PMNCH 2011 REPORT ON COMMITMENTS TO THE GLOBAL STRATEGY FOR WOMEN S AND CHILDREN S HEALTH QUESTIONNAIRE Norway Completed questionnaire received on September 7 th, 2011 Section 1: Understanding the specific financial nature of your commitment better Confirming the accuracy of your financial commitment to the Global Strategy Question 1.1 Does the following statement, which has been taken directly from the Every Woman, Every Child website: http://www.everywomaneverychild.org, accurately reflect your commitment? Norway will increase its contribution to the Global Fund for AIDS, Tuberculosis and Malaria by 20% for the next 3 years, making a total contribution in 2011-13 of USD 225 million. This is in addition to the commitment made in June as part of the Muskoka initiative of USD $500 million for the period 2011 2020, partly subject to the annual budgetary process. Prior to September 2010, Norway committed to: - Increase the annual support to the Global Fund for AIDS, Tuberculosis and Malaria by 20%, from NOK 375 million to NOK 450 million. Total contribution in 2011 13 will thus be NOK 1 1350 million. - Support IFFIm (additional funding to the Health Systems Funding Platform) with NOK 1500 million for 2010-20*. - Support the Health Results Innovations Trust Fund administered by the World Bank with NOK 1500 million for 2010-20*. - Support implementation research administered by the Alliance for Health Policy and Systems Research with NOK 45 million for 2010-12. After September 2010, Norway committed to: - Doubling annual contribution to GAVI between 2010-15 from NOK 500 million in 2010 to NOK 1000 million in 2015. - Support the Measles Initiative administered by the UN Foundation with NOK 120 million in 2011. - Support the Accountability Commission of the Global Strategy with NOK 50 million for 2011. - Support innovation and research administered by the Innovation Working Group of the Global Strategy related to m. Health with NOK 45 million from 2011; and Saving Lives at Birth: A Grand Challenge for Development administered by USAID with NOK 60 million for 2011-15, contingent upon parliamentary approval. Support research administered by the Norwegian Research Council with NOK 55 million per year for 2012-20, totaling NOK 495 million, contingent upon parliamentary approval. 1 Norwegian funds are committed in NOK, the exchange rate used here is 1USD = 5.6NOK 1 P a g e
*These are the commitment made by Norway as part of the non-g8 commitments of the Muskoka Initiative in June 2010 of USD 800 million for the period 2011 15. Question 1.2 Your financial commitment to the Global Strategy was estimated in September 2010 in consultation with the UN Secretary-General s office to be USD 21 million in 2011-2013 and part of USD 800 million ( non-g8 Muskoka commitments from Netherlands, New Zealand, Norway, Republic of Korea, Spain and Switzerland ) in 2011-2015. The following formula was used to arrive at that figure: 20% of US$ 225 million, of which 46% was assumed to go to MNCH. In your view, does the figure of USD 21 million + part of USD 800 million in 2011-2015 accurately reflect your commitment to the Global Strategy? No, it is not entirely correct. See 1.1 for overview. Question 1.3 If not, how did you estimate your commitment and what was the final figure of your estimate? See 1.1 for overview. Question 1.4 What progress have you been able to make in implementing your financial commitment to the Global Strategy? Are there any new or additional documents that give details of this? Proposition 1S (2010-2011) to the Parliament (the Governments budget proposal 2011 for the Ministry of Foreign Affairs). Press releases from Prime Minister Office, Ministry of Foreign Affairs, GAVI etc. Annual budget reports from grant receivers. Enabling better understanding by stakeholders of your commitment to enhance financing Question 1.5 What is the start date of your financial commitment to the Global Strategy? An exact start date is difficult to define as Norway was a central part of the process leading to the development of the Global Strategy, but in general a start date of April 2010 is acceptable. Question 1.6 2020. What is the end date of your financial commitment to the Global Strategy? Question 1.7 How does this financial commitment to reproductive, maternal, newborn and child health (RMNCH) differ from commitments you may have made prior to April 2010? 2 Again, due to high political involvement and engagement for MNCH prior to April 2010, commitments prior and after April 2010 are linked. In general, the Global Strategy has contributed to a higher priority given to MNCH. Question 1.8 To what extent is your commitment new and additional to previous spending for health? For example, is your commitment additional to what you would have spent in 2011 on RMNCH in the absence of the launch of the Global Strategy? Does this commitment increase the overall funding envelope for health, or does it involve a reduction in funding for other areas of health? The commitment is additional to previous spending and it increases the overall funding envelope for health. 2 The development of the Global Strategy was initiated by the UN Secretary-General in April 2010. 2 P a g e
