The global COVID-19 pandemic is testing international development cooperation like never before, magnifying existing challenges, but also creating a unique opportunity to embrace risk-informed approaches in the final push towards the Sustainable Development Goals, speakers said today as the 2021 high-level meeting of the Development Cooperation Forum got under way.
Held under the auspices of the Economic and Social Council, the two-day virtual meeting aims to advance international development cooperation in ways that reduce risk, enable social and economic recovery and build resilience during the ongoing pandemic and beyond. Its outcome will shape the role of development cooperation in the Decade of Action to deliver on the 17 Goals set out in the 2030 Agenda for Sustainable Development.
Speakers weighed the scale and scope of challenges posed by COVID-19, particularly for society’s most vulnerable groups, and presented recommendations for how to scale up development cooperation. They stressed the need to secure affordable, equitable access to essential diagnostics, therapeutics and vaccines worldwide, with several speakers praising the United States for supporting a waiver of intellectual property rights on COVID-19 vaccines and urging the World Trade Organization (WTO) to act promptly on the matter.
Calls for greater investment to strengthen health systems and expanded official development assistance (ODA) and other forms of support for developing countries were also heard throughout the day.
The Forum will reconvene at 9 a.m. on Friday, 7 May, to discuss the role of development cooperation in addressing the dual challenge of pandemic recovery and the climate emergency; regional cooperation to support science, technology and innovation in the COVID-19 period; and action to create a new paradigm for development cooperation.
MUNIR AKRAM (Pakistan), President of the Economic and Social Council, said that this year’s Forum comes at a critical juncture for development cooperation and sustainable development. Faced with the pandemic, development cooperation actors have shown resilience, addressing the consequences of COVID-19, putting new ideas on the table and new practices in motion. However, such initiatives offer only partial solutions to future challenges — including COVID-19 variants and uneven recovery — that will be exacerbated by the climate change. In these circumstances, development cooperation that is risk-informed and climate-smart can help to strengthen the resilience of developing countries and drive longer-lasting impact on the ground, he said.
Elaborating, he called for a reinvigorated multilateral response to COVID‑19, specifically regarding vaccine access and distribution. He praised the United States for supporting a waiver of intellectual property rights on COVID-19 vaccines and urged the World Trade Organization (WTO) to act promptly on that matter. The $19 billion funding gap for the Access to COVID-19 Tools (ACT) Accelerator and the COVAX Facility also needs to be closed. He also called for more financing for sustainable development, greater investment in infrastructure and lessons to be drawn from the pandemic’s unequal impacts to ensure a sustainable, inclusive and resilient recovery that leaves no country or person behind.
Old Debates to a New Decade of Action: The Future of Development Cooperation
The Council then held a session on the theme “From old debates to a new Decade of Action: the future of development cooperation”. It featured presentations by Liu Zhenmin, Under-Secretary-General for Economic and Social Affairs; Michael Marmot, Professor of Epidemiology, University College London and Special Adviser to the Director-General of the World Health Organization (WHO); and Sania Nishtar, Special Assistant to the Prime Minister and Federal Minister for Poverty Alleviation and Social Safety Minister of Pakistan.
Mr. ZHENMIN, citing the Secretary-General’s report on trends and progress in international development cooperation (document E/2021/10) and the Forum’s latest survey, said that effective development cooperation during the pandemic and beyond means helping developing countries to reduce risk and build resilience. Development finance in its various forms must be scaled up, with official development assistance (ODA) supporting resilience in developing countries.
Underscoring the critical role of development cooperation in the short-term health response to COVID-19, he said that it is now essential to build long-term resilience into developing countries’ health systems. Post-pandemic recovery efforts should lower obstacles to development cooperation for climate action and climate risk reduction, he said, adding that pandemic-driven innovation can help make resilience building “part of the new DNA of development cooperation”. The 2030 Agenda for Sustainable Development, Paris Agreement on climate change and the Sendai Framework for Disaster Risk Reduction 2015–2030 are in place; what is now needed is more concerted and creative implementation.
