school, the burden of illness and diseases such as malaria and HIV/ AIDS has been eased through important global interventions, and fewer people now live in extreme poverty. While global progress has been uneven, and much remains to be done, we should not forget the achievements that we have made together.



One thing that became clear in the lead-up to the 10-year review of the MDGs was that the world was falling behind on its commitment to reduce child mortality and improve maternal health, and that urgent action was required. In response to this unacceptable situation facing women and children in developing countries, Canada led the G8 in launching the Muskoka Initiative for Maternal, Newborn, and Child Health in 2010, a $7.3 billion commitment focused on strengthening health systems, reducing the burden of illness and disease, and improving nutrition for women and children.

That same year, building on momentum from G8 Leaders in Muskoka, the United Nations Secretary General launched his Global Strategy for Women’s and Children’s Health, which resulted in an unprecedented global commitment –over $40 billion from governments, nongovernmental organizations, the private sector and other stakeholders—to accelerate progress on reducing child mortality and improving maternal health. In addition, a significant number of developing countries, including the United Republic of Tanzania, made bold policy and service delivery commitments towards improving women’s and children’s health.

To ensure that these commitments lead to real results for women and children, the United Nations Secretary-General convened the Commission on Information and Accountability for Women’s and Children’s Health in 2011, which we had the honour to co-chair. The Commission put forward ten practical recommendations for improving national and global reporting, oversight, and accountability to ensure that all partners are focused on results, delivering on their pledges, and working together to save lives. An independent Expert Review Group has been established to report regularly on these commitments.

Saving lives and improving the health of women and children can have a “multiplier effect” on the progress of other development objectives. The health and well-being of women and children is essential to long-term prosperity and security in countries around the globe. Where women and children thrive, communities and countries thrive. Women are the bedrock of families and have enormous potential to become decision-makers, drivers of economies and role models for future generations. Children offer a glimpse into a country’s future—the teachers, doctors, entrepreneurs, and leaders of tomorrow. By investing in the health of women and children, we can reduce their burden of illness and disease, enabling them to participate fully in their communities, steering their countries toward future prosperity.

The continued attention and momentum that women’s and children’s health have received from the global community is inspiring. Recent key global events, such as the Child Survival Call to Action and the Commission on Life-Saving Commodities for Women and Children, are all playing a positive and significant role in accelerating action on improving maternal health and reducing child mortality. We would like to congratulate and thank President Goodluck Jonathan of Nigeria, Prime Minister Jens Stoltenberg of Norway, Prime Minister David Cameron of the United Kingdom, and other leaders and partners for their leadership and ongoing dedication to improving the lives of women and children.

Progress achieved to date in maternal, newborn, and child health is encouraging: more women are surviving to watch their children grow and more children are reaching their fifth birthday. Since 1990, maternal deaths worldwide have dropped by nearly 50%; under-five child mortality rates have also been dramatically reduced, from nearly 11.6 million deaths in 1990 to 6.9 million in 2011. Yet, improvements in women’s and children’s health has been uneven with the slowest progress on the African continent, which accounts for half of the global maternal deaths and those of children under five years of age.

Accelerating progress will require a focused and continued commitment by all. There are signs, however, that funding to maternal, newborn, and child health is declining due to the impact of the global financial and economic crisis; resources remain a crucial gap in low-income countries, where health spending has remained low; and the world is making slow progress in implementing the recommendations of the Commission.

We cannot afford to let up now. The health and well-being of women and children must remain at the forefront of our efforts to accelerate progress on achieving real results. Crucial to our success will be:

  • Greater accountability, which remains the linchpin to accelerating progress towards our collective goals. Our Commission developed an integrated accountability framework of monitor, review and action – for ongoing improvement and impact in our work. Accountable behaviour includes a very strong focus on results, and an openness to review our work, and a willingness to adjust strategies for greater impact as required.
  • A continuing focus on the continuum of care. The health needs of a mother and her child are interlinked and so service delivery must be integrated and organized around their needs. A pregnant mother should only have to travel to one clinic for antenatal care, HIV treatment, nutritional learning and support, further underscoring that health system strengthening is crucial for effective delivery of maternal, newborn and child health care.
  • A strong commitment to national leadership and ownership of results, for the primary accountability for delivering results for women and children lies with the countries in which they live. Initiatives to support countries should be country owned and led, focused on national priorities, conditions, and needs. We welcome the groundbreaking resolution of the Inter-Parliamentary Union that will empower Parliamentarians to fully engage in addressing fundamental challenges to improving the health of women and children.
  • Strengthened coordination and coherence with a view to reducing duplication and the proliferation of initiatives, and the fragmentation of our collective efforts. We achieved a great deal by working together, now is not the time to revert to old habits.
  • Dedication to bold, innovative ideas with the potential of having a big impact on accelerating progress. The recommendations of the Commission on Life-Saving Commodities for Women’s and Children’s Health are designed to do just that. Researchers, communities and the private sector are working together, including through the “grand challenges” approach, focusing on critical bottlenecks and bringing new ideas, practice and solutions to our work.


Tanzania and Canada remain committed to advancing this effort to save the lives of millions of women and children around the world, strengthening our existing partnerships and establishing new ones.

While we engage in the growing global discussions on what will succeed the MDGs in 2015, we cannot forget the promises we have already made. We still have three years until the end of 2015 to accelerate progress towards achieving our collective commitment to a better world; a world that includes improved health outcomes for women and children.

Greater accountability and transparency, improved coordination and coherence, expanded partnerships, strengthened governance systems, innovation, and learning from our successes as well as our mistakes, are factors that are helping to accelerate progress. By increasing the transparency of our work and our commitments, our partnerships are generating further momentum, engaging new stakeholders, and making new solutions possible. Working together, we can make a difference for women and children around the world and pave the way for a brighter future for all.

The potential contained in the post-2015 process is exciting and full of new possibilities, but it will be important to carefully weigh what we have learned from our efforts and to integrate those lessons as we move forward.

The world has changed fundamentally in the years since we adopted the Millennium Declaration. What has not changed is our shared belief that a world without poverty or deprivation, where human dignity, security, and respect for all is not only possible but within reach — as long as we work together.