Summary of GIZ’s 2-day retreat on Health, Social Protection and Inclusion in Bad Neuenahr
Some 200 delegates from GIZ and partner organisations attended the two-day retreat on Health, Social Protection and Inclusion GIZ hosted in Bad Neuenahr-Ahrweiler. The main theme addressed was: How far does the new development agenda of the Sustainable Development Goals (SDGs) represent a paradigm shift, and what will that mean for our work?
Conference programme with links to session summaries and presentations
Interviews with key speakers
The retreat was facilitated by the British journalist Claire Bolderson, and formally opened by Carsten Schmitz-Hoffmann, Director of GIZ’s Economic and Social Development Division. He began by reminding delegates that the 17 SDGs adopted by the United Nations in 2015 would define our development work for the next 15 years and require a change in the way think about and implement development. Implementing SDG10 – to reduce inequalities – would be particularly challenging, since inequalities cut across many areas of development work. Eradicating inequalities in health and ensuring social protection would be essential, not just in developing partner countries, but also in Germany itself and other industrialised countries, which – for the first time – had also signed up to global development goals.
Germany’s renewed commitment to development goals
In his opening speech, Heiko Warnken, BMZ’s Head of Health, Population Policy and Social Protection, reiterated that the universality of the SDGs would require a shift towards a more holistic and interconnected approach and that this would be a huge challenge. On the issue of social protection, Mr.Warnken said that Agenda 2030 demonstrated the importance of making human rights and social protection a reality for everyone, from the cradle to the grave.
Mr Warnken said that Germany was committed to the concept of universal health care, and would closely track health outcomes for vulnerable groups. This would require better monitoring and measurement of achievements and accountability, and this in turn would depend on collecting better evidence-based data. He expressed doubt that the development community, including GIZ, had yet fully grasped the extent of paradigm shift required for the new development agenda: “It is no longer a North-South divide, and the donor-recipient relationship is definitely over.”
In recognition of this fact, BMZ had launched a special programme for health in Africa to enable the continent to become more resilient to threats and emergencies, and to this end the German government had pledged a further 600 million Euros until 2019. The programme would also respond to the global shortage of health workers by expanding recruitment and training programmes for and health workers. Since diseases did not respect borders, Germany would also set up a rapid detection team to help respond to and strengthen the ability of countries to deal with the early stages of disease outbreaks and pandemics.
In this interview, recorded later on the same day, Mr Warnken explained the development roadmap for the “Healthy Systems, Healthy Lives”-initiative, which, according to him, will require development partners to work across sectors and outside their traditional silos .
The need for a revolutionary shift in development thinking
The keynote speech was jointly presented by Kent Buse, Chief of Political affairs and Strategy at UNAIDS in Geneva, and Sarah Hawkes, Professor of Global Public Health at University College London. They began crediting Germany with being “ahead of the curve” in grasping the requirements of the new development agenda, and in particular the inter-connectivity needed in the field of social protection. They said that since the SDGs now included non-communicable diseases, it was important to take a step back and determine what the drivers of ill health were. Treatment continued to be very important, but what we all really need to be asking is what makes people sick in the first place. The issues of road traffic accidents and air pollution, for example, could not be tackled by health systems working alone. A culture of treatment currently prevailed over a weak and fragmented culture of prevention.
The multi-sectoral approach required to address this imbalance would have profound implications for the way we all work, said Kent Buse, who called for what he described as “revolutionary paradigm shift” if the international community was to avoid reinventing the development wheel. These would include an unprecedented level of inter-sectoral leadership and coordination, which currently simply did not exist in many countries. “We need to work outside the silos we are in.”
Although the right to health had been traditionally thought of as right to treatment, Kent Buse argued that the 2030 Agenda would need a broader definition, based on non-discrimination and needing people to understand and demand their rights to affordable and accessible healthcare. This would involve greater civic engagement to hold health authorities to account and bring about a catalyst for further political change.
Professor Hawkes and Kent Buse concluded their keynote presentation by saying that the fact that GIZ was already willing to have this conversation meant that Germany was at the forefront of the debate and that this gave grounds for optimism that the SDGs could ultimately be successfully implemented, despite the many challenges ahead.
In this interview, recorded during the lunch break, the two key note speakers further explained their call for a “revolutionary paradigm shift” in thinking to meet the new development demands of the Sustainable Development Goal.
The devil is in the details
A discussion on the practical implications of this new phase of development then followed, with a panel comprising: Heiko Warnken (BMZ), Paola Bustamante (Former Minister of Development and Social Inclusion, Peru), Maliki (Indonesia’s Director of labour and Development Employment), Matthew Jowett (WHO) and Jean-Olivier Schmidt (GIZ’s Head of Competence Center Health).