Mr. MARMOT delivered special remarks, saying that the world needs to “build back fairer” and overcome health inequities laid bare by the pandemic. While high priority should rightly be given to the equitable distribution of vaccines, that won’t solve the problem of health inequities. He noted that, in the United Kingdom, the so-called social gradient in mortality — meaning the more deprived a given area, the higher the mortality rate — was almost exactly the same for COVID‑19 as it was for other causes of death, such as heart disease and cancer.
Elaborating, he said that, in the decade leading up to the pandemic, improvements in life expectancy in the United Kingdom and the United States decelerated. Inequalities grew and so did mortality, particularly among the poor, he explained, adding that both countries witnessed high levels of excess mortality when COVID-19 struck. Turning to the Eastern Mediterranean region, he said that, at low levels of national income, small improvements in income are associated with relatively big improvements in life expectancy. Once national income, adjusted for purchasing power parity, reaches $20,000 per capita, however, further increases in national income are no longer associated with higher life expectancy.
“If you’re a poor country in whatever region in the world, doing something will make a difference,” he said, underscoring the value of good enrolment in primary education, good clean water and sanitation, dealing with tax avoidance by multinational corporations and tackling intimate partner violence. Coming out of the pandemic, the world must address the structural drivers of health inequities, the causes and consequences of conflict, the climate crisis and the nature of culture and society. It then must address the conditions in which people are born, grow, live, work and age, alongside systems of governance and respect for human rights. Fundamentally, however, Governments must put equity of health and well‑being, and not simply economic growth, at the heart of policy, he said.
Ms. NISHTAR, in a keynote statement, drew attention to her country’s response to the pandemic, saying that, within days of the start of a national lockdown, the Government had distributed one-time cash grants to 40 per cent of the population. Its ability to do so was made possible by a strong digital foundation, in a country where poverty‑alleviation is a Government priority. A similar approach, employing among other things mobile telephones and national identity numbers, was pressed into service for the distribution of vaccines as they became available.
Lessons learned in Pakistan are relevant beyond its borders, she said, underscoring the power of data, the value of transparency in a rules-based system and the importance of investing in large-scale data systems. In the Forum’s 2020 survey, half of the respondents pointed to the lack of quality data as an obstacle. Partnerships with the private sector, philanthropic organizations, civil society and the United Nations and other international organizations are just as important as cooperation between States, particularly when budgets are being squeezed. She concluded by saying that the international community must give priority to a new framework for development, one that brings stakeholders together to mitigate risks.
Navigating the Risk Landscape through Development Cooperation
The Forum then held a session on the theme “Navigating the risk landscape through development cooperation”. Moderated by Mikaela Gavas, Co-Director and Senior Policy Fellow of Development Cooperation, Europe, Centre for Global Development, it featured presentations by Wang Shouwen, Vice‑Minister for Commerce and Deputy International Trade Representative, China; Teuku Faizasyah, Director‑General of Information and Public Diplomacy, Ministry of Foreign Affairs, Indonesia; Rania al Mashat, Minister for International Cooperation, Egypt; Alvaro Calderón, Director of International Cooperation, Ministry of Foreign Affairs, Colombia; Kimio Takeya, Distinguished Technical Advisor on Disaster Risk Reduction, Japan International Cooperation Agency; and Laure Blanchard-Brunac; Director of Policy and Partnerships, European Development Finance Institutions.
Saulos Klaus Chilima, Vice-President and Minister for Economic Planning and Public Sector Reform of Malawi, delivered a scene-setting statement. Mami Mizutori, Special Representative of the Secretary-General for Disaster Risk Reduction, and Sandeep Chacra, Executive Director, Action Aid and Co-Chair, World Urban Campaign, United Nations Human Settlements Programme (UN-Habitat), were lead discussants.
Mr. CHILIMA, speaking on behalf of the least developed countries, said that, during the African Regional Review Meeting in preparation of the fifth United Nations Conference on Least Developed Countries, held in February, participants flagged the need to build resilience for crises as varied as tropical storms and locust invasions to commodity price shocks. Enhancing the research and development capacity of least developed countries can unlock innovative solutions in a variety of areas, including agriculture, health and education. More focused development cooperation, aligned with the priorities of these countries, can improve their ability to adapt and respond to risks. The cascading nature of the pandemic has underscored the urgent need for financing directed at disaster risk reduction, prevention, preparedness and response.
