News Deeply

The Princess and the VP: The Maverick Collective’s Approach to Giving

This article originally appeared on the Women's Advancement Deeply newsletter, and you can find the original here. For important news about issues that affect women and girls in the developing world, you can sign up to the Women's Advancement Deeply email list. Follow them on Twitter at @womenND, or on Facebook at /womenND.

By Lara Setrakian

Frustrated by the lack of women philanthropists on the world stage, Kate Roberts and Crown Princess Mette-Marit of Norway set up their own network of donors to invest in women and girls. Roberts spoke to News Deeply about their outlook.

DAVOS, SWITZERLAND – Kate Roberts was sick of “manels.” After years of regularly attending the World Economic Forum, the senior vice president at Population Services International felt she wasn’t hearing from enough women, nor hearing enough about them.

At her first meeting in the Swiss ski resort, she says, “I immediately noticed two things: the lack of women at Davos – the lack of women philanthropists on the podium – and the need to have more women and girl-centered programming in development.”

This year, it seems the organizers of the annual gathering of politics and business leaders have gotten the hint. While the list of attendees is still overwhelmingly male, for the first time in its history the event’s eight co-chairs are all women, including managing director of the International Monetary Fund Christine Lagarde and Norwegian prime minister Erna Solberg.

It’s in partnership with Solberg’s fellow Norwegian, Crown Princess Mette-Marit, that Roberts is trying to get more women involved in philanthropy, and to ensure more are on the receiving end of it.

In 2016, the two women cofounded the Maverick Collective, assembling a coterie of female donors to invest in health projects that help women and girls in the developing world.

Women’s Advancement Deeply spoke to Roberts in Davos about the Maverick Collective’s approach to giving.

Women’s Advancement Deeply: Your goal is to lift women and girls out of poverty. Why did you feel philanthropists should focus on improving health as opposed to education? What was it about health as a gateway?

Kate Roberts: Health is at the center of everything. If you’re not healthy, you can’t go to school. If you’re not healthy, you can’t go to work. If you’re not healthy, you cannot be the caregiver of the family.

We see the link to education, which is a very close second, and probably what we’re going to focus on next. But we wanted to prove this model with what we knew best, and we also had these big bets in mind that are gargantuan. We want to end AIDS in our lifetime. We want to see the end of cervical cancer in our lifetime. We want 250 million women to have access to contraception. These are big tasks.

That’s where we’re starting, but education intersects every step of the way. Agriculture will probably be next.

Women’s Advancement Deeply: Does private money go further on the ground than government aid or money from large international donors, do you think?

Roberts: It goes much further. The reason is that large international donors do not fund innovation. You’re not allowed to fail with that money. Governments, by and large, or donors, will give you money, but for something that’s proven, so that their money is safe and that you can write a report of success.

When we work with Mavericks, it’s risky. And it’s flexible, so we can fail fast and then pivot and invest in something else if we realize that this is not working. You can’t do that with traditional funders.

Women’s Advancement Deeply: Critics of project-based development say that communities can risk ending up back where they started, or worse, when the project ends. How do you ensure the sustainability or the overall long-term impact of the project on the ground?

Roberts: Maverick Collective was actually designed to test out sustainable solutions. We’re not about aid. We don’t believe in aid. We believe in testing out long-term sustainable projects that are usually linked to the private sector.

There’s $5 trillion at the bottom of the economic pyramid. That means that our beneficiary, who we’re looking to serve with this, does have spending power. If she can afford to buy a health service or buy a health product, we want her to do that because that’s going to lead to building local capacity, to having solutions that work locally in the field, and that can survive without us. We want to be out of a job.

Women’s Advancement Deeply: Can you tell us about a Maverick Collective project that has been particularly successful?

Roberts: We started a project in India that is very simple. We had learned that if you dab a woman’s cervix with household white vinegar, you can detect signs of cervical cancer, because it bubbles up. Then, quite simply, what we do is, we freeze off the cancerous cells. It costs about a cent for this whole intervention. In the developing world, diagnostics are very limited, so we need to find very simple, effective solutions.

We started this project thinking that it would be a private-sector adoption, and very quickly we discovered that we had the interest of the government, who were watching and hearing about what we were doing. They came to us and they said, “We’d like to adopt this within the government public health clinic system.” They adopted it in Uttar Pradesh, and they’re now reaching up to 24 million women with this intervention.

