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The O'Neill Institute Welcomes the Report of the Independent accountability Panel and Urges New Implementation of Accountability Framework

The O’Neill Institute welcomes the report released yesterday from the Independent Accountability Panel (IAP) for the Global Strategy on Women’s, Children’s and Adolescents’ Health, 2016: Old Challenges, New Hopes, and calls for the thorough implementation of its accountability framework. The framework’s emphasis on remedies rounds out a cycle of accountability that must include but extend beyond the traditional emphasis on monitoring and evaluation if both the right to health and other health-related rights are to be realized. This report is intended help to catalyze the use of national, regional, and global legal accountability mechanisms - and vitally, ensure that all people, with special attention to the most marginalized, have the resources and respect that empower their ability to access them. If all of the stakeholders in the Global Strategy, together with other actors around the world, can work towards implementing these recommendations, the report will have had a central role in enabling people to be rights-holders in more than name only.

The report is the culmination of a year-long effort that began when UN Secretary-General Ban Ki-moon launched the Global Strategy, and subsequently appointed the panel of distinguished individuals from diverse regions and backgrounds, including leaders in human rights and humanitarianism, to help ensure accountability to the United Nations’ Global Strategy on Women’s, Children’s, and Adolescents’ Health. Among the IAP’s ten members is Alicia Ely Yamin, who recently joined the O’Neill Institute as Program Director of its Health and Human Rights Initiative.

The report builds on work of the Commission on Information and Accountability (CoIA), which the World Health Organization launched in 2011 to develop a framework of monitoring, oversight, and accountability for the Global Strategy for Women's and Children's Health, and the Independent Expert Review Group that followed. And if countries and other partners adhere to its framework, it will contribute to countries achieving the Sustainable Development Goal (SDG) targets on equal access to justice for all and effective, accountable, and inclusive institutions.

The IAP’s critical addition to the CoIA framework is the need for remedies at national, regional, and global levels. As Yamin explained, “An array of legal accountability mechanisms already exist, from national courts and human rights institutions to international human rights treaty monitoring mechanisms. Fully utilized, these can and should help to more explicitly ground health systems and development initiatives regarding health in the rule of law.”

Yamin was quick to emphasize, “Remedies are not primarily about punishing individual wrongdoers or compensating for wrongful actions, but rather about reforming the underlying structures that lead to rights violations. Remedies should be transformative, not simply restorative.”

Seen this way, institutions critical for accountability extend from courts to the legislatures and the executive branch, which can develop the laws and policies needed to give effect to rights. For example, they should allocate sufficient budgets for women’s, children’s, and adolescents’ health, reform discriminatory laws, and incorporate rights principles into health facility management practices. As one example of using law for proactive accountability, in 2006 Uruguay’s legislature passed sweeping tobacco control legislation to protect uphold its responsibilities to protect public health, despite significant opposition from the tobacco industry. Here it was Phillip Morris that turned to the courts, arguing that the law violated its rights. Earlier this year, an international arbitration panel ruled against the tobacco giant.

Social accountability, too, is central to accountability. In this respect, the Panel calls for people to be made aware of their rights and to be involved throughout the policymaking process. It highlights that “[p]eople from traditionally disadvantaged or marginalized communities have shown extraordinary capacity to have an impact on health outcomes by their collective action to monitor health systems. This type of cooperation leads to better policy, leadership, investment and preventive actions, and can help citizens assert their rights and entitlements, and produce better health outcomes.” Civil society has a central role in enabling people, including the most disadvantaged, to take this action, yet as the IAP notes with concern, in many countries, civil society space is shrinking.

Disadvantaged communities also consistently have worse health outcomes, though in some areas, gaps are narrowing. To ensure that gaps in health outcomes across such dimensions as wealth, age, and gender, among others, are identified and redressed, the IAP stresses the need for disaggregated data, and for monitoring the Global Strategy to be “concerned with equity, not just aggregate advances.”

The IAP also draws attention to extensive humanitarian crises around the globe, with historic numbers of refugees and internally displaced persons. “It is...time,” the IAP maintains, “to address the absence of accountability - the data and monitoring gaps - in these settings.” The Panel similarly draws attention to the immense shortage of health workers in many lower-income countries, observing that “nothing less than a transformational global effort to augment and equitably deploy a competent and client-respecting health workforce would be required to meet the 2030 ambition of healthy lives and well-being for all ages.”

The O’Neill Institute congratulates Alicia Ely Yamin and the other members of the IAP on their efforts to infuse human rights into SDG implementation and ground health systems in human rights. We look forward to working with our partners to seize on the opportunities for human rights accountability that the IAP’s report rightly insists become integral parts of national and global systems for health.