Although bilateral ODA to least developed countries, or LDCs, has increased slightly, it is smaller than expected, meaning that development partners are failing to make progress towards meeting their commitments. “In this regard, more ODA to LDCs that takes risk into account and is aligned with LDC priorities is needed in order to build resilient economies.” He called for the Aid for Trade initiative to be enhanced, but noted that only 6 per cent of blended finance was channelled to least developed countries from 2012 to 2018, concentrated in only a few countries, with social sectors excluded. He went on to say that Governments must take the lead in adopting in taking a risk-informed approach to financing and investing for sustainable development, alongside enhancing partnership with development partners, to build back better.
COLLEEN VIXEN KELAPILE (Botswana), Vice-President of the Economic and Social Council, said that everyone can agree that, to be effective, risk-informed approaches to sustainability requires greater coordination and solidarity.
Ms. GAVAS, describing the pandemic as the biggest-ever stress test for international development, said that the session would hear insights and lessons from development leaders on ways to manage risk and scale up the impact of development cooperation. Many challenges have remained the same, but, overall, things have become more complex and uncertain, not least due to the pandemic.
Mr. WANG, describing China as the world’s largest developing country and an active contributor to the international development cooperation system, said that the problem of unbalanced and inadequate global development is increasingly pronounced. More finance is needed to implement the Sustainable Development Goals, he said, emphasizing that North-South cooperation remains the main channel for development assistance, complemented by South-South cooperation. Developed countries must honour their ODA commitments. He added that the pandemic must be fought through practical international cooperation, with vaccines made more accessible and affordable for developing countries. Greater coordination is also needed to bring the strengths of the United Nations development system into full play.
Mr. FAIZASYAH said that it is very important that development cooperation models adopt a long-term approach that addresses future crises. They also need to be risk-informed to build resiliency. Underscoring Indonesia’s inclusive, transparent and flexible approach to development cooperation, he drew attention to the grant assistance that it extended to the Solomon Islands, Timor-Leste and Fiji to procure medical devices in response to the pandemic. It is also helping Mozambique and Zimbabwe deal with climate change. In a regional context, it is ensuring the implementation of Association of Southeast Asian Nations (ASEAN) agreements in response to the pandemic. “As a solidarity-based mechanism, development cooperation is our vehicle to build resilience,” he said.
Ms. MASHAT stressed the need to rearrange priorities and reidentify what truly matters. The pandemic and its repercussions are encouraging policymakers to reconsider the way they do business and shift towards risk-informed decision‑making. Economic and social reforms enabled Egypt to swiftly respond to the pandemic to mitigate its spread, with major infrastructure projects going ahead, helping to sustain economic growth. With the deadline for the 2030 Agenda less than 10 years away, identifying areas for investment with international partners will be key. However, ODA is coming under strain due to fiscal retrenchment in many countries, making blended finance more urgent, she said, emphasizing also the importance of transparent governance and complying with environmental standards.
Mr. CALDERÓN said that the interconnected nature of today’s world is key to overcoming the pandemic and the foundation for a solidarity-based response. Colombia is no stranger to risk, with a geographic location that makes it vulnerable to natural disasters which are exacerbated by climate change. The global South has been a great platform for sharing knowledge, skills and best practices, he said, underscoring the importance of support networks and fostering South-South risk management institutions. He added that the migration crisis is putting great pressure on his country, with data from the Office of the United Nations High Commissioner for Refugees (UNHCR) indicating that Venezuelan migrants now outnumber those from Syria.
Mr. TAKEYA, putting a spotlight on the Sendai Framework, underscored Japan’s support for disaster risk reduction as part of its international development policy. Natural disasters may strike randomly, but unlike pandemics and emergencies caused by human error, there have been the subject of much research.
Ms. BLANCHARD-BRUNAC outlined initiatives being taken by the European Development Finance Institutions, adding that engagement with the private sector, while difficult at times, is an absolute priority to confront the pandemic and achieve the Goals. In working with the private sector, her organization focuses on those policy areas where a difference can be made, including climate change mitigation projects, financial inclusion for women and small and medium-sized enterprises, digital infrastructure and sustainable value changes. The pandemic has shown that it is right to focus on long-term investment for vulnerable groups, but it also revealed that much more needs to be done.
