More predictable, long-term funding and planning needed for protracted emergencies
The World Health Organization (WHO) is committed to the recently launched Sustainable Development Goals and their objective to leave no one behind by 2030. However, WHO operates in many countries impacted by protracted emergencies –usually due to conflict – and it is these countries that face the highest hurdles in achieving the Goals.
It is estimated that 60% of preventable maternal deaths, 53% of under-five deaths, and 45% of neo-natal deaths take place in settings of conflict, displacement, and natural disasters. In 2016, WHO and health partners are responding to health needs in more than 30 protracted humanitarian crises. Why crises become protracted varies, but conflict is common to most.
“Protracted crises disrupt people’s lives, economies and societies for prolonged periods of time,” said Dr Richard Brennan, Director of WHO’s Emergency Risk Management & Humanitarian Response Department. “These crises break health systems. The Sustainable Development Goals will never be achieved if we do not address both the root causes and consequences of protracted emergencies.”
Almost all of the 17 Sustainable Development Goals contribute to improved health outcomes – either directly or indirectly. One goal (SDG3) specifically sets out to “Ensure healthy lives and promote well-being for all at all ages.” Two of the key indicators expected to show success will be major reductions in deaths of mothers and children.
Most of the countries with the highest rates of maternal and child deaths are considered protracted emergencies. WHO has emergency operations in eight of the ten countries falling farthest behind on maternal mortality, including South Sudan.
South Sudan, an example of a protracted crisis in need of more assistance to make SDG progress
In settlements for Internally Displaced Persons, overcrowded conditions and poor access to safe water, sanitation and hygiene increase the risk of diseases such as respiratory infections, diarrhoea, hepatitis E and cholera. With more than half of South Sudan’s population under age 18, the country’s current health problems and related issues may continue to deteriorate without major support and change.
Yet, South Sudan’s health sector remains consistently underfunded. The Health Cluster, which is led by WHO and is comprised of more than 60 partner organizations, aims to provide health services to 2.5 million people this year. The Cluster has requested US$ 110 million for 2016, but so far received US$ 8.6 million.
“If we are going to achieve the Sustainable Development Goals, we need sustainable, predictable financing to ensure the delivery of basic health services across countries like South Sudan, so that when peace comes people will be healthy enough to move the country forward on achieving the Goals, such as on education, jobs and gender equality,” said Dr Abdulmumini Usman, the WHO Representative to South Sudan.
Despite many challenges, WHO has achieved results. For example, WHO has worked with many partners to reduce deaths of children and mothers in South Sudan. A partnership called the Comprehensive Emergency Obstetrics Neonatal Care project built and operated three fully-equipped maternity complexes in Bor, Wau and Yambio. Dr Usman noted that in the last quarter these three complexes provided emergency obstetric and newborn services to over 18 000 mothers. Plans are underway for a second phase of the project to develop similar maternity complexes in Torit, Kuajok and Awiel.
“We are trying our best to do what we know works to reduce deaths from a range of priority conditions, including complications of pregnancy, neonatal problems and disease outbreaks. In order to improve people’s health, we need to prioritize the limited resources that we have,” said Dr Usman.
Protracted emergencies are not going away, but opportunities to achieve the SDGs will
Achieving the Sustainable Development Goals will depend on strengthened relationships among governments, communities, humanitarian and development actors, who must come together to produce longer-term plans that are based on thorough needs assessments and prioritized to achieve real change in the lives of the people they serve. This long-term, joint planning also requires long-term flexible funding.
“Protracted crises are not going away,” Dr Brennan said. “Piecemeal , inflexible funding and planning do not work. We have learned that local ownership is key to making progress in any development or emergency setting. It is vital to move away from short-term fixes to achieving long-term collective results. We need enlightened political leadership to address conflict where it occurs, empowered communities, closer collaboration between development and humanitarian agencies, and predictable financing. The stakes are too high not to engage in a new way of doing things”
The most vulnerable in all situations need access to healthcare. This means ensuring that critical functions in health service delivery are fulfilled and supported in the most challenging countries, and that the most affected areas in these countries are prioritized. To do this, national and local efforts must be supported and partnerships leveraged. WHO believes this should be organized around a collective commitment to provide a package of minimum health services that everyone can access in any situation.
“We can get better long-term results if we shift humanitarian actions from what the UN Secretary-General has called ‘delivering aid to ending need’, ’” Dr Brennan said. “As a humanitarian and development actor, WHO is uniquely positioned to help better unify our actions for the long-term.”
WHO is actively engaged in UN efforts to adapt existing humanitarian practices to better support multi-year planning; blend development approaches into humanitarian response; and produce operational guidance for area-based programming.
WHO views the World Humanitarian Summit, to be held in May 2016 in Istanbul, as an opportunity to help bridge development and humanitarian worlds. The Summit aims to generate greater global leadership and political will to end conflicts, alleviate suffering, and reduce risk, as well as to agree on a concrete set of actions and commitments to enable the international community to better prepare for and respond to crises. WHO will continue to play an active role in discussions at the Summit and beyond, and to advocate for the greater collaboration between humanitarian and development partners. The Organization remains committed to saving lives, reducing suffering, improving people’s health and achieving the Sustainable Development Goals.