Janus, the two headed Roman god, had the ability to look both forward and backward in time simultaneously. This image is symbolic as we embark on a new year. We traditionally take time to reflect on the events of the previous year and look forward to the challenges of the next. We must evaluate our successes and our shortcomings to ensure continued progress. Sometimes this process can be difficult. It is only through honest and open review of our past that we can achieve success in the future.
As we approach 2015 there is an increasing need to evaluate our progress in the global achievement of the Millennium Development goals. The common beliefs enshrined in the MGDs have not changed since their inception. The world in which we live in has changed significantly. Changes in the global economies have created new pressures to use our resources more effectively.
Accountability and transparency are fundamental to accelerating progress in global health. It allows for recognition of global health programs where we have fallen behind in our goals. It allows us to accept that some strategies may not produce the desired results and make modifications necessary to continue with our achievement of the MDGs. In 2010 shortfalls in our commitments to maternal and child health were recognized by the Muskoka Initiative for Maternal, Newborn and Child Health and the UN Global Strategy for Women’s and Children’s Health. In 2011, the global health community took steps to ensure that initiatives launched in 2010 led to results by creating the Commission on Information and Accountability for Women’s and Children’s Health, led by Prime Minister Stephen Harper and President Jakaye Kikwete. This Commission has assembled an accountability framework that provides an outcome based system to monitor and review actions leading to adjustment of future strategies to accelerate progress for women’s and children’s health.
The principles of accountability and transparency are not only important in maternal and child health but also in continuing the fight against infectious diseases including malaria, HIV/AIDS and TB. Review of efforts to sustain universal coverage of malaria control interventions led to the recognition of financial shortfalls. Outcome based efforts led by President Ellen Johnson Sirleaf and global health partners led to identification of new strategies to improve procurement strategies to support the fight for eradicating malaria. Honest and accountable review of our global health efforts can also lead to innovative thinking to address challenges as evidenced by the African Leaders Malaria Alliance’s (ALMA) plans to develop innovative new funding streams to support malaria control.
Ultimately accountability requires metrics by which we can measure successes and failures. The Global Burden of Disease, Injuries and Risk Factors data provides a new standard for quantifying global health problems. It also helps to identify the areas of greatest need in a given region.
This issue of GHD News also provides a special focus on efforts to address tuberculosis, particularly in Afghanistan. While these articles highlight the challenges of drug resistance and the success of earlier diagnosis techniques it also brings focus to the personal challenges faced by much of the world’s population. The personal costs of tuberculosis are not only measured in mortality and morbidity data but also in the ability to pursue our dreams and those of our children.
Global health challenges do not discriminate. They affect all of us. In this issue of GHD News some of the authors share their own personal experiences with potentially life threatening complications which face all mothers around the world. It is only though accountable review of our global efforts on health that we can refine our plans to create healthier futures for all.