Ms. MIZUTORI, recalling that the Sendai Framework addressed, among other things, biological risks, said that “we live in a multi-hazard world” in which not enough has been done to prepare or to build resilience. Most development cooperation comes after disaster happens, but COVID-19 is a clarion call to make changes and to direct more prevention funding to least developed countries, small island developing States and landlocked developing countries. Every programme and project must be risk-informed and aim to ensure that health, education and critical infrastructure are not disrupted. The extra dollars involved should be seen as an investment, not as a cost. She added that post-pandemic recovery is a once-in-a-lifetime opportunity to build back fairer and better. This is not the time to retreat to the trenches by reducing ODA, but rather to make resilience part of the DNA of development cooperation.
Mr. CHACRA that the United States’ decision in support of an intellectual property waiver for COVID-19 vaccines represents a glimmer of hope for millions around the world. It could herald the new start of cooperation between individuals, organizations and nations, after the pandemic exposed the extent to which multilateral promises and agreements have been trampled upon. He recalled that India, a prominent country in the global South, took the path of self‑reliance when it gained independence, yet, today, its public health system is near the point of breakdown. Moreover, in the past decade, he added, few countries in the global South could aspire to self-reliance. Building a future from the vantage point of those most in need requires a solidarity-based development partnership that includes South-South and North-South cooperation, including technology transfers for the long term and not for short-term profit.
Strengthening Health Systems for Vulnerable Countries
In the afternoon, the Forum held a virtual session on the theme, “Strengthening health systems for vulnerable countries”, featuring guest speakers Joy St. John, the Executive Director, Caribbean Public Health Agency; Pablo Tettamanti, Deputy Minister for Foreign Affairs, Argentina; Bård Vegar Solhjell, Director‑General, Norwegian Agency for Development Cooperation; Andalib Elias, Director General for Multilateral Economic Affairs, Ministry of Foreign Affairs, Bangladesh; Natasha Bilimoria, Deputy Assistant Administrator of the Bureau of Global Health, United States Agency for International Development; and Vanessa Rouzier, Assistant Professor of Pediatrics, Weill Cornell Medical College, and Head of Pediatrics and Nutrition, Haitian Global Health Alliance (Gheskio). The discussion was moderated by Stefan Swartling Peterson, Professor of Global Transformations for Health at the Karolinska Institutet, Sweden.
Kate Dodson, Vice‑President for Global Health, United Nations Foundation; Jan van Zanen, Mayor of Utrecht, Netherlands; Thembisile Nkadimeng, Mayor of Polokwane, South Africa, and President of the South African Local Governments Association; and Amanda Banda, Global Health Advocate, Wemos, made special remarks.
Ms. ST. JOHN, in a video message, shared how the Caribbean Community (CARICOM) is weathering the “COVID-19 storm”, explaining that it is one of the most vulnerable regions needing support in this pandemic. As a tourism‑dependent region, its small populations are struggling to keep illnesses and deaths at bay, with insufficient access to vaccines. For half of the year, hurricanes and severe weather events have repeatedly induced loss of property, infrastructure and development gains, she said, “sending us back to start rebuilding all over again”. Add to that one of the worst chronic disease burdens in the world, its health systems are in an almost never-ending cycle of rebuilding, mitigating and strengthening. She then highlighted how the European Union and the World Bank are supporting the Caribbean Public Health Agency in strengthening the region’s COVID-19 responses and overall health systems. The current and upcoming Caribbean Public Health Agency strategic plans include strengthening health security and health systems, as key pillars for action. The fight against COVID-19 is contextualized by this focus on building back better, she said, drawing attention to the regional coordination mechanism for health security, as well as the COVID-19 tourism task force, which has brought tourism and health sectors together.
Mr. PETERSON, stressing that “we are in this together as one humanity”, noted that many countries face the challenge of maintaining essential health services while fighting the COVID-19 pandemic. Universal health coverage is a step towards health security. The session, he noted, addresses questions regarding international cooperation, preparedness and capacities of health systems in vulnerable countries, and relating to models and partnerships.