For us, this is a real success, because this can go to enormous scale in a country like India, and then of course be adopted in the region, and also in Southeast Asia and beyond.

Women’s Advancement Deeply: Is the Maverick Collective using an economic approach that considers women and girls to be strong investments? Or more a rights-based approach, to invest in women and girls because they deserve human rights? How do you put the two together?

Roberts: They are on a par with each other. It’s a proven fact that if we invest in girls and women, we can work our way out of poverty. It’s a strong economic investment. All the facts and figures speak to that. So investing in a woman is a no-brainer.

But quite frankly, I don’t even talk about equality anymore, because, for me, it goes without saying. Why is a woman different from a man? We bring just as much to the table, if not more. It’s just not a human right anymore, it goes without saying that we deserve it.

How Nurses and Cheap Morphine Made Uganda a Model for Palliative Care

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This article originally appeared on the Women & Girls Hub of News Deeply, and you can find the original here. For important news about issues that affect women and girls in the developing world, you can sign up to the Women & Girls Hub email list. By Grainne Harrington

Uganda’s underfunded health system struggles to effectively treat the country’s growing number of cancer patients. But for the terminally ill, a small hospice organization has come up with a homemade pain relief treatment that has revolutionized end-of-life care.

 

KAMPALA, Uganda – Roselight Katusabe sets off for work in the morning with her usual tools: patient notes and a pen, some gauze dressings, and a suitcase full of morphine. Katusabe is a palliative care nurse at Hospice Africa Uganda (HAU), an NGO based in Kampala, which focuses on home care. The bottles of morphine she brings to her patients have revolutionized the way terminally ill people spend their final days in Uganda. And it all began at a kitchen sink in the hospice, where for 17 years healthcare workers made up the solution for thousands of patients.

“It’s easier to make than a cup of coffee,” says Dr. Anne Merriman, the British founder of HAU. Merriman, a palliative care specialist and former missionary doctor, developed her own formula for affordable oral morphine while working in Singapore, and brought it to Uganda in 1993. At the time, the most commonly used analgesic for severe pain was codeine. Commercial injectable morphine was expensive and only available in hospitals on an “as needed” basis, which Merriman says left patients in pain. To make HAU’s cheaper, oral solution, “all you need is accurate scales to weigh the [morphine] powder, then all you do is add distilled water, a preservative … and then we add a dye to show the strength,” says Merriman.

These days, the formula hasn’t changed, but the kitchen sink has been replaced by a modern laboratory. Since 2011, the hospice, in partnership with the Ugandan government, has been manufacturing its morphine solution for the entire country, free of charge.

In Uganda, where the underfunded health system struggles to provide even basic care, morphine is the key to pain relief and a better end of life for thousands of cancer patients. HAU’s homemade approach makes the drug affordable: While other countries buy injections and tablets from pharmaceutical companies, a 10-day supply of oral solution costs just $2.

And by pioneering a system that allows nurses to administer morphine, Uganda has led the way in palliative care for cancer patients in low-income countries.

On this day’s rounds, Katusabe is delivering a bottle of Merriman’s formula to Agatha, a 38-year-old battling stage-four breast cancer, at her home in a slum in Kawempe, northern Kampala. The nurse takes out a brown bottle and a dosing syringe, shows the patient how much she should take and gently answers her questions. When asked what difference the hospice has made to her life, Agatha pauses. She cannot express it in words, she says.

The palliative care Agatha is receiving is unique in this region. Uganda was the first country in the world to let specially trained and registered nurses administer morphine, a job previously reserved for doctors. This development, too, was largely due to Merriman and her NGO. When HAU was founded, the country was going through one of the worst AIDS epidemics in the world, and widespread immunodeficiency led to a rise in many types of cancer. The minister of health at the time immediately agreed to Merriman’s plan to introduce her cheap morphine solution, but doctors were far more reticent, fearing it would lead to addiction and overdose.

“The doctors said we were bringing in euthanasia,” says Merriman. “Many of those senior doctors would not let any of their patients have morphine. They said, ‘They’re going to be addicted.’”

