Improve health security for three billion people by 2023?

Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO has committed to making it a “modern, seamless, impact-focused organisation to better help Member States achieve the health-related Sustainable Development Goals.” 

To make this change and reach their goals, they need exceptional implementation – a clear and coordinated system for translating ambitious goals into specific targets, trajectories, solutions, and action items at the regional, national, and subnational level.

Part of this transformation was setting out the ambitious Triple Billion Targets: ensuring one billion more people benefit from Universal Health Coverage, protecting one billion more people from health emergencies, and helping one billion more people lead healthier lives. 

DA is working closely with WHO to operationalize the Triple Billion Targets in the context of their broader organisational goals. 

Real-world challenges

Large-scale transformation is a challenge for any large organization, but especially for one as far-reaching as the WHO. Like other multinational organisations, the WHO faces a common conundrum: They must aspire to inspire – in other words, they must define big goals, such as the Triple Billion targets, to motivate people to action and acknowledge the extent of the problems on the ground. 

However, they must also translate those aspirational goals into discrete, meaningful and measurable milestones with consistently available indicators in order to deliver on the promises. For the WHO, that means reinforcing the current capacity of each member country while building a system for and culture of delivery that permeates every level of the organisation.

Real-world solutions

Building the team: The Division of Data, Analytics and Delivery for Impact (DDI) was established to provide support across the three main levels of the organisation (global, regional, national) in achieving the Triple Billion Targets. As the delivery unit was staffed, the DDI team worked to build strong relationships across the organisation in support of these targets. This team helps keep everyone focused on the triple billion targets throughout the year.

‍Defining the targets: The WHO then translated the Triple Billions into specific, operational, time-bound indicators at the global, regional, and national levels. This meant working closely and methodically with each part of the WHO to understand what was feasible, and estimate:

• Baseline: where they were at the start of the transformation in 2018 
• Gap: how far they are from the 2023 targets 
• Accelerators: Scenarios for speeding up progress between now and 2023
• Collective impact: How much the WHO will be able to close the gap to the Triple Billion goals if every country achieved the scenarios 
  

From there, DDI set out to make sure each programme and region understood their role in reaching the targets and trajectories for each major indicator, as well as the broader Triple Billion goals. 

‍Solving problems together: Where there are critical risks to achieving their goals, DDI coordinates the right team of technical experts, decision makers, leaders from every level, and teams on the ground to understand challenges and tackle them head-on. DDI ensures the right people are in the room at the right time, and maintains disciplined focus on solutions that will move the numbers. 

‍Building routines: Stocktakes establish a cadence of accountability among key players at every level of the organisation. Held every 6 months, these sessions are informed by the latest data and oriented towards a single, driving question: Where are we in relation to our goals, and what can we do to make sure we stay on track? 

‍These are designed to ensure the entire organisation keeps focus on the Triple Billion Targets, acting early and often to address any issues rather than waiting until the end of 2023 to assess progress towards that year’s milestone. Stocktakes had the added benefit of maintaining focus on the Triple Billion targets even during the COVID-19 pandemic. 

‍Building capacity: The Delivery for Impact Knowledge Hub is a virtual capacity-building initiative – the first of its kind – launched in October 2020 and designed to help build internal delivery capacity at the national level. The pilot program worked with 8 country teams to define meaningful, measurable and moveable strategic objectives; define specific, time-bound targets; and build a real-world implementation plan. Experience from this trial will inform the transition to an open access, capacity-building course, fully accessible to all 194 member countries.

The Knowledge Hub blends webinars, workshops, problem-solving sessions and peer groups; the “I do, we do, you do” approach helps countries build sustainable skills and systems for ongoing success.

Pilot countries have valued the insights, tools, and opportunity to share with international colleagues.

91% of participants surveyed feel confident they will hit their targets.

The tools make us more institutionalized; more systemic... this will also help us in the future.

-Dr. Sabeen Afzal, Deputy Director Programs/Health Systems, MoNHSR&C , Pakistan

Results

This work is ongoing. Taken as a whole, efforts to date have fundamentally shifted the conversation at the WHO. Early work translated the Triple Billion targets from a political commitment to concrete milestones; this has helped the WHO and its partners focus on results and drive coordinated progress across every layer of the organisation.

The WHO is emerging as a model for how large, multinational, multi-layered organisations can achieve single-minded goals even whilst adapting to the unique needs of every country on the ground.