Tracking

Are we on track or off track in reaching for our global health goals? Without solid measurement tools, we would be lost.

There are myriad health interventions across many countries and involving multiple players, yet there is no global “command and control” system. As decentralized decision-making and “country-ownership” – rightly – take hold, it is becoming more difficult to monitor and track-progress in real-time. As a result, data are often reported with more than a year’s delay and are used to “report-up” rather than at local levels to inform local decisions. The UN Special Envoy’s Office helps gauge the collective efforts of development agencies, governments and donors to achieve the health targets of Agenda 2030, working to understand whether the global community is “on track” or “off track” to achieving its goals and identifying where extra support or coordination may be needed.

We will work with our partners such as the World Health Organization, UNICEF and others, to “triangulate” different sources of data – including data from mosquito net manufacturers themselves – who will provide us with monthly production data in order to track efforts as broadly as possible. These analyses will guide the thinking of the Special Envoy’s Office, development partners and country governments around the highest value levers for our office and partners to pursue.

ATLAS

Recent years have seen tremendous gains in global health, yet many of the world’s poorest remain uncounted, and as a result, unreached and underserved. Rates of preventable death vary considerably by district even in countries that have already met the Sustainable Development Goals target for under-five mortality. Between 2015 and 2030, an estimated 6 million children under the age of five will die in countries regarded as “low-mortality” countries, and many more deaths will occur in high-mortality countries.

In high- and low-mortality countries alike, the poorest of the poor suffer disproportionately. Equitable improvement in health and human development in coming decades will require tools aimed at including the world’s most marginalized populations. This challenge necessitates the timely creation of a crucial public good: a “Health Equity Atlas”–referred to as ATLAS– that will provide a basis for planning and measurement, and will have unprecedented impact on the delivery of services to those in greatest need.

The Office of the Special Envoy has initiated work on and convened a broad coalition of partners to rectify the low quality and incompleteness of health data on the world’s most marginalized populations, who remain digitally invisible. ATLAS aims to provide a platform that unites, standardizes, and comprehensively maps health data across sub-Saharan Africa. This automatically annotated, easily queried geospatial framework will ideally provide rapid feedback, analysis, and prediction. The Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai is taking administrative leadership of the project, with the Office of the Special Envoy acting as a convener and providing political and strategic support. The Massachusetts Institute of Technology Media Lab is a key technical partner.

Lives Saved Scorecard

In response to the intense measurement needs at the end of the Millennium Development Goal era, the UN Special Envoy’s Office partnered with the Institute for Health Metrics and Evaluation at the University of Washington to develop a tool, the Lives Saved Scorecard, to allow governments, policymakers, and donors to track investments in child health and to link these investments to child deaths averted across countries in a comparable way. The unprecedented analysis was published in The Lancet titled Keeping score: fostering accountability for children’s lives,” and revealed that more than 34 million children’s lives have been saved since 2000 because of investments in child health programs at a cost of as little as $4,205 per child.

The scorecard is an important tool for fostering accountability and accelerating progress toward the crucial goal of preventing suffering throughout the world. The scorecard is best utilized in three main areas:

  1. Countries that receive development assistance can use the scorecard to focus on the programs that have proven most effective at saving lives or to reorient programs to focus on the most disadvantaged populations.
  2. Donor nations can use the scorecard to take into account how their contributions flow through bilateral and multilateral channels and to identify funding gaps on a country-by-country basis.
  3. For both funding recipients and donors, the scorecard can provide a warning flag to show where child deaths are increasing despite increased spending.

IHME and the UN Special Envoy’s Office hope that the scorecard will be further developed and updated annually to measure the effects of investments, incentivize progress, and drive innovation to fill gaps in funding or interventions.