As cancer rates continued to rise, Merriman realized her morphine wouldn’t get to the people who needed it unless the number of prescribers increased. Nurses were already allowed to administer another opioid drug, pethidine, to women in labor. In 1998, HAU began to lobby the Ministry of Health to widen the legislation so that nurses could also prescribe morphine. The change eventually went through in 2004. Uganda has an average of one doctor per 20,000 people but almost twice as many nurses, so allowing nurses to administer the homemade morphine solution has made affordable pain relief accessible from the capital right down to village level.

Merriman credits the Ugandan government’s progressive policymaking for bringing about radical changes in the way people with terminal illness are treated in the country. In the Economist’s 2015 Quality of Death Index, Uganda ranked 35th out of 80 countries, and was one of only two African countries in the top 50, along with South Africa.

But while it has made strides in quality of death for cancer patients, Uganda’s healthcare system still struggles to provide effective treatment that could improve their quality of life. Katusabe’s patient was diagnosed when her illness was at stage two. In many countries, this is early enough to hope for a good outcome, but Agatha first turned to a traditional healer for help – she didn’t seek medical treatment until her cancer was advanced.

The Uganda Cancer Institute says that 75 to 80 percent of cancer patients are diagnosed at stage three or four, when surgery and other curative therapies are far less effective. Part of this is due to a lack of awareness, despite a considerable outreach effort on the part of the Ugandan government and other organizations. Financial constraints also play a big part. Hospitals frequently run out of necessary drugs, Katusabe says.

And even when treatment is available, it’s often too expensive for most Ugandans. According to HAU, a four-week course of chemotherapy can cost from $900 to $1,000. Because of this, Katusabe says patients who know they can’t afford treatment will simply accept a cancer diagnosis as a death sentence.

In April, Uganda’s only radiotherapy machine broke down after years of disrepair. Replacing it will take over a year. In the meantime, patients who can afford it have been told to go to neighboring Kenya for treatment.

After leaving Agatha, Katusabe visits two cervical cancer patients who are going for treatment in Nairobi with HAU funding. The women are cheerful and hopeful that radiotherapy will help. But for many other cancer patients in Uganda, Katusabe and her plastic bottles of morphine are the best relief they can hope for.

Pushing to Put Women and Girls at the Center of Development

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This article originally appeared on the Women & Girls Hub of News Deeply, and you can find the original here. For important news about issues that affect women and girls in the developing world, you can sign up to the Women & Girls Hub email list. By Eline Gordts

As world leaders gather in New York for the U.N. General Assembly, Katja Iversen, president and CEO of Women Deliver, says that gender should be at the forefront of the development conversation.

 

One year ago, during the 2015 U.N. General Assembly, world leaders adopted the Sustainable Development Goals: 17 targets to help end poverty, fight inequality and injustice, and tackle climate change by 2030. This year, as global leaders meet to debate how to make that ambitious agenda a reality, Women Deliver argues that gender should be at the forefront of the conversation.

On Wednesday, the international advocacy organization officially kicked off Deliver for Good, its campaign to transform the way the development community looks at women and girls – from powerless victims to agents for change – and to push stakeholders to apply a gender lens to the Sustainable Development Goals. Nine organizations, including Business for Social Responsibility, Landesa and Plan International, have signed on to the campaign.

Women & Girls Hub spoke with Katja Iversen, president and CEO of Women Deliver, about Deliver for Good’s approach and goals on the sidelines of a panel discussion hosted by the organization in New York.

Women & Girls Hub: Why is putting women and girls at the center of the Sustainable Development Goals so important?

Katja Iversen: The philosophy of the campaign is that we need to invest in women and girls if we want to see positive change happen in the world. While some people may find that obvious, apparently it’s not.

We need to focus on them, their needs and their opportunities. The Sustainable Development Goals are a fabulous opportunity. Every single country in the world has to make national plans, so why not use this opportunity to really place women and girls at the center of them. They should be a focus in health, education and economic development plans.

We do anything we can to put girls and women in the driver’s seat and also showcase, with evidence, how they are the change agents. That evidence is rolling in. Studies by McKinsey & Company explained during the panel have shown that it economically pays off to invest in women and girls.

Women & Girls Hub: The Deliver for Good campaign cuts across sectors and focuses on “the whole woman.” Please expand on those ideas.