Question 1.9 How much do you estimate you will spend 3 of your commitment to the Global Strategy in calendar years 2011-2015? The estimated budget appropriations in the years 2011-2015 to global health, primarily directed towards the Global Strategy, are given in the table below. The annual increase in the period is the Norwegian commitment to scale up our annual contribution to GAVI from NOK 500 million in 2010 to NOK 1000 million in 2015. The budget is subject to annual appropriations from the Storting. (the support to UNITAID is not included here). Actual spending will depend on the implementation rate of partners. 2011 2012 2013 2014 2015 1490 1640 1743 1846 1950 Million NOK Question 1.10 Is there anything specific you are considering to increase the predictability of funding, as this is an important theme of the Global Strategy? Norway is committed to being a predictable donor and has therefore committed funds for the programmatic periods of the Muskoka Initiative up to 2020, for GAVI up to 2015, and GFATM 2013 subject to annual budgetary process. We are in the process of entering into multi annual agreements for our financial contributions to GAVI and The Global Fund. Question 1.11 Does your commitment to the Global Strategy rely on external funding from bilateral donors, foundations, multilateral development agencies, or NGOs? If so, please give details. Not applicable as Norway is a government donor. 3 The Guide to the Questionnaire for this question provides definitions of what we mean by spend. 3 P a g e
Section 2: Understanding the development impact of your commitment better the combined role of financing, policy, service delivery and advocacy Confirming the accuracy of your commitment, and understanding it better Question 2.1 Does the following statement, which has been taken directly from the Every Woman, Every Child website: http://www.everywomaneverychild.org, accurately reflect your commitment to strengthen policy, service delivery or advocacy? Norway will increase its contribution to the Global Fund for AIDS, Tuberculosis and Malaria by 20% for the next 3 years, making a total contribution in 2011-13 of USD 225 million. This is in addition to the commitment made in June as part of the Muskoka initiative of USD $500 million for the period 2011 2020, partly subject to the annual budgetary process. Norway emphasizes financial support to programs and activities that are linked to delivery of results and services. There is high level political engagement for policy for change both at global and bilateral levels. At the national level, the up-coming Norwegian White Paper on Global Health highlights the Global Strategy as one of the guiding documents for Norwegian policy, and Norway will continue to advocate for predictable funding, strong multilateral and civil society organizations, strengthened health systems, development of human resources and focus on women s and children s health. Norway is a major donor to WHO which has a leading role in the development and follow up of the Global Strategy. Question 2.2 What additional funding might be required to implement your policy, service delivery or advocacy commitment? Were those additional funding needs included in any financial commitment you may have made to the Global Strategy (see question 1.1)? It is important for Norway that the Accountability Commission of the Global Strategy will deliver quality products and enhance accountability for all stakeholders, hence Norway has committed to support the Commission with NOK 50 million. Question 2.3 How does this policy, service delivery or advocacy commitment to RMNCH differ from commitments you may have made prior to April 2010? 4 Norway has in recent years become more focused on accountability for resources (also beyond aid flows) and results, which the commitment to the Accountability Commission is an example of. The up-coming White Paper on Global Health will reflect the priorities towards 2020. Achieving Impact Question 2.4 Does your commitment to the Global Strategy target a specific type of intervention: for example family planning, nutrition, skilled birth attendance, newborn health, immunization or other specific components of the continuum of care? If yes, what are they, and why were those particular interventions given special priority? Special focus is given to areas and diseases with a high burden but with limited resources where results can be achieved like immunization and sexual and reproductive health and rights including newborn 4 The development of the Global Strategy was initiated by the UN Secretary-General in April 2010. 4 P a g e
care, as well as issues related to equity, gender and human rights and innovative ways of financing and strengthening health systems. These areas are given priority in line with the MNCH consensus. In general funds from Norway are mainly channeled through multilateral organisations. Question 2.5 Does your commitment to the Global Strategy involve a specific focus on a particular region of the world, or a specific country? If yes, which region or country? Why did you choose that region or country? In general the focus are on the poorest countries with lowest income (like the 49 countries identified by PMNCH) and selected middle-income countries with large disparities where policy dialogue is central. For example: the Norwegian bilateral MDG 4&5 programs focus on provinces, states or districts with the highest maternal mortality rates in the selected