Mr. TETTAMANTI, in a recorded message, shed light on Argentina’s policies to mitigate the rapid spread of COVID-19. The early implementation of health, social and economic measures has enabled the country to strengthen its health system and national production of critical inputs, such as respirators and personal protective equipment. The country’s laboratories are currently working on agreements to manufacture COVID-19 vaccines developed overseas. National vaccines are also under development. However, these efforts will not bear fruit without active cooperation, coordination and technology transfer at a global level. Argentina is working with other countries and international and regional organizations, especially in the framework of the Southern Common Market (MERCOSUR) and the Community of Latin American and Caribbean States (CELAC) to share experiences and explore joint solutions. South-South cooperation has proven to be a valuable tool for recovery from the COVID-19 crisis. However, developed nations must make a greater commitment so that all countries, without exception, have access to medicines, vaccines, medical equipment and health technologies as global public goods.
Mr. SOLHJELL, in a recorded message, said Norway has most recently joined South Africa to co-facilitate the ACT-Accelerator. There are difficult questions for the interface between the public and private sectors in medical markets, including how to ensure innovation, cooperation, effectiveness and equity all at once. There is increasing emphasis on ensuring better global distribution of research and manufacturing capacity. Sustainable business models for regionalized production will take a long time to develop, but they must start now. Every region must be a participant, not a recipient, in preparing and responding to global pandemics. Investments in pandemic preparedness cannot be at the expense of daily services and they must be vital all the time and not just purposed for pandemic response, he said, stressing they need to be “kept warm”. Public health priority settings, surveillance systems, labs, diagnostic systems, staffing and community engagement platforms cannot sit cold, waiting for the next outbreak. Development cooperation must support competent public health institutions, regulatory bodies and research platforms that are both global and local. Emphasizing the need to collectively invest in local data from local systems, he said now is the time to build national data systems.
Mr. ELIAS, in a recorded message, said Bangladesh has adopted “whole‑of‑government” and “whole‑of‑society” approaches to respond to the pandemic. The Government has been very quick to roll out a stimulus package worth more than $14.58 billion, which represents approximately 4.44 per cent of its GDP. It has also developed a national COVID-19 response plan, including the 1.1 million Rohingyas refugees in its overall strategy. The response plan outlines a multi‑sector coordination structure, including 10 technical pillars that focus on the epidemiological response and health service delivery, such as surveillance and laboratory support; infection prevention and control; as well as cross-cutting pillars, such as planning coordination and response strategies, logistics and procurement, risk communication and community engagement, and research. Furthermore, a national committee and a technical committee have been established to monitor the situation. Development cooperation should give priority to building resilient and robust health systems in vulnerable countries to enable them to respond effectively to future shocks. These support measures would be more effective if they focus on capacity-building. Developing countries will require short-, medium- and long-term support from the bilateral and multilateral development partners in the form of finance, capacity-building, technology transfer, debt waiver, concessional loans and grants.
Ms. BILIMORIA said the rapid spread of COVID-19 and its emerging variants demonstrates that no nation can act alone in a global pandemic. Vaccinating as many people as quickly as possible is the only way to reduce the tragic loss of life, end the pandemic, and foster socioeconomic recovery. Multilateral cooperation, through organizations like the COVAX Facility and more broadly within the ACT‑Accelerator, is key to ensuring that people everywhere receive safe and effective vaccines. However, epidemic preparedness and control programmes in low‑income countries are often vertically aligned and not fully integrated at all levels of the health system. Instead of reacting to emergencies, the international community should direct attention towards fostering everyday health system resilience. This means improving the ability of partner Governments to leverage and coordinate capacities across public, private institutions and community health structures.
The United States Agency for International Development focuses on strengthening health systems so that they can respond to both shocks and stressors, she said. To be resilient, health systems must be flexible enough to adjust resources, policy and focus in response to constantly emerging challenges. The Agency’s new 10-year vision for health system strengthening underscores the importance of integrated approaches that leverage the strengths of the private sector, public health and non-governmental organizations. It highlights the inclusion of all stakeholders, such as communities, and emphasizes the need for locally driven solutions and social and behavioural change. She expressed hope this new vision can serve as a useful tool for the global community when considering ways to increase the ability for a health system to withstand and effectively respond to shocks and stressors.