Iversen: It’s important because it’s the most efficient. We’re not a body part. I’m not identified by a sickness or by my age. We’re whole people. Why build a clinic for nutrition advice, a separate clinic for HIV and one for family planning? It’s a holistic approach that looks at people as whole people and not as however an organization wants to define them.

It’s also efficient funding-wise. It’s not as if we live in an abundant world, so why not do it the best way? Let’s come up with some smart solutions that bring it together.

Women & Girls Hub: Peder Michael Pruzan-Jorgensen, the senior vice president of Business for Social Responsibility, explained during the panel discussion that in many parts of the private sector, the development of women and girls is still a foreign language. What are some of the crucial things that can be done to make it part of their language?

Iversen: Make it easy, and make it economically viable and desirable.

Showcase the evidence that proves that investing in women and girls will lead to growth for the company. I met with the CEO of Sony yesterday, and he said that investing in women, whether at the assembly line or in boardrooms, has paid off. He said that with the evidence there is now, he wouldn’t be a responsible manager if he didn’t invest in women.

It’s also important for us to get into the fora where people like him are. Make the communities come together. At the Women Deliver conference, we brought together 65 business leaders. We also worked with BSR to develop a book – a toolkit, basically – that explains how to approach this, whether you’re a small, medium or multinational company.

Women & Girls Hub: That ties into an interesting insight Peder brought up – that just targeting the multinationals is not enough, because those big companies are not the main employers that women and girls in the developing world interact with.

Iversen: Exactly. The biggest growth in employment is in small- and middle-sized companies. If those companies apply a gender lens and break down some of the gender barriers and prejudices, that’s where the growth in the female workforce will come from.

Women & Girls Hub: Plan International CEO Anne-Birgitte Albrectsen noted today that in the areas where her organization works, the needle hasn’t moved much when it comes to the lived reality for women and girls. How can we speed up actual change in women and girls’ lives? How can we go from amazing goals to implementation?

Iversen: I’m a pragmatist. Let’s look at who’s out on the front line, the organizations that are working in the field. We need to push so that those people and organizations deciding the reality put gender central, do more and get the opportunity to do more by receiving funding for what they do well.

The U.N. works with governments, that’s their job, but we want to push in the same direction across sectors, with everyone who touches upon the lives of girls and women.

This conversation was edited for length and clarity.

Women’s Refugee Commission: Protecting Female Refugees Is Essential

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This article originally appeared on Refugees Deeply and the Women & Girls Hub of News Deeply, and you can find the original here. For important news about the global migration crisis and issues affecting women and girls, you can sign up to the Women & Girls Hub email list as well as the Refugees Deeply email list. By Preethi Nallu

Speaking at the opening of the United Nations Refugee Summit on September 19, Women’s Refugee Commission members reiterated their calls for a “complete rethink of traditional humanitarian response.” This conversation is part of our “Voices from the Summit” coverage.

 

NEW YORK – Addressing world leaders at the first roundtable of the U.N. Summit for Refugees and Migrants on Monday was a defining event for Foni Joyce from South Sudan. A 24-year-old woman who was displaced from her home due to conflict, she opened the conversation at the morning session, as an individual representative of displaced women and girls across the world whose specific needs deserve closer attention amid the accelerating migration influxes.

“The solutions are right in front of you. We can contribute,” said Joyce, speaking on behalf of the Women’s Refugee Commission (WRC). Joyce had to defy odds to be able to graduate from university, but she would like to see education and employment become more accessible to female refugees in their transition towards stability. Indeed, it is not often that women are leading voices at the podium, whether with international policies or community-level decisions within displaced communities. The WRC has been working on rectifying this dearth of female voices that has become abundantly clear over the Mediterranean migration crises.

Given that a majority of women like Joyce increasingly end up in urban centers of the world, while seeking asylum, WRC has been documenting this growing trend and its impact on female refugees over the past several years.

In February of this year David Miliband, the president of the International Rescue Committee, announced a statistic at the U.N. that rang alarm bells for mayors of cities and municipalities across the globe.

“At least 60 percent of refugees are now living in urban areas,” Miliband said during his briefing.

This never-before-witnessed level of urban displacement is being investigated by field research that calls for a more “nuanced” understanding of the hurdles that female refugees, in particular, face in urban contexts.