Given the ambition and scope of the SDGs, and the fact that they included the more advanced economies as well as developing economies, Maliki said the SDGs were a hope for everyone – particularly the 40% of people who still did not have open access to basic health services. He was confident that Indonesia could implement a new way of thinking to implement programmes. Paola Bustamante added that Peru regarded the SDGs as not only a challenge, but as an opportunity to focus on individual solutions and involve people directly in development.
Matthew Jowett said that international organisations such as WHO had already started to change their way of working, especially with regard to public health financing for universal health coverage. Henko Warnken spoke of the need to more actively reach out to the media, civil society and academia to generate a lot more public discourse about the SDGs. Jean-Olivier Schmidt said that the new multi-sectoral approach required meant that GIZ and other development partners needed to break down their traditional “silo” mentality of working, as well as the old paradigm of North-South relations.
Breakout sessions and beyond
Over the two-day retreat delegates took part in a wide variety of breakout sessions. These included digitisation for better provision of public services, leveraging open source tools, certification for social protection programmes, collaborative design for health innovations and adaptive social protection. For summaries of all breakout session and their presentations, go to the respective slot of the conference programme.
A number of information displays and talking corners were also set up in the foyer of the conference hall, and throughout the two-day retreat colleagues and partners enjoyed exchanging ideas about and experiences of the new development agenda.
Bridging the data gaps
On the second day of the retreat Eduardo Celades, a Technical Officer for WHO’s Global Platform for Measurement for Accountability gave the keynote speech on how the development community could ensure greater accountability – which, he said, is often an afterthought – within the SDG framework. The new development agenda had put health centre stage, he said, but the big question now was: would it be business as usual or require a new response?
Mr Celades spoke about the “huge data gaps” he said existed at both global and national levels, and the problem of comparing data from high income countries with those in low income countries. Collective action would be needed at both the global and national level to develop and harmonise monitoring standards. A fragmented data landscape would no longer work.
Improving accountability and data collection – a discussion
A panel discussion moderated by Claire Bolderson then took place on how GIZ and its partners could improve data and accountability in SDG implementation. The panel consisted of Eduardo Celades, Ann Biddlecom (Director of International Research, Guttmacher Institute, USA) anand Eduardo remarked thatd Paul Rückert (Chief Technical Adviser for GIZ’s health programme in Nepal).
Paul Rückert spoke passionately about the need to establish routine collection of data, rather than focusing on health surveys every four to five years. He hoped that the 2020 target would act as a catalyst for GIZ and other organisations and governments to work together to establish reliable data systems. He said very few developing countries had so far managed to do this and that too many partners were competing with each other to introduce parallel systems. In Nepal for example there were no fewer than 13 parallel information systems in operation, all funded by different co-operation partners. GIZ was now helping to develop one unified e-health but this would take time.
Eduardo Celades made the point that this would be a major challenge since thousands of people would need o be trained to use compatible or unified systems for data collection and analysis at country level to support national plans. This was being supported by GIZ, but it would be a major investment, especially since many health centres currently have no computer or electricity. These would also need to a shift in attitude: “Data collectors sit in a dark room in the basement – they need to be on the top floor.” Political leadership would be critical in this process.
Following the panel discussion, Anne Biddlecom further explained in this interview how successful implementation of the Sustainable Development Goals will depend on improving data and accountability.
Reflections on the two-day retreat
Before the conclusion of the retreat, delegates were asked to reflect on the overall outcomes of the meeting. Nikos Nikolidakis, from GIZ’s Global Alliance for Social Protection said that, although there had been much talk during the retreat about the need for more holistic cross-sectoral cooperation as a way of meeting the challenges of the SDGs, he felt that many of the discussions had been too general, and he would have liked more specifics about how the challenges could be adequately addressed. However, another delegate said that she felt that the retreat’s discussions had given “lots of take home messages to take back to our desks and maybe change the way we work.” But, she added, there needed to be more continued dialogue and discussion.
A representative from Management4health said he had very much enjoyed the opportunity to debate some of these issues, but the retreat event had only been “an appetiser, which leaves us hungry for more.” He would like to see GIZ become a think tank for the key health issues for the 2030 agenda.
Jean-Olivier Schmidt wrapped up the debate by saying that the retreat had been a rare opportunity for colleagues from all over the world to meet and discuss how, as an organisation, GIZ could address he opportunities and challenges of the new development agenda.
Ensuring GIZ is THE development partner of choice
The closing speech was presented by Inge Baumgarten, GIZ’s Head Global Programmes in Health, Education and Social Development. She said that the meeting had been an exciting opportunity to create a shared understanding of the impact of the SDGs on German development work and contribute to a world we envisage for 2030, where truly nobody is left behind. It had demonstrated the need to break down the silos and wire fences that currently existed between sectors and organisations. Agenda 2030 was ambitious and complex, she said, and some of the goals might not be met unless changes were made. Inge Baumgarten concluded by saying GIZ was already doing a good job, but needed to work harder to meet the SDGs. Her hope, she said was that GIZ would become “THE development partner of first choice.”
Ruth Evans, September 2016