Ms. ROUZIER, noting that Haiti is mired in poverty, political turmoil and natural disasters, said that Gheskio is helping the country build a resilient health system that can withstand future crises. Focusing on the health issues at hand is important. Over the decades, the institution helped Haiti tackle numerous health-related challenges, including diarrhoea, AIDS, cholera and Zika. Studies by the institution were vital. Success with HIV was undermined when a catastrophic earthquake hit Haiti in 2010, which was followed by the devastating outbreak of cholera. However, those disasters provided opportunities to rethink and revisit its health systems. Haiti established a centre to address cholera and introduced oral vaccinations, which later led to the revision of WHO guidelines. All these experiences and long‑standing capacity-building efforts helped Haiti prepare for a future crisis. When the COVID-19 pandemic hit, the country was ready to roll out PCR testing. Stressing the need for training for community leaders, she said that the institution developed a nurse practitioner programme with a university to prevent brain drain. Successful programmes that exist at the community level will be helpful to the rest of the world, she stressed.
Following the panellists’ presentations, the other featured speakers delivered remarks.
Ms. DODSON stressed ACT‑Accelerator is an essential innovation to create a global level playing field and help vulnerable countries gain access to science. Stressing the importance of social and financial protection for women and children, she said that heavy health‑care costs plunge them further into poverty. Universal health‑care coverage is the best and only path forward, she said, urging development partners to pay greater attention to this. Progress needs to be made in implementing the targets of the Political Declaration of the High-level Meeting on Universal Health Coverage in 2019 before the review process in 2023.
Mr. ZANEN, in a recorded message, said that the fight against COVID-19 is also a fight against poverty and inequality. Stressing the need for a universal response, he said patent rights must be waived to create a level playing field. Regional and local governments must be placed at the centre of pandemic recovery as they — as the providers of basic services — know what approaches work for their respective populations. It is important to leave no one and no place behind.
Mr. NKADIMENG said South Africa’s health system is vulnerable, with the public sector underfunded and understaffed. The country is establishing a new national health insurance system to provide affordable health‑care services for all. The bill to set up the system is pending passage by the National Assembly. Support is also needed for the water and sanitation sectors, he said, due to a lack of technology. The local government is working with development partners, such as the Joint United Nations Programme on HIV/AIDS (UNAIDS), to improve services.
Ms. Banda highlighted how the COVID-19 pandemic has strained the health‑care workforce. Pointing to the serious shortage of health‑care workers, she said these workers are experiencing stress, burnout and mental health issues. Many have died from COVID-19. Moreover, the already scarce health‑care workforce has been redeployed to emergency care, threatening routine health‑care services. She called for greater investment in recruiting health‑care workers, emphasizing that they are at the heart of a resilient health system.
In the ensuing discussion, a speaker representing Catholic churches challenged the United Nations and Governments to ensure social protection, saying that, if the Organization and its Member States want to achieve the Sustainable Development Goals, they must ensure the health and well-being of their peoples. As part of the COVID-19 response, Catholic churches provided oxygen when needed in Peru’s Amazon Basin. “If churches can do it, why not Governments,” he said.
The representative of Guatemala, speaking on behalf of Like-Minded Group of Friends of Middle-Income Countries, called for a change to the system of categorizing countries by per‑capita income. The current measure is making it difficult for middle-income countries, which face many development challenges, to access financial and non-financial resources. He also called for more equitable access to COVID-19 vaccines, which are global public goods. Stressing that South‑South cooperation is not a substitute for North-South cooperation, he urged developed countries to do more to help developing countries.
The representative of Malawi, speaking on behalf of the least developed countries, stressed that COVID-19 diverted resources from other diseases that are killing many people. A bright spot is that the pandemic forced innovations. However, without significant investments in health‑care systems, least developed countries will not be able to withstand future shocks. Stressing the need to allocate 15 per cent of annual national budgets to strengthening health systems, he called for participation in the fifth United Nations Conference on Least Developed Countries to be held in Qatar in January 2022, as a big chapter will be devoted to health in the Conference’s outcome document. He also expressed support for the call by WTO Director General to lift patent protections for COVID-19 vaccines so that vaccines can be produced in Africa and elsewhere.