Earlier this year, WRC published a report called “Mean Streets,” based on conversations with diverse refugee populations in Quito, Ecuador; Beirut, Lebanon; Kampala, Uganda; and Delhi, India. Over this summer, they further identified the risks that female refugees in Greece and Turkey, especially those stranded in urban centers, encounter due to an “ineffective” deal between the European Union and Ankara.

Reiterating their “Call to Action on Protection Against Gender-based Violence in Emergencies” at the U.N. summit in New York, the WRC’s researchers explain that policy initiatives do exist to protect female refugees in transition and once they reach their destination. What WRC researchers would like to see is an explicit commitment from governments and acceptance of a concrete action plan that they, together with 50 other groups, have endorsed as part of a five-year road map.

The latest findings, WRC says, show that Greece is “shockingly ill-equipped” to handle basic gender-based needs. Marcy Hersh, senior advocacy officer at WRC, spoke with Refugees Deeply about how the U.N. summit can pave the way not only for protection of women and children but also for providing livelihoods and education. These crucial elements can reduce the risk of women and minors being trafficked, attacked or manipulated into harm.

Refugees Deeply: Could you spell out your main campaigning points at the U.N. Summit for Refugees and Migrants?

Marcy Hersh: The summit should advance effective asylum and legal protection mechanisms in domestic migration management policies and in international forums. It must seek to end arbitrary detention for asylum seekers and instead emphasize the lifesaving importance of access to comprehensive reproductive health services. We are looking for an explicit, detailed commitment to protect all displaced women and girls from gender-based violence while in transit and upon reaching their destinations. We are also calling for expansion of legal and safe employment opportunities that leverage the capacity of refugee women and youth to sustain and protect themselves and their families.

Refugees Deeply: Is it possible to formulate a global, binding policy to protect displaced women and girls from gender-based violence (GBV)? How would such a policy come into effect?

Hersh: I would say that that the policy initiatives needed to protect displaced women and girls from the threat of gender-based violence, in fact, already exist and it is our hope that the U.N. Summit for Refugees and Migrants is an opportunity to further the uptake of said initiatives. The “Call to Action for the Protection of GBV in Emergencies” is a commitment by all humanitarian partners to change how we work so that every humanitarian and refugee response provides safe and comprehensive services for those affected by GBV and mitigates GBV risk. A group of more than 50 governments, U.N. agencies and NGOs have developed a five-year road map that outlines concrete steps all humanitarian and refugee stakeholders can take over the next five years to build this change into the policies, systems and mechanisms we use to respond to emergencies. Each stakeholder has unique strengths and capacities, and by coordinating action and working together we can provide better protection from GBV to the people we serve. When more partners become members of this initiative, and fulfill their commitments under the road map, displaced women and girls will experience meaningful protection.

Refugees Deeply: How does the current E.U.-Turkey deal expose female refugees to gender-based violence (GBV)?

Hersh: Virtually overnight, the E.U.-Turkey agreement forced an unprepared and ill-equipped Greece to shift from being a transit country, where refugees stayed for a few days, to being a host country for 50,000 stranded refugees seeking legal protection. The consequences have been alarming. The deal has had profound and distressing ramifications for refugees, especially women and girls seeking asylum and family reunification in Europe. Refugees now endure prolonged displacement, family separation and unacceptable hurdles to accessing legal protection. Refugee women and girls face unsafe and dire living conditions, increased risk of gender-based violence and heightened fear, anxiety and uncertainty.

Refugees Deeply: How can this situation be remedied?

Hersh: In our recent report, the Women’s Refugee Commission issued a number of recommendations to the European Union, Greece and Turkey. Foremost, we urge the E.U. to review and overhaul its humanitarian and asylum policies to fairly, humanely and expeditiously respond to the needs of all refugees seeking safety, protection and relocation and adhere to international and European laws that bar the return of refugees to unsafe countries. We call on the E.U. to increase financial, material and human resources and oversight to help Greece and Turkey effectively adjudicate claims and deliver needed humanitarian services.

We call on both Greece and Turkey to establish appropriate alternatives to sheltering refugees, wherever they are. Turkey is also urged to ensure refugees have equal access to legal protection and aid regardless of nationality, and to facilitate and increase humanitarian assistance, legal counsel and psychosocial support for returned refugees.

Refugees Deeply: How can the Greek asylum system be scaled up to better protect the interests of all asylum seekers and lone women in particular?

