Three ways to protect the health of the world's most vulnerable women, children and adolescents

Protecting and supporting the most vulnerable women, children, and adolescents is a challenge the world has failed to meet for far too long.

Too often, just as progress is being made, we are knocked backward by war, economic crisis or the pandemic. It will not be possible to achieve the Sustainable Development Goals (SDGs) by 2030 by sticking to business as usual.

A system-wide paradigm shift is critical to catalyse action for Universal Health Coverage (UHC). We must commit to permanent, robust solutions that can ride out storms and ensure that progress is maintained — whatever the global circumstances.

Now, more than ever, countries must invest in delivering social and economic returns and eradicate widening health inequities that are catastrophic for economies, political stability, health security and human rights.

The stakes are particularly high in countries at the lower end of the health-financing spectrum. In many of these settings, international donor financing for health is waning and fragmented. This is compounded by the diversion of domestic funding away from women’s, children’s and adolescents’ health and wellbeing in response to the COVID-19 pandemic. These challenges are heightened by pessimistic macroeconomic forecasts and limited fiscal space in low- and middle-income countries. Moreover, progress on the SDGs has stalled as countries battle the combined impact of conflict, climate change and COVID-19.

As is often the case, the most vulnerable women, children and adolescents bear the brunt of these adverse circumstances. For example, the COVID-19 pandemic and associated disruption saw 5.9 million more children missing out on life-saving vaccinations in 2021 than in 2019, bringing the total missing out to 25 million children — the highest number since 2009. Vulnerable populations in conflict settings also face increased risks of gender-based violence, human trafficking and other forms of exploitation, with life-long, inter-generational negative impacts.

We must act now, across stakeholders and sectors, to support vulnerable communities and adopt a human-centred approach to save and transform the lives of those heavily affected by these crises. This is the ethos of the WHO’s Partnership for Maternal, Newborn and Child Health (PMNCH), the world’s largest alliance for women’s, children’s, and adolescent health, with more than 1,300 members drawn from 192 countries.

In particular, we must pursue three critical priorities: political leadership, innovative financing and meaningful partnerships.

Solid political leadership means both action and accountability. It involves the will to make deliberate policy decisions to accelerate progress for women, children and adolescents, especially the most vulnerable. Effective leadership is essential to champion collaboration for health and to engage women and girls meaningfully in health systems and multi-sectoral reforms.

This is fundamental in the run-up to the UN’s High-Level Meeting on Universal Health Coverage in New York in September 2023, which aims to address the needs of this population.

Innovative financing, focused on solutions that protect the rights of the most vulnerable, is also crucial. Social impact financing, blended financing and domestic funding from non-established players, such as local small and medium enterprises, all have a role to play. This is important because we know that investing in the continuum of care for women, children, and adolescents provides an excellent long-term return for societies. Every dollar invested in child immunisation brings at least $20 in benefits. And every dollar invested in selected adolescent health interventions yields a 10-fold return in health, social and economic benefits.

Meaningful partnerships must play an integral part in developing and scaling up these new financing models. Intersectoral collaboration is crucial.

The collective endeavour can be powerful in pioneering research, developing digital interventions for health and championing inter-sectoral financing. Recent and massive investments in COVID-19 responses also provide us with opportunities to support and sustain health-systems strengthening in the long term.

This is why we — as President of South Africa and Chair of PMNCH — are establishing the Global Leaders Network, comprising ten bold heads of state and government, convened to address these challenges, advocate for greater impact, combat the rising threats against the health and well-being of women, children, and adolescents and build back better and fairer for a sustainable future.

As we cross the SDG halfway point, the world remains far off track from a critical objective set for 2030: Universal Health Coverage for All.

Fine words and ambitious targets don’t, in themselves, mean change. We will only achieve our ambitious goals through action, sustained investments and accountability.

If these interventions align with the needs of the most vulnerable, we can only deliver on Universal Health Coverage for every woman, child and adolescent everywhere.