countries (India, Pakistan, Nigeria, Malawi and Tanzania). Question 2.6 Are there specific provisions in your commitment to improve equity of access and outcomes and/or to reach the poorest and most vulnerable? If yes, what are they? As stated above, the general commitment is to the poorest countries and the most vulnerable within these countries. Norway has an increased focus on metrics at sub-national level and disaggregated data collection for equitable decision-making and service delivery. Question 2.7 What specific provisions are you considering to ensure that the additional financing, policy, service delivery or advocacy commitments you made to the Global Strategy will strengthen health systems at the country level? Norwegian funding is channeled primarily in support of national health strategies and plans. Norway has close collaboration with H4+ agencies, and support health systems strengthening as part of GAVI and GFATM grants. Norway is also part of the IHP+ platform. Also, there is focus on human resources for health and health management information systems. Question 2.8 Are you planning anything particularly innovative that will help improve effectiveness, efficiency and impact of your commitment? Norway chairs the Innovation Working Group of the Global Strategy and has committed funding to support innovations in RMNCH through IWG grants, Saving Lives at Birth: a grand challenge for development, and through programs by the Alliance for Health Policy and Systems Research. Further, Norway is a key donor to the Health Results Innovations Trust Fund administered by the World Bank (i.e. results based financing). Question 2.9 What specific action are you taking to monitor and assess the impact of your commitment? Are there specific opportunities for operational research and knowledge generation that you are aware of in your or others commitments? In addition to the knowledge generated as part of the innovations mentioned under 2.8, Norway s MDG 4&5 bilateral support programmes (India, Pakistan, Nigeria, Malawi and Tanzania) have incorporated programme monitoring and evaluation, and operational and implementation research to document and learn from the processes. At the global level, the Accountability Commission will provide important knowledge and likewise the global health research portfolios of the Norwegian Research Council (GLOBVAC) and the UN bodies TDR, HRP and AHPSR. 5 P a g e
Recent Progress, Constraints to implementation, and Opportunities for Future Engagement Question 2.10 What progress have you been able to make in implementing your commitments to the Global Strategy? Are there any new or additional documents that give details of this? The Norwegian bilateral programs are planned in line with national priorities and plans, and are currently being implemented with annual meetings, mid-term reviews and end of project reviews and evaluations planned. Calls for interest under the Health Results Innovations Trust Fund have been placed. The websites of GAVI, GFATM, AHPSR and Accountability Commission provide updated details of progress. Norway follows common implementation and monitoring mechanisms and do not insist on separate documentation. Question 2.11 What specific opportunities are there for other stakeholders, including governments, bilateral donors and foundations, multilateral organizations, civil society, health care professionals, and academia, to participate in the delivery of your commitment? Norway strongly supports collaboration and coordination between the various stakeholders. Most of the funds from Norway are channeled through multilateral and civil society organizations, funds and partnerships. Norway s commitments to the health systems financing platform, IHP+ etc. are examples of this. Question 2.12 Have you encountered any constraints to implementation of your commitment? National issues like change in government, natural disasters that take priority etc. have slowed down implementation in some areas. UN bureaucracy has slowed down progress in others. Whereas national support to the Global Strategy has been high with efficient delivery, increased demands for donor collaboration and harmonisation sometimes slow down implementation. Question 2.13 Are you aware of any specific needs for technical assistance or other support to help you, or others, make progress? Not at the national level but at the global level it is important that the Accountability Commission delivers good quality products to keep the momentum of the Global Strategy high. 6 P a g e
Section 3: Other issues Question 3.1 Where, when and how will you be reporting on implementation of your commitment to the Global Strategy? Reporting will primarily be done as part of the national, annual budget process. Norway further intends to follow the recommendations of the Accountability Commission. Question 3.2 In what specific ways did the launch of the Global Strategy assist you in providing additional support for women s and children s health? The Global Strategy is a document that assists in gathering more and broader consensus as there is now a reference to a common international strategy. Further, it helps when advocating vis-a-vis governments, partners, and international players in the field. Question 3.3 Not applicable Do you have any other comments you wish to make? 7 P a g e