Overview of commitments

Support for the EWEC Global Strategy is truly global, with supporters based all over the world (Figure 18). About half of all commitments come from North America (29%) and Europe (25%). Just over one fifth come from sub-Saharan Africa (21%). The remaining quarter of commitments come from four other geographic areas and from global-level stakeholders.

Commitments by the private sector, CSOs, NGOs, foundations and academic institutions are primarily from North America and Europe (78%), representing the need for more engagement by supporters in other regions of the world. Nongovernmental commitments are particularly low from sub-Saharan Africa: although half of commitments by governments come from sub-Saharan Africa, only 8% of private sector commitments, and 14% of CSOs’ and NGOs’ commitments, come from this region.

WHAT ARE THE DIFFERENT TYPES OF COMMITMENTS?

Substantial financial commitments have been made to the updated EWEC Global Strategy and the funds are being disbursed. Between September 2015 and December 2016, commitment-makers pledged a total of US$ 28.4billion in financial commitments.¹²⁷ Of this amount, donor governments pledged 49%, and low- and lower-middle income countries 30%, with the remainder coming from NGOs, CSOs, foundations, the private sector and intergovernmental bodies (Figure 19).¹²⁸ Commitment-makers are on track with their disbursements, with an estimated US$ 6.0billion disbursed by December 2016.

The magnitude of the financial commitments to the EWEC Global Strategy becomes even more impressive when financial commitments to the Global Strategy 2010–2015 and related disbursements are taken into account. Disbursements for these commitments amounted to US$ 40billion, bringing the total disbursements since September 2010 to more than US$ 45billion.¹²⁹

Significant commitments have been made to provide advocacy, policy, service delivery and product development; these are harder to quantify but nonetheless contribute substantially to achieving the EWEC Global Strategy’s objectives. For example, supporters were asked to identify which of 14 “types” of activities their commitment related to (Figure 20).¹³⁰ The majority referred to health system strengthening (n = 104, 48%), the provision of services and products (n = 93, 43%), political mobilization (n = 92, 43%), and/or advocacy (n = 87, 40%). These pledge in-kind delivery of services, products or innovation, rather than direct financial support.¹³¹

Some supporters unite around a specific area of activity. Commitments to meet the family planning needs of women and adolescent girls made through Family Planning 2020 (FP2020) are one example (Box 2).

The private sector accounts for one third of all commitments to innovation. It provides substantive in-kind and shared value interventions that leverage the unique functions of business to address social needs in diverse ways, including through market-based business models, rather than making direct financial contributions (Box 3). CSOs and NGOs made strong pledges on service delivery and education and training, while UN organizations, multilateral agencies and global partnerships provide essential policy support.

Commitments show strong support for the “survive” and “thrive” objectives of the EWEC Global Strategy but could be expanded to better address the social determinants of health reflected by the “transform” objective. While 80% and 70% of the 215 commitments refer to at least one of the 16 key indicators of the “thrive” and “survive” objectives respectively, only 27% reference any of the key indicators measured under the “transform” objective. This reflects the need to further develop connections between the objectives.

Of the commitments under the “survive” objective, maternal mortality (54%) and under-five mortality (51%) are the two most frequently referenced key indicators; fewer commitments are targeted at adolescent mortality and stillbirths (Figure 21). Commitments covering the “thrive” objective show strong support for essential health services. Few commitments address sexual and reproductive health and rights (SRHR) laws or out-of-pocket health expenditure. Key indicators of the “transform” objective, with topics such as education and violence against women and children, receive less attention and need further engagement.

In addition to the 215 commitments made through EWEC’s formal process, nine others were made at the World Humanitarian Summit in Istanbul on 23–24 May 2016, expressing support for the world’s most vulnerable people. Four of these were made by governments, two each by UN organizations and CSOs, and one by the private sector.¹³⁴ All nine commitments were in support of the core responsibility to “leave no one behind”. Six of them explicitly commit to ending all preventable deaths of women and adolescent girls in crisis settings. For example, UN Women will work towards this aim by supporting partners in removing structural barriers such as discriminatory policies and practices. Through the Agenda for Humanity Platform for Action, Commitments and Transformation, all stakeholders who made commitments will report on progress annually.¹³⁵