Hersh: Greece must build the capacity and resources of the Greek Asylum Service to ensure the timely and fair review of asylum claims, as well as requests for family reunification or relocation. They must ensure that refugees have information about legal options and processes in a language they understand. Lastly, they must simplify and streamline administrative requirements and decision-making processes to reduce bureaucratic delays.

Greece should coordinate closely with international aid organizations to upgrade safety and services at all sites – increasing access to specialized medical care, psychosocial support and safe spaces for GBV survivors, and reproductive health care and mental health services.

Refugees Deeply: Is there evidence of discrimination based on nationality in terms of aid and shelter, once refugees arrive in Greece?

Hersh: Refugees’ rights and ability to access legal protection in Europe vary dramatically depending on nationality. WRC believes policies linked to nationality create an unofficial and unfair hierarchy among refugees – impacting everything from protection options to the ability to access services. Such discriminatory policies are also in contradiction of the concept and tradition of due process and individualized determinations.

Refugees Deeply: What are the conditions you discovered in Turkey that render it less than safe for mass returns?

Hersh: WRC was not granted direct access to the centers where refugees are returned. From our mission in Turkey, we learned that returned refugees arrive in Turkey most often by boat or sometimes by air and are then transported to one of two “removal centers.” Non-Syrians are largely sent to a center in the Kirklareli area near the Bulgarian border and Syrian refugees to the Düziçi center, a remote site in southern Turkey. Turkey describes removal centers as temporary accommodation while background checks and the registration process unfolds, but WRC would characterize the facilities as detention centers. Freedom of movement is limited at these sites, and individuals can’t leave the premises. Possessions were confiscated and specialized medical care, legal counsel and other needed services are reportedly not available. European MEPs who visited the sites “documented violations of fundamental rights” and cases of “inhumane and degrading treatment.”

Refugees Deeply: Given that a majority of female refugees across the globe are now in urban centers and often on streets, how should U.N. agencies and NGOs address the needs of such refugees differently? Where has UNHCR’s 2009 Urban Policy fallen short?

Hersh: Protecting urban refugees with heightened risks, including women and adolescent girls, requires innovative, tailored programming and outreach. First, recognizing that they are the chief responders in urban settings, humanitarians must systematize and broaden engagement of local actors. Next, in recognition that shelter and livelihoods are extremely fraught with risks and dangerous for urban refugee women, humanitarians must develop proactive and targeted strategies for addressing GBV risks related to shelter and livelihoods. Lastly, humanitarians in urban settings must balance programming done within refugee communities with sessions in the host community. Women refugees remarked that while GBV awareness-raising activities, for example, are beneficial to refugee communities, it is equally important – if not more important, in some locations – to conduct these activities within the host communities where they feel vulnerable and targeted.

Refugees Deeply: How can the U.N. better engage local actors and why is this key?

Hersh: Local actors are the first responders in humanitarian emergencies. They are the first on the scene, they have the best knowledge of humanitarian needs, and will stay the course, providing lifesaving support to displaced populations, long after international donor funding dries up and international partners have moved on to the next crisis. The World Humanitarian Summit included in its Grand Bargain a commitment to direct 25 percent of humanitarian funding “as directly as possible” to local and national organizations. Fulfilling this pledge would be a major milestone and would firmly recognize the essential contributions of civil society organizations in humanitarian response.

Refugees Deeply: How would you propose for “accountability mechanisms” to be put in place to assess the performances of U.N.’s implementing partners?

Hersh: There needs to be far greater accountability throughout the humanitarian system, not just from the U.N. to its implementing partners, but in fact a more robust system of mutual accountability that resonates at all levels. When donors issue funds to an implementing partner, they will include mandatory monitoring and reporting to ensure that the aims of the project are achieved and that the funds are well spent. In order to achieve thorough and meaningful change throughout the humanitarian system, accountability must go in the other direction as well, from implementing partners, up to the U.N. and donors.

The World Humanitarian Summit provides an ideal opportunity to create mechanisms of mutual accountability, where everyone’s commitments, be they from an NGO, a U.N. agency or a donor, all are monitored and publicly reported on, to ensure that all actors fulfill their pledges. It is only through collective action and collective accountability that members of the humanitarian community will meet our ambitious and essential goals.